Geriatric Care

Question 1

There are various adverse effects that may result from the hospitalization of geriatric patients.  One of these effects is the negative psychological changes that are manifested in acute changes in the mental state. Specifically, elderly patients may develop delirium, which is a fluctuating and sudden change in the mental functions of elderly patients. According to Lima et al. (2010), 14%-56% of hospitalized elderly patients develop delirium.  It may be caused by environmental changes, medication side effects, dehydration, isolation and constipation among others. If delirium is not treated, it lengthens the patient’s hospital stay and increases risk of death tenfold.  Medical practitioners should address the causative agent to mitigate the condition. 

Another adverse effect is deterioration in bodily function as a result of prolonged bed rest.  When elderly patients are immobilized for a long period of time, it affects their digestion, cardiovascular, respiratory, muscular and circulatory systems. For instance, research has linked an increased risk of pressure ulcers among hospitalized elderly patients due to the reduction of blood flow to the tissues (Baumgarten et al. 2012). Moreover, prolonged bed rest for the elderly may also cause toxicity and complications in medication due to decreased clearance. 

The third effect is increased risk of infection, and when elderly patients are hospitalized for long periods of time, the risk of developing infections increase (Katz & Roghmann, 2016). Infections cause poor outcomes for the patient and increased length of stay, and in some cases it may cause sepsis. Elderly patients have a compromised immune system and this is why their risk of infection increases with hospitalization. It is therefore imperative that healthcare practitioners identify the risk factors that the hospitalized elderly patients face in order to address them and improve patient outcomes. 

Question 2

1. Sundowners syndrome

This is a condition where an elderly patient faces confusion usually late into the afternoon or at night, and it is common for patients with Alzheimer’s disease or dementia. 

2. ICU psychosis

This is a condition where a patient in the ICU experiences a variety of psychiatric symptoms, and it is caused by an acute brain failure or delirium. 

3. Sensory overload

This is a degenerative change linked to elderly people as part of the aging process, and it involves the decline of functional cells within the central nervous system.

4. Safety 

This is the prevention of adverse effects to the elderly including reducing risk of injury or harm, and prevention of errors in the course of giving healthcare services to the elderly 

Question 3

1. Financial

Hospitalization places a huge financial burden on the family since many geriatric patients are not financially empowered to pay their hospitalization bills. Moreover, the family continues to incur the costs associated with taking care of the needs of geriatric patients after discharge from the hospital 

2. Polypharmacy

This is the usage of many medications concurrently especially by the elderly, and it leads to low effectiveness of treatment. The patient’s family has the responsibility of monitoring medicines taken by the elderly after discharge to ensure that they only take the necessary medicine prescribed by the physician.   

3. Durable medical equipment in the home

The families of geriatric patients have the responsibility of ensuring that the elderly use durable equipment safely, comfortably and appropriately. They also have the responsibility of maintaining such equipment to ensure that it is in proper working order at all times. 

4. In-home assistance

The family members of geriatric patients have the responsibility of working together with care providers to assess the patient’s needs and ascertain the level of home assistance required. They should hire caregivers or healthcare professionals depending on their assessment of the patient’s needs.  

Question 4

1. Greeting

One should greet elderly patients by saying hello and offering a warm smile, to show the patient that the person is glad to see them. It makes the patient feel appreciated and they are likely to create an honest and trustful relationship with the person.  

2. Educating

One should start by talking and problem solving before embarking on educating the patient. It is also important to maintain a patient and positive attitude when educating geriatric patients. Moreover, one should also consider the social and cultural factors that may affect learning. Finally, the person should involve the geriatric patient in setting learning goals. 

3. Communication challenges 

One should stand in the patient’s line or sight and maintain eye contact while listening. It is also important to use simple and short sentences while speaking slowly. Moreover it is important to be patient and give the patient time to understand and respond to instructions or questions.  Moreover, it is imperative that one seeks help, like for instance from an interpreter, if they experience cultural barriers such as language. 

References

Baumgarten, M., Rich, S. E., Shardell, M. D., Hawkes, W. G., Margolis, D. J., Langenberg, 

P., Orwig, D. L., Palmer, M. H., Jones, P. S., Sterling, R., Kinosian, B. P. & Magaziner, J. (2012). “Care-related risk factors for hospital-acquired pressure ulcers in elderly adults with hip fracture”. Journal of the American Geriatrics Society, 60(2), 277-83. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532032/

Katz, M. J., & Roghmann, M. C. (2016). “Healthcare-associated infections in the elderly: 

what’s new”. Current opinion in infectious diseases, 29(4), 388-93. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5648009/

Lima, D. P., Ochiai, M. E., Lima, A. B., Curiati, J. A., Farfel, J. M., & Filho, W. J. (2010). 

“Delirium in hospitalized elderly patients and post-discharge mortality”. Clinics (Sao , Brazil), 65(3), 251-5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845764/