Geriatrics

Question 1

Hallmark of delirium is inattentiveness

Answer 1

test with:

• counting backwards
• months backwards
• serial 7’s (begin at 100 and start subtracting 7s)

Question 2

Who should be screened for delirium

Answer 2

• At-risk elders

- Everyone above the age of 65

Question 3

Treatment of delirium

Answer 3

• address underlying cause
• reorient
• untether
• antipsychotics as last resort

Question 4

What are elderly patients at risk for after ED or inpatient discharge?

Answer 4

Elderly patients (mean age of 84 years) living in the community who are seen and discharged from the Emergency Department due to illness or injury are at increased risk for further disability and functional decline for at least six months after their visit. This is associated with increased mortality, cost and need for long term care in previously self-functioning individuals.

• When appropriate to discharge from the ED, we should consider discharge planning that includes coordination with care management services to be sure these individuals have adequate home support systems in place and access to close outpatient follow-up.
• It should be noted that the risk is even greater after inpatient hospitalization.