The main impetus for these musings is to
communicate information from the Long Term Care Medical Directors'
Meetings, an annual gathering of long-term care medical directors and
other disciplines to discuss issues in residential geriatric care.
recurrent theme has been the uniqueness of prescribing for the oldest
of the old. This is a term that identifies those over 85 who are
becoming a larger proportion of the long-term care population. There is
a near absence of research in the management of chronic diseases in
this population. We extrapolate the findings from the younger age
groups to direct our management in the oldest of the old. However, this
age group has significant changes in drug metabolism and has a very
high risk for adverse reactions aggravated by drug interactions.