GERIATRIC AND MEDICAL PATIENTS Flashcards
What is considered a “fall”
patient fell and sustained an injury enough to limit their daily function
Falls account for ___% of admissions in hospital
~62%
What should a subjective assessment of a geriatric population include
- complete understanding of home and/or potential discharge destination environment
- Complete understanding of previous level of function
what should an objective assessment of a geriatric population include
- Chest assessment
- ROM
- Strength
- balance
- Bed mobility
- Transfers
- Ambulation
What is hemodynamic monitoring include
HR
SPO2
BP
RR
What is the elderly mobility scale
7 item performance based test which includes transfer, gait, and balance activities related to ADL function in the frail elderly
What does the chair stand test assess
leg strength and endurance
What is a chair stand test useful
may show increased gains not seen with manual muscle testing and is more functional
Can indicate risk of falling
What does the TUG assess
mobility, balance, ambulation and falls risk in older adults
Is the TUG standardized?
yes in the frail elderly and community patient population
What is gait speed correlated with
survival
What are some pros to using gait speed as an assessment tool for frail and elderly
Quick, inexpensive, reliable measure of functional capacity, high interrater and test-retest reliability
What is comfortable gait speed for women and men age 70-79
women - 1.13 m/s
men - 1.26 m/s
what is comfortable gait speed for men and women age 80-89
men - 0.97 m/s
women - 0.94 m/s
A gait speed of ___ m/s is a predictor of poor clinical outcomes
0.8 m/s
a gait speed of ___ is a threshold to predict further functional decline in those older adults already impaired
0.6 m/s
When do you start and stop the time for gait speed assessments
when the patients foot crosses the start and finish lines
How many times do you repeat gait speed tests
3x
how do you get the final score of gait speed tests
average the results
A 4m gait speed test needs how many meters of clear space? 10m gait speed test?
6m
14 m
walking speed correlates with ___
function - see table in notes
What is the minimum to be designated an independent ambulator
able to ambulate a minimum of 46m
What is the recommended walking speed to safely cross an intersection
1.2 m/s
What is the FITT recommendation for aerobic exercise in older adults
F: 3-5 x wk
I:5-6 RPE on a 1-10 RPE scale
T: 30-60 minutes per day
T: varies
What is the FITT recommendation for strength training for older adults
F: 2 x wk
I: 40-50% 1RM
T: major muscle groups, 8-10 exercises, 10-15 reps each
What are recommendations of an exercise prescription for individuals with a fall history (not a FITT)
- Activities that combine balance, agility, proprioceptive training
- Min 2-3x/week of exercise
- Progress difficulty in postures while reducing base of support
- Dynamic movements; closed chain
- Stress on postural muscles
- Reducing sensory input
What are 3 possible discharge destinations for geriatric populations
- Home
- Rehab
- Facility
What are 3 cares levels for elderly patients getting discharged home
- No supports
- Home care PT/supports
- Community program
What are the 3 forms of rehab a geriatric patient may be discharged to
- Subacute
- Holy family hospital
- Transition care unity
What are the 2 forms of facility a geriatric patients may be discharged to
- Community hospital
- LTC
