Older Persons Flashcards
CGA
comprehensive geriatric assessment
CGA considerations
functional status co-morbidities cognition nutrition poly-pharmacy social support + mental status
CGA cycle
assessment > problem list > goal identification > care plan > interventions > regular planned r/v
CFS
Clinical frailty scale
CFS 1
very fit
CFS 2
well
CFS 3
managing well
CFS 4
vulnerable
CFS 5
mild frailty
CFS 6
moderate frail
CFS 7
severely frail
CFS of robust, active, energetic
and motivated individual
exercise often and among fittest in age range
1 very fit
CFS of individual with no active disease
symptoms
exercise very occasionally
2 well
CFS of people whose medical problems
are well controlled, but are not regularly active
beyond routine walking
3 managing well
CFS of individual not dependent on others for
daily help, often symptoms limit activities
“slow” / “tiredness” often
4 vulnerable
CFS of individual with more
evident slowing, and need help in high order IADLs
impaired shopping, meal prep, housework, walking outside alone
5 mildly frail
CFS of individual who needs help with all
outside activities and with keeping house
eg. bathing / stairs
6 moderately frail
CFS of individual completely dependent for
personal care
not at risk of dying, stable condition
7 severely frail
CFS of individual completely dependent
approaching end of life
typically wouldn’t recover from minor illness
8 very severely frail
CFS of individual approaching end of life
not otherwise evidently frail
<6 months life expectancy
9 terminally ill
four factors of assessing capacity
- understand information relevant to decision
- retain information
- use information to make a decision
- communicate a decision
CFS 8
very severely frail
CFS 9
terminally ill
what common medications can cause constipation
opiates
common causes of constipation in older people
poor mobility poor oral intake hypercalcemia hypokalemia hypomagnesia hypothyroidism mechanical obstrcution IBD neurological dysfunction
management of constipation
IV fluid resuscitation OT referral assess psychological status PR enema soft stool: enema hard stool: stimulant laxatives / bulk forming / faecal softener
side effects of anticholinergics
hot as a hare (increased body temp) dry as a bone (dry eyes, dry mouth, decreased sweat, UR) blind as a bat (dilated pupils) red as a beet (flushing) mad as a hatter (delirium)
common anticholinergics
antipsychotics, benztropine, atropine and antihistamines
overactive bladder pharmacological treatment
antimuscarinics
mirabegron
desmopressin (nocturia)
