Geriatric Hospital Medicine Decision Manual: Clinical Frameworks for Frailty, Delirium, Falls, Polypharmacy, Acute Decline, Discharge Risk, and Goals-of-Care Decisions in Older Adult Inpatient Care

Older adults in the hospital often present with more than a single diagnosis. Frailty, delirium risk, falls, functional decline, medication complexity, caregiver limitations, and discharge uncertainty can all shape the outcome of an admission. Clinicians need a practical way to connect these risks at the bedside and turn complex presentations into clear, patient-centered decisions. Geriatric Hospital Medicine Decision Manual is a clinical reasoning guide for inpatient teams caring for older adults with complex medical, functional, cognitive, and social needs. Designed for hospitalists, internists, residents, advanced practice clinicians, nurses, pharmacists, case managers, therapists, and interdisciplinary care teams, this manual provides structured frameworks for recognizing risk early, prioritizing care, and planning safer transitions from admission through discharge. Inside, readers will find: • Practical frameworks for frailty, acute illness, functional decline, delirium, falls, pain, immobility, nutrition, and recovery risk • Medication safety guidance for polypharmacy, renal vulnerability, anticholinergic burden, deprescribing, and discharge medication reconciliation • Decision-oriented chapters on capacity, consent, surrogate decision-making, caregiver burden, social risk, and goals-of-care communication • Concise appendices with admission checklists, bedside risk frameworks, medication review worksheets, and discharge documentation templates The manual is written in a serious, clinically useful style for real inpatient practice. Each chapter focuses on how to think through common geriatric hospital problems, how to recognize patterns that increase risk, how to align treatment with function and patient values, and how to communicate decisions clearly across the care team. For clinicians who want a structured, practical, and compassionate approach to older adult inpatient care, Geriatric Hospital Medicine Decision Manualoffers a usable bedside companion for turning complexity into clearer clinical action.