Lecture Content (frailty, GCA)

Question 1

Frailty definition

Answer 1

Increased vulnerability resulting from ageing and a decline in the reserve and function of physiological systems. Patients are unable to integrate responses to everyday or acute stressors.

Question 2

Components of geriatric medicine

Answer 2

Frailty
Co-morbidities
Chronic illness
End of life care
Slower responses to treatment
Different patterns and presentations of disease
Rehabilitation

Question 3

Most common presentations in geriatric medicine

Answer 3

Falls
Confusion
Incontinence
'off-legs' (can't walk)
Social admissions
SOB/chest pain

Question 4

Geriatric giants 5Ms

Answer 4

Mind e.g dementia
Mobility e.g. falls/gait
Medications e.g. polypharmacy
Multi-complexity e.g.co-morbidity
Matters most e.g. individual meaningful outcomes.

Question 5

Geriatric giants 4 Is

Answer 5

Immobility
Intellectual impairment
Instability
Incontinence
=Loss of independence!

Question 6

Acopia

Answer 6

Social admissions of geriatric patients - ‘inappropriate admission’
Can’t cope with activities of daily living.
DON’T USE THIS WORD!

Question 7

Geriatric pharmacy

Answer 7

POLY-PHARMACY COMMON
More prone to side effects.
Lack of research and guidelines in elderly.
Reduced organ function (excretion in liver/kidneys?)

Question 8

Deconditioning in the elderly

Answer 8

Physiological change following a period of inactivity, bedrest or sedentary lifestyle.

Question 9

Comprehensive Geriatric Assessment

Answer 9

Inter and multi-disciplinary diagnostic process to determine the medical, psychological and functional capability of someone who is frail and old. Involves medical, functional, psychological and social & environmental assessment.

Question 10

Problems with PEG and artificial nutrition feeding

Answer 10

Risks include bowel perforation, wound infection, peritonitis, aspiration, death. Evidence that artificial nutrition in patients with advanced dementia neither prolongs nor improves quality of life.

Question 11

Lasting power of attorney

Answer 11

2 types - financial and medical. Legal document. Lets patient appoint people (known as ‘attorneys’) to make decisions on your behalf.

Question 12

IMCA (Independent Mental Capacity Advocate)

Answer 12

Safeguards people who lack capacity to make their own serious decisions and have no one else able to represent them.

Question 13

Advance directives

Answer 13

Document made by a person detailing their wishes for health care decisions in the event that, in the future, he/she becomes unable to make those decisions

Question 14

Discharge points

Answer 14

Correct medication
Social - continued social care support, including wishes of family/carers.
Continued health support, GP follow-up and contact information.
Environmental and function - OT and physio input.