MJ Geriatrics Final TQs (haley)

What do the 5 M’s stand for?

Mind

Mobility

Meds

Multi-complexity

Matters most

How does incorporating the 5 M’s help?

Improve outcomes for frail seniors - positive patient and provider satisfaction

Which Mind condition is an emergency?

Delirium - often confused with Alzheimer’s and dementia

What condition is indicated if the patient presents with an infection, dehydration, and seems ‘off’?

Delirium

What does the Patient Health Questionnaire screen for?

Depression

What is a primary indicator of late onset essential tremor and dementia?

Alcohol sensitivity → 1-2 drinks reduces amplitude by 50-70%

What does late onset essential tremor have a strong correlation with?

Cognitive decline and dementia

What score in the ‘Stay Independent’ Questionnaire indicates increased fall risk?

4+

Over what time indicates an increased fall risk in the TUG test?

More than 12 seconds

How far do patients travel in the TUG test?

9 feet (3 meters)

What time in the TUG test is problematic and indicates a gait aid requirement?

>30 seconds

Under what time in the tandem stance indicates an increased fall risk?

<10 seconds

What is scored with the Barthel index?

ADLs - higher score → greater level of independence

What exercise is recommended for seniors to increase their mobility?

Tai Chi (through Silver Sneakers)

What are high-priority targets of medications to stop taking unnecessarily?

Anti-coagulants/Warfarin

Anti-diabetic agents/insulin

Opiods

What is a primary concern of opiods?

Changes made to kidneys, liver, and body that change detox process → leave body with highly toxic and concentrated metabolites → increased adverse drug effects

Why should adults use these meds with caution or stop altogether: long-lasting NSAIDS, Digoxin, diabetic drugs, muscle relaxants, insomnia, anxiety meds, anticholinergic, pain reliever meperidine (Demerol), antihistamines, antipsychotics, estrogen pills/patches?

Increase fall risk → increase mortality risk

In what population is 2+ chronic medical conditions more prevalent in?

Patients with adverse social determinant of health and increases with age

T/F: Having end-of-life conversations should wait until after a crisis situation.

FALSE - have before a crisis situation to avoid partner distress and patient’s wishes followed

What is the leading cause of fatal and non-fatal injuries in those aged 65+?

Falls

T/F: Falls are increasing in prevalence.

True

What is the MC cause of TBIs in older adults?

Falls - especially if taking a blood thinner!

seek medical attention to rule out brain bleed

What body parts are commonly fractured in a fall?

Arm, wrist, hip

What is the MC fall-related injury?

Fall on outstretched arm - radius fx

How to prevent falls in older adults?

Brochure - stay independent

What You Can Do To Prevent Falls

Check for Home Safety (hazards)

Chair Resistance Exercises

Balance Exercises

Strength Exercises - squats

Berg Balance test

What does a higher score of the Berg Balance Test mean?

Better balance (max = 56)

T/F: We want patients to be in the overweight category of weight.

True - wiggle room in case of falls/injuries/illness

In the Kirkaldy-Willis model Dysfunction Phase, what does management involve?

SMT aimed at improving and reducing inflammation

In what phase of the Kirkaldy-Willis model does spinal stenosis occur?

Stabilization phase as structural changes reduce space in the canal

What red flags should be included in health promotion?

Acute onset of physical mobility decline

Memory issues

Changes in personal hygiene

Social withdrawal

Financial management problems

Cauda equina, stroke, MI, fx, unremitting night pain, unintentional weight loss, incontinence, history of cancer

What are yellow flags?

Changes in blood pressure

Psychiatric/psychosocial changes

1 fall

What is the 4th leading cause of death in aging population?

Stroke

How much walking is optimal exercise for stroke prevention?

12.5 miles per week

How can we reduce negative outcomes?

Focus on patient-centered care

Give patient realistic goals and expectations

Employ least-invasive option

What is the focus for an aging adult in an adjustment?

Global or kinetic chain involvement

What are some of the primary regional adjusting considerations for an aging adult?

Neck-shoulder-scapula complex

TL Junction Region

Hip

What is the goal of chiro care in spinal degeneration changes?

Slow progression of degeneration changes equal to wear and tear on joints

What are the primary chiro techniques for the aging adult?

Thompson drop

Sacro-occipital (prone pelvic blocking)

Logan Basic

Upper Cervical

Activator

Flexion distraction

In what position is Sacro-Occipital technique best performed on a geriatric patient?

Prone

What is an extremely low-force technique with use of sacro-tuberous ligament contact?

Logan Basic technique

What is flexion-distraction good for?

Stenosis, limited ROM, stiffness, disc issues

What does SLIP stand for?

Strengthen LE

Limber up

Improve balance

Posture

What are the MC locations of OA?

Hip, medial knee, spine

T/F: OA is common in ankles.

FALSE

What is the MC cause of death in both males and females?

Lung cancer

What size of AAA requires an immediate referral?

>3 cm

What is the MC location for metastatic disease?

Spine, followed by pelvis and ribs