Geriatric Medicine
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| three important aspects of health assessment | history, review of systems, physical exam
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| seven important history aspects | continence, abuse, pain, cognition, relationship, sensory changes, compensation(covering, confabulation)
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| 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
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| purpose of PE in elderly patients | establish baseline, evaluate new S&S, monitor chronic illness
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| timed "get up and go" | get out of chair, walk 10 feet, turn around, walk 10 feet sit down
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| timed get up and go of 10 seconds or less | low risk of fall
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| timed get up and go of 11-19 seconds | low to moderate of fall
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| timed get up and go of 20-29 seconds | moderate to high of fall
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| timed get up and go of 30+ seconds | high risk of fall
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| 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
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| standardized tools for congnitive assessment | MMSE, Clock drawing, fluency testing, parable interpretation, judgment, observation, concerns of others
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| 3 components of functional assessment | physical abilities, cognitive abilities, environmental fit
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| 7 activities of daily living (ADL's) | eating, bathing, grooming, dressing, walking, transferring, toileting
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| 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
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| 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
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| choosing preventative measures should be guided by __ | patients general condition
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| 1/10 people diagnosed with AIDS in the US is older than __ | 50
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| 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
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| frail elderly patient | severe chronic disease, functionally dependant, loss of physiologic reserve, frequently hospitalized and institutionalized. prevention of accidents and iatrogenic complications
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| 11 primary preventative strategies for older adults | influenza vacc, pneumococcal vacc, tetanus vacc, blood pressure, exercise, cholesterol, sodium, social support, environment, seat belts
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| 10 secondary preventative strategies for older adults | pap smear, breast exam, self breast exam, mammography, hypothyroidism, depression, vision, hearing, oral cavity, TB
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| 4 tertiary prevention strategies for older adults | assessment, foot care, dental care, toileting efforts
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| 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
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| 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)
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| 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
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Created by:
Abarnard
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