GENERAL ASPECTS OF DISEASES IN THE ELDER: GERIATRIC SYNDROMES

Introduction:

There are few diseases that affect only the elderly, but there are more incidence in this age and especially the implications that any of them can have in this group. There are characteristics of pathological processes geriatric, they determine the specificity of care, so you need to keep in mind the professional work in gerontology.

GENERAL ASPECT OF DISEASES IN THE ELDERLY

-        the heterogeneity of the population over 65 years

-        the peculiarities of the diseases

-        frailty

-        comorbidity and polypharmacy

-        long latency periods of many to be symptomatic diseases, immune disorders and iatrogenic

-        tendency to chronicity and frequent inability

-        poorer prognosis of disease

-        diagnostic and therapeutic difficulties

-        increased use of health care resources

-        common ethical issues

SYMPTOMATOLOGY:

The symptoms don’t appear clearly. However there’re a number of symptoms that are repeated in various diseases, but are not known for being itself and/or population specific.

1)     Pain: is a manifestation linked to different situations. Chronocity is common and that is why many people have adapted to their way of life by minimizing its valuation.

a.      Abdominal pain and chest pain require special attention

b.      Pain out of proportion to the cause, also requires close observation

c.      Assessment of pain:

                                                    i.     Onset of pain

                                                   ii.     Pain perception

                                                 iii.     Pain response

                                                 iv.     Pain threshold

                                                   v.     Stimulus onset

                                                 vi.     Pain tolerance

                                                vii.     Amount and duration of pain

                                              viii.     Location

                                                 ix.     Intensity duration

                                                   x.     Quality

                                                 xi.     History

                                                xii.     Facial expression

                                              xiii.     Mobilization body

EVA SCALE:

2)     Temperature: the high temperature in the elderly is an important clinical problem because when displayed indicates infection or other general disorders.

a.      Digestive and urinary problems:

                                                    i.     Urinary problems à Polyuria, nocturia and urinary frequency

                                                   ii.     Diarrheal

b.      Fatigue or weakness

c.      Tremor

d.      Senile pruritus

e.      Mental disorders

Principal risk factors:

-        organic’s origin:

o       hypertension

o       malnutrition

o       sensory difficulties

o       incontinence

-        environmental’s origin

o       architectural barriers

o       poor economic

o       inactivity

o       polypharmacy

o       alcoholism

o       changes in the environment

-        relational risk:

o       loneliness/isolation

o       insomnia

o       disorientation

Geriatric syndrome:

Combination of a number of diseases that have their expression through pathological framed not in common diseases. It’s require evaluation of their meaning and etiologic. for proper treatment. Essential of Clinical Geriatrics (book):

-        Immobility

-        Instability and falls

-        Incontinence urinary and fecal

-        Intellectual impairment

-        Infections

-        Inanition

-        Impairment of vision and hearing

-        Irritable colon

-        Impotence

-        Iatrogenesis

-        Immune deficiency

-        Isolation/Insomnio

Characteristics:

1. Systemic disease or comorbidity
2. the cause is multifactorial
3. Establishment and rapid disease progress
4. Shortly expressive with minimal clinical or silent and sometimes contra
5. It’s very sensitive to infections, dehydration temperature changes, anemia, malnutrition, accidents.
6. more severe in terms of the intensity of tissue damage and complications
7. irreversible loss of organ function with impaired mobility, immobily syndrome
8. adaptive responses of the organs can trigger new symptoms
9. produces apathy, depression and mental confusion
10. acceptance of the inability of the patient and family
11. iatrogenic type response
12. denial of symptoms
13. have some kind of social or family problem
14. unfavourable prognosis

Personal reflection:

In geriatric syndromes, the patient has vulnerabilities. We should be attentive, observe and analyze the elderly. Observe the symptoms and properly evaluate.

BIBLIOGRAPHY:

Spanish Society of Geriatrics and Gerontology