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Multimorbidity in the elderly in a geriatric hospital
Dramatic demographic changes influence the present and future structures of hospitals: In our geriatric hospital we treat older stroke patients, patients after falls and fractures, and patients with a wide range of different health problems. These older people often present a „age-related polypathy“, combining multimorbidity with multiple functional disabilities and interferences. The majority of our patients present a strong psychiatric co-morbidity and psychosocial problems. Therefore, they need specific biopsychosocial approaches. By the underlying multimorbidity we are often forced to make pragmatic use of polypharmacy: mean number of different drugs: 6,8; especially cardiac remedies, diuretics, analgetics, and psychoactive substances. We then have to consider not only the potential drug benefits, but also the resulting adverse reactions, interactions and side-effects, specific pharmacodynamics and -kinetics in the elderly, the unsatisfactory bad compliance following multimedication, drug handling problems etc.