Elderly intro - just notes

Question 1

What is classed as elderly?

Answer 1

Over 65
Young elderly is 65-75
Very elderly is >85

Question 2

What system commonly gets symptoms when there is a general problem?

Answer 2

Locomotor system

Question 3

Challenge with elderly patients

Answer 3

Complex - lots of causes to problems which have to be adressed
Atypical presentation - non specific to disease, systems are slower to react to infection etc

Question 4

Problems with risk of falls after 1 fall

Answer 4

After 1 fall risk of falls increases due to change in behaviour

Question 5

Reasons for under-reporting symptoms in elderly

Answer 5

• Fear hospital
• Embarassed
• Fear of being a burden
• Independence
• Think symptoms normal part of aging

Question 6

Why can sexual diseases increase in elderly?

Answer 6

• No fear of pregnancy so no protection sometimes
• Increased risky behaviours if change of frontal lobe etc

Question 7

What to ALWAYs ask about in elderly?

Answer 7

Alcohol can be cause of delirium, common in elderly, can also cause falls

Question 8

Clinical frailty scale

Answer 8

Question 9

What are geriatric syndromes?

Answer 9

• Group pf signs and symptoms that characterise a specific disorder
  Multifactorial origin
• No single common pathway to the disorder

Question 10

Examples of geriatric syndrome components

Answer 10

• Falls
• Urinary incontinence
• Dizziness
• Syncope
• Insomnia
• Malnutrition

Question 11

How to the elderly often present with illness?

Answer 11

• Atypical presentation
• Multiple concurrant problems
• Non-specific symptoms
• Hidden illness - they also under report

Question 12

Examples of atypical presentations

Answer 12

• MI with no chest pain
• Hyperthyroidism without tachycardia, weight loss etc
• Infection without rising WBC and fever
• Fatigue as symptom of CHF

Question 13

Non-specific symptoms elderly often present with

Answer 13

• Confusion
• Self neglect
• Falling
• Incontinence
• Fatigue
• Weight loss/anorexia
• Dyspnoea

Question 14

What must you ask elderly people about as they often do not offer up this information?

Answer 14

• Sexual dysfunction
• Depression
• Incontinence
• MSK stiffness
• Alcoholism
• Hearing loss
• Memory loss

Question 15

Reasons elderly under report

Answer 15

• Belief symptoms due to old age
• Fear/denial
• Concern about cost
• Embarassed
• Mentally mpaired
• Concern about ill spouse insted
• Previous bad experience with NHS
• Fear of institutionalization

Question 16

What does it mean when elderly experience multipla concurrent losses?

Answer 16

• Loss of physical health
• Loss social contacts - family/friends die
• Loss familial roles
• Loss financial security
• Loss independence and power
• Loss mental stability

Question 17

Normal ageing vs disease

Answer 17

Ageing is not disease

Question 18

Core components of geriatric assessment

Answer 18

• Functional capacity
• Fall risk
• Cognition
• Mood
• Polypharmacy
• Social support
• Financial concerns
• Goals of care
• Advanced care preferences

Question 19

What should you always consider in elderly if they develop new symptom?

Answer 19

Could this be due to a drug therapy?

Question 20

Medication management strategy for elderly

Answer 20

STOPP/START medications
Beers criteria