Clinical Pearls

Valuable bits of wisdom learned by experience and observation

Clinical pearls are best defined as small bits of free-standing, clinically relevant information based on experience or observation. They are part of the vast domain of experience-based medicine and can be helpful in dealing with clinical problems for which controlled data do not exist. We offer this section as relevant information across professionals working with older adults.

  • Listen to how you feel.
  • Feelings are a terrible thing to waste.
  • Look at how you’re thinking.
  • Start low and go slow when prescribing and monitoring medications in older adults.
  • It’s about finding meaning.
  • The strengths of weak ties provide valuable insights.
  • Modulate your ego in the interest of better outcomes.
  • Listen with your eyes and ears.
  • Work from a strengths perspective with your patients and clients.
  • Validation and recognition are essential in working with older adults.
  • It’s about inter-dependence not only independence.
  • Clinical wisdom resides not in designated individuals, but in a dedicated network.
  • Try to stay in the frame of mind called: Open-Closure.
  • One person with dementia is one person with dementia.
  • No one has a monopoly on the truth.
  • Connect the dots (to discover patterns and connections).
  • Avoid premature closure.
  • Use patient-specific analogies (build upon what people already know, per adult-learning theory).
  • Use triangulation with the arms of the star (to find patterns that suggest origins of current problems and/or likely predictions of the future.
  • Every older adult is an N of 1 (i.e. unique, due to heterogeneity of factors in each arm of the Star map).

Meaning reconciliation

  • Effective outcomes require effective communications.
  • Effective communication requires effective meaning reconciliation (to establish that the same words will essentially mean the same thing to all those involved).
  • Use paraphrasing (to test whether your understanding of what you have heard means the same to the speaker as what it means to you).

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