geri giants Flashcards
5 geri giants
- frailty
- del and dementia
- falls
- meds
5 incontinence
def. frailty
variable susceptability or vulrnerability to adverse health outcomes despite having the same chrono age
2 models of frailty
- phenotype model
2. cumulaitve co-morbidity model
def. phenotype model
3 of: - unintentional weight loss - muscle weakness - slow walking - feeling exhausted - low phys. activty leads to: - falls - funct. decline - hostpilization
7 leveks in clinical failty scale
- very fit
- well- without active disease
- well- treated comorbid disease
- apparent vulnerabilty - slowed
- mildyl frail - limited dep for IADLs
- mod. frail - help needed for IADLs and ADLs
- severe - completely dep
what does clincal frailty predict
survival and institutionalization
how to deal with frailty
comp. geri assessment
def. confusion assessment method (CAM) for delirium
1 and 2 and 3 or 4
- acute changes in mental status with fluctuating course
- inattention
- disorganized thinking
- altered level of consciousness
how is delirium differ from dementia
- acute v chroinc
- fluctuating v progressive
- variable consc. v. normal LOC
- distrubed sleep v. variable
- impaired orientation v. normal
- hallucination v. maybe
- disorganized rich thinking v. paucity
4 hypotheses for cause of delirium
- cholinergic failure
- DOPA excess
- stress response
- inflammation
predisposing facotrs for delirium
- age
- dementian or CNS issues
- comorbidities
- imparied vision hearing
- dehydration
- meds
*** precipitant causes to rule out
DIMS Drugs - too many, too few Infections, Inflammation, Infarction Metabolic Structural
3 methods to Tx del
- Tx underlying cause
- conservative strats - family, aids
- pharma
- if risk
- can’t do med therapy
- patient suffering
main class of meds
neruoleptics - start low and go slow
- haloperidol
- risperidone
- olanzipine
- quetiapine
2 parts of mechanics of falls
- perturbation of balance
2. failure to adequately respond
2 types of falls and their subtypes
- mechanical
- displaced COM - push
- prevent BOS - slip - informational
risks for falls
- weakness
- Hx of falls
- gait imbalance
- visual defect
- impaired ADL
- cog. impairment
- psych drugs
how can Vt D help
- improved myocytes
4 ways to reduce risk of injury in falls
- Tx osteoporosis
- bisphosphonate
- denosumab
- hip protectors
