Gerontology and Geriatrics in Nursing

¶ … Geriatric patients between the ages of 70 and 95 have very different needs from those of their younger counterparts. In part, these are due to differences that have clear physiological bases. These structural and physiological differences necessitate different assessment and interview techniques. It is necessary to ensure that one gets all the correct and up-to-date information about any patient, and in the cases of both children and geriatric adults, this can become problematic.

Cognitive deficits that may be related to dementia are one possible hurdle that must be overcome in the case of interviewing older patients. It is important to recall that not all dementia is Alzheimer's-related, and many cases are a natural result of the aging brain. (It is useful for the health care professional to recall that the original disease diagnosed by Dr. Alzheimer related to pre-senile dementia: in other words, a dementia occurring physiologically much earlier than one would expect.

As a result, we may expect such naturally-occurring forms of senile, rather than pre-senile, dementia to become increasingly prevalent within the aging population.) In order to be certain that the patient can hear and understand everything you ask, it is necessary to make eye contact, speaking face-to-face at all times. You should pay careful attention to their reactions and make sure that they respond appropriately to questions and that they understand them.

Because older patients are also more likely to have hearing- and vision-related problems, it can be helpful for them to read your lips and for you to check in on them and make sure they understand. Cognitive deficits may also impair memory. For this reason, it can be useful to ask a patient to bring all of their pill bottles with them, or else to write a list.

If you ask them to recount all of their medications on the spot, some may forget some, which would obviously be a problem. In fact, written lists are helpful in general, including with their health histories. If possible, ask them to bring in a written document that describes their health history and medication. In addition to the different interview techniques, these physiological and anatomical variations are also important to look out for during an assessment. For example, elderly patients are more likely to have more brittle bones and fragile skin.

Osteoporosis is a serious condition that one ought to look for in elderly patients. Fragile skin is more important than it sounds, because the skin is the first defensive layer of a person's body. Skin that bruises and cuts easily can lead to myriad infections and conditions. In addition, diabetes is more likely to occur in geriatric patients, which also has major effects on the immune system. Eye-related diseases are very common in older patients. Glaucoma and cataracts are possible conditions that can lead to serious complications.

More commonly, myopia and presbyopia are normal parts of growing older but ought to be recognized in a clinical setting because of the effects that they can have on daily life. As was noted previously, they can also lead to complications during the actual interview and assessment processes. It is also normal for hearing to be affected with age, and this is important to look for during an assessment.

It is necessary to distinguish between communication difficulties that result from dementia and those that result from conditions related to the inner ear. Although both neurological and ear-related hearing disorders can have similar effects, the treatments for each differ, and they can lead to some slightly different complications which ought to be anticipated. Muscle atrophy is common in older adults. It is far more likely to occur in geriatric patients who are not active.

Physical activity is important even for older adults who may not get the amount or the types of exercise that they require. Diet is also an important component in ensuring appropriate muscle composition. A poor diet also leads geriatric patients to be far more likely to have other conditions, such as incontinence and constipation.

We should observe that these conditions are also, in many cases, overlapping with the issue of muscle atrophy -- other conditions (such as prostate cancer and its ensuing treatment, or ordinary prostatitis) can also exacerbate certain types of incontinence. While incontinence may be viewed as an embarrassment or a heartbreak, it must also be regarded as a health issue. After all, these conditions then have reciprocal effects on the absorption of necessary nutrients and the compositions of various organ systems.

Osteoporosis, for example, becomes more likely both in the case of poor diet and in the case of gastro-intestinal disorder. Further complicating the issue of nutrition and digestion, many geriatric adults have dentures due to lose teeth. If these dentures don't fit properly or aren't taken care of in the right way, they can cause sores in the mouth. These.