GERIATRIC PATIENTS

A wide variety of medical calls from the specific to the vague Communicating: Hearing loss Deterioration of vision Speech Memory loss consider base-lines

Make sure your patient can see and hear you Be respectful Get at eye level

Assessing Scene size-up and safety How well kept Safety issues Temperature

Initial Assessment General Impression level of distress Mental Status base-line Airway difficulty extending or flexing the neck dentures

Breathing poorly chewed food dentures Circulation difficulty obtaining a radial pulse irregular

Priority patients less severe symptoms high index of suspicion if symptoms are mild or vague

Focused History and Physical Exam Misunderstandings in communication Speak slowly and clearly Allow time to respond Ask one question at a time Depression can mask or mimic other serious medical problems Possible inaccurate history Confabulation

Confabulation Replacing lost circumstances with imaginary ones

Physical Exam Maintain dignity Threshold of pain Base-line Vital Signs Systolic b/p has a tendency to increase Skin looses elasticity dry fragile and thin Pupils may not be round and reactive

Side effects from medication weak and dizzy

Detailed Physical Exam Head and Neck injures to face common with fall and mva neck may be stiff head may be forward due to changes in the spine immobilization issues

Chest and Abdomen decreased sensitivity to pain Pelvis and Extremeties hip or proximal femur injuries common in falls, especially in women Spine Common injury in MVAs

On-Going Assessment Decline in condition may be slow Patients may not complain of sudden changes Monitor frequently Remember the components of the On- Going and what to assess for

Calls you may encounter Pharmacology Patient may take multiple meds Drug-patient interaction Drug-drug interaction Shortness of Breath Chest pain AMS

AMS Medication Hypoglycemia Stroke Generalized infection Hypothermia

Abdominal Pain AAA A “tearing” pain Bowel Obstruction Diverticulitis Internal Bleeding black tarry stools

Diverticulitis Diverticulitis is a common digestive disease particularly found in the colon (the large intestine). Diverticulitis develops from diverticulosis, which involves the formation of pouches (diverticula) on the outside of the colon. Diverticulitis results if one of these diverticula becomes inflamed or infected. [1] The colon can become infected with craters of food stuck inside, which causes abdominal pain.

Dizziness, weakness, and malaise Dizziness may be an indication of blood loss, especially upon standing Weakness can possibly be cardiac in nature. Some patients may have a pacemaker

Unusual Problems Shingles Falls Elder Abuse and neglect Mental Physical Financial

Shingles Herpes zoster (or simply zoster), commonly known as shingles and also known as zona, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe. The initial infection with varicella zoster virus (VZV) causes the acute (short-lived) illness chickenpox which generally occurs in children and young people. Once an episode of chickenpox has resolved, the virus is not eliminated from the body but can go on to cause shingles—an illness with very different symptoms—often many years after the initial infection.