Zeitschrift für Gerontologie und Geriatrie
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Establishing a trustful therapeutic relationship and reflecting on attitudes and behavior is essential in caring for patients with functional pain syndromes. Hope-disappointment circles are common and can be intensified by unfavorable caregiver behavior. A biopsychosocial, empathetic and coping-oriented attitude has proved to be useful. A motivating communication is recommended that carefully explores the pain and its interactions with psychosocial factors following the three typical phases of accepting complaints, establishing biopsychosocial understanding and developing coping strategies.
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Older patients more often suffer perioperative complications than younger people. Especially geriatric patients who require emergency treatment represent a high-risk group. Therefore, perioperative risk assessment supports the treatment team in identifying patients at risk and in defining the treatment plan accordingly. ⋯ For a comprehensive risk assessment in geriatric patients, the organ-specific risk stratification is insufficient. Assessment instruments that reflect the idiosyncrasies of multidimensional disease in geriatric patients can complement risk stratification. These should include the assessment of multimorbidity, frailty, nutrition, activities of daily living, and cognition. In addition to risk prediction, geriatric assessment has the major advantage of providing both a diagnostic and a planning perspective. This allows the implementation of supporting measures for optimal perioperative care, which is the goal of any risk stratification. Risk scores provide a global assessment, but they have their limitations in predicting individual patient risk.