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Geriatric Health

Geriatric Medicine

three important aspects of health assessment history, review of systems, physical exam
seven important history aspects continence, abuse, pain, cognition, relationship, sensory changes, compensation(covering, confabulation)
strategies for taking a history of elderly patient environment (quiet/private), communication, dates, verbal (lower, slower), nonverbal communication, validate and verify, "have we met before", the red pajama question
purpose of PE in elderly patients establish baseline, evaluate new S&S, monitor chronic illness
timed "get up and go" get out of chair, walk 10 feet, turn around, walk 10 feet sit down
timed get up and go of 10 seconds or less low risk of fall
timed get up and go of 11-19 seconds low to moderate of fall
timed get up and go of 20-29 seconds moderate to high of fall
timed get up and go of 30+ seconds high risk of fall
6 strategies of PE of elderly patient slow, prioritize, assess both sides non-tender, sensory function, minimize ups and downs, if not goin to do anything with the findings then don't do it
standardized tools for congnitive assessment MMSE, Clock drawing, fluency testing, parable interpretation, judgment, observation, concerns of others
3 components of functional assessment physical abilities, cognitive abilities, environmental fit
7 activities of daily living (ADL's) eating, bathing, grooming, dressing, walking, transferring, toileting
8 instrumental Activities of Daily Living (IADL's) ability to use the telephone, shopping, food prep, housekeeping, laundry, driving a car, medication management, money management
positive physical approach come from the front, go slow, get to the side, get low, offer you hand, call out the name, wait for response
choosing preventative measures should be guided by __ patients general condition
1/10 people diagnosed with AIDS in the US is older than __ 50
healthy elderly patient minimal or no chronic disease and are functionally independant, primary and secondayr prevention of disease and prevention of frailty are the most beneficial measures for this group. maintianing and preserving function
frail elderly patient severe chronic disease, functionally dependant, loss of physiologic reserve, frequently hospitalized and institutionalized. prevention of accidents and iatrogenic complications
11 primary preventative strategies for older adults influenza vacc, pneumococcal vacc, tetanus vacc, blood pressure, exercise, cholesterol, sodium, social support, environment, seat belts
10 secondary preventative strategies for older adults pap smear, breast exam, self breast exam, mammography, hypothyroidism, depression, vision, hearing, oral cavity, TB
4 tertiary prevention strategies for older adults assessment, foot care, dental care, toileting efforts
What’s a living will? written advance directive; competent person indicates health care preferences; May specify instructions for care in life-prolonging situations; Take effect when pt no longer able to make or express own decisions
What’s appropriate legal palliative care? Interdisciplinary care that aims to relieve suffering and improve quality of living and dying; not hospice care (last 6 mos)
How do you communicate with your terminally-ill patient about their end of life? Name, understand, respect, support, explore; “what do you understand about dz?” Opportunity at end of life to complete unfinished business & to grow
Created by: Adam Barnard Adam Barnard