Review Articles

Treating complexity in the older adult - the role of the geriatric giants

L. Greenstein, A. Abraham, B. Tipping
South African Family Practice | Vol 61, No 6 : November/December| a5065 | DOI: https://doi.org/10.4102/safp.v61i6.5065 | © 2019 L. Greenstein, A. Abraham, b. Tipping | This work is licensed under CC Attribution 4.0
Submitted: 11 December 2019 | Published: 09 December 2019

About the author(s)

L. Greenstein, University of the Witwatersrand, South Africa
A. Abraham, Donald Gordon Medical Centre and Helen Joseph Hospital, University of the Witwatersrand, South Africa
B. Tipping, Donald Gordon Medical Centre and Helen Joseph Hospital, University of the Witwatersrand, South Africa

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Abstract

As people age, they accumulate medical conditions. Geriatric giants comprise a group of conditions that lead to significant mortality and morbidity and contribute to the complexity in treating geriatric patients. They are common and rarely occur in isolation. The 5 Is of geriatric giants are: iatrogenesis, immobility, instability, incontinence and impaired cognition. Consequences for the patient and their caregivers include loss of functional independence, institutionalisation and caregiver burnout. Primary care practitioners are often the first port of call for geriatric patients in South Africa and by asking a few key questions and performing a thorough examination; these conditions can be recognised early. Whilst there are often limitations to cure, the main aim is to maintain the older adult’s functional independence as much as possible, and by following an organised management approach to each of these conditions, the quality of life of patients can be improved.

Keywords

Geriatric giants; iatrogenesis; immobility; instability; incontinence; impaired cognition

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