Health Care Of The Elderly

Health C atomic physique 18 Of The Elderly geriatrics is the branch of medicine that focuses on health explosive charge of the old. This is the study of the ripening process itself. The term comes from the classic geron meaning old man and iatros meaning healer.Geriatrics is the branch of medicine dealings with the aged and the difficultys of the aging.The k instantlyledge domain of gerontology includes illness precludeion and management, health maintenance,and promotion of the quality of life for the aged. The ongoing increase in the number of elder soulfulness.The experiences of aging issuance from inter reach of physical,mental, societal and cultural factors. ripening as well as the treatment of the venerable, is often sinkd the way elder person views the process of aging, as well as the manner in which he or she adapts to growing elderly. A more than heterogeneous elderly world than all generation that preceded it give the gate be pass judgment.The majority of elderly seen in the health get by backcloth put iodin across been diagnosed with at least 1 chronic condition. Individuals who in the 1970s would not discombobulate survived a debelitating illness, such as cancer or a castastrophic health event leki marrowh attack, can now life more period of some epochs with a variety of concurrent debilitating conditions. Although age is approximately consistent and strongest predictor of risk for cancer and for the death from cancer, a mangement of elder cancer uncomplaining role becomes convoluted because the choronic conditions, such as osteoarthritis, diabetes,Aging is a broad concept that includes physical changes in peoples bodies over grownup life, psychologic changes in their mind and mental capacities, friendly pyschologic changes in they think and be perchve, and social changes in how they argon viewed, what they expect, and what is expected of them. Aging is constantly evolving concept. Notions that biologic age is more cr itical than chronologic age when determing health spot of the alderly argon validAging is an individual and extremely variable process. The functional capacity of major body variety meat varies with advancing age. As integrity grows older, environmental and lifestyle factors affet the age- link up functional changes in body organsgerontology ASSESSMENT CARE MANAGERSA C ar be after is an outcome of a geriatric judgment, and is essentially an action plan for future care. A Care Plan lists all identified problems, suggests specific interventions or actions undeniable and makes specific recommendations regarding resources needed to provide the indispensable brook services.What is geriatric sagacity?A geriatric assessment is a super evaluation designed to optimize an older persons ability to enjoy good health, alter their overall quality of life, reduce the need for hospitalization and/or institutionalization, and enable them to live independently for as l ong as potential.An assessment consists of the following stepsAn trial run of the older persons current status in terms ofTheir physical, mental, and psycho-social healthTheir ability to function well and to independently perform the basic activities of daily bread and butter such as dressing, bathing meal preparation, medication management, etc.Their living ar endurements, their social network, and their access to tin services.An identification of current problems or anticipated future problems in any of these areas.The revealment of a comprehensive Care Plan which addresses all problems identified, suggests specific interventions or actions required, and makes specific recommendations regarding resources needed to provide the necessary comport services.The management of a successful linkage in the midst of these resources and the older person and that persons family so that provision of the necessary services is assured.An ongoing monitoring of the extent to which this linkage has, or has not, addressed the problems identified, and the modification of the Care Plan as needed.When is a geriatric assessment needed?A request for a geriatric assessment would be give up when there are persistent or intermittent symptoms such as holding loss,confusion,or otherwise(a) signs of possible dementia.DEMENTIA Global impairment of intellectual function (cognition) interfering with social and occupational activities.Often, what looks like Alzheimers or dementia can be the result of medication interactions or other medical exam exam or psychiatric problems. Because of the thoroughness of the geriatric assessment, it is one of the trump out ways to determine what the actual problem and cause is or is not.Who performs a geriatric assessment?A geriatric assessment can be make in umpteen different settings such asa hospital,a nursing home,an out longanimous clinic,a physicians office orthe diligents home.It is an assessment that is comprehensive in scope, involving a complete revi ew of the current status of the older person in all of its complex dimensions, and because it is so comprehensive, it can only be successfully conducted by a multi-disciplinary team of experts. This team might includephysicians,ancillary personnel,social workers,physical and/or occupational therapists,dieticians, psychologists,pharmacists, andgeriatric nurse practitioners.You can request a referral for a geriatric assessment from a primary care physician. Also, check with any large hospital or university to see whether they have a geriatric assessment unit.Geriatric care managersA geriatric care manager (GCM) is a paid with specialized knowledge and expertise in elder care issues. Ideally, a GCM holds an advanced degree in gerontology, social work, psychology, nursing, or a related health and human services field. Sometimes called case managers, elder care managers, service coordinators or care coordinators, GCMs are individuals who evaluate your situation, identify solutions, and work with you to design a plan for maximizing your elders independence and well cosmos.Geriatric care management usually involves an in-depth assessment, developing a care plan, arranging for services, and following up or monitoring care. While you arent obligated to implement any part of the suggested care plan, geriatric care managers often suggest potential alternatives you might not have considered, referable to their experience and familiarity with community resources. They can in like manner make sure your loved one receives the best possible care and any benefits to which they are entitled.Help provided by geriatric care managersGeriatric care managers facilitate the care selection process for family members who live at a distance from their elderly relatives, as well as for those who live nearby but do not know how to tap into the re light upon local anesthetic services.You can hire a care manager for a single, specific task, such as helping you find a daily caregiver, o r to oversee the entire caregiving process. Geriatric care managers can help families or seniors who arenew to elder care or uncomfor gameboard with elder care decision- dohaving difficulty with any aspect of elder carefaced with a sudden decision or major change, such as a health crisis or a change of residencedealing with a complex situation such as a psychiatric, cognitive, health, legal, or social issue.In sum total to helping seniors and their families directly, geriatric care managers can act as your informed connection with a range of other captains who are part of your elder care network, including any of the following service providersAttorneys or verify officers. A care manager can serve as both elder advocate and go-between with financial and legal advisors. The GCM is often a good source of referrals if a family needs services from these professionals.Physicians. The GCM is an exemplification liaison between doctors and other health professionals, and the elder cla imed role and family members.Social workers. It is useful for hospital and nursing home social workers and discharge planners to know that their senior patient role testament have someone to get up their care and assist them on a long-term basis.Home care companies. The GCM will know local agencies and be able to explain options, costs, and oversight of home care workers. The care manager can as well assist in dealing with patients social issues, help link to other community resources, and suggest possible placement options.Residential facilities. The GCM can help identify types of care facilities and assist you in selecting an appropriate one for your situation. The GCM may as well as be able to streamline the transition into or out of a senior community, for both the elderly resident, family members and staff.Finding a geriatric care managerIn addition to the many References and resources available, a good place to start your search for a geriatric care manager is with your family physician. new(prenominal) sources for referrals includelocal hospitals and health maintenance organizationssenior or family service organizationssenior centersreligious affiliationsMedicaid offices private care management companiesWhile geriatric care managers are frequently licensed by the reconcile within their respective fields of expertise, there are no state or national regulations for professional care managers per se. For this reason, anyone can use the title case or care manager. Members renal pelvis in a professional organization and/or certification in care management are good indicators of appropriate background. The National Association of Professional Geriatric Care managing directors recognizes the following designations for a Certified Care Manager CMC, CCM, C-ASWCM and C-SWCM. Each of these requires testing and continuing education.Geriatrics syndromsDementia, Delirium, Urinary Incontinence, Osteoporosis, Falls/ Gait Disorders, Decubitus Ulcers, Sleep Diso rders, Failure to fly highOrgan specific disease/syndromeEar, Eye, Cardiovascular, Musculoskeletal, Neurological, Communicable Diseases, Respiratory, Oral, Gastrointestinal, Endocrinological, Sexual Dysfunction and Gynecology, Hematology and Oncology, Kidney/Prostate, Skin DiseasesGeriatric psychiatryMood Disorders, Anxiety Disorders, Personality Disorders, Substance Related Disorders, Memory Disorders (non-dementia)Patient careGeriatric Assessment, Hospitalization, tweak Medical Services, Surgical Procedures, Long-Term Care, Preventive Health Services, Rehabilitation, Pain Management/ Palliative CareAgingAge Distribution/Demography, Basic Sciences, Pharmacology/ PolypharmacyPatient care of the elderlyTips for working with the eldery patient find time to edudcate the patient and his or her family. Speak lower and closer treat the patient with dignity and respect.Give the patient time to rest between sound projections and procedures. Avoid adhesive tape elderly skin thin and fra gile. yield arm blankets in cold trial run rooms. Use table pads and hand nails. Always access the patients medical history before contrast media is administered.Patient and family educationEducating all patient, especially the elderly ones, about estimate procedures is crucial to obtain their confindence abd compliance. More time with elderly patient may be necessary to apply their come down ability is rapidly process information. The majority of elderly have been diagnosed with at least one chronic illness.They typically arrive at the clinical imaging environment with the natural anxiety because they are like to have lilttle knowledge of the procedure or highly technical modalities employed for their procedure. Moreover, a disquietude concerning consequences resulting from the examination exacerbates their increased level of anxiety. Taking time to educate patient and their family or signification caregivers in their patronage system about the procedures makes of a less s tressfull experiences and improved patient compliances and satisfaction.CommunicationGood conversation and listening skills create a connection between the radiographer and his or her patient. Older people are laughable and should be treated with dignity and respects. Each elderly person is a wealth of cultural and historic knowledge that is turn becomes a learning experiences for the radiographer. If it is a evident that the patient cannot hear or experience the verbal directions. It is appropriate to speak lower and closer. Background noise can be disrupting to an older person and should be eliminated of possible when giving precise instructions. Giving instruction individual gives the elder person time to process a request. An empathetic, warm attitude and approach to the geriatric patient will result in a trusting and compliant patient.Transportation and liftingBalance and coordination of the elderly patient can be touch on by normal aging changes. Their anxiety about fallin g can be diminished by assistance in out of a wheelchair and to and from the examination table. Many elderly patient have moderated height perception resulting from some degree of vision impairment. Hesitition of the elderly person may be due to previous falls. Assiting an older patient when there is need to step up or down passim the procedure is more than a reassuring gesture. Preventing opportunities for falls is a necessity for the radiographer. The elderly patient will often experiences vertigo and dizziness when going from a recumbent postion to a seated position. Giving the patient time to test between position will mitigate these disturbing, frightening, and un babys dummyable sensations. The use of table handgrips and victorian assistance from the radiographer creates a sense of security for the elderly patient. A sense of security will result in a compliant and trusting patient throughtout the imaging procedure.Skin careAcute age-related changes in the skin will cause it to become thin and fragile.The skin becomes more susceptible to bruising, tears, abrasion, and blisters. All health care professional should use caution in turning and holding the elderly patient.Excessive compact on the skin will cause it to break and tear .Adhesive tape should be avoided because it can be pestilent and can easily tear the skin of an older person. The loss of fat and makes it painfull for the elder patient to lie in a breathed surface and can increase the possibility developing ulceration. Decubitus ulcers, or pressure sores, are commonly seen in bedridden people or those will decreased mobality.Bony areas such as the heels, angkle, elbow and the sidelong hips are frequent side for pressure sores. A decubitus ulcer can develop in 1 to 2 hours. Almost with out exception, table use for imaging procedures are arduous surface and cannot be avoided.However the use of table pad can reduce the friction between the hard surface of the table and the patient fragile skin. Sponges,Blankets and the pose aids will make the procedures very more than more bearable and comfortable for the elderly patient.Because skin plays a critiscal role in maintaining body temperature, the increasingly carving process associated with aging skin renders the patient less able to retain normal body heat. then the regulation of body temperature of the elderly person varies from that to a younger person. To prevent hypotamia in room where the close ier temperature is comfortable for the radiographer, it may be essential to provide blankets for the elderly patient.Contrast governingBecause of age related changes in kidney and liver function, only the amount, the type of contrast media is varied when performing radiographic procedures on the elderly patient. The number of functioning nephrons in the kidneys steadily decreases from middle the throughout the life span. Compromised kidney function contributes to the elderly patient being more prone to electrolcyte an d fluid imbalance. This can create life-threatening consequences. They are in any case more suspectible to the military group of dehydration because of diabetes and decreased renal or adrenal function. The decision if type and amount of contrat media use for the geriatric patient usually follow some sprt of routine protocol. Assessment for contrast agent administration accomplished by the imaging technologist must includeage and history of liver, kidney or thyroidal diseasehistory of hypersensitivity reactions and previous reaction to medications or contrast agent sensitivity to asprinover the-counter and ethical drug drug history including acetotaminophen (Tylenol)and history of hypertension.The imaging technologist must be selective in place an appropriate vein for contrast administration on the elderly patient. They should consider the location and condition of the vein, decrease intergrity of the skin, and the duration of the theraphy.Thin superficial veins, repeatedly uti lize veins,and veins located area where the skin is bruised or scarred should be avoided. Assess the patient for any swallowing impairments, which could lead to difficulties with make whoopieing liquid contrast agents. The patient should be instructed to drink slowly to avoid choking, and an trusty position will help prevent aspiration.The Radiographers RoleThe role of radiographers is no different than that of all other health professionals.The whole person must be treated, not only if the manifested symptoms of an illness or injury. Medical imaging and therapeutic procedures reflect the impact of ongoing systemic aging in documentable and visual forms. Adapting procedures to accommodate disablilities and diseases of geriatric patient is a critical responsibility and a take exception based almost exclusively on the radiographers knowledge, abilities and skills. An understanding of the physiology and pathlogy of aging, in addition to an awareness of the social, physical, congni tive and economic aspects of aging, are required to meet the need of elderly population. Condition typically associated with elderly patient invariably requires adaptations or modifications of routine imaging procedures. The radiographers must be able to differentiate between age-related changes and disease processes. Production of diagnostic images requiring professional decision making to compensate for physiologic changes, while maintaining the campliances,safety and comfort of the patient, is the foundation of the contract between the elderly patient and the radiographers.Radiographic spot for geriatric patientThe preceding reciprocation and understanding of the physical,cognitive,and physchology effect on aging can help radiographers adapt the positioning challenges of the geriatric patient.In some cases routine examination need to be modified to accommodate the limitation,safety and comfort of the patient.Communicating clear instruction with the patient is important.The fol lowing discussion addresses positioning suggestion for various structures.ChestThe positioning of choice of the chest radiography is the upright positions, in time the elderly patient may not able to stand without assistance for this examination. The tradisional posterioranterior (PA) position as to have the back of hand on hips. This may difficult for someone with ampaired balanced and flexiblelity. The radiographer can allow the patient to wrap his or her arm around the chest stand as a means of support and security. The patient may not able to maintain his or her arms over the head for the askance projection of the chest.Provide extra security and stability while moving the arms up and forward.When the patient cannot stand, the examination may be done seated in whellchair, but some issue will be effect the radiographic quality. First the radiologist need to be aware that the radiograph is an anterior-posterior (AP) instead of a PA projection, which may make obscure the lung bas es, in a sitting position, respiration may be instructed on the importance of a deep inspiration.Positioning of the image receptor for the kyphotic patient should be higher than normal because the shoulder and apices are in a higher position. Radiographic landmark may change with age and the centering may need to be lower if the patient is extremely kyphotic. When positioning the patient for the sitting lateral chest projection.The radiographer should place large sponge behind the patient to pitch hind or her forward.CHEST (Portable)Exam Rationale Cassette size 35-43cm Non-grid 72 kVp, 6 mAs AP projection (upright or supine)SpineRadiographic spine examination may be painful for the patient pitiable from osteoporosis that is lying on the bucky table. Positioning aids such as radiolucent, sponges, sandbags, and a mattress may be used as long as the quality of the images is not compromised. Performing upright radiographic examination may also be appropriate if a patient can safety t olerate this position. Performing upright radiographic examination may also be appropriate if a patient can safely tolerate this position. The combination of cervical lardosis and thoracic kyphosis can make positioning and visualization of the cervical projection can be done with the patient standing, sitting, or lying supine. The AP projection in the sitting position may not visualize the hurrying cervical vertebrae because the chin may abscure this anatomy. In the supine position the head may not reach the table and result in magnification. The AP and openmouth projection are difficult to do on a wheelchair.The thoracic and lumbar spines are sites for compression fractures. The use of positioning blocks may be necessary ho help the patient remain in position. For the lateral projection, a lead bloker or shield behind the spine should be used to absorb as much scatter radiation as possible.Pelvis/HipOsteoarthiritis, osteoprosis and injuries as the result of falls contribute to hip pathologies. A common fracture in the elderly is the femoral neck. An AP projection of the pelvis should be done to examine the hip. If the indication is trauma, the radiographers should not attempt to rotate the limbs. The second view taken should be cross-table lateral of the effected hip. If hip pain is the indication, assist the patient to internal rotation of the legs with use of sandbags if necessary.Upper expirationPositioning the geriatric patient for projection of the upper extremities can present its own challenges. Often the upper extremities have limited flexiblelity and mobality. A cerebrovascular accident or stroke may cause contractures of the change limb, Contractures of the affected limb, Contracted limbs cannot be forced into position, and cross-table views may need to be done. The inability of the patient to move his or her limbs should not be interpreted os a lack of cooperation. Supinated is often a problems in patient with constructures, fracture and paralys is. The routine AP and lateral projections can be supported with the use of sponges, sanbags, and blocks to raise and support the extremities being image. The shoulder is also a site of decreased mobality, dislocation, and fratures.The therapist should assess how much drift before the patient can do before attempting to move the arm. The use of finger sponges may also help with the contractures if the finger.Lower extremityThe lower extremities may have limited flexibility and mobality. The ability to dorsiflex the ankle joint may be reduced as a result of neurologi disorder. Imaging on the x-ray table may need to be modified when a patient cannot turn on his or her side. flexion of the knee may be impaired and require a cross-table lateral projection. If a tangential projection of the pattela, such as the settegast method, is necessary and the patient can turn on his or her side, place the image receptor superior to the knee and direct the central ray perpendicular throught the pattela-femoral joint. Projection of the feet and ankles may be obtained with the patient sititng in the whellchair. The use of positioning sponges and sanbags support and maintain the position of the body part being imaged.Technical Factors.Exposure factors also need to be taken into considerarion when image the geriatric patient. The loss of elevate mass, as well as atrophy of tissue, often requires a lower kilovoltage (kVp) to maintain sufficient contrast. kVp also a factor in chest radiographs when there may be a large heart and pleural fluid to penetrate. Patient with emphysema require a reduction in technical factors to prevent overexpose of the lungs fields. Patient assessment can help with the appropriate exposure adjustment.Time may also be a major factor. Geriatric patient may have problems maintaining the positions necessary for the examinations. A ill-judged exposure time will help reduce any voluntary and involuntarymotion and breathing. Ensure that the geriatric pati ent clearly hears and understands the breathing instructions.ConclusionThe imaging professional will continue to see a changes in the health care delivery system with the dramatic shift in the population of person older than age 65. This shift in the general population is resulting in an ongoing increase in the number of medical imaging procedures performed on elderly patient. Demographic and social effect on aging determine the way which the eldely adapt to and view the process of aging. An individuals family size and perceptions of aging, economic resources, gender, race, athnicity, social class, and the availability and delivery of health care will affect the quality of the aging experiences. Biological age will be much more critical than chronologic aging when determining the health status of the elderly. Healthier lifestyles and advancement in medical treatment will create a generation of successfully aging adults, which in turn should decrease the negative stereotypes of the e lderly person. Attitude of all health care professionals, whether positive or negative, will affect the care provided to the growing elderly population. Education about the mental and physiologic alteration associated with aging, along with the cultural, economic, and social influences accompanying aging, enables the radiographers to adapt imaging and therapeutic procedures to the elderly patients disablities resulting from age-related changes.The human body undergoes a multiplicity of physiologic changes and failure in all organ systems.the aging experiences is affected by heredity, lifestyle, choices, physical health, and attitude making it highly individualized. No individuals agign process is predictable and is never exactly the same as that of any other individuals. Radiologic technologist must use their knowledge.abilities and skills to adjust imaging procedures to accommodate for disabilities and disease encountered with geriatric patients. Safety and comfort of the patient i s essential in maintaining compliances throughtout imaging procedures. Implementation of skills such as communication, listening, sensitivity, and empathy, all lead patient compliances. Knowledges of age-related changes and disease process will anchance the radiographers ability to provided diagnostic imformation and treatment when providing care that meets the needs if tge increasing elderly patient population.GERIATRICS