Geriatrics Flashcards
Geriatric population
> 65 present with musculoskeletal, cardiopulmonary, integumentary, or neuromuscular conditions and dysfunction
Focus of geriatrics
- patient’s functional goals
- Promoting optimal health
- Restoring and maintaining the patient’s highest level of function and independence
Key factors of geriatrics
- Consider the patient as a whole
2. Involve the patient in all decisions when appropriate
Geriatric exam/assessment
- Patient and caregiver/family interview
- Pain assessment
- Physical assessments dependent on the patient’s pathology
- Psychosocial assessment
- Functional assessment
- Environmental assessment
Psychosocial assessment
- minimental state examination (orientation, attention, recall, and language)
- Montreal cognitive assessment (screen for mild cognitive impairment)
- depression-screening assessment
Functional elements of assessment
- Testing for patient independence in ADLs or functional status
- Testing for mobility, personal care, home chores, and social activities
- Physical function (sensory and motor)
- Mental funciton (intelligence, cognitive, and memory)
- Sensory changes (hearing and vision)
- Social function: interaction with family, community, etc. And economic considerations
- Emotional function: ability to cope with stress and anxiety. Patient’s satisfaction with life
Reimbursement issues
- medicare: 65+ years or disability
- Medicaid: low income or resources
Interventions
- Strengthing
- ROM/stretching
- Manual techniques
- Functional retraining
- Modalities
Goals
- Improving funciton within environment
- Prevention of disability
- Most interventions involve focus on musculoskeletal, neurological, and cardiopulmonary systems
Treatment considerations
Age-related skeletal changes - changes in posture - decreases in muscle endurance and early onset of fatigue - increased reaction time - decreased flexibility - medication use
Commmon geriatric disfunction
Immobility - fractures - falls - co-morbidities - frailty
Immobility
- Compilations in major organ systems
- Pressure sores and contractures
- Loss of bone mass
- Muscle atrophy
- Negative self image
- Depression and/or confusion
- Loss of independence
- Social isolation
Fractures
Associated with age-related changes in skeletal system (low bone density and mass, frailty)
- 30% die 1 year after hip fracture and 75% dont return to previous level of function
Falls
Leading cause of fatal and non-fatal injuries in adults 65+
- preventable and multi-factorial
Interventions for falls
Balance - strengthening - reduce underlying impairments (weakness, decreased ROM)
*increased awareness of stability limits