Intro. to Geriatrics Flashcards
T/F: Old age or being a geriatric is defined as 60 years and over.
False; 65 years old!
When does medical care dramatically rise amongst all age groups? (Hint it’s in the geriatric range)
75 years old
T/F: Women outlive men
True
By 2050, the percent of white elders will ______ by 20% and Asians & Hispanic percent rate will _______ by 300%.
Drop; Increase
As we get older, we get obese and unhealthy. Womp womp womp. Why?
We are overfed and undernourished!
The percentage of income that Social Security provides differs from total income depending upon income level.
And in modern times, less elders are in the low-income/poverty level. And the high income groups have increased.
T/F: Better healthcare is extending lives
False! This change is due to changes in public health.
- Cleaner Water
- Better nutrition
- Less poverty
- Improved Prenatal Care
- Childhood Immunizations
- Smoking Less
- Safety Measures
On a very basic level, what is the cause of human aging?
Disruption of homeostasis
Factors of aging:
- Gender
- Genetics
- Lifestyle
Common causes of death since the 1940s
- CVD
- CA
- CVA
- DM
Common Sensory Impairments due to Aging
- Presbycusis (50%)
- Presbyopia (20%)
- Memory Impairment (10%)
- No natural teeth (33%)
Common Geriatric Syndromes
- Falls
- Urinary Incontinence
- Confusion
- Immobility
- Sleep Disorders
- Fatigue
- Weight Loss
T/F: Generally, minority group members die later in life from preventable causes
False; They die earlier
Goal of geriatrics:
Older adults will maintain full function and live active lives in their homes and communities
Two foundations of Geriatric Medicine
- Ethical Decision Making (can vs. should)
2. Patient-Centered Care
What to consider with Patient-Centered Care? (FIFE)
F- Feelings (hopes and fears)
I- Ideas about what’s going on
F- Function (How is the illness affecting their life?)
E- Expectations
When assessing the older adult, what should we focus on?
***Healthy or successful aging – Quality of Life
- Understand and mobilize family, social, and community supports
- Important of skill directed to functional assessment
- Opportunities for promoting older adult’s long-term health and safety
Geriatric/Aging Changes of Blood Pressure
Widened Pulse Pressure
Geriatric/Aging Changes of Heart Rate and Rhythm
Rhythms Change in multiple ways!
Maximum Rate decreased!
Geriatric/Aging Changes of Respiratory Rate and Temperature
RR Unchanged
Basal Temp lowered
Geriatric/Aging Changes of Integumentary System
- Think Skin
- Grey Hair
- Thick Nails
- Sun Damage starts catching up
Geriatric/Aging Changes of Eyes
- Increased incidence of degenerative diseases
- Presbyopia
Geriatric/Aging Changes of Ears
- Presbycusis
Geriatric/Aging Changes of Thorax and Resp System
- Increased Chest Wall Stiffness
- Osteoporosis and Kyphosis can reduce the thoracic capacity
- Osteoporosis, kyphosis, and alveolar stiffness leads to “senile emphysema” with FEV1/FVC < 70% of the predicted for age and gender.
Respiratory Problems are associated with all cause mortality and specifically with:
- CVD
- COPD
- Lung Cancer
Geriatric/Aging Changes of the CV System
- Reduced Cardiac Output
- Increased BP
- Increased Peripheral Vascular Resistance
Geriatric/Aging Changes of Male and Female Genitalia
- Female: Menopause between aged 48-55
- Male: ED - common after 4th decade – important marker for CVD
- Prostate: BPH
Geriatric/Aging Changes of MSK
- Loss of height
- Loss of Muscle Mass
- Osteoarthritis
- Osteoporosis
- Increased risk for fracture
Geriatric/Aging Changes of Neuro
- Neuronal loss is normal in the aging brain but ability to learn remains generally unchanged
- Recall memory declines
- Increased incidence of dementias
Geriatric/Aging Changes of Renal System
- Decreased renal mass and size
- Mostly loss of renal cortex - 40% less glomeruli by age 80
- Reduced Renal Blood Flow (dec 10% reduction per decade after 20)
- Less Urine Concentration
Geriatric/Aging Changes of GI
- Decreased Global Functions (secretion/absorption)
Geriatric/Aging Changes of Endocrine
- Hypothyroidism
- DM has an increased incidence
- Vitamin D absorption - Parathyroid Issues
- Androgen/Estrogen lessens
Geriatric/Aging Changes of Immune System
- Global Decrease in immune function and response to antigens
Things to think about when treating the elderly
- They can undergo most surgeries that younger patients can
- Treat infections AGGRESSIVELY
- Mental Status Changes, you should think urgent/emergent disease
ADLs
- Bathing
- Dressing
- Toileting
- Transferring
- Continence
- Feeding
IADLs
- Using Telephone
- Shopping
- Preparing Food
- Housekeeping
- Laundry
- Transportation
- Taking Medications
Health Promotions and Counseling
- Encourage regular health screening exams
- Assess vision and hearing
- Encourage immunizations (flu- annually, pneumococcal single does)
- Encourage household safety
- Encourage cancer screening
- Assess for depression
- Assess for dementia and mild cognitive impairment
- Assess for elder mistreatment
Things older patients should do, that you should advocate for with every visit:
- Exercise! Some is better than none! We need to maintain maximal muscle mass
- Maintain Careful Hydration
- Maintain Nutritional Status
- Avoid excess weight gain, but protect weight loss unless morbidly obese.
A drop in LDL, TG, and/or albumin are red flags for?
Senescence and decline
