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Geriatrics -PTA responsibilities

                     PTA 100
                  Troy Metzinger



11/3/2009                                  1
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
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
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
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
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
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
• 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
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
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
Medical conditions
•   Dementia.
•   Cancer
•   Diabetes
•   Epilepsy
•   Heart disease*
•   Osteoporosis
•   Parkinson's disease
•   Sleep disorders
•   Stroke

11/3/2009                         11
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
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
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
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
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
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
• ^ 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,
  http://ageing.oxfordjournals.org/cgi/pmidlookup?view=long&pmid
  =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

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Geriatrics

  • 1. Geriatrics -PTA responsibilities PTA 100 Troy Metzinger 11/3/2009 1
  • 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. 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. 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. 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. 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. 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. • 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. 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. 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. Medical conditions • Dementia. • Cancer • Diabetes • Epilepsy • Heart disease* • Osteoporosis • Parkinson's disease • Sleep disorders • Stroke 11/3/2009 11
  • 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. 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. 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. 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. 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. 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. • ^ 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, http://ageing.oxfordjournals.org/cgi/pmidlookup?view=long&pmid =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