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Biomedical subjects

V A Portnoi

Publications and source records attributed to V A Portnoi.

At least 19 recordsLinked to original sources

Role of the family in nursing home care.

Family participation is extremely important in managing the nursing home patient. In order to attract and maintain close family involvement in the care, the physician and the nursing staff should design an ongoing program of family participation in the physical, psychologic and social rehabilitation of the patient. By maintaining a continuous rapport with the family, the physician can make sure that all who are concerned are satisfied with the patient's care.

Aged

The natural history of retirement. Mainly good news.

The number of persons retiring from work early or at the "normal" age of 65 to 69 years is rapidly increasing owing to current social forces. The impact of retirement, one of life's major events, on a person's health is of particular interest for a physician counseling a patient on the advisability of retirement. Despite the common belief, held by the medical community and lay persons alike, that retirement has a profound negative impact on the health of the retired person, available scientific data indicate that retirement per se may have a positive or no effect on health. New medical philosophy and approaches to retirement are suggested after review of the literature pertaining to the relationship between health, life satisfaction, and retirement.

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Urinary incontinence in the elderly.

The incontinent elderly face many difficulties from a problem that can have a multiplicity of causes. Etiologic factors of incontinence may be medical, psychologic or social. The cortical inhibitory stimuli that prevent involuntary voiding tend to decline with age. When carefully measured, some degree of uninhibited neurogenic bladder is often found in the elderly. Nonetheless, incontinence does not necessarily result. Precipitating factors, often emotional, determine the outcome.

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Diagnostic dilemma of the aged.

The complexity of symptoms seen in the elderly patient derives from the nature of age-related psychological and physiological changes and the variety of medical illnesses and psychiatric disorders common in advanced age. Without using differential diagnosis, the changes in mental status are too often ascribed to manifestation of senile decay, resulting in overdiagnosis of senile dementia. There is an interrelationship between somatic and psychiatric disorders and unusual appearances of many clinical entities common in the elderly. A review of pertinent literature and related clinical examples illustrate the common symptom complexes, including psychosomatic and somatopsychic disorders, seen in aged patients.

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Delivery of geriatric services to black senior citizens.

Society in this century faces an unprecedented rapid increase in both the absolute number and the relative proportion of senior citizens among the general population. The problems and needs of the elderly should be addressed by a comprehensive, holistic health and social services delivery system. The care of the black elderly requires not only a better quality of services than is available at the present time, but also a particular sensitivity to this population's unique and specific needs.

Black or African American

Steam baths.

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Health

Multilevel care.

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Health Services for the Aged

Management of the mental health of ambulatory elderly patients.

Geriatric health care practice strives to respond to the medical, psychologic and social needs of the elderly person through coordinating the services of the physician and the psychiatric social worker. In a geriatric clinic at the George Washington University Medical Center, the medical regimen for elderly ambulatory patients is supported and augmented by psychotherapy, counseling, behavioral therapy, and instruction of the family about the patient's need for environmental or residential changes. A review of the records of 40 elderly patients initially enrolled in the geriatric clinic program showed that 20 were in need of mental health support. Among these, 8 had a depressive disorder, 1 had paraphrenia, 2 had longstanding schizophrenia, and the rest showed mental decline secondary to organic brain syndrome. The geriatrician and the psychiatric social worker were able to provide sufficient mental health support for these elderly mental patients to permit them to remain in the community for worthwhile periods. Ambulatory geriatric patients, especially those with mental health impairment, can benefit greatly from services offered in a comprehensive fashion by a geriatrician and a psychiatric social worker.

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