Module 10: Geriatrics Flashcards
How many old people are there in the US?
37 Million, expected to reach 86 million by 2050.
What is the expected life span for men and women?
Men: 74 years old
Women: 79 years old
What is the “demographic imperative”?
To maximize not only the life span but also the “health span”. Just as long as it isn’t c-span
What does frailty have to do with older people?
NOTHING…it’s a common myth about aging.
What is primary aging?
Changes in physiologic reserves over time that are independent of and not induced by any disease. Emerge during periods of stress, fluctuating temperatures, dehydration, and shock.
What impairs an older person’s response to heat?
Decreased cutaneous vasoconstriction and sweat production.
What is optimal aging?
It occurs in those people who escape debilitating disease entirely and maintain healthy lives late into their 80’s and 90’s. Genes have to do with 20% of it and healthy lifestyle 20-30% of it.
What happens with BP as you age?
Systolic BP tends to rise from childhood through adulthood. The arteries stiffen from atherosclerosis. The aorta becomes less distensible, a given stroke col. causes a greater rise in SBP. Systolic hypertension with a widen pulse pressure often occurs. Diastolic BP stops rising at approx. the 6th decade . Orthostatic Hypotension can occur.
Does an old person’s resting heart rate change?
No BUT pacemaker cells decline in the SA node and so does maximal heat rate.
What about respiratory rate?
No change.
What happens with your skin?
Wrinkles and looses turgor. Since the vascularity of the dermis decreases, your skin becomes pale and more opaque. You can develop purple patches/macules called actinic purpura, that fade over time. These spots coe from leaky, weakly supported capillaries.
Nails?
Loose luster and yellow and thicken.
Hair? I am starting to get depressed here and feel like I need a facelift.
Hair looses pigment, hair loss is genetically determined though! A man’s hairline may start to recede at temples and loss at vertex follows. Scalp hairs decrease in both sexes and diameter of hair decreases.
Hair on the rest of the body?
We start to lose hair on the trunk, pubic areas, axillae, and limbs.
What are some changes in the eyes/head?
- Atrophy of fat around eyes.
- Eyelids wrinkle
- Fewer lacrimal secretions sooo… c/o dry eyes.
- Corneas lose some of their luster.
- Pupils decrease and can become irregular.
What happens to visual acuity?
- Stays constant for 20-50 years.
- Most elderly maintain good vision.
- Near vision blurs
- Lens loses its elasticity and the eye can’t accommodate and focus on nearby objects
What is presbyopia?
Lens loses its ability to focus.
What increases with age?
-Risk for cataracts, glaucoma, and macular degeneration.
How many people does elder abuse affect in the US?
1.2 MILLION. Only 1 in 10 cases are reported.
What is EAI?
Elder Assessment Instrument is a 41 item Likert scale. It is made up of seven sections that reviews signs, symptoms and subjective complaints of elder abuse, neglect, exploitation and abandonment.
When should you report elder abuse to social services?
- If there is any evidence of mistreatment without sufficient clinical explanation.
- Whenever there is a subjective complaint by the elder of EM.
- Whenever the clinician believes there is a high risk or probable abuse, neglect, exploitation, abandonment.
What are the strengths of the EAI?
-Its rapid assessment capacity (the instrument takes approximately 12-15 minutes) and the way that it sensitizes the clinician to screening for elder mistreatment.
What are the weaknesses of the EAI?
No scoring system and weak specificity.
Are geriatric patient’s sexually active?
YEP!! Don’t assume they are not!
Does sexual interaction necessarily mean sexual intercourse?
NOPE.. Those dentures come out for a reason! ;-)
Who often initiates sex?
Elderly women.
The female sexual response consists in what three phases?
Arousal, orgasm, and resolution.
What happens during sexual arousal in women?
Vasocongestion of the genitals. The clitoris and labia minora become engorged with blood and vaginal and clitoral length and diameter increase.
How long is a woman’s libido maintained?
Until quite late in the aging process.
What happens with aging in women?
- delayed or diminished vaginal lubrication and vasocongestion
- diminished frequency of contraction of the vagin
- decreased frequency of orgasm
T or F: It is not certain if estrogen replacement therapy improves sexual function in women.
True.
