General Approach to EM Geriatrics

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Background

Generalized Approach to the Geriatric patient.

4 Basic Assessments.

  • Medical
  • Cognitive
  • Functional
  • Social

Medical

  • Common acute illness presents atypically - generalize weakness = MI or Hyponatremia
  • Vital signs often normal in illness
    • beta blocked, lack temperature
  • Labratory studies often nornmal
    • no leukocytosis
  • Often consider polypharmacy

Cognitive

  • assess memory and orientation; compare to baseline
    • evaluate for deliruim
  • important for assessing reliability of history and remembering dispo instructions

Functional

  • Up to 3/4 of older patients present with chief complaint of functional decline
    • ask about shortness of breath during episodes
  • Basic ADLs
    • walking, transferring, dressing, toileting
    • get up and go test:ability to rise, ambulate 10 ft, turn around, and sit back down
  • Instumental ADLs
    • finances, taking medications, meal prep, driving
  • Patients must be able to transfer and ambulate at a minimum to consider discharge by self

Social

  • Supports
    • who live with, family in town, anyone helps out?
  • Living environment
    • steps, hallways wide enough for walker, how far bathroom/kitchen from bedroom


See Also

Geriatrics (Main Page)

References

ACEP Geriatric Video Series

Authors:

Ross Donaldson