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4 Cards in this Set
- Front
- Back
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What are the geriatric giants? (5)
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1. Frailty
2. Delerium and Dementia 3. Falls 4. Medication Issues 5. Incontinence |
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Frailty:Two Models, Phenotype of Frailty Definition, Clinical Frailty Score, Comprehensive Geriatric Assessment
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1. Two Models: Phenotype of Frailty, Cumulative Co-morbidity Theory
2. Phenotype of Frailty Definition: 3+ of unintentional weight loss, muscle weakness, slow walking speed, feeling exhausted, low physical activity (predicts falls, mobility/functional decline, hospitalization, death) 3. Clinical Frailty Score: very fit>well>well with comorbidity>apparently vulnerable>mildly frail (limited dependance for IADLs)>moderately frail (help with IADL and ADL)>severely frail(completely dependent) (predicts survival and institutionalization) 4. Comprehensive Geriatric Assessment: multidimensional assessment (physical health, functional ability, cognitive/mental health, socio-environmental situation) by interprofessional team (improves quality of care/QOL/functional ability and decreases hospitalization |
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Delerium: Confusion Assessment Method of diagnosis, Pathophysiology, Predisposing Factors, Precipitating Factors, Prevention, Management, Indications for Pharmacotherapy
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1. Confusion Assessment Method: acute and fluctuating change in mental status+inattention+(disorganized thinking or altered LOC)
2. Pathophysiology: cholinergic failure hypothesis, dopamine excess, stress response, inflammation 3. Predisposing Factors: advanced age, underlying dementia, CNS disease, functional impairment, multiple comorbidities, multiple medications, impaired vision/hearing 4. Precipitating Factors: CVA/TIA, pneumonia/PE, MI/ischemia/arrhythmia, urinary retention/UTI/constipation, pain, intravascular volume/electrolyte disturbance, medications/withdrawal 5. Prevention: orientation, sleep, early mobilization, vision, hearing, hydration 6. Management: identify and treat underlying cause, conservative strategies (prevention), pharmacotherapy starting at low dose (Haloperidol, Resperidone, Olanzapine) 7. Indications for Pharmacotherapy: treat to self/others, unable to maintain necessary medical treatment, patient suffering |
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Falls: Epidemiology, Definition, Mechanics of Fall, Risk Factors, History, Assessment, Prevention, Reduce Risk of Injury
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1. Epidemiology: 1/3 of seniors in community
2. Definition: coming to rest inadvertently on ground or at a lower level 3. Mechanics: perturbation (mechanical/informational), failure to compensate 4. Risk Factors: muscle weakness, history of falls, gait/balance problem, visual deficit, impaired ADL, cognitive impairment, psychotropic drugs 5. History: symptoms, previous falls, location, activity, time, trauma (SPLATT) 6. Assessment: intrinsic factors (3P's)-> pathologic cause (neurological, cardiac, resp, etc), physiological (vision, hearing, proprioception, etc), psychological sequelae (fear of falling) OR extrinsic factors->homesafety 7. Prevention: multidisciplinary approach (27% reduction), Vitamin D (19% reduction) 8. Reduce Risk of Injury: treat osteoporosis, hip protectors |
