Geriatrics Diagnosis and Treatment Handbook: Person-Centered Decision-Making Through Functional Reserve Mapping, Medication Stewardship, & Goal-Concordant Planning for Primary Care Clinicians

Geriatrics Diagnosis and Treatment Handbook connects the biology of aging, diminished physiologic reserve, and multimorbidity to the decisions primary care clinicians make every day. Built for physicians, trainees, hospitalists, advanced-practice clinicians, pharmacists, and care teams treating older adults, it shows how cognition, mobility, medication burden, caregiver capacity, and personal goals reshape diagnosis and treatment across settings.The Reserve-to-Goal Clinical Compass translates assessment into a defensible plan: recognize vulnerability, identify modifiable burden, align treatment with patient priorities, and establish a safety net for follow-up and transition.- Map functional reserve - use reserve signals, recent change, and physiologic burden to distinguish stable chronic disease from a patient at risk for rapid decline.- Structure the comprehensive geriatric assessment - integrate function, cognition, mobility, mood, nutrition, social conditions, and caregiver capacity into clinical data that changes the plan.- Steward medication decisions - identify treatment burden, high-risk combinations, and deprescribing opportunities while preserving therapies that still support the patient's goals.- Act on mentation and mobility signals - recognize delirium risk, cognitive vulnerability, gait decline, and fall exposure early enough to prevent avoidable loss of independence.- Build goal-concordant treatment plans - connect prognosis, symptom burden, functional priorities, and shared decision-making to proportionate diagnostic and therapeutic choices.- Navigate clinical pivots - use the Clinical Pivot Directory to respond when a new symptom, hospitalization, medication change, or caregiver concern changes the patient's risk profile.- Protect patients across transitions - apply route maps, safety-net triggers, and cross-setting planning to reduce medication errors, communication failures, and post-discharge deterioration.- Address caregiver and safeguarding concerns - incorporate caregiver strain, home safety, social risk, and possible mistreatment into a plan that can be carried out beyond the clinic.Make every geriatric decision more precise, more person-centered, and more likely to preserve the outcomes your patients value.