Geriatric Medicine Overview Flashcards
Are older men or women more likely to live in poverty?
Woment
Highest poverty rates by gender/demographic
- Older Hispanic women
who live alone (32.1%) - Older Black women
who lived alone (31.7%)
EMPLOYMENT of Age 65+ in the labor force
○ 24% men
○ 16% women
OTHER BARRIERS TO HEALTHCARE ACCESS for older adults
- Transportation
- Street safety
- Medical bills
- Doctor’s lack of responsiveness to
patient concerns - Fear
More than ____ of persons 65 years
& older have some kind of disability
1/3
WHAT IS AGING?
- Processes in an organism that increase the
mortality risk as a function of 6me - Time-sequen6al biological deteriora6on
WHAT IS “NORMAL” AGING?
Most organ systems lose function ~1% per
year, beginning ~age 30
PHYSIOLOGIC CHANGES OF AGING
Cardiovascular
- ↓ cardiac output
- ↑ vascular resistance
- The heart becomes more
dependent on blood volume
PHYSIOLOGIC CHANGES OF AGING
Pulmonary
- Impaired gas exchange
- ↓ vital capacity
PHYSIOLOGIC CHANGES OF AGING
↓ autonomic nervous system responsiveness
- ↑ postural hypotension
- Profound following spinal or epidural
anesthesia
PHYSIOLOGIC CHANGES OF AGING
Kidneys
- ↓ renal function
- Creatinine clearance ↓ with age
- Serum creatinine level remains constant
PHYSIOLOGIC CHANGES OF AGING
GI
- Functional changes related to motility
patterns - Progressive ↑ of blood glucose
PHYSIOLOGIC CHANGES OF AGING
Skin
- Epidermis atrophies with age
- Changes in collagen & elasticity
PHYSIOLOGIC CHANGES OF AGING
MSK
- Osteoporosis due to ↓ in bone
mass after 4th decade - Lean body mass ↓
- Loss & atrophy of muscle cells
- Degenerative changes in joints
PSYCHOLOGICAL CHANGES OF AGING
Cognitive changes
- 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
Dementia
- Irreversible mental deterioration
- 5-7% of adults over 65 years
- 30% of adults over 85 years
- Behavior disorders
Older adults consume ____% of medication taken in the US
25
LEADING CAUSES OF DEATH OF PERSONS AGE
65 YEARS & OLDER IN THE US
- Heart disease
- Cancer
- COPD
- Cerebrovascular disease
- Alzheimer’s
- Diabetes
- Pneumonia/influenza
- Accidents
- Nephri6s
- Sep6cemia
What is a Reverse mortgage program?
- 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
What is a Section 8 housing voucher?
- 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.”
MEDICARE
Part A: Hospital/Hospice Insurance
- 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
MEDICARE
Part B: Medical Insurance
- Outpa?ent
- Op?onal
- Typically covers 80% of
approved services - Physicians, nurses, labs,
diagnos?c tests, vaccines,
chemo, durable medical equipment
MEDICARE
Part C: Medicare Advantage
- 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
MEDICARE
Part D: Prescritioon Drug Plans
- Anyone with parts A or B v is eligible
- Approved & regulated by Medicare
- Designed & administered by private insurance companies
Supplemental Nutrition Assistance Program (SNAP)
○ 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
Commodity Supplemental Food Program (CSFP)
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.
Seniors Farmers Market Nutrition Program
○ 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
GOALS OF GERIATRIC MANAGEMENT
- 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
