Clinical decision support that reasons like a geriatrician: recognize delirium with the CAM and treat the cause, assess the faller by STEADI, deprescribe with the Beers criteria, and work up the cognitive decline — with the decision rule and exactly what would change it. Built for verified physicians.
Two real geriatrics questions, each reasoned the way HeyHippocrates answers: the skills fire, the answer is cited, the decision rule is explicit, and what's missing is flagged. Scroll to each.
An 84-year-old, acutely confused and inattentive after surgery, fluctuating through the day — the approach?
Diagnose delirium with the Confusion Assessment Method: an acute onset with a fluctuating course and inattention, plus either disorganized thinking or an altered level of consciousness. Then hunt the cause — infection, a new or culprit medication, a metabolic derangement, pain, or urinary retention. Manage non-pharmacologically first: reorient, restore the sleep-wake cycle, mobilize, and remove tethers. Reserve a low-dose antipsychotic only for agitation that threatens safety, and avoid benzodiazepines except in alcohol withdrawal.
Decision ruleDelirium by CAM (acute + fluctuating + inattention, plus disorganized thinking or altered consciousness) → find and treat the cause; non-pharmacologic first; low-dose antipsychotic only for dangerous agitation; avoid benzodiazepines except alcohol withdrawal.
Not established from this alone — the cause, the medications and the baseline cognition change the management.
A 78-year-old with two falls this year, now on five medications — the assessment?
Two falls in a year triggers the full CDC STEADI multifactorial assessment. Watch the gait and balance with a Timed Up and Go, check orthostatic blood pressure, vision, feet and footwear, and review every medication for fall risk — sedatives, antihypertensives and anticholinergics — deprescribing where you can by the Beers criteria. Check vitamin D, screen the home for hazards, and prescribe a strength-and-balance exercise program. A fall is a sentinel event, not aging.
Decision rule2 or more falls per year (or an injurious fall) → STEADI multifactorial: gait and balance (TUG), orthostatics, vision, feet, medication review and deprescribe (Beers), vitamin D, home hazards, strength-and-balance exercise.
Not established from this alone — the gait, the orthostatics, the medications and the home change the intervention.
Illustrative simulations. The physician always decides.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
Screen every older adult yearly for falls; two or more falls, an injurious fall or a gait problem triggers the STEADI multifactorial assessment. Evaluate gait and balance with the Timed Up and Go, measure orthostatic blood pressure, review vision, feet and footwear, and scrutinize the medication list — sedatives, antihypertensives and anticholinergics raise the risk. Intervene with medication reduction, vitamin D where deficient, home-hazard removal and a supervised strength-and-balance program.CDC STEADI
Decision ruleAnnual screen → STEADI if 2+ falls / injurious fall / gait problem: TUG, orthostatics, vision, feet, medication review; intervene with deprescribing, vitamin D, home safety, strength-and-balance exercise.
Missing data: the gait pattern, the orthostatics and the medication list change what helps.
Review the whole medication list against the goals of care and the AGS Beers criteria for potentially inappropriate medications in older adults, supported by the STOPP/START tool. Target the highest-risk agents first — anticholinergics, benzodiazepines and sedative-hypnotics, and long-term NSAIDs — and taper rather than stop abruptly where withdrawal is a risk. Confirm each drug still has an indication and a benefit that outlives the patient, and monitor as you reduce.AGS Beers
Decision ruleReconcile the list → Beers + STOPP/START; deprescribe the highest-risk first (anticholinergics, benzodiazepines, sedative-hypnotics, chronic NSAIDs); taper where needed; confirm indication and time-to-benefit; monitor.
Missing data: the indication, the goals of care and the withdrawal risk change what to stop.
Diagnose with the Confusion Assessment Method: an acute change with a fluctuating course and inattention, plus disorganized thinking or an altered level of consciousness — and distinguish it from dementia and depression. Search for and treat the precipitants — infection, medication, metabolic upset, pain, constipation and retention. Prevent and treat non-pharmacologically first with reorientation, sleep, mobility and sensory aids; use a low-dose antipsychotic only for agitation that endangers the patient.AGS · delirium
Decision ruleCAM to diagnose (distinguish from dementia and depression); treat the precipitants; non-pharmacologic prevention and management first; low-dose antipsychotic only for dangerous agitation; avoid benzodiazepines except alcohol withdrawal.
Missing data: the precipitant, the baseline cognition and the medications change the plan.
Confirm a cognitive decline that impairs function with a structured tool such as the MoCA or MMSE, corroborated by an informant, after excluding delirium and depression. Order a basic reversible-cause workup — thyroid function, B12, a metabolic panel — and structural neuroimaging when the picture is atypical or rapidly progressive. Characterize the pattern to distinguish Alzheimer, vascular, Lewy body and frontotemporal disease, and plan safety, driving and caregiver support.AAN · dementia
Decision ruleCognitive tool (MoCA/MMSE) + informant + function; exclude delirium and depression; reversible-cause labs (TSH, B12, metabolic); neuroimaging if atypical or rapid; characterize the dementia type; plan safety and support.
Missing data: the cognitive testing, the reversible-cause labs and the informant history change the diagnosis.
Your whole practice, one specialist brain — grounded in champion-authored, cited knowledge.
A generalist geriatrics colleague across falls and mobility, cognition, polypharmacy, frailty, the common syndromes and goals of care — cited, non-directive, always with the decision rule.
Deep specialist agents for falls and mobility, cognitive disorders, deprescribing and geriatric pharmacology, and palliative and end-of-life care — each its own soul and knowledge base — plus your own uploaded materials.
From the Beers deprescribe to the CAM at the bedside the margin is thin. Only one of these reasons like a geriatrics colleague whose every claim you can trace.
The waitlist is a founding cohort. Members shape the geriatrics build, get in before anyone else, and lock the founding price for good.
Leave your name and work email. We'll reach out the moment geriatrics opens — with your Founding Geriatrician offer.
One email at launch. No spam, ever.
It reasons in the frameworks you use — the CAM, CDC STEADI, the Beers criteria and the cognitive tools — and always shows the reasoning, the decision rule and what would change it. The decision always stays your call.
Both. Fellows use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion on the ward and in clinic. Access is gated to verified physicians.
Falls and mobility, cognitive disorders, deprescribing and pharmacology, and palliative and end-of-life care each have their own deep specialist agent on the Pro plan, on top of the full geriatrics scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in champion-authored, cited geriatrics knowledge — traceable, not hallucinated — and always states the decision rule plus what data is missing, instead of a confident guess.
HeyHippocrates