Geriatrics

Question 1

What are the red flag signs of frailty in Geriatric patients?

Answer 1

Weight loss
Incontinence
Delerium/confusion
Recurrent falls
Reduced levels of phyiscal activity
Slow/impaired gait
Reduced endurance
Diminished grip strength
Easy tiring/SOB

Question 2

What are the most common geriatric frailty scales?

Answer 2

Clinical frailty scale (most common)
PRISMA 7
Edmonton frailty scale

Question 3

What are the features of the clinical frailty scale?

Answer 3

Question 4

What modifications to standard ED care can be done for the elderly?

Answer 4

Early mobilisation
Rationalise NSAIDs/opiates
Overall medication rationalisation
Opportunistic advance care planning
Social work involvement during and after visits
Assess for pressure areas and nutrition

Question 5

What are the elements of elder abuse?

Answer 5

• An act or lack of action that causes harm or distress to an elderly person
• Occurs within a relationship where there is expectation or implication of trust

Also victim may be dependent on the trusted individual, but doesnt have to be

Question 6

what are the different types of elder abuse?

Answer 6

• Physical
• Sexual
• Verbal abuse designed to humilate, degrade, demean, intimidate or subjugate
• Economic (financial abuse(
• Psychological/emotional
• Social (ie forced isolation from family or friends)
• Neglect

Question 7

What factors make the elderly vulnerable to abuse?

Answer 7

• Poor physical health
• Poor mental health
• Declining cognition
• Financial illiteracy
• Victim of prior domestic violence
• Language/cultural barriers
• dependency on others
• Female gender more common
• Poor future planning
• Legal loss of control (ie EPOA)
• Victim was previously the abuser and the abuser was the victim (as a child for example)

Question 8

What factors make carers more likely to commit elder abuse?

Answer 8

Drug/alcohol dependence
mental illness
carer stress
Gambling/financial hardship
Carer previously abused by patient
Forensic history
Domestic violence history
Dependance on the victim

Question 9

What is the earliest sign of delirium on bedside cognitive testing?

Answer 9

• An inability to recall 3 items after 3 minutes

Question 10

What are the complications that the elderly are at risk for with admission to hospital?

Answer 10

Question 11

What is the ACEM definition of palliative care?

Answer 11