Diseases of aging

Question 1

Impact of disability on patients

Answer 1

Loss of independence
Reduced activity
Social isolation
Relationship problems
Psychological problems
Increased risk of ill health
Increased risk of hospital admission
Increased risk of institutionalisation
Increased risk of abuse
Reduced life expectancy

Question 2

What are the four main diseases of aging?

Answer 2

Geriatric giants:
Incontinence
Immobility
Intellectual impairment
Instability

Question 3

Common chronic diseases in the elderly

Answer 3

Strokes

Falls

Dementia

Arthritis

Question 4

Define frrailty

Answer 4

Chronic disease (geriatric giants) with functional impairment (diability)

Question 5

Define disability

Answer 5

A condition or function judged to be significantly impaired compared to the usual standard of an individual or group.

Prevalence and severity of diability increases with age. Higher in women than men, higher in care homes than private households

Question 6

Types of diability

Answer 6

Mobility impairments
Personal care difficulties
Vision loss
Hearing impairment
Continence problems
Communication difficulties
Cognitive or learning disabilities
Psychological disorders

Question 7

Briefly describe the circle of decline in a falls patient

Answer 7

Gradual reduction in function over time caused by cumulative effect of disease.

Patient has a fall, this may lead to admission to hospital and subsequent reduced mobility. May suffer from acute illness.

Patient now has reduced activity and may withdraw socially. Consequence is further reduced mobility (increasing risk of further falls) and depression.

Question 8

What are the two patterns of decline in aging?

Answer 8

Circle of decline

Cliff-edge scenario

Question 9

Briefly describe the cliff-edge scenario

Answer 9

Sudden reduction in function caused by exposure of a hidden vulnerability and change in social stasis.

Patient appears to be functioning normally and well, however after suffering from an acute illness has a considerable reduction in function.

Question 10

Impact of disability on carers

Answer 10

Grief reaction: anger, denial acceptance. Drawn out in carers of disabled patients.

Disruption of work
Disruption of family life
Relationship problems
Increased risk of ill health
Financial loss

Question 11

Rehabilitation

Answer 11

An active process by which those disabled by injury/disease achieve a full recovery, or if full recovery is not possible, realise their optimal physical, mental and social potential and are integrated into their most appropriate environment

Question 12

Factors affecting rehabilitation

Answer 12

Presence of acute illness
Severity of acute illness
Pre-morbid state
Cognitive state
Psychological state

Question 13

Things to consider when planning discharge of elderly patients

Answer 13

Begin early

Predict extent and speed of recovery

Set estimated discharge date in advance

Refer to external agencies early

Identify Patient capacity

Manage relatives

Manage staff

Question 14

Barriers to discharge planning in elderly

Answer 14

Distant relatives

Concerns about recurrent falls at home

Attitudes of staff (ageism)

Lack of appropriate care

Question 15

Name 5 possible causes of falls in the elderly

Answer 15

Environment: poor lighting, furniture

Visual impairment

Musculoskeletal: eg. arthritis

Neurological: loss of coordination, neuropathy

Syncope

Dementia

Vestibular: Vertigo

Question 16

Key tasks when assessing cognitive decline in the elderly

Answer 16

Ask a carer/informants view

Carry out a risk assessment - includes risk to patient and risk to others.

Biological: Exclude a medical cause for dementia. Consider physical health and options for treatment

Psychological: Explore patient and carers understanding of dementia and concerns. Screen for depression.

Assess social effects: driving, care, power of attorney