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28 Cards in this Set
- Front
- Back
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eldery
old old oldest |
65
75-85 85+ |
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Women comprise ____ of those over the age of 65 and about ____ of those 85 or older
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58%
70% |
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THe longer life expectancy is a result of _______, rather than improved medical care for adults
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Decreased childhood fatalities (larger population of older people increased the mean age)
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Four major areas of declining function in old age
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Cognitive
Frailty Iatrogenesis Nutrition |
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Medicare/Medicaid does NOT reimburse for stay in ____, only ____
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LTC facilities
Nursing Homes |
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Instability refers to
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State of reduced physiological reserves associated with increased chances of disability
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Instability, in general, is due to
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Declining executive function
Visual problems Nutritional Problems |
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Instability d/t nutritional problems include such etiologies as
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MEALS ON WHEELS
M edications E motion (depression) A norexia L ate life paranoia/EtOHism S wallowing disorders O ral factors N o money W andering/dementia-related H yperthyroidism/parathyroid E ntry problems/malabsorption E ating problems L ow salt or low-choles diet S hopping and food prep problems |
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Misc causes of instability include
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Polypharmacy
Balance problems Anemia CHF DM osteoporosis/fx Sarcopenia/m atrophy Decreased endurance Pain |
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ANATOMIC causes of fecal incontinence
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rectal prolapse
previous surgery fistula |
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Muscular causes of fecal incontinence
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fecal impaction
IBD radiation proctitis myasthenia gravis scleroderma |
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NEUROLOGIC causes of fecal incontinence
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stroke
dementia MS spinal cord lesions DM |
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Urinary urge incontinence is the ____ common and is d/t what?
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MOST common
irritability of trigone of the bladder, causing involuntary detrusor contractions |
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Overflow incontinence accounts for ____% of incontinence, and is the ____ serious
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5%
most serious |
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Most common cognitive impairments in the aged are (2)
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Depression
Delirium |
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Delirium in the aged is commonly due to (9)
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DELIRIUMS
D rugs E motional L ow O2 state I nfection R etention (urine or feces) I ctal U nderhydration, undernutrition M etabolic S ubdural |
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Causes of REVERSIBLE dementia include
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Depression
Metabolic toxic rxn Medications Vitamin deficiency |
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Causes of IRREVERSIBLE dementia include
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ALzheimers (most common, 75-80%)
Cerebrovascular Mixed dementia Parkinsons EtOH MS |
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Most common cause of irreversible dementia in the aged
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Alzheimers
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Potential causes of Inanition (malnutrition) in the aged include
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CHronic medical dz
Psych/cognitive dysfunction Rx Restrictive diets Functional and social problems |
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The ten Is include
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Immobility
Inanition Impoverishment Isolation Iatrogenesis Incoherence Insulin resistance Intellectual impairment Incontinence Instability |
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Iatrogenesis can be equated with
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physicians hurting their pts
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Components unique to the health hx of geri pts include
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Rx review
Caregiver status Specialty physicians currently involved in care Functional hx Current utilization of community resources |
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Unique considerations in the geriatric systems review include
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Cognitive impairment
Dental Status Falls Foot dz Gait abrnormalities/adaptive equip Hearing loss Incontinence Nutrition/feeding Osteoporosis Pressure ulcers Psych illness Sexual hx SLeep dz VIsion loss CDFFGHINOPPSSV |
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An additional vital sign "unique" to geris, which is also done in infant visits ...
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O2 sat
Temp PR RR BP sO2 Ht/Wt |
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Labs important for geri pts include
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CBC
Metabolic panel Thyroid function RPR Vitamin B12 Folate |
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51% of deaths d/t ADR are pts 60+, typically caused by
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polypharmacy and inappropriate medication use
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The rules for rational drug therapy in the aged include
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MASTER
M inimize number rx used A lternatives considered S tart low and go slow T itrate therapy E ducate pt R eview regularly |
