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  1. 1. Geriatrics -PTA responsibilities PTA 100 Troy Metzinger 11/3/2009 1
  2. 2. Objectives • Define geriatrics • History of geriatrics • Differences between adult and geriatric medicine • Types of geriatric specialties • Geriatric giants • Surgical geriatric specialties • Medical conditions • Salary Data • Employment outlook • Achievement in geriatric physical therapy research and practice. • Conclusion 11/3/2009 2
  3. 3. Geriatrics is the branch of medicine that focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults. • There is no set age at which patients may be under the care of a geriatrician. Rather, this is determined by a profile of the typical problems that geriatrics focuses on. • People over the age of 65 make up one of the fastest growing segments of the population of many industrialized nations. The variation in health, daily function, cognition, social roles, and living conditions among these older adults requires that allied health, medical, social service, social science, health education, health management, and movement science professionals develop the competence to address the unique needs of this age group. 11/3/2009 3
  4. 4. History of Geriatrics: • “The Cannon of Medicine” written by Abu Ali Ibn Sina in 1025 • Arabic physician, Ibn Al-Jazzarr Al-Qayrawani (898-980), addressed sleep disorderss and another one on forgetfulness and how to strengthen memory • The first modern geriatric hospital • "Father" of Geriatrics, Dr. Ignatz Leo Nascher • "Mother" of Geriatrics, Dr. Marjorie Warren • Most pressing issue facing geriatrics is the treatment and prevention of delirium 11/3/2009 4
  5. 5. Differences between Adult and Geriatric medicine • Geriatrics is the branch of medicine that focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults. The term geriatrics differs from gerontology which is the study of the aging process itself. • Disease is a medical condition where an abnormal condition impairs bodily function impairs bodily functions whether it is physically or psychologically. • Functional ability, independence and quality of life issues are of greater concern to geriatricians, than to physicians of adults. 11/3/2009 5
  6. 6. Geriatric Specialities • Geriatric psychiatry or psychogeriatrics (focus on dementia, delirium, depression and other psychiatric disorders). • Cardiogeriatrics (focus on cardiac diseases of elderly) • Geriatric nephrology (focus on kidney diseases of elderly) • Geriatric Rehabilitation (focus on physical therapy in elderly) • Geriatric oncology (focus on tumors in elderly) • Geriatric rheumatology (focus on joints and soft tissue disorders in elderly) • Geriatric diagnostic imaging • Geriatrics dermatology(focus on skin disorders in elderly) • Geriatric subspeciality medical clinics (As Geriatric Anticoagulation Clinic Geriatric Assessment Clinic, Falls and Balance Clinic, Continence Clinic, Palliative Care Clinic, Elderly Pain Clinic, Cognition and Memory Disorders Clinic) 11/3/2009 6
  7. 7. Medically Treatment Issues • Treating an elderly patient is filled with complications with the major difference of treating a geriatric patient is that treating an elderly person sometimes needs to have a guardian or healthy proxy make the medically decision required for the situation or treatment required. The issues of power of attorney, privacy, legal responsibility, advance directives and informed consent must always be considered in geriatric procedure • • Geriatric pharmacotherapy(medications) • Issues with medications often need to be addressed with the elderly because of the multiple over the counter medications and herbs as well as those medications prescribed by their physician. Many of the drugs that are taken by the elderly have many contraindications with other medications they may be taking and react in an adverse way to other medications. 11/3/2009 7
  8. 8. • The presentation of disease in elderly persons may be vague and non-specific and may also be a secondary symptom to the actual cause of the issue. Description of the disease itself may be the patient not being able to verbalize or explain the symptoms due to confusion or delirium caused by the disease itself. 11/3/2009 8
  9. 9. Elderly Disease and the Geriatric Giants • Elderly disease and the geriatric giants • Immobility • Instability • Incontinence • Impaired intellectual memory functioning • Elderly care • Delirium • Multiple medications • Impaired vision • Impaired hearing 11/3/2009 9
  10. 10. Surgical specialties directly related to geriatrics • Orthogeriatrics (close cooperation with orthopedic surgery ) • Geriatric Cardiothoracic Surgery • Geriatric Urology • Geriatric General Surgery/Trauma • Geriatric Gynecology • Geriatric Ophthalmology • Geriatric Anesthesia (focuses on anesthesia & perioperative care of elderly) • Geriatric Intensive Care Unit: (a special type of intensive care unit dedicated to citically-ill elderly) • Geriatric Nursing (focuses on nursing of elderly patients and the aged). • Geriatric Nutrition • Geriatric Occupational Therapy(part of Geriatric Rehabilitation) • Geriatric Pain Management • Geriatric Physical Therapy 11/3/2009 10
  11. 11. Medical conditions • Dementia. • Cancer • Diabetes • Epilepsy • Heart disease* • Osteoporosis • Parkinson's disease • Sleep disorders • Stroke 11/3/2009 11
  12. 12. Geriatric Psychology • As society continues to age and more information becomes clear as to the way the body reacts to time and the abuse the body takes over time the treatments of aging and its diseases will become more efficient and effective. The process of developmental learning as we age from childhood to adulthood and to the elderly stages of development has begun theories of how the brain reacts to those learned processes or experiences. • The experience of physical activity not only proves to be physically helpful but mentally the mylen sheaths continue to be activated in brain and thicken, showing to show a delayed onset of dementia. 11/3/2009 12
  13. 13. The College of St. Catherine Physical Therapist Assistant Program • June 2007 • Employment/Salary Data: Reported Range of Current Hourly Salaries: Full time Geriatrics = $17.50 – $22.50 11/3/2009 13
  14. 14. EMPLOYMENT OUTLOOK FOR PHYSICAL THERAPIST ASSISTANTS • Employment of physical therapist assistants expected to grow much faster than the average through the year 2010 • • The large baby-boom generation is entering the prime age for heart attacks and strokes • • Medical developments should permit an increased percentage of trauma victims to survive, creating added demand for therapy services. • • “Physical therapist assistant is listed in the Top 100 Occupation List as number 69th , with a 41.1% increase anticipated between 2000-2010 • • Job outlook for physical therapist assistants is described as “Very Good” 11/3/2009 14
  15. 15. Minimum Geriatric Competencies • Cognitive and behavioral disorders • Medication management • Self-care capacity • Falls, balance, gait disorder • Atypical presentation of disease • Palliative care • Hospital care for elders • Health care planning and promotion 11/3/2009 15
  16. 16. Awards in geriatric physical therapy • Adopt-A-Doc Program • Clinical Educator • Clinical Excellence • Consumer Brochure Contest for Students • Distinguished Educator • Entrepreneurial Loan • Excellence in Research • Fellowship for Geriatric Research • Joan M. Mills; Outstanding Service • Lynn Phillippi; Advocacy • Outstanding PTA • Previous Award Recipients • Student Award for Research • Student Membership Award • Volunteers in Action 11/3/2009 16
  17. 17. Conclusion • As the population ages, so does the need for those trained in the specialized care of the elderly patient as it applies to the physical therapy and its treatments required for quality of life and independent living activities 11/3/2009 17
  18. 18. • ^ GERIATRICSFOR-SPECIALISTS INITIATIVE (GSI) • ^ Increasing Geriatrics Expertise in Surgical and Medical Specialties • ^ Howell, Trevor H. (January 1987), "Avicenna and His Regimen of Old Age", Age and Ageing 16: 58–9, doi:10.1093/ageing/16.1.58, PMID 3551552, =3551552 • ^ Howell TH (1972). "Avicenna and the care of the aged". Gerontologist 12 (4): 424–6. PMID 4569393. • ^ Pitskhelauri GZ, Dzhorbenadze DA (1970). "[Gerontology and geriatrics in the works of Abu Ali Ibn Sina (Avicenna) (on the 950th anniversary of the manuscript, Canon of Medical Science)]" (in Russian). Sov Zdravookhr 29 (10): 68–71. PMID 4931547. 11/3/2009 18