2. GERIATRIC PATIENTS

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

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

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

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

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

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

9. 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

10. Confabulation
Replacing lost circumstances with imaginary ones

11. 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

12. Side effects from medication
weak and dizzy

13. 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

14. 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

15. 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

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

17. AMS
Medication
Hypoglycemia
Stroke
Generalized infection
Hypothermia

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

19. 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.

20. 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

21. Unusual Problems
Shingles
Falls
Elder Abuse and neglect
Mental
Physical
Financial

23. 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.