Geriatric Medicine Overview

Question 1

Are older men or women more likely to live in poverty?

Answer 1

Woment

Question 2

Highest poverty rates by gender/demographic

Answer 2

• Older Hispanic women
  who live alone (32.1%)
• Older Black women
  who lived alone (31.7%)

Question 3

EMPLOYMENT of Age 65+ in the labor force

Answer 3

○ 24% men
○ 16% women

Question 4

OTHER BARRIERS TO HEALTHCARE ACCESS for older adults

Answer 4

• Transportation
• Street safety
• Medical bills
• Doctor’s lack of responsiveness to
  patient concerns
• Fear

Question 5

More than ____ of persons 65 years
& older have some kind of disability

Answer 5

1/3

Question 6

WHAT IS AGING?

Answer 6

• Processes in an organism that increase the
  mortality risk as a function of 6me
• Time-sequen6al biological deteriora6on

Question 7

WHAT IS “NORMAL” AGING?

Answer 7

Most organ systems lose function ~1% per
year, beginning ~age 30

Question 8

PHYSIOLOGIC CHANGES OF AGING
Cardiovascular

Answer 8

• ↓ cardiac output
• ↑ vascular resistance
• The heart becomes more
  dependent on blood volume

Question 9

PHYSIOLOGIC CHANGES OF AGING
Pulmonary

Answer 9

• Impaired gas exchange
• ↓ vital capacity

Question 10

PHYSIOLOGIC CHANGES OF AGING
↓ autonomic nervous system responsiveness

Answer 10

• ↑ postural hypotension
• Profound following spinal or epidural
  anesthesia

Question 11

PHYSIOLOGIC CHANGES OF AGING
Kidneys

Answer 11

• ↓ renal function
• Creatinine clearance ↓ with age
• Serum creatinine level remains constant

Question 12

PHYSIOLOGIC CHANGES OF AGING
GI

Answer 12

• Functional changes related to motility
  patterns
• Progressive ↑ of blood glucose

Question 13

PHYSIOLOGIC CHANGES OF AGING
Skin

Answer 13

• Epidermis atrophies with age
• Changes in collagen & elasticity

Question 14

PHYSIOLOGIC CHANGES OF AGING
MSK

Answer 14

• Osteoporosis due to ↓ in bone
  mass after 4th decade
• Lean body mass ↓
• Loss & atrophy of muscle cells
• Degenerative changes in joints

Question 15

PSYCHOLOGICAL CHANGES OF AGING
Cognitive changes

Answer 15

• Takes more ?me to encode, store,
  & retrieve informa?on
• Rate at which new informa?on is
  learned can be slower
• Short-term memory shows
  substan?al changes
• Word-finding ability declines

Question 16

Dementia

Answer 16

• Irreversible mental deterioration
• 5-7% of adults over 65 years
• 30% of adults over 85 years
• Behavior disorders

Question 17

Older adults consume ____% of medication taken in the US

Answer 17

25

Question 18

LEADING CAUSES OF DEATH OF PERSONS AGE
65 YEARS & OLDER IN THE US

Answer 18

• Heart disease
• Cancer
• COPD
• Cerebrovascular disease
• Alzheimer’s
• Diabetes
• Pneumonia/influenza
• Accidents
• Nephri6s
• Sep6cemia

Question 19

What is a Reverse mortgage program?

Answer 19

• Provides a guaranteed monthly
  income payment to senior age 62 &
  older who own their own home &
  have substantial equity value
• Senior homeowner does not have to
  repay the money or make interest
  payments on it for as long as they
  continue to reside in their home

Question 20

What is a Section 8 housing voucher?

Answer 20

• Helps eligible low-income households with rent
• “The housing choice voucher program is the federal
  government’s major program for assisting very low-income
  families, the elderly, & the disabled to afford decent, safe,
  & sanitary housing in the private market. Since housing
  assistance is provided on behalf of the family or individual,
  participants are able to find their own housing, including
  single-family homes, townhouses & apartments.”

Question 21

MEDICARE
Part A: Hospital/Hospice Insurance

Answer 21

• Inpatient hospital stays up to 90 days
• Semiprivate room, food, tests
• Medicare penalizes hospitals for
  readmissions
• Brief stays in skilled nursing facilities
  following a preceding hospital stay of at
  least 3 days
• Hospice if less than 6 months to live

Question 22

MEDICARE
Part B: Medical Insurance

Answer 22

• Outpa?ent
• Op?onal
• Typically covers 80% of
  approved services
• Physicians, nurses, labs,
  diagnos?c tests, vaccines,
  chemo, durable medical equipment

Question 23

MEDICARE
Part C: Medicare Advantage

Answer 23

• Medicare-approved private insurance
  plans for individuals enrolled in
  Medicare A & B
• Generally, offers additional benefits
  such as hearing, vision, dental
• Plans often have networks

Question 24

MEDICARE
Part D: Prescritioon Drug Plans

Answer 24

• Anyone with parts A or B v is eligible
• Approved & regulated by Medicare
• Designed & administered by private insurance companies

Question 25

Supplemental Nutrition Assistance Program (SNAP)

Answer 25

○ AKA “food stamps”
* Elderly
* Must be 60+ yo
* < $4,250
* Does NOT including home, Supplemental Security Income (SSI),
Temporary Assistance for Needy Families (TANF), most
retirement plans & pensions

Question 26

Commodity Supplemental Food Program (CSFP)

Answer 26

Must be 60+ yo
* CSFP food packages do not provide a complete diet, but are good sources
of the nutrients typically lacking in the diets of the beneficiary population.

Question 27

Seniors Farmers Market Nutrition Program

Answer 27

○ Low-income seniors with access to locally grown fruits, vegetables, honey and herbs
○ Must be 60+ yo
○ Household incomes < 185% of the federal poverty income guidelines.
○ Farmers
○ Farmers Markets
○ Roadside Stands

Question 28

GOALS OF GERIATRIC MANAGEMENT

Answer 28

• Minimize drug interactions
• Prevent disease & complications
• Maintain independence while
  balancing safety
• Maintain quality of life
• Minimize hospitalization
• Provide compassionate end-of-life
  care when the time comes