Clinical Rotations Geriatrics

Geriatrics deals with healthcare of the elderly or aging

• Gerontology is the study of the aging process

Gerontology involves:

• The pathology that develops with age• Psychological changes• Physical and physiological aging changes• Aging is NOT an illness so don’t treat the

elderly as if they had a disease• They are treated by MDs, RNs, LVNs, CNAs,

PAs CRNPs, etc.

Sometimes interacting with geriatric pts. alone is the best medicine

• Isolation, loneliness and feeling useless are often hallmarks of those aging

• US population aging rapidly due to:• Baby boomers making up 1/3 of population

and now hitting senior citizen yrs.• Loss of independence may lead to depression• Can’t drive anymore or even dress themselves• Loss of memory contributes to depression

Decubiti (pressure ulcers/bed sores)

• Dry, thinning skin occur with aging• Bruise easily• Continued pressure in skin losing its

circulation can cause skin breaking down• Skin must be kept clean, moist and residents

must be turned regularly, varies with each pt.• Prevention is the key

Incontinence

• Nocturia vs. enuresis• Incontinence is the inability to retain

water/feces• Increases with age; it all Depends

Osteoporosis

Osteoporosis

• Affects females 2:1 over males• Lack of exercise• Lack of calcium• Lack of Vitamin D• Lack of sunshine• Lack of female hormones/post menopausal

and not on HRT• Brittle, thin, porotic bones

Arthritis

• Osteoarthritis/degenerative arthritis of aging• Enlarged, stiff, painful joints with cartilage

erosion and bone spurring• Treatment; exercise for increased ROM• Anti-inflammatories like ASA, Celebrex, Advil

(Ibuprofen), cortisone shots and pills• All however can upset and cause ulcerations

to aging GI systems

Arteriosclerosis/athersclerosis

• Aging arteries, especially coronary arteries• Reduced circulation to limbs and heart• Angina• Risk of MI and CVA• Blood thinners• BP pills to control hypertension• Cholesterol lowering meds like Zocor, Crestor,

Lipitor

Alzheimer’s Dementia

• Retrograde amnesia• Disorientation• Very docile, not aggressive• Terminal• Aricept meds

Emphysema/COPD

• Loss of lung function• Supplemental O2, green cannister• O2 tent, explosive warnings• Dyspnea• IPPB

Cataracts/Glaucoma

• Cataract is clouding of the lens• Glaucoma is increased pressure inside the

eye’s vitreous humor• Glaucoma causes tunnel vision/loss of

peripheral vision and inability to drive at night• Glaucoma has no symptoms but can lead to

slow blindness

Personal hygiene in geriatric care

• Very important since they are not always mindful of personal appearance and odors

• May forget to take meds• Forget to bathe and change clothes and clean

room• MEALS ARE THE SOCIAL AND PERSONAL

HIGHLIGHT OF THEIR DAY• Sometimes, meals are the only reason they

leave their rooms