Both were physicians. This series will present clinical information as case studies. These are actual cases, or composites, sufficiently altered to serve confidentiality. We hope that you will enjoy these cases. Consider them as shared, one physician with another.
Older patients present unique challenges to the thoughtful physician.
Virtually all patients over age 75 have physicial limitations from chronic disease and virtually all over 85 have limitations of activities of daily living. In a sense, successful aging is the ability of the patient to maintain homeostasis in the face of progressive decline in reserve function of organs and tissues. Homeostenosis is the term given by a wag to this declining reserve of function with aging. For each human being, finally, reserve function will be exhausted and death will ensue. The challenge for the physician is to help the patient maintain homeostasis in the face of progressive chronic disease and, particularly, when that patient is assaulted by acute disease.