1. GERIATRICS
General review of what we have learned in this course.
*Information is primarily based from Hartman’s Nursing Assistant Care/Long term
Care textbook, 4th edition.
2. What is Geriatrics?
Geriatrics is the study of health, wellness and disease later in life. Generally
considered age 65 and above.
The Holistic approach
In healthcare the goal is to care for the WHOLE person which includes their
physical, mental as well as spiritual health. Some facilities may focus on this
term/idea more than others.
4. Culture pg 36
A culture is a system of learned beliefs and behaviors that are practiced by a group of
people.
Each culture may have different knowledge, behaviors, beliefs, values, attitudes,
religions and customs.
The term Culture diversity refers to different groups of people with varied backgrounds
and experiences living together in the world.
5. Some terms you should know
● Ombudsman - legal advocate for residents in LTC facilities who help resolve
disputes and settle conflicts many times involving abuse/neglect.
● Fowler’s position -sitting up 45-60 degrees
● Medial - towards the midline of the body, Anterior - referring to the front of the
body
● Elopement - when a resident leaves the facility unsupervised
● Reality Orientation - the use of calendars, clocks, signs and lists to help residents
who and where they are. This is useful in the early stages of AD.
● Sundowning - When a resident gets restless or agitated in the evening and night
hours.
● Incontinence - inability to control the bladder or bowels.
6. Normal Changes With Aging
● Skin is thinner, drier, more fragile, and less elastic, less fatty tissue under the skin.
Bath less frequently.
● Muscles weaken and lose tone.
● Bones lose density and become more brittle. (osteoporosis)
● Digestion takes longer and is less efficient. ( constipation)
● Appetite decreases
● Heart pumps less efficiently
● Oxygen in the blood decreases
● Lung strength and lung capacity decrease, weakend slower voice, Dyspnea with
activity and movement.
● Sensitivity of nerve endings in the skin decrease, responses & reflexes are slow,
senses of vision, hearing, taste, touch and smell weaken.
7. Normal Changes With Aging
● Short term memory loss occurs.
● Urinary elimination is more frequent.
● Levels of hormones decrease
● Immunity weakens
● Sleep patterns may be impaired, possible insomnia due to changes in the brain.
8. Changes That Are NOT Normal
● Signs of depression
● Suicidal thoughts
● Loss of ability to think logically, dementia
● Poor nutrition
● Shortness of breath
● Incontinence
9. Cancer
Cancer is a general term used to describe a disease in which abnormal cells
grow in an uncontrolled way.
● Tumor- a cluster of abnormally growing cells
● Benign tumors - are considered non-cancerous
● Malignant - are cancerous
10. Causes of Cancer
● Genetic factors
● Tobacco use
● Alcohol use
● Poor diet/obesity
● Lack of physical activity
● Certain infections
● Environmental exposure
● Sun exposure
11. Warning Signs of Cancer
● Unexplained wt loss
● Fever
● Fatigue
● Pain
● Skin changes
● Changes in bowel or bladder function
● Sores that do not heal
● Unusual bleeding or discharge
● Thickening or lump in the breast, testicle
or other parts of the body
● Indigestion or difficulty swallowing
● Nagging cough or hoarseness
● New mole or recent change in
appearance of a mole, wart or spot.
12. Mental Healthpg 372
Mental health is the normal functioning of emotional and intellectual abilities. A person
who is mentally healthy is able to:
● Get along with others
● Adapt to change
● Care for self & others
● Give and accept love
● Deal with situations that cause anxiety, disappointment, and frustration.
● Take responsibility for decisions, feelings, and actions
● Control and fulfill desires and impulses appropriately
13. Depression pg 375
Depression is a mood disorder. Depression is characterized by the loss of interest in
everything a person once cared about, and may interfere with the person’s ability to
work, eat, and eat.
Depression may cause intense mental, emotional and physical pain and disability.
Depression also makes other illnesses worse.
The best thing you can do as a CNA is LISTEN to your patients as they express their
feelings and report any suicidal ideation.
14. Disorientation pg 82
Disorientation means confusion about person, place, or time.
If a person is A/O (alert & oriented) x3, it means they are awake and responsive, alert
and oriented to person, place, and time. They should be able to answer the following
questions.
Who are you?
Where are you?
What is the date, year, and/or season?
Who is the current president of the United States of America?
15. Confusion pg 354
Confusion is the inability to think clearly and logically. A confused person may have
trouble concentrating and may feel disoriented. Some common causes of confusion
are:
● UTI, infections in general
● Low blood sugar
● Head trauma or head injury, brain tumor
● Dehydration, Nutritional problems
● Medications
● Lack of O2
16. Dementia pg 355
Dementia is a general term that refers to a SERIOUS loss of mental abilities such as
thinking, remembering, reasoning and communicating
The 7 most common forms of dementia
Alzheimer’s disease, Vascular dementia, Lewy bodies, Parkinson’s disease,
Frontotemporal (affects front & sides of brain) dementia, CJD, Wernicke-Korsakoff
syndrome
17. Alzheimer’s pg 357
Alzheimer’s is a progressive, degenerative, and irreversible disease. It has no cure and
can only be diagnosed with an autopsy.
1/10 people age 65 and older has AD.
What are the stages of AD?
Residents with AD are at greater risk for accidents, injury, and elopement.
18. Disruptive Behavior
● Disruptive behavior is anything that interferes with the normal routine, any
disturbing behavior.
● Inappropriate sexual behavior - the CNA should calmly tell the resident to stop and
immediately report the behavior to the nurse.
● If a resident is confused and angry never attempt to restrain them, this will escalate
the situation.
Do not overreact to any negative behaviors because this may reinforce the
behavior.
