Teaching Geriatrics in the Hospital: Bedside Geriatrics Teaching

Older adults make up about 1% of the population in the USA but represent nearly 40% of hospitalized adults and almost 50% of all health care dollars spent on hospitalization. The hospital is a very important setting for geriatrics teaching given that hospitalization is a high-risk time for older adults. For many older adults, hospitalization often results in complications, including functional, physical, and cognitive decline (Creditor, Ann Intern Med 118(3):219-223, 1993), that are unrelated to the inciting problem prompting hospital admission. The care that older adults receive during a relatively short hospital stay often have long-term impacts. This chapter addresses key teaching topics in the care for hospitalized older adults, including delirium, immobility, hospital-associated disability, pressure injuries, adverse drug events and medication errors, sleep disturbances, urinary retention and incontinence, constipation, malnutrition and dehydration, goals of care discussions, and discharge planning. Teaching rationale, concepts, and clinical teaching pearls during daily bedside rounds are provided.