Geriatrics - frailty and comprehensive assessment

Question 1

define frailty

Answer 1

A susceptibility state that leads to a person being more likely to lose function in the face of a given environmental challenge.

Question 2

name the theories of aging

Answer 2

Stochastic, programmed, homeostatic failure

Question 3

what happens to inter-induvidual variability with age?

Answer 3

Increases

Question 4

what is dyshomeostasis

Answer 4

frailty, impaired function of any organ system, inability to maintain a steady state.

Question 5

name the 4 decompensated frailty syndromes

Answer 5

falls, delerium, immobility and incontinence, functional loss

Question 6

what are the effects of aging on heat stress?

Answer 6

reduced sweat gland oiutput, skin blood flow, smaller increase in cardiac output, less redistribution of blood flow from renal and splanchnic circulation.

Question 7

”” cold stress

Answer 7

reduced peripheral vasoconstriction and metabolic heat production

Question 8

what is social dyshomeostasis and give and eg

Answer 8

difficulty caused by environmental insults not just bio-medical (e.g. death of a spouse)

Question 9

how does hyperthyroidism preset I people with frailty?

Answer 9

depression, cognitive impairment, ,nuscle weakness, atrial fibrillation, heart failures, angina.

Question 10

withh age what happens to - body composition (ALSO thinnk about what happens to other systems

Answer 10

more fat, cenntral fat, reduced total body water, reduced bone mass, reduced energy requirement, reduced muscle mass

Question 11

what is susceptibility state composed of?

Answer 11

multimorbidity, frailty, disability

Question 12

frailty phenotype as defined by Fried…

Answer 12

unintentional wieght loss, exaustion, weak grip strength, slow walking speed, low phhysicl activity. (need 3/5 of the criteria)

Question 13

what are the failty syndromes?

Answer 13

falls, immobility, delerium, fucntional loss ALSO care home, list of 6 or more medicines (composes the HIS frailty - if this person would benefit from a comprehensive geriatric assessment)

Question 14

define a person centred/ goal-centred approach

Answer 14

Means we do what the patient wants (not what the doctor wants)Preserves autonomy. Is an effective way of dealing with multimorbidity and competing clinical priorities.

Question 15

iatrogenic harm…

Answer 15

harm done by doctors/ healthcare professionals through admisteration of drugs.

Question 16

what composes good geriatric care?

Answer 16

early identification of need, early comprehensive geriatric assessment, early provision of appropriate level of care for needs.

Question 17

What compoeses a CGA (which health domains and professions)?

Answer 17

Medical, spiritual, psychological, functional, behhavioural, nutritional, environmental, social, societal. Multidimensional, multidisciplinary assessment.
Produce a plan to try and make the patient feel better
geriatrician, OT, PT, nurses,m GP, social workers, homecare, dietitian, SALT.

Question 18

whata re risks vs bennefits of the hospital?

Answer 18

disorientation, dependency, deconditioning, iatrogenic harm, hhospital acquired infection/ clincial expertise, tests and Ix, rapid access to care and support.