10: Geriatrics

Question 1

Up to 35% of elders have some form of frailty or FTT. Numbers increase in _____.

Answer 1

Nursing homes. 50-60% of hospitalized veterans.

Question 2

Does FTT affect men or women more?

Answer 2

Older men

Question 3

What are functional considerations in the home (4)?

Answer 3

1. Monitor upkeep of home
2. Witness others in home able to help
3. Look at stairs/potential hazards
4. Nutritional assessment of home foods

Question 4

Causes of frailty and FTT (5).

Answer 4

1. Organic illness
2. Polypharmacy
3. Depression
4. Dementia
5. Inadequate social support

Question 5

A biological syndrome of decreased reserves in multiple systems that results from dysregulation that can occur with aging and is initiated by physiologic changes of aging, disease, and/or lack of activity or inadequate nutritional intake.

Answer 5

Frailty

Question 6

Clinical features of frailty (4).

Answer 6

1. Generalized weakness (lack of energy, slower task performance)
2. Weight loss
3. Memory loss
4. Biochemical abnormalities (low albumin, low cholesterol)

Question 7

High risk symptoms for functional decline (4).

Answer 7

1. Falls
2. New onset incontinence
3. Syncope
4. Mental status changes

Question 8

T/F In cases of dementia, people may not self-assess abdominal pain.

Answer 8

True

Question 9

Safety and _____ should be kept at the forefront of our assessment.

Answer 9

Dignity

Question 10

Using _____ as a marker, studies of nursing home patients reveal rates as high as 50-60% frailty or FTT on admission.

Answer 10

Malnutrition

Question 11

High risk predictors for functional decline (7).

Answer 11

1. 70+
2. Living alone
3. Lacking support systems
4. Self-care deficits
5. Need for skilled care at home
6. Hospitalization
7. Recent hospital discharge

Question 12

_____ screening tool can be helpful with health history.

Answer 12

OARS
Older
Americans
Resources and
Services

Question 13

The largest group with functional decline is over the age of _____.

Answer 13

85

Question 14

T/F Hearing and vision tests could help correct deficits that contribute to frailty/FTT.

Answer 14

True

Question 15

What are functional considerations to think about in the office?

Answer 15

Instrumental ADLs

Question 16

Mobility testings (2).

Answer 16

1. Get -Up and Go Test (rise from chair, walk 10 feet, turn around, return to chair)
2. Functional reach (extend arms forward without moving the feet and distance is measured–helps with understanding if they can prepare meals)

Question 17

A syndrome that occurs near the end of life that is associated with weight loss, functional loss, and social withdrawal.

Answer 17

FTT

Question 18

What needs to be considered with functional decline and hospital settings?

Answer 18

Be mindful to promote as much optimal functioning as possible. Hospital staff can encourage declines in functioning.

Question 19

High risk diagnoses for functional decline (7).

Answer 19

1. FTT
2. HF
3. A-fib
4. Pneumonia
5. Digoxin toxicity
6. Sensory deficits
7. DM