Optimized Prescribing with Seniors is a joint communication of the Alberta Medical Association and the College of Physicians & Surgeons of Alberta, these articles are written by physicians for physicians prescribing in the care of older patients.
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Dr. Lesley Charles, MBChB, CCFP, is a geriatric physician at the Grey Nuns Community Hospital. Her areas of clinical interest include dementia, delirium and treatment of osteoporosis. She obtained her medical education at the University of Edinburgh then completed her family medicine residence at the University of Alberta.
Dr. Charles is a professor with the Department of Family Medicine (Division of Care of the Elderly) at the University of Alberta. Her research interests include the Care of the Elderly Program; Decision-Making Capacity Assessment and Implementation and Sustainability Framework; Care of the Elderly Graduates Research; Developing and the Effects of Introducing Core Competencies; and Caregivers
Using a real‑world case, this article examines how intercultural communication tools can help physicians build common ground, navigate cultural differences and support patient‑centred end‑of‑life care.
How can delusional disorder present in older adults with otherwise intact function? Using a clinical case, this article examines diagnostic features, safety considerations and management challenges.
This article explores a structured, evidence-based approach to assessing and managing insomnia in older adults. Through a practical case study, it highlights how careful evaluation, non-pharmacologic strategies and prudent prescribing can improve sleep and quality of life for seniors.
How do we ensure medications align with a patient’s evolving health status and care preferences? This case study explores how Goals of Care Designations can guide deprescribing decisions and optimize quality of life for patients with advanced illness.
This article, developed in collaboration with the Canadian Geriatrics Society, explores the use of melatonin as a treatment for sleep disturbances in older adults, reviewing current evidence and offering practical guidance for clinicians.
This article, in collaboration with the Canadian Geriatrics Society, explores the evolving evidence and clinical considerations for prescribing SGLT2is in seniors, offering practical insights for optimizing care in this vulnerable population.
How do we manage pain in cancer patients with pain refractory to opioids? Minimally Invasive Palliative Procedures (MIPPs) offer a way and can enhance patients' quality of life when standard treatments fall short.
John is 72 years old and presenting with a two-year history of memory change. In the last six months he has forgotten to take his medications and missed paying his power bill. He is remarkably healthy excepting a history of dyslipidemia and GERD. He has a family history of Alzheimer’s dementia affecting his brother, father and paternal grandfather.
Richard is 75 years old with a history of gastroesophageal reflux disease. 12 years ago he was started on a proton pump inhibitor, but his last family doctor retired so he was never reassessed. He was mildly obese for much of his adult life, but since retiring 10 years ago, he has worked to eat healthier and be fairly active, with good results, having lost about 15 pounds and being able to keep it off.
Frank, age 82, is admitted to a long-term care facility with moderate cognitive impairment, severe osteoarthritis of the hips, COPD, sleep apnea, hypertension, mild renal impairment and a history of GI bleed.
This story illustrates the dangers of creating a false dichotomy between “cancer pain” and “non-cancer Pain”.
Falls among older adults are a public health issue in Canada.