Geriatrics is the medical specialty dedicated to providing care for older adults. Geriatricians are trained to address health issues that may affect older patients differently than younger adults, such as multiple illnesses occurring at the same time or medications affecting older people differently. Common conditions seen in older adults include heart disease, arthritis, diabetes, falls, depression, Alzheimer's disease, and Parkinson's disease. As people age, assistive devices and home modifications may help extend independence by assisting with activities of daily living.

1. UNIT 6:
GERIATRICS

2. What is geriatrics?
• Geriatrics is the medical specialty dedicated exclusively to providing
high-quality, patient-centered care for older adults. Older adults have a
unique set of issues and concerns which geriatric clinicians are trained
to focus upon. Illnesses, diseases, and medications may affect older
people differently than younger adults, and older patients may have
overlapping health problems that require multiple medications.
Geriatricians prevent and manage illnesses and develop care plans
that address the special health problems of older adults.

3. Common questions about geriatrics
• Why should I see a geriatrician?
• How old should I be to see a geriatrician?
• What are the most common medical problems you see in older
adults?
• When should you start seeing a geriatric doctor?
• If I see a geriatrician, can I still see my family doctor whom I have
gone to for many years?

4. • Common conditions in older age include hearing loss, cataracts and
refractive errors, back and neck pain and osteoarthritis, chronic
obstructive pulmonary disease, diabetes, depression and dementia. As
people age, they are more likely to experience several conditions at
the same time.

5. Alzheimer’s Disease
• Alzheimer’s disease accounted for 92,604 deaths of people over age
65 in 2014, according to the CDC. The Alzheimer’s
Association reports that one in nine people age 65 and older, which is
about 11 percent, have Alzheimer’s disease, but because diagnosis is
challenging, it’s difficult to know exactly how many people are living
with this chronic condition. Still, experts acknowledge that cognitive
impairment has a significant impact on senior health across the
spectrum, from issues of safety and self-care to the cost burden of
care, either in the home or a residential facility.

6. Heart Disease
• According to the CDC, heart disease remains the leading killer of adults over
age 65, accounting for 489,722 deaths in 2014. As a chronic condition,
heart disease affects 37 percent of men and 26 percent of women 65 and
older, according to the Federal Interagency Forum on Aging-Related
Statistics. As people age, they're increasingly living with risk factors, such as
high blood pressure and high cholesterol, that increase the chances of
having a stroke or developing heart disease. Dr. Bernard’s advice for
addressing this senior health risk not only helps with heart disease but can
improve senior health across the board: “Exercise, eat well, get a good
night’s rest. Eating well means eating in a fashion that will allow you to keep
a healthy weight with a well-balanced and healthy diet."

7. Arthritis
• “Arthritis is probably the number one condition that people 65 or
older contend with,” says geriatrician Marie Bernard, MD, deputy
director of the National Institute on Aging in Bethesda, Maryland.
The CDC estimates that it affects 49.7 percent of all adults over 65
and can lead to pain and lower quality of life for some seniors.
Although arthritis can discourage you from being active, it’s
important to work with your doctor to develop a personalized activity
plan that, along with other treatment, can help maintain senior
health.

8. Diabetes
• The CDC estimates that 25 percent of
people ages 65 and older are living with
diabetes, a significant senior health risk.
According to CDC data, diabetes caused
54,161 deaths among adults over age 65 in
2014. Diabetes can be identified and
addressed early with simple blood tests for
blood sugar levels. The sooner you know that
you have or are at risk for diabetes, the
sooner you can start making changes to
control the disease and improve your long-
term senior health outlook.

9. Falls
• The risk for falls requiring emergency room care increases with age. Each year, 2.5 million
people ages 65 and older are treated in emergency departments because of falls,
according to the CDC. That’s more than any other age group. And, one-third of people
who go to the emergency room for a fall may find themselves there again within one year,
according to a study published in August 2015 in the American Journal of Emergency
Medicine. Also be aware that most falls occur in the home, where tripping hazards include
area rugs and slippery bathroom floors, according to a study published in January 2013 in
the Journal of Injury and Violence Research.

10. Depression
• According to the American Psychological
Association, 15 to 20 percent of Americans over 65
have experienced depression. A threat to senior
health, depression can lower immunity and can
compromise a person’s ability to fight infections. In
addition to treatment with medication and therapy,
other ways to improve senior living might be to
increase physical activity — 59.4 percent of adults
65 and older don’t meet CDC recommendations for
exercise— or to interact socially more — seniors
report spending just 8 to 11 percent of their free
time with family and friends, according to the
Federal Interagency Forum on Aging-Related
Statistics.

11. Parkinson’s disease
• Parkinson’s disease is a brain disorder
that causes unintended or
uncontrollable movements, such as
shaking, stiffness, and difficulty with
balance and coordination.
• Symptoms usually begin gradually and
worsen over time. As the disease
progresses, people may have difficulty
walking and talking. They may also
have mental and behavioral changes,
sleep problems, depression, memory
difficulties, and fatigue.

14. Elder Care Products and Equipment
• As activities of daily living (ADLs) become more challenging, assistive
devices may be used to extend a senior’s independence. Evaluate
the current living environment to assess if any of the following items
could be used to make a senior’s home safer and more accessible.

16. • Personal Alert System (a wearable electronic device designed to summon help in an
emergency)
• Toilet seat riser
• Bidet attachment for toilet
• Grab bars for the bathroom near the toilet and shower
• Hand-held shower head
• Bathtub/shower transfer bench
• Stepless/walk-in bathtub or shower
• Adjustable bed
• Waterproof mattress/mattress pads
• Over-bed table
• Disposable incontinence underpads (sometimes referred to as “chux”)
• Bed railings
• Adequate lighting throughout the home, including night lights
• Medication organizer or alarmed dispenser
• Button loopers and zipper pulls for easier dressing

17. • Adaptive clothing and shoes
• Touch-tone telephones with large buttons, speaker or hands-free capabilities, and/or text
capability for those who are deaf or hard of hearing (TTY or TDD)
• Talking clocks and wristwatches for seniors with poor vision
• Low vision aids to assist with reading and other activities
• Kitchen tools that make opening cans and jars, peeling vegetables, and cutting and
dicing ingredients easier and safer
• Specialized eating utensils and dinnerware for easier dining
• Automatic shut-off safety devices for kitchen appliances
• “Reacher/grabber” tools for seniors who have weak grip strength and/or limited mobility
• Ramps for entryways with steps
• Stair lifts for multi-story homes
• Sturdy railings along all stairways
• Mobility aids for seniors who have difficulty getting around the house (e.g. cane, rollator,
walker, wheelchair, motorized scooter)
• Baskets or other accessories for mobility equipment to assist in carrying items
• Lift chairs for those who have difficulty getting in and out of a seated position