What is a comprehensive geriatric assessment ?
Creation of a problem list, objectives of care and management plan
What are the four components of a CGA?
What is involved in the medical part of a CGA?
What is involved in the Functioning component of CGA?
Activities of daily living
Activity and excercise status
Gait and Balance
What is involved in the Phsychological component in CGA?
Metal status and congnitive function
Mood and depression testing
What is involved in the social/enviromental component in CGA?
Informal needs and assests
care resource eligibility and resources
What does CGA stand for?
Comprehensive Geriatric Assessment
How is the presentation of MI different in older people?
1/3 dont have chest pain
How would you investigate an MI in an older person?
May not be able to tolerate an angiogram
How does Sepis present differently in older people?
BP may drop early
Temp low rather than high
Tachycardic response absent
CRP and WCC may not rise that much
What is sacrcopenia?
Age related loss of muscle mass and function
What is the diagosing criteria for sarcopenia?
Low muscle mass
Low muscle strength or low physical performance
When does muscle decline start ?
Starts around 30 yrs of age and gets much worse around 60
What is primary and secondary sarcopenia?
Primary:- caused by age
Secondary:- got a secondary cause
How do you treat sacrcopenia?
Progressive resistance training
What are the activity level requirments for older people?
150 minutes a week of moderate intensity
75 minutes of vigorous activity
Strength and balance work 2x a week
What common drug is a good intervention for sarcopenia?
What are the predisposing factors for delirium?
What are the percipitating factors of deleriums?
Being in hospital
What are the hallmarks of delirium?
Acute and fluctating
Altered level of consciousness (Hypoactive or Hyperactive)
Which type of delerium i worse hypoactive or hyperactive?
Hypo is way worse
What smart helpfull things can you do to help delerium?
Approach patient calmly from the front
Keep a normal sleep pattern
Mobilise patients safley ( dont restrain them)
Ensure they can see and hear !!!
ensure adequate diet
Have clocks and calenders nearby
Reduce background noise
Whats the aim of the game in delerium treatment?
fix everything else first !
When i sedation approriate?
Only when the patient is a danger to themselves or others
What is the sedative of choice?
(0.25mg - 0.5mg)
oral or IM
What is the max dosage of Haloperidol?
5mg in 24hr
Who cant take haloperidol and what is used instead?
People with Parkinson's or Lewy Body Dementia
25mg oral Quetiapine
What can be used in alcohol related delerium?