Cumulative Index 1991 Volume 7 February GERIATRIC SEXUALITY, pages 1-184 May GASTROENTEROLOGIC PROBLEMS, pages 185-400 August CEREBROVASCULAR DISEASES IN THE 1990s, pages 401-643 November GERIATRIC HOME CARE, pages 645-892 Note: Page numbers for complete issues and articles appear in boldface type. Abdominal pain, in irritable bowel Alcoholism, effect on sexuality, 20, 103, syndrome, 267 117-118, 138 Abuse, of elderly, 831-845. See also Elder case study of, 145-146 abuse. Alpha-blockers, and sexual dysfunction, 101 Accidents, fails caused by, 709 Alzheimer’s disease, effect on sexual Achalasia, and esophageal dysphagia, 222— function, 139-142 224 histologic features of, and intracerebral Acid peptic disease, 231-254. See also hemorrhage, 555 Peptic ulcer disease; Ulcer(s). Amaurosis fugax, 526 Activities of daily living (ADL), poststroke stroke involving, 433 rehabilitation for, 514-515 American Academy of Home Care Acute-care facility, feeding in, 204-209 Physicians (AAHCP), role in home Adenomas, and colorectal cancer, 335-336 health care quality assurance, 859, 862 Adjustment, in home rehabilitation, 703 American Medical Association (AMA), role Adult children, living with, effect on sexual in home health care quality assurance, expression, 155-156 855, 862 Aging, as disease, 387-388 Amino acid antagonists, excitatory, for interaction with disease, 196 ischemic stroke, 462 philosophic approach to, 387-394 Aminophylline, for ischemic stroke, 467 physiologic changes with, 134 21—Aminosteroids, for ischemic stroke, 468 psychologic and cultural issues in, 165- Amitriptyline, for poststroke depression, 167 499-500 rationing of medical care in, 390-392 Amnestic effects, of antidepressants, 500 sexual physiology of, drug interactions Amoxapine, for poststroke depression, 502 with, 96-98 Amyloid angiopathy, cerebral, 617-630 sexuality and, 1-7 amyloid plaques in, 622 Agitation, in dementia, home management and intracerebral hemorrhage, 553-555 of, 793 differential diagnosis of, 624-625 Airway, establishment of, in ischemic epidemiology of, 617-618 stroke, 456 histopathology of, 620-624 Alcohol consumption, and chronic subdural molecular, 623-624 hematoma, 585 parenchymal, 621-623 and intracerebral hemorrhage, 551 vascular, 620-621 and vascular dementia, 606 laboratory features of, 625-626 876 CUMULATIVE INDEX 1991 Amyloid angiopathy (Continued) for ischemic stroke, 462—463 signs and symptoms of, 618-620 Antispasmodics, for irritable bowel treatment of, 626-627 syndrome, 278 Amyotrophic lateral sclerosis, and Antithrombotic therapy, for acute oropharyngeal dysphagia, 219 cardiogenic stroke, 439-440 Ancrod, for ischemic stroke, 466 for ischemic stroke, 462—464 Androgen, and sexual function in women, Anxiety, effect on sexual function, 138-139 32, 47, 91 Anxiolytics, and sexual dysfunction, 99 Andrology Clinic case studies, 144-148 Aphasia, in chronic subdural hematoma, 587 Aneurysm, and subarachnoid hemorrhage, Apoplexy, pituitary, 533-535 569 Appetite, aging-related changes in, 193-195 surgical treatment of, 575-576 Arm, poststroke rehabilitation of, 515 cerebral, seizures with, 487 Arterial disease, and erectile failure, 77 intracavernous, and ocular motility distur- Arterial disorganization, in brain, 444 bances, 540, 542 Arteriosclerotic encephalopathy, subcortical, ruptured, and chronic subdural hema- dementia with, 608 toma, 584 Arteriovenous malformation, and chronic Angiography, for carotid-cavernous fistula, subdural hematoma, 584 539 and subarachnoid hemorrhage, 569, 578- for cerebral amyloid angiopathy, 625 580 for chronic subdural hematoma, 589 Arteritis, fibrinoid, in brain, 444 for lower intestinal bleeding, 314-316 giant cell, and permanent visual loss, Angionecrosis, in brain, 444 529-533 Angiopathy, amyloid. See Amyloid Arthritis, effect on sexuality, 122 angiopathy. Ascites, 380-381 Angiotensin converting enzyme inhibitors, L-Aspartate, for ischemic stroke, 462 and sexual dysfunction, 101 Aspirin, for acute cardiogenic stroke, 440 Anorexia, in home hospice care, 812 for atherothromboembolic stroke prophy- Anthropometric measures, 198-199 laxis, 404—407 Antiarrhythmic agents, and sexual for carotid artery disease, 421 dysfunction, 102 for ischemic stroke, 463 Antibiotics, for cavernous sinus syndrome, ulcers associated with, 245 537 Assistive devices, home assessment of, 726 intravenous, home-administered, 749-763 Ataxia, one-sided, lacunar infarction and, Anticholinergic agents, and sexual 448 dysfunction, 103 Atenolol, for ischemic stroke, 467 Anticholinergic effects, of antidepressants, Atherosclerosis, and lacunar brain infarction, 500 444 Anticoagulants, for atherothromboembolic and stroke, prevention of, 401-416 stroke prophylaxis, 411-413 Atrial fibrillation, and cardiogenic stroke, for cavernous sinus syndrome, 537 431, 436-439 for cerebral amyloid angiopathy, 626 Autonomy, in elder abuse, 841 for ischemic stroke, 463-464 Anticonvulsants, and sexual dysfunction, 102 for cerebral amyloid angiopathy, 626 for poststroke seizures, 489 Barbiturates, for cerebral edema, in Antidepressants, and sexual dysfunction, 98- ischemic stroke, 460 99 Barium enema, for colorectal cancer, 334 for irritable bowel syndrome, 279 for lower intestinal bleeding, 313-314 for poststroke depression, 499-501 Barthel index, of stroke outcome, 519 Antifibrinolytic agents, for subarachnoid Basal ganglia, left, lesions of, depression hemorrhage, 575 with, 496 Antihypertensive medication, and sexual Bathroom, home assessment of, 722-724 dysfunction, 66, 99-101, 169 Beanpole family, and elder abuse, 835 Antilipemic agents, and sexual dysfunction, Bedroom, home assessment of, 724-725 102 Behavior, poststroke rehabilitation of, 517- Antiplatelet therapy, for 518 atherothromboembolic stroke preblems in dementia, home management prophylaxis, 404-410 of, 787-801 for carotid artery disease, 421 Beneficence, in elder abuse, 842 CUMULATIVE INDEX 1991 Benzodiazepines, for dementia home for ischemic stroke, 460 management, 798-799 for subarachnoid hemorrhage, 577 Beta-blockers, and sexual dysfunction, 100- Caloric density, of tube feeding formulas, 101 205-206 for ischemic stroke, 467 Calorie needs, aging-related changes in, Beta protein, in cerebral amyloid 193-194 angiopathy, 624 Cancer, effect on sexuality, 122-123 Biliary tract disease, 347-370 inflammatory bowel disease vs, 293 cholangitis, drainage for, 356 of colon and rectum, 331-346. See also cirrhosis, primary, 378-380 Colorectal cancer. obstruction, benign, 358-362 Carbamazepine, for dementia home malignant, 362-363 management, 799 pancreatitis, 357-358 for poststroke seizures, 489 stricture, 358-363 Carbonic anhydrase inhibitors, and sexual postsurgical, 358-360 dysfunction, 103 Binswanger’s disease, and vascular Carcinomatosis, meningeal, and chronic dementia, 608 subdural hematoma, 584 Biochemical parameters, measurement of, Cardiac care, in stroke patient, 480 199-200 Cardiac status, monitoring of, in ischemic Bladder cancer, and erectile failure, 76-77 stroke, 456 Bleeding diathesis, and chronic subdural Cardiogenic stroke, 429-442 hematoma, 584 Cardiovascular agents, and sexual Blood flow, effect on penile erection, 64 dysfunction, 99-102 Blood pressure, management of, in stroke Cardiovascular disease, effect on sexuality, patient, 475-477 123-124 monitoring of, in ischemic stroke, 457 Caregivers, in home health care, burden on, Board-and-care facilities, sexual expression 660, 817-829 of elders in, 156-157 family relationship problems, 820 Body composition, measurement of, 199 Body fat, aging-related changes in, 193 sources and solution of, 819 Border-zone infarctions, dementia with, 609 conflict in, 818 Bowel dysfunction. See also Irritable bowel education of, and medication compli- syndrome. ance, 741 diagnosis of, 276-277 pain management by, 767-768 incidence by age, 269 role in poststroke depression, 503 poststroke management of, 509 Carotid artery, external, biopsy of, in giant Brain, atherothromboembolic infarction of, cell arteritis, 530-531 prevention of, 401-416 intracranial, aneurysm of, frequency of, biopsy of, for cerebral amyloid angiopa- 574 thy, 625 stenosis of, asymptomatic, 418-419 radioisotopic scans of, for chronic subdural studies of, in lacunar infarction, 450—451 hematoma, 589 Carotid artery disease, asymptomatic, 417- tumor of, and chronic subdural hema- 428 toma, 584 plaque morphology in, and prognosis, Breast, cancer of, and sexual dysfunction, 419-420 54-56 risk factors in, 419-421 decreased vasocongestion of, with aging, treatment of, 421-424 89 Carotid-cavernous fistula, and ocular Bromocriptine, for impotence, 104 motility disturbances, 537-540 Bronchodilators, anticholinergic, for home Carotid endarterectomy, for carotid artery respiratory care, 779-780 Bruit, asymptomatic, in carotid artery disease, 421 disease, 417-418 CASANOVA, 424 Bulking agents, for irritable bowel Case-finding, in home assessment, 678 syndrome, 276—278 Catastrophic reactions, in dementia, home Bupropion, for poststroke depression, 502 management of, 794 Burns, 717-718 Catheterization, urinary, following stroke, 509 Caudate nucleus, hemorrhage in, clinical features of, 557-558 Calcium channel blockers, and sexual Cavernous sinus syndrome, and ocular dysfunction, 101 motility disturbances, 535-537 878 CUMULATIVE INDEX 1991 Cavernous sinus syndrome (Continued) and vascular dementia, 606 with pituitary apoplexy, 534 Ciliary artery, posterior, occlusion of, and Central nervous system, changes with aging, permanent visual loss, 529 effect on sexual function, 86 Cirrhosis, biliary, primary, 378-380 disorders of, and impotence, 66—67 Climacteric, normal, management of, 31-33 and oropharyngeal dysphagia, 218-219 Climate, problems with, in travel, 323-324 in aging men, 96 Clinical parameters, measurement of, 200 Central venous nutrition, 210 Clumsy hand syndrome, in lacunar Cerebellum, hemorrhage in, clinical features infarction, 447-448 of, 561 Cognitive function, impairment of, as Cerebral artery(ies), amyloid angiopathy of. barrier to sexual expression, 139-142, See Amyloid angiopathy. 158 aneurysm of, frequency of, 574 tests of, in vascular dementia, 609 middle, infarction of, hemorrhagic, 434 Colitis, infectious, and lower intestinal seizures in, 485 bleeding, 309-311 Cerebral cortex, stroke involving, and ischemic, and lower intestinal bleeding, seizures, 484 304-308 cardiogenic source of, 433 barium enema of, 306 in cerebral amyloid angiopathy, 621- inflammatory bowel disease vs, 292 622 mucous, incidence by age, race, and sex, Cerebral edema, in ischemic stroke, 270 management of, 458-460 Colon, cancer of, 331-346. See also with chronic subdural hematoma, 593 Colorectal cancer. Cerebral infarction, and vascular dementia, diverticula of, and lower intestinal bleed- 606 ing, 304-305 embolic, seizures in, 484—485 ischemia of, and lower intestinal bleeding, in cerebral amyloid angiopathy, 619 304-308 Cerebral ischemia, acute, medical causes of, 305 management of, 455-473 distribution and length of, 308 Cerebrospinal fluid, testing of, for cerebral neoplasm of, and lower intestinal bleed- amyloid angiopathy, 625 ing, 311 Cerebrovascular disease, effect on sexuality, stricture of, barium enema of, 306 123-124 Colonoscopy, for colorectal cancer, 334 ischemic, seizures in, 484—485 for lower intestinal bleeding, 314 management of, ethical issues in, 631-636 Colorectal cancer, 331-346 Change, illness as agent of, 827 American Cancer Society reeommenda- Chemotherapeutic agents, and sexual dysfunction, 103 tions concerning, 334 and erectile failure, 76-77 Chest pain, with pulmonary embolism, in causes and pathogenesis of, 332 stroke patient, 479 classification of, 338-339 Children, adult, living with, effect on sexual clinical features of, 336-337 expression, 155-156 epidemiology of, 331-332 Chlorpromazine, for dementia home gross features of, 337 management, 798 histology of, 337 Cholangitis, 355-357 primary sclerosing, 361-362 laboratory findings in, 337 Cholecystitis, acute, in gallstone disease, management of, 339-343 352-353 chemotherapy, 340-342 Choledocholithiasis, 354-355 in aged, 342-343 Cholesterol, serum levels of, and laser therapy, palliative, 342 intracerebral hemorrhage, 551 patient follow-up of, 343 Chronic-care facility, feeding in, 204-209 radiation therapy, adjuvant, 340 Chronic illness, and low sexual desire, 175 surgery, 339-340 as agent of change, 827 natural history of, 338 Chronic obstructive pulmonary disease, pathology of, 337-339 home oxygen therapy for, 780-782 physical examination for, 337 Cigarette smoking, and intracerebral prevention of, dietary recommedations hemorrhage, 551 for, 343 and peptic ulcer disease, 238 prognosis in, 338, 339 and risk of stroke, 402 risk factors for, 333 CUMULATIVE INDEX 1991 879 screening for, antibiotic prophylaxis in, Death, in home hospice care, 814-815 335 Deconditioning, effect on poststroke guidelines for, 332-335 rehabilitation, 514 signs and symptoms of, 336 Defecation, disturbed, in irritable bowel staging of, 337-339 syndrome, 267 US death rate for, 332 Dehydration, in home hospice care, 812 Commercial food supplements, 203-204 in travel, 324 Common bile duct, obstruction of, 354-355 Delusions, in dementia, home management Communication, family patterns of, effect on of, 794-795 home health care, 826-827 Dementia(s), and sexual dysfunction, 117, poststroke rehabilitation of, 515-516 139-142 Community elderly, functional assistance behavioral problems in, demographics of, needs of, 653-656 787-790 Community Health Accreditation Program, factors precipitating or worsening, 790- Inc (CHAP), 854-855, 863 791 Community services, home assessment of, frequency and types of, 788-790 727-729 home management of, 787-801 Complementary marital arrangement, effect general methods for, 791-792 on home health care, 823—824 psychoactive drugs for, 796-799 Compliance. See Patient compliance. specific methods in, 792-796 Computed tomography, for chronic subdural treatment goals and approaches in, hematoma, 587, 589-590 790-792 for lacunar infarction, 443 diagnostic criteria for, 788 for subarachnoid hemorrhage, 572, 573 in cerebral amyloid angiopathy, 619-620 Congestive heart failure, and sexual vascular (multi-infarct), 599-615 function, 170 classification of, 602-603 Conjunctiva, chemosis of, with carotid- clinical and laboratory tests for, 609- cavernous fistula, 538 610 Consciousness, impaired, in intracerebral clinical syndromes of, 607-609 hemorrhage, 556 definition of, 600 with pituitary apoplexy, 534 diagnostic criteria for, 600-603 Constipation, and lower intestinal bleeding, epidemiology of, 603-607 311 neuropathology of, 610-611 in irritable bowel syndrome, management prevalence and incidence of, 603-605 of, 280 prognosis in, 611 Continence, poststroke rehabilitation of, 518 risk factors in, 606-607 COPD, home oxygen therapy for, 780-782 treatment of, 611-612 Coronary disease, and sexual function, 168- Department of Veterans Affairs, in home 170 health care, 649 Corticosteroids. See Steroids. Dependent living situations, sexuality in, Cost-effectiveness, of home health care, 153-160 865-874 Depression, and impotence, 67 Counseling/therapy, for sexual problems, criteria for, 496 161-179 drugs causing, 502-503 Cranial nerve, compression of, subarachnoid effect on sexuality, 116-117, 137-138 hemorrhage and, 570-571 poststroke, 493-506 dysfunctions of, in cavernous sinus syn- biologic basis of, 497-499 drome, 535-536 diagnosis of, 494-497 Crisis intervention, in home assessment, 679 incidence of, 493 Crohn’s disease, 288 symptoms of, 494—495 Cultural attitudes, and sexuality, 135, 174 treatment of, 499-503 Cystatin C, in cerebral amyloid angiopathy, Desipramine, for poststroke depression, 624 499-500 Cystectomy, radical, and sexual dysfunction, Detachment, family, effect on home health 56-57 care, 826 Dextran, for ischemic stroke, 466 Diabetes mellitus, and impotence, 66-67 and risk of stroke, 402 Day-night disturbance, in dementia, home and vascular dementia, 606 management of, 794 effect on sexuality, 114-116, 167-168 880 CUMULATIVE INDEx 1991 Diabetic foot infection, 757 Dyspepsia, nonulcer, ulcerlike symptoms Dialysis, and chronic subdural hematoma, with, 249 585 Dysphagia, 216-228 Diarrhea, in traveling elderly, 325-326, 328 commercial food supplements for, 203 pretravel advice concerning, 322 esophageal, 221-228 Diazepam, for poststroke seizures, 489 in irritable bowel syndrome, 268 Dietary fiber, for irritable bowel syndrome, oropharyngeal, 217-221 276-278 poststroke rehabilitation of, 517 Dietary intake, evaluation of, 198, 202 Dysphasia, poststroke rehabilitation of, 516 Dietary problems, in traveling elderly, 325- Dyspnea, in home hospice care, 813 326 with pulmonary embolism, in stroke pa- Digoxin, and sexual dysfunction, 102 tient, 479 Dipyridamole, for atherothromboembolic Dysthymic disorder, criteria for, 496 stroke prophylaxis, 409 for carotid artery disease, 421 Disease(s), aging as, 387-388 chronic, and geriatric sexuality, 113-131 Early satiety, in irritable bowel syndrome, in traveling elderly, 324-328 268 interaction with aging, 196 Eating dependency, in institutionalized Disuse atrophy, in female sexual patients, 197-198 dysfunction, 33 Edema, cerebral, in ischemic stroke, Diuretics, and sexual dysfunction, 99-100 management of, 458-460 for intracranial hypertension, in intracere- periorbital, with carotid-cavernous fistula, bral hemorrhage, 562 538 Diversion colitis, and lower intestinal Ejaculatory problems, in aging men, 97, 162 bleeding, 311 in diabetes, 168 Diverticula, colonic, and lower intestinal Elder abuse, 831-845 bleeding, 304-305 clinical assessment of, 836-842 relation to irritable bowel syndrome, family history, 838 275 medical history, 837-838 Diverticulitis, colonic, barium enema of, 307 physical examination, 838-839 Diverticulosis, inflammatory bowel disease psychological, 839-840 vs, 292 risk factor identification, 840 Dizziness, and falls, 711 definitions of, 831-832 Do not resuscitate/intubate orders, for home ethical issues in, 840-842 hospice care, 815 etiology and risk factors for, 834-836 for home respiratory care, 782 intervention in, 842-843 Doxepin, for poststroke depression, 499-500 laws regarding, 843 Drop attacks, and falls, 711 types of, 832-834 Drug(s), abuse of, and subarachnoid Elderly, acid peptic disease in, 231-254 hemorrhage, 580 assessment of, in home, 677-693. See also cost of, and medication noncompliance, Home assessment. 741 biliary tract disease in, 347-370 depression caused by, 502-503 functional assistance needs of, 653-656 effects on sexual function, 96—98 gastroenterologic diagnoses in, 266 hepatotoxicity with, 371-374 inflammatory bowel disease in, 287-299 history of, in home medication assess- irritable bowel syndrome in, 265-286 ment, 734 liver diseases in, 371-385 metabolism of, 373 lower intestinal bleeding in, 301-319 reactions to, 373-374 nutritional problems of, 191-214 Duodenal ulcer, 242-243 physician view of, in hospitals, 388-389 Helicobacter pylori infection and, 237 sexual problems in, 161-179 Durable power of attorney for health care, swallowing disorders in, 215-230 808 travel-related problems in, 321-330 Dying patient, home hospice care for, 803- upper gastrointestinal bleeding in, man- 816. See also Home hospice care. agement of, 255-264 Dysarthria, lacunar infarction and, 447-448 urologic disease and surgery in, 75—78 poststroke rehabilitation of, 515 Electroencephalography, for chronic Dyspareunia, and decreased sexual activity, subdural hematoma, 588 45 role of, in poststroke seizures, 488 CUMULATIVE INDEX 1991 Electrolytes, management of, in ischemic diagnostic approach to, 714-716 stroke, 456 epidemiology of, 707-709 Elemental diets, for tube-feeding, 207 incidence of, 708 Embolism, cardiogenic sources of, 431, 434- patient history in, 714 435 physical examination in, 715 Embolization, for carotid-cavernous fistula, prevention of, 707-731 539 risk factors for, 712-714 Emotional expressions, in family, effect on therapy for, 716-717 home health care, 826 Family(ies), caregivers in. See Caregivers. Encephalopathy, arteriosclerotic, dementia dynamics of, in home health care, 659, with, 608 817-829 Endarterectomy, for carotid artery disease, assessment of, 682, 821 422-424 developmental stages, 822-823 Endocarditis, infective, and subarachnoid membership, 821-822 hemorrhage, 580 organization, 823-825 Endocrine system, in aging men, 96 structure, 821-827 in geriatric sexuality, 85-93 systems theory of, 820-821 Endothelial surface infections, home Fecal incontinence, in irritable bowel intravenous antibiotic therapy for, 757 syndrome, 267—268 Enmeshment, family, effect on home health management of, 280-281 care, 826 Fecal occult blood, testing for, 333-334 Enterocolitis, inflammatory bowel disease Feeding process, improvement of, 202-203 vs, 292 Fiber content, of tube feeding formulas, 206 Environment, home assessment of, 682 Fibrinoid necrosis, in brain, 444 Epilepsy, development of, following Financial abuse, of elderly, 834 intracerebral hemorrhage, 486 Floors/rugs, home assessment of, 720-721 following subarachnoid hemorrhage, Fluid(s), intake of, regulation mechanisms 487 of, aging-related changes in, 196 in chronic subdural hematoma, 587 poststroke management of, 456, 508-509 in stroke patients, 484 Flunarizine, for ischemic stroke, 461 Epsilon-aminocaproic acid, for subarachnoid Fluoxetine, for poststroke depression, 502 hemorrhage, seizures with, 487 Food intake, aging-related changes in, 193— Erectile failure. See Impotence. 196 Erection, physiology of, 74-75 supplementation of, 200-202 effects of aging on, 63-64 Food poisoning, in traveling elderly, 328 Erythrocyte sedimentation rate, in giant cell Footwear, home assessment of, 727 arteritis, 530 Framingham Study, of stroke outcome, 519 Esophagus, lesions of, and esophageal Frontal lobe, left, lesions of, depression dysphagia, 221-228 with, 496 carcinoma, 225-226 Functional activities, in home rehabilitation, diffuse spasm, 224-225 701 medication-induced injury, 227-228 Functional disabilities, and medication rings and webs, 226 noncompliance, 740—741 tumor, 216, 217 Furosemide, for cerebral edema, in vascular, 227 ischemic stroke, 459 and oropharyngeal dysphagia, 220 Estradiol therapy, and sexual function in women, 91 Estrogen, and female sexual function, 32, Gait, poststroke rehabilitation of, 514 47-48, 90-91, 107-108, 163 problems with, and falls, 710 Ethical issues, in cerebrovascular disease Gallbladder cancer, in gallstone disease, 354 management, 631-636 Gallstone disease, 347-354 Eye(s), deviation of, lacunar infarction and, complications of, 352-354 448 acute cholecystitis, 352-353 motility disturbances of, 535-544 gallbladder cancer, 353 pain in, in cavernous sinus syndrome, 535 gallstone ileus, 353-354 management of, 349-352 expectant, 350 extracorporeal shock-wave lithotripsy, Falls, causes of, 709-712 351-352 882 CUMULATIVE INDEX 1991 Gallstone disease (Continued) Headache, with chronic subdural hematoma, methyl tert-butyl ether, 352 587 nonsurgical, 250-352 with intracerebral hemorrhage, 556 oral dissolution therapy, 350-351 with pituitary apoplexy, 534 surgical, 349-350 with subarachnoid hemorrhage, 570 natural history of, 348-349 Health, and sexuality, in aging, 167-171 prevalence of, 347-348 home assessment of, 681 symptoms of, 348 Heart disease, and vascular dementia, 606 types of gallstones in, 349 Heart valves, prosthetic, and cardiogenic Gallstone ileus, 353-354 stroke, 431 Gastric disorders, in traveling elderly, 325- Heat stroke, in traveling elderly, 324 326 Heaters, home assessment of, 721-722 Gastric ulcer, 240-242 Height, measurement of, 199 Helicobacter pylori infection and, 237— Helicobacter pylori infection, and peptic 238 ulcer disease, 236-238 Gastritis, and peptic ulcer disease, 235-238 Hematemesis, upper gastrointestinal Gastrointestinal bleeding, lower, 301-319 bleeding with, 257 upper, 255-264 Hematoma, intracerebral, and seizures, 486 endoscopy of, 258-261 subdural, chronic, 583-598. See also Sub- for esophageal varices, 260-261 dural hematoma. for nonvariceal lesions, 259-260 Hemicraniectomy, for cerebral edema, in sedation with, 258 ischemic stroke, 460 technique of, 259-261 Hemiparesis, in chronic subdural hematoma, 587-588 history of, 256-257 in lacunar infarction, 445-447 initial evaluation of, 256-258 poststroke rehabilitation of, 513 physical examination in, 257-258 Hemodilution, for ischemic stroke, 465—466 Gastrointestinal disorders, in traveling Hemoptysis, with pulmonary embolism, in elderly, 321-330 stroke patient, 479 Gastrointestinal tract, aging, 186-188 Hemorrhage, intracerebral, 549-567 Genitourinary infection, home intravenous age distribution of, 549-551 antibiotic therapy for, 756 clinical features of, 556-562 Geriatric assessment, in home, 677-693. differential diagnosis of, 624 See also Home assessment. distribution by site, 557 Giant cell arteritis, and permanent visual in cerebral amyloid angiopathy, 618— loss, 529-533 619, 621-622 Glaucoma, with carotid-cavernous fistula, incidence of, 549-550 539 mechanisms of, 552-556 L-Glutamate, for ischemic stroke, 462 risk factors for, 550-552 Glycerol, for cerebral edema, in ischemic treatment of, 562-564 stroke, 459 intracranial, seizures in, 485-488 GM, gangliosides, for ischemic stroke, 467— intraplaque, in carotid artery disease, 468 prognosis with, 420 Groshong catheter, for home intravenous subarachnoid, 569-582 therapy, 754 causes of, 578-581 Gut, aged, general perspectives on, 185-189 clinical presentation and diagnosis of, Gynecologic factors, in sexual dysfunction, 571-574 41-57 epidemiology of, 570 cancer, 51 in cerebral amyloid angiopathy, 620 gynecologic surgery and therapy, 49-57 mortality in, 573 postmenopausal problems, 44—45 premonitory signs in, 570-571 seizures in, 487-488 treatment of, 574-578 Hemorrhagic infarction, computed H, blockers, and sexual dysfunction, 102 tomography of, 434 Hachinski Ischemic Score, for multi-infarct Hemorrheologic treatment, for ischemic dementia, 600-601 stroke, 465-466 Haloperidol, for dementia home Hemorrhoids, and lower intestinal bleeding, management, 797-798 311 Hand, poststroke rehabilitation of, 515 Heparin, for acute cardiogenic stroke, 440 CUMULATIVE INDEX 1991 for atherothromboembolic stroke prophy- history of, 646-647 laxis, 411-412 home assessment of, 679-680 for deep venous thrombosis, in stroke pa- hospice, 803-816. See also Home hospice tient, 479 care. for ischemic stroke, 463-464 informal, 658-661 for pulmonary embolism, in stroke pa- Medicare payment for, 866 tient, 479 quality assurance in, 847-863 Heparin lock, for home intravenous therapy, activities in, 849-850 753 concerns in, 848 Heparinoids, low molecular weight, for formal mechanisms of, 852-855 ischemic stroke, 464 improvement in, 859-860 Hepatitis, type C, 376-378 methods and goals of, 850-852 Hepatotoxicity, drug-induced, 371-374 multidisciplinary perspectives of, 855- High-tech methods, for home pain 859 management, 773-774 reasons for, 658 Hip fracture, falls and, 709 recent changes in, 667-668 Home assessment, 677-693 role of physicians in, 665-675 checklist for, 682 academic physician and, 672-673 comprehensive, 680-683 background, 666—668 extent of, 681-682 decline in, 666 medications in, 736-737 education, 669-671 implications for primary care, 690-691 home visits, importance of, 857 limitations and barriers to, 688—689 medical specialties, 671-673 location of, 689-690 quality assurance, 855 need for, 689 reasons, 668-669 of assistive devices, 726 reimbursement, 667, 673 of medication, 734-737 responsibilities, 671 of pain, 768-770 studies of, 870-872 of safety, 718-729 third-party payment of, 647-653 outcomes from, 687-688 unique aspects of, 848-849 problems identified by, 684 visits involving, composition of, 871 recommendations from, 685-687 Home hospice care, 803-816 team approach to, 683 clinical aspects of, 809-814 types of, 678-680 death in, 814-815 unresolved issues in, 689-690 ethical and legal aspects of, 807-808 yield of, 683-685 goals of, 803 Home health agency(ies), accreditation of, laboratory tests in, 813-814 853-854 Medicare certification of, 804-805 certificate of need of, 853 organization of, 804-807 Medicare certification of, 651, 852-853 reasons for, 804 physician as medical director of, 672 reimbursement for, 807 selection of, guidelines for, 855-857 team dynamics in, 806 state licensure of, 853 treatment plan for, 805 users of, 652 Home intravenous therapy, antibiotic, 749- Home health aide-homemaker, quality 763 monitoring of, 858 drugs used in, 758-760 Home health care, 645-664 experience in elderly, 759-761 benefits of, 869 financial considerations in, 761 caregiver burden in, 817-829 types of infection treated by, 756-758 cost-effectiveness of, 662, 865-874 development of, 750-751 definition of, 645-646 equipment required for, 753-756 desirablity of, 868-869 patient selection for, 752 elderly use of, 653-661 types of, 751-752 family dynamics in, 817-829 Home management, of dementia, 787-801. financing for, 865 See also Dementia(s). for respiratory problems, 777-786. See of intravenous antibiotics, 749-763. See also Respiratory problems. also Home intravenous therapy. formal, effectiveness of, 661-662 of medication, 733-748. See also Medica- functionally dependent community elderly tion. receiving, 656-658 of pain, 765-776. See also Pain. 884 CUMULATIVE INDEX 1991 Home pharmacy, assessment of, 734-735 Imipramine, for poststroke depression, 499- Home rehabilitation, admission criteria for, 500 696 Immunizations, pretravel advice concerning, multidisciplinary, 695-706 323 nursing care in, 697-699 Implantable port, for home intravenous occupational therapy in, 701-703 therapy, 755 physical therapy in, 699-701 Impotence, 63-72 psychosocial issues in, 703-705 diabetes mellitus and, 114, 168 role of physician in, 696-697 evaluation of, 68—69 Home safety, 707-731 pathogenesis and diagnosis of, 64-68 Home visitor, home assessment by, 682 treatment of, 31, 69-70, 78 Homemaker-home health aide, quality medications for, 104—107 monitoring of, 858 urologic considerations in, 73-84 Hookworm, in traveling elderly, 326 Incontinence, urinary, effect on sexuality, Hormone therapy, and sexual function in 125 women, 90-91 Infection, and chronic subdural hematoma, for impotence, 104 584 Hospice care, home, 803-816. See also and subarachnoid hemorrhage, 580 Home hospice care. Infectbiloeuesd incgol,i ti3s,0 9a-n3d1 1 lower intestinal Hospitals, physician view of elderly in, 388— 389 Inflammatory bowel disease, 287-299 House calls, by physicians, 857 and lower intestinal bleeding, 309 in home assessment, 678-679 cancer risk in, 295 causes of, 293-294 Hyalinosis, in brain, 444 Hydatid cysts, in traveling elderly, 327 diagnosis of, 288-293 incidence and prevalence of, 288-289 Hypercholesterolemia, and risk of stroke, natural history of, 294-295 402 surgery for, 296 Hyperestrogenemia, effect on sexuality, 120 treatment of, 290, 295-297 Hyperlipidemia, and vascular dementia, 606 university-based experience with, 297— Hyperprolactinemia, effect on sexuality, 48, 298 120 Infusion pumps, for home pain Hypertension, and intracerebral hemorrhage, 550 management, 773 Intercourse, frequency of, with aging, 44, 86 and risk of stroke, 402 Interpersonal factors, and sexual and vascular dementia, 606 dysfunction, 135-136 control of, in cerebral amyloid angiopathy, Intestinal bleeding, lower, 301-319 626 causes and clinical features of, 301-312 Hyperthyroidism, effect on sexuality, 120 evaluation and management of, 312-316 Hyperventilation, for cerebral amyloid upper, 255-264 angiopathy, 626 Intracranial hemorrhage, seizures in, 485— for intracranial hypertension, in intracere- 488 bral hemorrhage, 562 Intracranial pressure, elevated, in Hypnotic effects, of antidepressants, 500 intracerebral hemorrhage, 556, 562— Hypogonadism, in aging men, 88 563 Hypotension, orthostatic, and falls, 711 in ischemic stroke, 458-459 Hypothalamic-pituitary-testicular axis, age- low, and chronic subdural hematoma, 584 related changes in, 87-89 Intrapersonal issues, and sexual dysfunction, Hypothermia, in traveling elderly, 324 135 Hypothyroidism, effect on sexuality, 120 Intravenous antibiotic therapy, home- Hysterectomy, in older women, and sexual administered, 749-763. See also Home dysfunction, 49-50 intravenous therapy. Intussusception, and lower intestinal bleeding, 311 Ipratropium bromide, for home respiratory Illness, as agent of change, 827 care, 779-780 chronic, psychosocial aspects of, 125-126 Irritable bowel syndrome, 265-286 Imaging studies, of cerebral amyloid anorectal abnormalities and, 272 angiopathy, 625 cause of, 271-275 of lacunar infarction, 450 diet in, 273