Assessment of the individual with several chronic illnesses becomes very complicated. Things are not always what they seem. The traditional signs and symptoms of disease that were learned from textbooks do not always apply in an older adult. Often there are atypical presentations of illness. For instance an elderly person might not demonstrate a temperature with an infection. The assessment of the complex older adult requires critical thinking to put together the assessment clues.
For this discussion the class is divided into three groups, each of which will answer a different question. When responding to classmates, make at least one response to a classmate’s post in each of the two questions you were not assigned to answer.
Group 1: Those with last names that begin with A-H will answer this question:
There is a high correlation between the presence of multiple chronic co-morbid conditions, geriatric syndromes, iatrogenesis, frailty, and poor outcomes.
What is a geriatric syndrome? Which comes first? Might the presence of geriatric syndromes be the clues to the diagnosis of underlying chronic illness? Or might the complex presence of chronic co-morbid conditions lead to the development of geriatric syndromes? Does the condition of frailty meet the criteria of a geriatric syndrome? Why or why not? Give an example of how our well-intended interventions might cause iatrogenesis.
Group 2: Those with last names that begin with I-P will answer this question:
Most elderly adults want to remain independent in their homes. The thing the elderly fear the most is the loss of independence. But with aging often comes loss of mobility, loss of function, sensory loss, loss of friends, etc. and this can lead to social isolation. What are the health effects of social isolation? How do you assess for the signs and symptoms of social isolation?
Group 3: Those with last names that begin with Q-Z will answer this question:
One’s concept of “old” changes as one ages. What is the “stereotypical” image of “old” or “chronically ill”? Discuss an example of negative stereotyping or attitudes towards a chronically ill elderly person or child this week. Use newspapers, TV reports or programs, greeting cards, motion pictures, or even something you witness yourself. Did you find any positive examples? Imagine yourself as a chronically ill elderly person or child. What can nurses do to change these negative stereotypes?