Topics Demographics of the Elderly The Aging Process Assessment & Management of the Elderly Patient.
The Elderly... Are one of the fastest growing segments of our population. Are persons age 65 or older. And their growing number presents a challenge to all health care providers.
The Facts The mean survival rate of older persons is increasing. The birth rate is declining. There has been an absence of major wars or other catastrophes. Health care and living standards have improved significantly since WWII. By 2030, 70 million people will be 65 or older.
Gerontology is the scientific study of the effects of aging and age-related diseases on humans. Geriatrics is the study and treatment of diseases of the aged.
Societal Issues Elderly persons living alone represent one of the most impoverished and vulnerable parts of society. Factors include living environments, poverty, loneliness, social support. A deterioration of independence is not inevitable and not necessarily a function of aging. It may well be a sign of a heretofore untreated illness.
Ethics In the course of caring for elderly patients, ethical concerns frequently arise. You may be confronted with: Multiple decision-makers Questions about a patient’s competency Advanced directives, or DNRs
Financing & Resources for Health Care Medicare Medicaid Veterans Administration
General Pathophysiology, Assessment, and Management
Pathophysiology The body becomes less efficient with age. The elderly often suffer from more than one illness or disease at a time. The existence of multiple chronic diseases in the elderly often leads to the use of multiple medications.
Factors that may decrease compliance in the elderly: Limited income Memory loss Limited mobility Sensory impairment Fear of toxicity Child-proof containers Duration of drug therapy
Factors that may increase compliance in the elderly: Good patient-physician communication Belief that a disease or illness is serious Drug calendars Compliance counseling Blister packaging Pill boxes Transportation services to the pharmacy Ability to read Clear simple directions
Falls Present an especially serious problem. Represent the leading cause of accidental death among the elderly. May be intrinsic or extrinsic. The elderly should be encouraged to make their homes safe.
Communications Normal physiological changes may include impaired vision, impaired or loss of hearing, an altered sense of taste or smell, and/or a lower sensitivity to touch. Any of these conditions can affect your ability to communicate with the patient.
Speak into a stethoscope with the hearing-impaired.
Change in altered mental status candenote serious underlying problems.
Only experience and practice will allow you to distinguish acute from chronic physical findings in the elderly patient. When caring for the elderly: Encourage patients to express their feelings. DO NOT trivialize their fears. Avoid questions. Confirm what the patient says. Recall all that you have learned about communicating with the elderly. Assure patients that you understand that they are adults.
Substance AbuseFactors that contribute to substance abuse in the elderly include: Age-related changes Employment loss Loss of spouse Multiple prescriptions Malnutrition Loneliness Moving to an apartment/care home
Behavioral/Psychological DisordersSome of the common classifications of psychological disorders related to age include: Organic brain syndrome Depression Dependent personality Paranoid disorders
Trauma is the leading cause of death in the elderly. Factors include: Osteoporosis Reduced cardiac reserve Decreased respiratory function Impaired renal function Decreased elasticity in the peripheral blood vessels
Assessment Remember that blood pressure and pulse readings can be deceptive indicators of hypoperfusion. Leading causes of trauma in the elderly include falls, motor vehicle crashes, burns, assault, and syncope. Observe the scene for signs of abuse and neglect.
Serious head injuries sometimes denote geriatric abuse.
Many states have laws that requireEMS personnel to report suspected cases of Geriatric abuse and/or neglect.
General ManagementWhen caring for elderly patients,consider the various changes andunderlying conditions which may affectyour care, such as: Cardiovascular considerations Respiratory considerations Renal considerations
BurnsPeople age 60 and older are more likelyto suffer death from burns than any othergroup except neonates and infants.Factors include: Slower reaction time Pre-existing diseases Age-related skin changes Immunological/metabolic changes Reductions in physiological function
Summary Demographics of the Elderly The Aging Process Assessment & Management of the Elderly Patient