<P>26UCSF MAGAZINE | Spring 2014 S he walked into the hospital and came home in a wheelchair, says her son, Stephen Aitel. Hellen Aitels condition deteriorated further after a stint in a rehabilitation center, but she was determined to return to her home near Lake Merced in San Francisco. The stairs in Aitels two-story house loomed as a major obstacle. Her son had to arrange medical transport for every doctor visit, turning a simple appointment into a stressful event that left both mother and son drained. A constellation of problems – including lack of mobil- ity, high blood pressure, fluid in her lungs, and pain from rheumatoid arthritis – conspired to further impact her health. Thats when geriatrician Helen Kao, MD 03, stepped in with a powerful tool – her car. It carries her up and down San Franciscos hills to visit frail residents who cannot surmount the citys steep streets, or even the precipitous steps out their own front doors. For Kao, who is the medi- cal director of geriatric clinical programs at UC San Francisco, these visits allow her to practice the kind of care that she and her colleagues find to be best for older patients: individualized and team-based. This approach shapes much of their work, from the flagship Housecalls program – a practice from days past thats gaining renewed traction – to a new program for patients with complex psychosocial medical needs. And its an approach grounded in leading research by UCSF experts in the Division of Geriatrics who care for older people every day in clinics, hospitals, and homes. Their work – which helped UCSF Medical Center earn a top-10 ranking for geriatrics in U.S. News & World Reports most recent survey of the nations best hospitals – is transforming health care for the burgeoning population of older adults in the United States. TAILORING CARE FOR THE SILVER SURGE Every day, roughly 10,000 Americans turn 65. The growth in the num- ber of older adults is unprecedented in the history of the United States, fueled by longer life spans and the aging of the baby boom generation. For older adults, a one-size-fits-all path to health care falls short, say faculty members in UCSFs Division of Geriatrics. If youve seen one older patient ... youve seen one older patient, points out Kenneth Covinsky, MD 88, MPH, who holds the Edmund G. Brown Sr. Distinguished Professorship in Geriatrics. Whats right for an older person hinges on their full medical and social context. For starters, older adults tend to need the most care, yet most medical studies exclude participants over 75, says Louise Walter, MD, a resident alumna and chief of the Division of Geriatrics. If you do the same thing to an 85-year-old as a 50-year-old, youre probably going to cause harm, she explains. In studying diabetes, for example, Associate Professor Sei Lee, MD, also a resident alumnus, found that guidelines developed for managing the disease in younger people led to overly aggressive management of blood sugars in older adults, increasing their risk for hypoglycemia. Two out of three older Americans have multiple chronic conditions; in fact, 95 percent of health care costs for those 65 or older are for chronic diseases.</p> <UL><LI><a href="http://www.mzines.net/publication/618/aelvmorax/1/1/">Front-Cover</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/2/2/">Inside-Front-Cover</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/3/3/">Page-1</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/4/4/">Page-2</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/5/5/">Page-3</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/6/6/">Page-4</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/7/7/">Page-5</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/8/8/">Page-6</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/9/9/">Page-7</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/10/10/">Page-8</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/11/11/">Page-9</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/12/12/">Page-10</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/13/13/">Page-11</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/14/14/">Page-12</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/15/15/">Page-13</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/16/16/">Page-14</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/17/17/">Page-15</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/18/18/">Page-16</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/19/19/">Page-17</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/20/20/">Page-18</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/21/21/">Page-19</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/22/22/">Page-20</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/23/23/">Page-21</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/24/24/">Page-22</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/25/25/">Page-23</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/26/26/">Page-24</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/27/27/">Page-25</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/28/28/">Page-26</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/29/29/">Page-27</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/30/30/">Page-28</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/31/31/">Page-29</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/32/32/">Page-30</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/33/33/">Page-31</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/34/34/">Page-32</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/35/35/">Page-33</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/36/36/">Page-34</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/37/37/">Page-35</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/38/38/">Page-36</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/39/39/">Page-37</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/40/40/">Page-38</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/41/41/">Page-39</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/42/42/">Page-40</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/43/43/">Page-41</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/44/44/">Page-42</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/45/45/">Page-43</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/46/46/">Page-44</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/47/47/">Page-45</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/48/48/">Page-46</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/49/49/">Page-47</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/50/50/">Page-48</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/51/51/">Page-49</a></LI> <LI><a href="http://www.mzines.net/publication/618/aelvmorax/52/52/">Back-Cover</a></LI> <LI><a href="http://www.mzines.net/publications/618/x/sitemap.xml" target="_blank">site map</a></LI> </UL>

 

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