1. Geriatricsfor: PTA 100 presented by: Troy Metzinger 1

2. Objectives Definition Competencies Adult and Geriatric Differences Geriatric Giants Medical Conditions Medication Issues Geriatric Specialties Complication with Treatments Employment/Salary Awards Conclusion 2

3. Definition Geriatrics is the branch of medicine that focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults. People over the age of 65 are considered, geriatric but there is no set age 3

4. Minimum Geriatric Competencies Cognitive and behavioral disorders Medication management Self-care capacity Falls, balance, gait disorder Atypical presentation of disease Palliative care: any form of medical care or treatment that concentrates on reducing the severity of disease symptoms Hospital care for elders Health care planning and promotion Most pressing issue facing geriatrics is the treatment and prevention of delirium 4

5. Differences between adult and geriatric medicine Geriatric medicine is the study of the decline of the body organs as the body ages. This health varies according to the whether the body is in decline or maintaining as age continues to set in and the lifetime of good and/or bad habits that have accumulated. 5

6. Elderly disease and the Geriatric Giants Delirium: acute and debilitating decline in attention-focus, perception, and cognition that produces an altered form of semi-consciousness Immobility: disinclined to move Instability: lack of physical stability; unsteadiness Incontinence: involuntary excretion of urine Impaired intellectual memory functioning: various mental processes that underpin rational thinking. Elderly care: fulfillment of the special needs and requirements that are unique to senior citizens Multiple medications: prescription and nonprescription medications, herbal supplements, and vitamins Impaired vision: visual degenerative conditions Impaired hearing: full or partial decrease in the ability to detect or understand sounds 6

7. Geriatric Medical Conditions Dementia isn't a specific disease. Instead, it describes a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. It's caused by conditions or changes in the brain. Different types of dementia exist Alzheimer's is the most common form of dementia Cancer (e.g., ovarian cancer, prostate cancer) refers to any one of a large number of diseases characterized by the development of abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy normal body tissue Diabetes the term "diabetes mellitus" refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Epilepsy is a disorder characterized by episodes of abnormal neuronal signaling in the brain. 7

8. Geriatric MedicalConditions Cont. Heartdisease is an umbrella term for a variety for different diseases affecting the heart. As of 2007, it is the leading cause of death in the United States Osteoporosis which means "porous bones," causes bones to become weak and brittle — so brittle that even mild stresses like bending over, lifting a vacuum cleaner or coughing can cause a fracture. In most cases, bones weaken when you have low levels of calcium, phosphorus and other minerals in your bones Parkinson's disease develops gradually, often starting with a barely noticeable tremor in just one hand. But while tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes a slowing or freezing of movement. Sleep disorders nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth are kinds of sleep problems called parasomnias. There are treatments for most sleep disorders. Sometimes just having regular sleep habits can help Stroke occurs when the blood supply to a part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within a few minutes, brain cells begin to die. 8

10. 51% are taking more than one medication of any kind each day

11. 46% are taking at least one prescription medication each day

12. 28% are taking multiple prescription medications a day

13. 40% are taking multiple herbal supplements or vitamins each dayOf people age 65 or older, 79% are taking at least one prescription medication a day, with an average of 4 prescription medications a day. Although these medications could have a serious impact on their hospital care, the survey found that only 8% told hospital staff knew what medications they were taking, and only 3% brought samples of their medications with them to the hospital. 9

14. GeriatricSpecialties Geriatric Rehabilitation : Focus on physical therapy and rehabilitation Geriatric Psychiatry (focus on dementia, delirium, depression and other psychiatric disorders). Geriatric Cardiogeriatrics(focus on cardiac diseases of elderly) Geriatric nephrology(focus on kidney diseases of elderly) Geriatric oncology(focus on tumors in elderly) Geriatric rheumatology(focus on joints and soft tissue disorders in elderly) Geriatric diagnostic imaging Geriatrics dermatology(focus on skin disorders in elderly) Geriatric subspeciality medical clinics(As Geriatric Anticoagulation Clinic Geriatric Assessment Clinic, Falls and Balance Clinic, Continence Clinic, Palliative Care Clinic, Elderly Pain Clinic, Cognition and Memory Disorders Clinic) 10

15. Complications with treating Geriatrics Treating an elderly patient is filled with complications with the major difference of treating a geriatric patient is that treating an elderly person sometimes needs to have a guardian or healthy proxy make the medically decision required for the situation or treatment required. The issues of power of attorney privacy, legal responsibility, advance directives and informed consent must always be considered in geriatric procedure 11

16. The College of St. Catherine Physical Therapist Assistant Program Employment/Salary Data:Reported Range of Current Hourly Salaries from 2007: Out-state full time Geriatrics = $17.50 - 18.43Out-of-town full time Geriatrics = $22.50These are averages for the Minneapolis/St. Paul metro area West North Central: $31,764 (MN, IA, MO, KS, NE, SD, ND) The Median income of full-time PTAs in the East North Central area of the Midwest is $37,000 The Median income of full-time PTAs in the West North Central area of the Midwest is $33,140 The Median income of full-time PTAs with 1-3 years of experience is $34,000 12

17. EMPLOYMENT OUTLOOK FOR PHYSICAL THERAPIST ASSISTANTS Employment of physical therapist assistants expected to grow much faster than the average through the year 2010 The large baby-boom generation is entering the prime age for heart attacks and strokes Medical developments should permit an increased percentage of trauma victims to survive, creating added demand for therapy services. “Physical therapist assistant is listed in the Top 100 Occupation List as number 69th , with a 41.1% increase anticipated between 2000-2010 Job outlook for physical therapist assistants is described as “Very Good”. 13

18. APTA Employment PT’s, PTA’s active and retired number approximately 5000 Largest of any APTA component in 2006 PTA’s comprise 8% of the Section or 400 members 14

19. Geriatric APTA Awards Marilyn Moffat Foundation in Geriatric Physical Therapy Achievement in geriatric physical therapy research and practice specific to geriatric care and rehab. 15

20. Conclusion As the population ages, so does the need for those trained in the specialized care of the elderly patient as it applies to the physical therapy and its treatments required for quality of life and independent living activities. 16

21. Sources GERIATRICSFOR-SPECIALISTS INITIATIVE (GSI) Increasing Geriatrics Expertise in Surgical and Medical Specialties Howell, Trevor H. (January 1987), "Avicenna and His Regimen of Old Age", Age and Ageing16: 58–9, doi:10.1093/ageing/16.1.58 ,PMID3551552 http://ageing.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=3551552 Howell TH (1972). "Avicenna and the care of the aged". Gerontologist12 (4): 424–6. PMID 4569393 PitskhelauriGZ, Dzhorbenadze DA (1970). "[Gerontology and geriatrics in the works of Abu Ali IbnSina (Avicenna) (on the 950th anniversary of the manuscript, Canon of Medical Science)]" (in Russian). SovZdravookhr29 (10): 68–71. PMID 4931547 17