Three Basics in Geriatrics

Every nurse needs competencies in geriatrics. 85% of hospitalized patients are

elderly.

With aging, stomach absorption, metabolism and

liver and kidney function all change. Most seniors require increasingly lower doses of

medications as they age. They fail to clear medications before the next dose, so doses accumulate. Some take 20 or more prescriptions.

First reaction to a symptom is to call a doctor to add meds. But often medications are the problem.

Especially those on Beer’s List http://

www.americangeriatrics.org/files/documents/beers/PrintableBeersPocketCard.pdf

Too Many Medications and Too Many Reactions

Consider reducing doses and numbers of meds.

Too Many Medications and Too Many Reactions

Dementia with

Delirium Be alert to subtle changes in

mental status Learn to tell when delirium

superimposes onto dementia “Yes, he is very forgetful, but

this is much worse.” Hospitalization = stress Been abducted by aliens Look at new meds, an

infection brewing, mild fluid overload

Simulation helps students learn to recognize delirium being imposed onto Alzheimer’s dementia

NP Kim, Vanderbilt, helps us sort out their feelings and

ours There as many ways to die as there are to live We all have really different end-of-life wishes—advanced

directives Some want any intervention possible regardless of their

condition or prognosis Others define a threshold at which they no longer consider

life worth living.

End of Life

Everything Possible Done// Comfortable Interventions Only// I’m Done

End of life wishes—

clearly point out exactly what that threshold means for each individual

A person’s resting place is hallowed ground, venerated. It is an honor to be there. It is greater than you.

End of Life

Expertinfantry, Final plays of Taps for former Sergeant Major of Army, uploaded 1/28/09 via Flickr, Attribution 20 generic