Elderly intro - just notes Flashcards
What is classed as elderly?
Over 65
Young elderly is 65-75
Very elderly is >85
What system commonly gets symptoms when there is a general problem?
Locomotor system
Challenge with elderly patients
Complex - lots of causes to problems which have to be adressed
Atypical presentation - non specific to disease, systems are slower to react to infection etc
Problems with risk of falls after 1 fall
After 1 fall risk of falls increases due to change in behaviour
Reasons for under-reporting symptoms in elderly
- Fear hospital
- Embarassed
- Fear of being a burden
- Independence
- Think symptoms normal part of aging
Why can sexual diseases increase in elderly?
- No fear of pregnancy so no protection sometimes
- Increased risky behaviours if change of frontal lobe etc
What to ALWAYs ask about in elderly?
Alcohol can be cause of delirium, common in elderly, can also cause falls
Clinical frailty scale
What are geriatric syndromes?
- Group pf signs and symptoms that characterise a specific disorder
Multifactorial origin - No single common pathway to the disorder
Examples of geriatric syndrome components
- Falls
- Urinary incontinence
- Dizziness
- Syncope
- Insomnia
- Malnutrition
How to the elderly often present with illness?
- Atypical presentation
- Multiple concurrant problems
- Non-specific symptoms
- Hidden illness - they also under report
Examples of atypical presentations
- MI with no chest pain
- Hyperthyroidism without tachycardia, weight loss etc
- Infection without rising WBC and fever
- Fatigue as symptom of CHF
Non-specific symptoms elderly often present with
- Confusion
- Self neglect
- Falling
- Incontinence
- Fatigue
- Weight loss/anorexia
- Dyspnoea
What must you ask elderly people about as they often do not offer up this information?
- Sexual dysfunction
- Depression
- Incontinence
- MSK stiffness
- Alcoholism
- Hearing loss
- Memory loss
Reasons elderly under report
- Belief symptoms due to old age
- Fear/denial
- Concern about cost
- Embarassed
- Mentally mpaired
- Concern about ill spouse insted
- Previous bad experience with NHS
- Fear of institutionalization