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8/13/2019 geriatric-121003104217-phpapp02

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Demographics of the Elderly

The Aging Process

Assessment & Management of theElderly Patient.

Topics


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The Elderly...

Are one of the fastest growingsegments of our population.

Are persons age 65 or older.

And their growing numberpresents a challenge to all healthcare proiders.


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The Facts

The mean surial rate of olderpersons is increasing.

The birth rate is declining.

There has been an absence of ma!orwars or other catastrophes.

"ealth care and liing standards hae

improed significantly since ##$$. %y '(') *' million people will be 65 or

older.


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Societal Issues

Elderly persons liing alone representone of the most impoerished andulnerable parts of society.

,actors include liing enironments)poerty) loneliness) social support.

A deterioration of independence is notineitable and not necessarily a

function of aging. $t may well be a signof a heretofore untreated illness.


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Older active adult


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Senior volunteer

programs


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Ethics

$n the course of caring for elderlypatients) ethical concerns

fre-uently arise. ou may beconfronted with/ Multiple decision+ma0ers

1uestions about a patient2scompetency

Adanced directies) or D34s


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,inancing & 4esources

for "ealth are

Medicare

Medicaid

eterans Administration


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VA hospitals providea variety of services.


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In treating the elderly,

rememer that theest intervention is

prevention.


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"eals on #heels provide$%& meals a day


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Free screening programsfor the elderly


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General

!athophysiology,Assessment, and

"anagement


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!athophysiology

The body becomes less efficientwith age.

The elderly often suffer from more

than one illness or disease at atime.

The e7istence of multiple chronic

diseases in the elderly often leadsto the use of multiplemedications.


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,actors that may decrease

compliance in the elderly/ 8imited income

Memory loss

8imited mobility

9ensory impairment

,ear of to7icity hild+proof containers

Duration of drug therapy


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,actors that may increase

compliance in the elderly/ :ood patient+physician communication

%elief that a disease or illness is

serious Drug calendars

ompliance counseling

%lister pac0aging

Pill bo7es Transportation serices to the

pharmacy

Ability to read


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'lister(pac)s are easierfor the elderly.


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Falls

Present an especially seriousproblem.

4epresent the leading cause ofaccidental death among theelderly.

May be intrinsic or e7trinsic. The elderly should be encouraged

to ma0e their homes safe.


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*ome safety for the

elderly


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+ommunications

3ormal physiological changesmay include impaired ision)impaired or loss of hearing) an

altered sense of taste or smell)and;or a lower sensitiity totouch.

Any of these conditions can affectyour ability to communicate with

the patient.


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Sensory changes in the

elderly


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!rolems #ithincontinence elimination are

common in the elderly.


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,actors in ,orming a

:eneral Assessment

8iing situation

8eel of actiity 3etwor0 of social support

8eel of independence

Medication history

9leep patterns


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Try to distinguish the

patient-s chiefcomplaint from the

primary prolem.


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+ommunication+hallenges


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+ataracts diminish

eyesight


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Tal) directly to the

elderly,if possile.


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Spea) into astethoscope #ith the

hearing(impaired.


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+hange in altered mentalstatus can denote serious

underlying prolems.


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+hanges in the ody systemsof the elderly


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+ommon age(relatedsystemic changes


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+ommon "edical!rolems

in the Elderly


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espiratory

/isorders Pneumonia


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espiratory and cardiacprolems can cause

dyspnea.


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+ardiovascular

/isorders Angina pectoris Myocardial infarction

"eart failure Dysrhythmias

Aortic dissection;aneurysm

"ypertension

9yncope


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0eurological

/isorders erebroascular disease >stro0e?

9ei=ures

Di==iness;ertigo

Par0inson2s disease

Delirium) dementia) Al=heimer2s


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GI /isorders

:$ hemorrhage @pper :$ bleed

8ower :$ bleed

%owel obstruction

Mesenteric infarct


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S)in /isorders

90in diseases Pruritus

"erpes =oster

Pressure ulcers >decubitus ulcers?


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"usculos)eletal

/isorders


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Stretching and #eight(earinge1ercises help prevent

osteoporosis.


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enal /isorders

:lomerulonephritis


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2rinary /isorders

@rinary tract infections @rosepsis


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Environmental

Emergencies

"ypothermia "yperthermia


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To1icological

Emergencies 8idocaine %eta+bloc0ers

Antihypertensies;diuretics

AE inhibitors Digitalis >digo7in) 8ano7in?

Antipsychotropics

Par0inson2s disease medications Analgesics

orticosteroids

S


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Sustance Ause

,actors that contribute to substanceabuse in the elderly include/

Age+related changes

Employment loss 8oss of spouse

Multiple prescriptions

Malnutrition

8oneliness Moing to an apartment;care home


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'ehavioral3!sychological /isorders

9ome of the common classificationsof psychological disorders related

to age include/


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Trauma in theElderly


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Trauma is the leading cause of death inthe elderly.

,actors include/


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Assessment

4emember that blood pressure andpulse readings can be deceptieindicators of hypoperfusion.

8eading causes of trauma in the elderlyinclude falls) motor ehicle crashes)burns) assault) and syncope.


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Serious head in4uriessometimes denote geriatric

ause.


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"any states have la#s that re5uire"S personnel to report suspected case

of Geriatric ause and3or neglect.

G l


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General

"anagement#hen caring for elderly patients)consider the arious changes andunderlying conditions which may

affect your care) such as/ ardioascular considerations

4espiratory considerations

4enal considerations

T t


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Transport

+onsiderations


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"odifications in positioning,immoili6ation, and pac)aging may e

necessary in the elderly patient.

S ifi I 4 i


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Specific In4uries


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S i l f l )


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Sucapital femoral nec)fracture


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