geriatric pt
Post on 05-Dec-2014
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Subhanjan Das
What is GeriatricsGeriatrics is the branch of medicine that
focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults.
Geriatrics was separated from internal medicine as a distinct entity in the same way that pediatrics is separated from adult internal medicine and neonatology is separated from pediatrics.
Gerontology Gerontology is the branch of biomedical
sciences that studies aging. The term "geriatrics“ is used to refer specifically to the medical study of diseases and problems of the elderly.
Changes with ageingSKIN:Epidermis thinner and fragileDermis less elastin and flexibleHypodermis thinner and less paddingUV light accelerates skin ageingSenile purpura
Changes with ageingEYEPtosisDry eyeTearing Flatten & uneven cornea with light scatteringHyperopia (farsightedness)Smaller pupil requiring brighter light to readSlower dark adaptationReduced contrast sensitivity
Changes with ageingEARReduced sweat glands with increased ear
wax affecting hearingCochlea degeneration causing high tone loss
Changes with ageingKIDNEYSReduced ability to excrete water, waste
products and drugsLess tolerate water depletionLoss of circadian rhythm with nocturiaSmaller and less expansible bladder with
frequency of urineLess contractable bladder with hesitancyBigger prostate with fair urine stream
Changes with ageingBONEContinual loss of bone mass from the 4th
decadeHormonal change with more bone resorption
than formationLess Ca absorptionShorter and stoopBrittle with easy fractureNew bone formation at the verge of jointsCartilage thinner
Changes with ageingNERVOUS SYSTEM30,000-50,000 neurons die each day with
diminishing reserveIQ slowly decline after the age of 25Reduced short term memoryDecreased retrieval abilityInterrupted and less deep sleepReduced pain, touch, temperature, and vibration
sensationsReduced postural control and balance
Changes with ageingHEARTHeart becomes more rigid with decreased outputHeart beat less responsive to stressHeart beat less variable with each breathingIrregular heart beat more common with ageingSystolic blood pressure increases with agePulse pressure widened with hardened vesselsLess efficient venous return prone to postural
hypotension
Changes with ageingLUNGSLungs become more rigid with early closure of small
airwaysLess efficient blood gas exchangeChest wall becomes more rigid tooReduced Lung Volume and Vital CapacityBronchial villi thinner and cough reflex less effectiveReduced ability to cope with challenges like climbing
stairs, runningReduced immunity prone to chest infection
Changes with ageingGITSaliva glands secret less with dry mouthTaste and smell senses declineLess heathy teeth affecting chewing/nutritionStomach muscle weakened and less hungrySmall intestine villi absorb less calcium, vitamin B12, folic
acidLarge intestine muscle weakened and secrets less mucus
prone to constipationLess liver blood flow and function with fall in toxic
substance/drug clearanceBile thicker with cholesterol prone to gallstones
Diseases in old age
Diseases in old age
Geriatric physiotherapyGeriatric physiotherapy became a specialty of
physical therapy study in 1989. Since then, physiotherapists have worked to understand the problems of the aging. There is a long list of problems dealt with in geriatric physiotherapy.
Alzheimer's arthritis balance disorders cancercardiovascular disease incontinencejoint replacement pulmonary diseasestroke
3 major groups1. deconditioning2. cardiovascular diseases3. musculoskeletal problems
3 major groups1. deconditioning:
problems that happen because the patient simply does not use their limbs. These problems can be addressed by reconditioning through range-of-motion and other exercises
2. cardiovascular diseases: like heart disease and stroke. Exercise, aqua therapy, electrical stimulation and more can be used.
3. musculoskeletal problems: such as osteoporosis and osteoarthritis. These problems require special attention as osteoporosis makes patients frailer, and osteoarthritis is very painful.
Because falls are such a problem, the osteoporosis therapy is crucial. Along with that, geriatric physiotherapy is responsible for preventing many falls because of work with balance and gait. Some clinics focus entirely on balance issues for the elderly.
Qualities of geriatric physiotherapistProfound knowledgeCaring attitudeGood
communication skillAbility to think out
of the box
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