Elderly Care

Question 1

What does the increasing life expectancy mean for patients and what does it depend on

Answer 1

Life expectancy has socio economic drivers
Healthy ageing
Vs
Unhealthy ageing
In hospital we see the unhealthy ageing and tar everywhere he with the same brush
However the population is living longer but we are living longer in ill health

Question 2

Is there a typical older person

Answer 2

No
Older people are heterogenous
Much more heterogenous than younger population as there is vast difference in their cognitive ability, physical strength and physiological processes

Question 3

Age discrimination in care

Answer 3

In care older people can be infantilised and treated as having no views or wishes
They are low priority in health and social care

Question 4

What is multi pathology important in the elderly

Answer 4

With increasing age you are more likely to pick up diseases
Therefore have multiple things wrong with you and therefore poly pharmacy
Interplay between different drugs the effects of those drugs in the body leading to further adverse outcomes
OA = opioids = constipation = laxatives
Heart failure = beta blocker = hypotension = fall

Question 5

Why is treating patient single organ disease bad

Answer 5

Patients have many diseases
Treating each disease without addressing the patients other concerns or co morbidities leads to adverse outcomes
Need geriatrician to put it all together

Question 6

Define frailty

Answer 6

Medical syndrome with multiple causes and contributors that is characterised by diminished strength, endurance and reduced physiological function that increases an individuals vulnerability for developing inc dependency and or death
-vulnerabilities
- reduces physiological reserve
= more likely to suffer adverse outcomes

Question 7

What is important about frailty

Answer 7

Reduced response to stressors
So if they have a UTI compared to a person who isn’t frail, they will drop below the threshold of reserve and also not get as better as they should

Question 8

Widow we know what frailty is

Answer 8

Can be recognised
But we aren’t good at describing it
Word used to describe older people who are more fragile than what you’d expect

Question 9

How to recognise a frail person

Answer 9

Walking aids
Stopped posture
Grumpy
Knees bent

Question 10

What does frailty describe

Answer 10

Risk for death

Poor outcomes

Question 11

What are the geriatric giants

Answer 11

Intellectual failure
- delirium + dementia
Incontinence 
Immobility - off legs, falls, consequences of 
Instability - falls + physiology 
Iatrogenic
Inability to look after oneself 
- functional decline - the reverse of failure to thrive 
- Neglect