Friday, July 24, 2015

Treatment Planning for Frail Older Adults (Article 3 of 4)

 Treatment planning  for frail and dependent patients should meet the objectives of preventing pain and infection, maintaining function, preventing systemic complications and improving or maintaining quality of life.

Frail adults live in the community but have varying degrees of functioning limitations.Their treatment options are guided by their level of dependency- no dependency, medium dependency or high dependency status.

For medium dependency adults, the recommendation is to treat teeth conservatively. Restore carious lesions using atraumatic techniques and floride releasing restorative materials. Dentures or removable teeth replacements should be designed to facilitate hygiene and easy removal.

Dependent older adults typically live in long term care settings and are home  bound. For homebound and long term care residents, recommendations include managing discomfort and infection and performing  only procedures necessary for social interactions and normal function.

Early in the interactions with frail or dependent patients, it is important to gauge the patients ability to comprehend treatment recommendations and independently make competent decisions. Patient's financial resources, general health, cognition and  capacity for home care must be taken into account. The benefit from the proposed treatment must be weighed very carefully against the physical discomfort and mental anguish a particular patient may experience.  The focus is to address the patient's primary concern.

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