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This Month's CME Article in Clinical Geriatrics

Gait in Older Adults: A Review of the Literature with an Emphasis Toward Achieving Favorable Clinical Outcomes, Part II
Meredith H. Harris, PT, DPT, EdD, Maureen K. Holden, PT, PhD, Lawrence P. Cahalin, PT, MA, Diane Fitzpatrick, PT, DPT, MS, Susan Lowe, PT, DPT, MS, GCS, and Paul K. Canavan, PT, PhD

Changes in motor skills that occur with aging vary widely. It is generally accepted that many bodily functions decline with age, including the ability to walk. For older individuals, walking is one of the most important factors in maintaining an independent lifestyle and remaining in the community. As aging occurs, there can be distinct changes in gait patterns. There is some controversy in the field as to whether change occurs as a result of aging or as a result of pathology.

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Feature Article

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Annals of Long-Term Care - ISSN: 1524-7929 - Volume 15 - Issue 3 - March 2007
Linda Hiddemen Barondess, Executive Vice-President
Clinical Q & A:
ASK THE EXPERT
Fred M. Feinsod, MD, MPH, CMD, and Cathy Wagner, RN, MSN, MBA

Ethical Dilemmas with an Elderly Christian Scientist
Candace Lyn Perry, MD, Maria I. Lapid, MD, and Jarrett W. Richardson, MD
Letter to the Editor:
Ethical Caregiving in Hard Cases
Linda Ganzini, MD, MPH
Delirium is the most common mental disorder at the end of life. In palliative care settings, agitated delirium is rarely overlooked and is usually aggressively treated, but can be mistaken for worsening pain. In contrast, hypoactive delirium is more common but is more likely to be overlooked or misdiagnosed as depression. Both forms of delirium result in substantial patient distress. Deliria resulting from dehydration or drugs, particularly opioids, are among the most treatable at the end of life. Neuroleptic medications are the recommended pharmacologic treatment for agitation associated with delirium; benzodiazepines will worsen confusion, but may be needed in the final hours of life to facilitate calm. (Annals of Long-Term Care: Clinical Care and Aging 2007;15[3]:35-40)
Elliot Davis, PhD, James Biddison, and Jiska Cohen-Mansfield, PhD
Meredith Wallace, PhD, APRN, CS, Fairfield University School of Nursing, and Terry Fulmer, PhD, APRN, GNP, FAAN, New York University College of Nursing
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