Exam (elaborations)
N450 - Ch. 24 - Caring for Frail Older Adults w_Comorbidities (1)
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N450 - Ch. 24 - Caring for Frail Older Adults w_Comorbidities (1)
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N450 - Ch. 24 - Caring for Frail OlderAdults w/Comorbidities
Geriatric Syndrome - ANS-- common clinical conditions in older adults w/a cluster of
symptoms that are not caused by a specific disease - ex. falls
- Term used to capture those clinical conditions in older persons that do not fit into
discrete disease categories.
- Chief complaint does not represent the specific pathologic condition underlying the
change in health status
- Multifactorial health conditions that occur when the accumulated effects of
impairments in multiple systems render person vulnerable to situational challenges
***No linear cause and effect - more cyclical***
***Normal age related changes combined w/co-morbidities can predispose person to
geriatric syndrome and frailty***
Common Features of Geriatric Syndromes - ANS-High prevalence in older adults,
especially frail older people
Impact quality of life and disability
Multiple risk factors and multiple organ systems involved
Not always able to identify underlying cause - doesn't mean we can't intervene
Therapeutic management of clinical manifestation can be helpful even in the absence of
a firm diagnosis
***Most important to recognize those at risk for Geriatric Syndromes - catch it before
they start***
Examples of Geriatric Syndromes - ANS-Sleep disorders - insomnia
Eating/feeding disorders
Incontinence (urinary)
Confusion
Falls
Skin breakdown
Delirium
Dizziness/Syncope
Emerging Syndromes: Sarcopenia (decrease in muscle masss and strength) and Frailty
, Shared risk factors: older age, cognitive impairment, functional impairment, and
impaired mobility - these are the patients that you need to look out for
Sarcopenia - decrease in muscle mass and strength that occurs in aging
Frailty
Risk Fx - cognitive or functional or mobility impairments and age \
We can improve outcomes if we intervene sooner rather than later
Frailty (Geriatric Syndrome) - ANS-one of the geriatric syndromes
- decreased reserves in multiple organ system that maybe initiated by disease, lacks of
activity, inadequate nutrition, stress, and/or physiologic changes of aging
- decrease in the body's ability to maintain homeostasis during acute stress
(homeostenosis)
- combo of weakness, decrease in strength, weight loss and decrease in activity and
endurance
Frailty - Cont'd. - ANS-- has also been defined as the presence of three or more of the
following criteria:
~ Unplanned weight loss (10 lbs in the last year)
~ Weakness and exhaustion
~ Poor endurance and energy
~ Decline in grip strength and gait speed
~ Slowness
~ Low activity
Failure to Thrive - ANS-- grouping of syndromes including unintentional weight loss of
more than 5% baseline body weight, poor appetite, poor nutrition often accompanied by
dehydration, immobility, depression, impaired immune fx, and low cholesterol levels
- continuum of frailty
Risks of Frailty - ANS-- A frail older person is at high risk for dependency,
institutionalization, falls, injuries, hospitalization, slow recovery from illness, and
mortality.
- The frail older adult is most in need of, and most likely to benefit from specialized
geriatric services.
- these increase w/age and puts pt. at risk for further decline and complications
(geriatric cascade)
- Need more assistance, higher likelihood of falls & injuries, slower recovery, need to be
hospitalized
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