Area | Indication | Intervention |
---|---|---|
Modification of therapy | Polypharmacy | • Re-evaluate treatment indications (with general practitioner), optimize treatment according to elderly patient protocols. |
Balancing chronic diseases | CIRS-G* Grade ≥ 3, | • Adaptation of therapy. |
arterial hypertension, diabetes, arthritis, or sensory problems | • Other non-drug interventions such as dietary advice, devices. | |
• Referral to specialist doctor. | ||
Pain treatment | Pain >1 on numeric scale | • Drug: WHO levels 1–3 antalgic treatment |
• Non-drug: physiotherapy, devices | ||
Nutritional intervention | Malnutrition (MNA* ≤ 17) | • Referral to dietician (nutritional supplements, artificial nutrition, etc.) |
Weight loss ≥5 % over 3 m, or ≥10 % over 6 m | ||
At risk of malnutrition - 17 < MNA ≤ 23.5 | • Advice on increasing dietary uptake (use of food pyramid adapted for elderly patients) | |
Physical activity | Sedentary or at risk of falls | • Recommend daily walk, walking upstairs, carrying groceries |
Physiotherapy | Difficulty with walking and balance (TUG*, and SPPB*). Fall in the last 12 m, weight loss, muscle loss | • Prescribe physiotherapy for muscular reinforcement Work on balance, and getting up from lying down position |
• Prescribe walking aids | ||
Psychological support | GDS* ≥ 6 | • Consultation with psychologist or psychiatrist |
Apparent anxiety (clinical assessment) | ||
Antecedent of depression | ||
Prevention of further cognitive impairment | MMSE* < 24 | • Behavioral monitoring during chemotherapy |
• Prevention of confusion [39] | ||
Treatment for sleeping disorders | Positive screening score on adapted Epworth scale [40] | • Introduction, modification or discontinuation of treatment by hypnosis according to STOPP and START recommendations [37, 38] |
Assistance | Social fragility identified (absence of social support) | • Ask patient directly if help is needed |
• Refer to a social worker | ||
Home help | Difficulties performing daily tasks such as grooming, housework | • Prescribe support within the home (nursing, physiotherapy, housecleaner, etc.) |