At 88, Jean Yawitz had been living independently.

But multiple medications she was taking caused her to lose her appetite, strength and balance. A fall and hospitalization accelerated her downward spiral.

At less than 100 pounds, Mrs. Yawitz was dizzy, confused and depressed. Her children were concerned their strong-willed mother was declining rapidly and would no longer be able to care for herself. They sought the care of Washington University School of Medicine''s Older Adult Assessment Program at Barnes-Jewish Hospital.

Stanley Birge, MD, a geriatrician with the program, worked with the assessment team that included a geriatric pharmacist, social worker, and nurse, to reverse Mrs. Yawitz''s downhill spiral. "She had excellent physicians caring for her before she came to us," says Dr. Birge, "but we have a multidisciplinary team to assess the older adult whose problems are typically multiple and complex."

With her appetite restored and her strength and energy back to normal, Mrs. Yawitz is thankful. "They were just fighting one another," she says of the many medications she had been taking.

In addition to medication management, looking at a patient''s social and physical environment and their nutrition is a priority for the geriatric assessment team, who involve the entire family and caregivers in developing a care plan. That was key for the Yawitz family, who, with four sons and four daughters-in-law involved with the care of Mrs. Yawitz, were each seeking direction.

"It was very important that we were able to meet as one group and be able to go forward with a unified approach," says daughter-in-law, Alice Yawitz. "She is just a terrific and vital person. We were not willing to just let go and say this was a normal consequence of aging." Son David Yawitz agrees. "We just had a huge 90th birthday bash and there is no doubt in my mind it wouldn''t have happened without the help we received from the Older Adult Assessment Program."