Geriatrics is a complex and very lively field in the medical field. Holistic diagnoses and therapy concepts, adapted to the respective person, are created. But what is the term “geriatrics” and what specialties are covered?
What is geriatrics?
Geriatrics is the study of the diseases of aging people. The age of a geriatric patient is over 70 years. The term geriatrics is derived from Greek and refers to geriatric medicine or geriatric medicine. It is the study of the diseases of aging people. The age of a geriatric patient is over 70 years. It is tried to restore the health and well-being of the patient through the diagnoses. Independence and mobility are also trained, as well as mental vitality. When the patient is over 80 years of age, the geriatric patient is treated for secondary diseases related to age and for complications that arise. The term is used in the fields of internal medicine, neurology, orthopedics and psychology. This branch of medicine deals primarily with normal to pathological, mental and physical processes.
Treatments and therapies
Geriatric medicine is a specialized medical discipline that deals with various diseases that occur in old age. It will overlap the organ medical treatment and maintain the quality of life of the person. The list of diseases that are mainly associated with old age is long. But not every disease that an old person has is a disease of old age. Arteriosclerosis, the term for hardening of the arteries, which is associated with heart attacks, strokes and arterial occlusive diseases (for example, thromboses), is one of the most common diseases. Of course, an unhealthy lifestyle also contributes to this. Osteoarthritis, wear and tear of joints caused by overloading, manifests itself in pain during movement. Joint effusion and deformities are sequelae of this. Osteoporosis can also be a decisive factor in the development of osteoarthritis. If bone density is too low, the musculoskeletal system, in this case the human skeleton, collapses. The scope of treatment in geriatrics also ranges from diabetes mellitus, dementia, and age-related depression to cancer and Parkinson’s disease. With the consequence of aging, so-called old-age syndromes occur, as the accumulation of individual symptoms that appear after the age of 60. In geriatrics, these include intelligence decline as a result of dementia, brain dysfunction with increasing impairment of our senses, instability with a high risk of falls, incontinence of the bowel and urinary bladder, and the gradual loss of tissue fluid (exsiccosis). This combination makes it more difficult for the elderly to manage daily activities. At the first signs, it is necessary to perform diagnostics and develop a treatment plan. If there is no early therapy in these stages, even the slightest aggravation in a final stage can mean decompensation (the patient’s body can no longer compensate for a malfunction of an organ system). Early rehabilitative treatment is for patients who are not yet suitable for further rehabilitation. This is especially common for patients with heart disease, after fractures, with chronic lung disease, and for patients who have had a cerebral hemorrhage.
The patient receives care from a doctor, a physiotherapist or occupational therapist, a speech therapist, social services and trained nursing staff. Psychological care is also available. For pain treatment, ultrasound devices for heat treatment are used in addition to medication. The Galileo training system is used for fall prevention, but also for muscle building and treatment for osteoporosis. When administering medications, it should be noted that the risk of drug interactions and side effects is particularly high, as several medications must be taken at the same time during the day. A team of scientists has created a list of medications that lists the potentially dangerous drugs. The so-called “Priscus List” offers doctors and patients the opportunity to review their medication.Because of the extensive, inpatient and outpatient options available, geriatrics is highly valued in today’s medical care.
Diagnosis and examination methods
To avoid overlooking interactions due to damage to individual organ systems, the “geriatric assessment” has been introduced. It guides the physician through the examination step by step and is intended to facilitate the clarification of unclear symptoms. There are different assessment sets that can be used either at home, in a day clinic, in a hospital or in a nursing home. A person’s strengths are catalogued, the need for help is assessed and, if necessary, a care plan is drawn up for targeted intervention. The examination begins with a screening: a questionnaire is used to look for complaints in the area of vision and hearing, the mobility of arms and legs is analyzed, nutrition is discussed, possible incontinence is recorded and the patient’s emotional state is assessed psychologically. If problem areas are already apparent in the initial screening, a baseline assessment follows. The basic assessment is used to determine the Barthel Index (assessment procedure for daily living skills). A memory test according to Folstein (Mini-Mental-Status-Test), a depression test according to Yesavage, a mobility test according to Tinetti, a clock-sign test and a “Timed up and go test” are also performed. The “Timed up and go test” checks the patient’s mobility and the associated risk of falling. The watch-sign test is mainly used to clarify a possible dementia. Measurement of hand strength, as well as a social questionnaire, is part of the basic assessment. A screening takes approximately between five and ten minutes, although the basic assessment can take over an hour. The patient is generally interviewed by a physician or trained nonphysician staff. Only the depression questionnaire may be completed by the patient. After the results of the basic assessment, therapeutic consequences are discussed.
