Elderly Flashcards
what happens as w get older in terms of healthcare costs ?
increases
- costs go towards: hospital and community health services, GP services, pharma, capital spending (lifts chairs)
what is the biological model of aging?
- we are genetically programmed to be mortal
- happens due to telomeres = endings on chromosomes shorten with age as the chromosome replicates
- telomere will get critically short until it can no longer hold chromosome together at which point it can’t reproduce itself
what is the wear and tear model ?
- over time w e collect mutations (cause day radiation and drugs which affects mitchonrail and cellular dna)
- affects free radicals
what is social ageing
- due to cognitive changes and the way our role in society changes as we get older we become more independent then more dependant when elderly
what is psychological ageing?
what can the human body adapt to?
- infectious disease
- trauma
- poor nutrition
what is the link between quality of life and age ?
it reduces with age
- life expectancy can be increased but QOL lost
trips and falls in elderly ?
- cardiovascular reserve reduced = less stamina meaning our bone density is reduced and so is muscle mass = more likely to fall and have problems when we do fall = problems with coordination = problems with eyesight and hearing = increase risk of trips and falls
who trips and falls more ?
F>M
risk of death from fall
what happen sir you have had 2 falls in 2 years ?
indicates higher risk of further falls
- can cause injury and loss of confidence = poorer mental and psychological problems
what can elderly do to help prevent falls ?
- exercise
- diet
- physio
- physical aids
what are the different types of dizziness?
- vertigo: spring or movement
- about to faint: reduced brain perfusion
- unsteady: balance, muscle, proprioception
- psychogenic: anxiety, panic attack
- combination
- benign paroxysmal positional vertigo (bppv)
what is bppv?
- short episodes of vertigo associated with change in orientation of the head
- otoliths in semicircular canals = these measure change in position
- if you get otoliths (crystals) they impair Flow of fluid to canals = can give vertigo or dizziness
how do we treat BPPV?
meds
manoeuvre ettly
what is syncope ?
- fainting or near
- rises as we get older
what can syncope be caused by ?
- structural heart disease
- AF
- meds
- autonomic failure eg. bp problems
- stress anxiety
- dehydration
why is urinary incontince common in females?
- UT is much shorter in women than in men
- affects of pregnancy
what are the 3 different types of incontinence?
- overflow= urethral blockage due to obstruction =bladder unable to empty normally
- stress = relaxed pelvic floor = increased abdominal pressure
- urge = bladder overly sensitive from infection ie form neurological disorders
- mixed = above 3
- more frequent as we get older
how do we manage UI?
what is constipation ?
- no universal normal bowel habit
- harder poo
- less frequent
- pain or difficulty passing stool
- 30% of ppl in >60
- discomfort or damage to rectum or anus
- over flow diarrhoea, incontince, loss of apetite, vomiting
- delirium, pain, behavioural problems
why does constipation happen?
- GIT slows down with age
- lack of fibre
- immobility
- dehydration
- meds eg. opiates, antidepressants, antipsychotics
- hypercalcaemia = stones, bone, groans, moans
management of constipation ?
- hydration
- dirty fibre
- medication check
- mobility
- fybogel = increased bulk
- softening laxative = increase fluid in gut
- stimulant laxative = iritant to gut
how does cognitive ageing work ?
- no new neurone
- general reaction in brain size
- reduced speed of thinking
what can dementia lead to ?
- lang impairment
- memory impairment
- functional impairment
- disordered thinking
- > 6 months
- no other psychiatric cause
what is polypharamcy?
- kidneys and liver age
what are some other issues with polypharmacy
what is frailty ?
what are the scores of frailty ?
what is assisted living?
25,000 care homes
social care and help with daily activities
nursing care
special care
age ranges for assisted living ?
4% of >65
50% of 85
75% of cognitive impairment
what docs are involved in are home?
GP has contract to provide care for all residents of the home
NOT GDP
what is the emphasis in assisted care ?
bone health
falls prevention
continence
what are the common problems in assisted living?
prescribing in care homes
errors are common
multiple drugs in same class
inappropriate opiates
what is the gold standard framework for end of life?
last 12 months of life:
- pt
- family
- carers
- GP
- social and hospital care
- aim to identify ppl coming to end of their life
- assess needs support
- plan for end of life
