Barbara Workman; Week 6 MED1022; HLSD
Usual ageing is related to age disease. Normal ageing is time-dependant process of physiological change which is progressive and intrinsic. Ageing is from intrinsic and extrinsic factors. Milestones in ageing can be physical, social and cognitive. Natural death is when person has reached maximum lifespan; change in physiology which increases function and response to internal challenge. Adverse events rise with age. Cascade iatrogenesis is a related series of adverse events triggered by an initial medical intervention, which is more likely in aged population. Avoid delerium through choice of drugs. Avoid corticosteroids which accelerate bone loss and increase muscle weakness. Minimise bed rest. There is renal and genitourinary dysfunction, think about renally excreted drugs with a long half life. There is decrease in everything just about except that haemoglobin and haematocrit is unchanged. There is decline in homeostatic reserve (temp regulation, volume regulation, sleep. Mental health is at risk with many adjustments and losses occuring. Screening for depression: are you satisfied with your life? Do you often get bored? Do you feel helpless? Do you prefer to stay home than go out and try new things? Do you feel worthless the way you are now? 2 or more yes requires further testing.
Delerium (acute brain syndrome, toxic psychosis, postoperative psychosis) has confusion, hallucination, inattention, agitation, altered consciousness. Can be caused by drugs, infection, surgery, metabolic, organ failures. There is acute onset, inattention and disorganised thinking as well as altered level of consciousness. Dementia is more insidious.