GERIATRICS!#Logan

• ger·i·at·ric

• ˌjerēˈatrik/

• adjective

1. of or relating to old people, especially with regard to their health care.

• noun

1. an old person, especially one receiving special care

OVERVIEW

• Describe six physiological changes that occur with aging.

• Describe effective methods for communicating with geriatric patients.

• Describe the effects of the following illnesses and diseases on geriatric patients: • Cardiovascular and respiratory disease; • Neurological diseases; • Gastrointestinal diseases;• Altered mental status.

• Describe four trauma considerations that are unique to geriatric patients.

• Describe the general management of geriatric patients.

• Describe how to manage a geriatric patient with advanced directives.

SEVEN PHYSIOLOGICAL CHANGES THAT OCCUR WITH AGING

1. Sagging, stooping, drooping, not pooping

2. Neurological: brain changes, AMS and clinical depression common

3. Cardiovascular: Hypertension, changes in <3 rate and rhythm

4. Gastrointestinal: constipation, impaired swallowing, liver inefficiency

5. Musculoskeletal: Osteoporosis, arthritis common

6. Respiratory: cough power diminished, increased tendency for infection

7. Skin: Perspire less, tears easily, heals more slowly

EFFECTS OF THE FOLLOWING ILLNESSES AND DISEASES ON GERIATRIC PATIENTS:

• Cardiovascular and respiratory disease: hypertension, myocardial infarction, congestive heart failure.

• Neurological diseases: syncope, stroke.

• Gastrointestinal disease: abdominal emergencies, aneurysm, bowel obstruction, GI bleeding, peritonitis.

• Altered mental status: caused by infection, head injury, stroke, transient ischemic attack (TIA), and hypoglycemia.

MEDICATIONS

• SAMPLE

• Beta-blockers

• Calcium-channel blockers

• Diuretics

• Blood thinners

FOUR TRAUMA CONSIDERATIONS THAT ARE UNIQUE TO GERIATRIC PATIENTS

1. Falls: very common MOI (also slips, trips, stumbles, tumbles and eating sh*t)

2. Hip and pelvic fractures: often related to osteoporosis, significant associated bleeding common

3. Traumatic brain injury: concussions much more common, but often symptoms are hidden, so pay attention to LOR

4. Cervical spine injury: fracture patterns in the spine in seniors and especially C1-C2 injuries common, especially associated with head trauma

EFFECTIVE METHODS FOR COMMUNICATING WITH GERIATRIC

PATIENTS• Speak loudly and clearly

• Relate to them – topical suggestions?

• Avoid demeaning nicknames

• Be understanding, patient, normal

GENERAL MANAGEMENT OF GERIATRIC PATIENTS

Geriatric patients are typically more challenging to manage than younger patients because:

• Medical histories

• Use of multiple medications

• Age-related physiological changes

• General fragility and occasionally poor attitude

Also:

• delays in treatment may cause their condition to worsen more than would be expected for younger patients. As a result, geriatric patients often require more aggressive treatment to mitigate complications related to poor cardiac output, respiratory distress, blood loss, and/or shock.

QUESTIONS?