Approach to Geriatrics Flashcards
What age range is considered:
Elderly: __-__ y/o
Old: __-__ y/o
Very Old: __-__ y/o
Elderly: 65-75 y/o
Old: 76-90 y/o
Very Old: >90 (80 according to mike lamb) y/o
What is the average lifespan for a person who is 65 y/o?
How does this differ for women? Men?
18.8 years
Women: 20 yrs
Men: 17.3 yrs
What are the components of the biology of aging?
Free Radicals Errors and Somatic Mutations Wear and Tear Pacemaker Immunologic
What is the “rule of 1/4” attributed to decline and aging?
1/4 - Dz
1/4 - Disuse
1/4 - Misuse
1/4 - Actual physiologic aging
What lifestyle factors are involved in successful aging?
Exercise
Diet
Intellectual stimulation
Stop smoking
What should you establish upon entering a room to evaluate an elderly pt?
Can they…
See?
Hear?
Cognition?
Geriatrics commonly present (Typically/Atypically) w/ illnesses
Fevers are (Common/Uncommon) in geriatrics
Atypically
UNCOMMON
***Use their temp + 1 to evaluate if they have a fever
Generally community/outpatient settings and hospital inpatient w/ specialized units reduce pt ____, ____ , Delayed development of _____, and increased ____
Whereas a hospital inpatient w/ consultation teams has ____ results
Reduce mortality, permanent SNF use,
Delayed development of disability
Increased function
Mixed results
With evaluative H/P and Dx work-up, what do you need to consider in the geriatric population?
Prognosis
Values and preferences
Ability to fxn independently
What are special tests that should be used to assess function in a geriatric pt? (x4)
Cognition
Depression
Mobility
Senses
What determines the need/utilization of preventative screening in a geriatric pt?
Life expectancy
<10 years life expectancy: focus on QOL and harm vs benefit
What lifestyle topics should you address w/ a geriatric pt?
Smoking, alcohol, drug use
Sex
Exercise
Nutrition
What are the 4 questionnaires that can be used to evaluate spiritual hx?
HOPE
FICA
SPIRIT
FACT
What does SPIRIT stand for?
S: Spiritual belief system P: Personal spirituality I: Integration w/ a spiritual community R: Ritualized practices and restrictions I: Implications for medical care T: Terminal events planning
When obtaining a functional assessment, input from (a single source/multiple sources) is helpful
multiple sources
What does IADL stand for? ADL?
What is the difference between the two?
IADL: Instrumental Activities of Daily Living
ADL: Activities of Daily Living
IADLs are more complex activities than ADLs (basic care tasks)
IALDs - used to assess if they can live in the community independently
ADLs - used to assess if they can live at home/alone
T/F: Bacteria in the urine must be tx in geriatric women and men
False: if a women in asymptomatic, they do not need tx
Men ALWAYS need tx
What is included in the Mini Cognitive Test?
- Tell them 3 words (apple, table, penny)
- Have them do the clock drawing
- Ask them to repeat the 3 words
How are the points dispersed in the mini cognitive test?
What is a (+) result for dementia
What is a (-) result for dementia
1 point: All numbers are depicted once each, in correct sequence and positioned appropriately on clock face
1 point: The hands reasonably displayed the requested time
1 point: Per word recalled
(+) 0-2
(-) 3-5
What is a normal animal naming test?
Name x14 four-legged animals in 1 minute
What are the parts of a MOCHA test (Montreal Cognitive Assessment)
** Probably don’t need to know all of this……
Visual spatial/ Executive Naming Memory Attention Language Abstraction Delayed recall Orientation
What are common S/s that an elderly pt is suffering from depression?
Vague sx and somatic complaints
**check meds and conditions that can mimic depression
What are the screening tools for depression?
PHQ-9 (or PHQ-2)
Geriatric depression scale
How should you assess balance?
Seated
Transition
Walking
