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Geriatric Care

Rationale

Care of the elderly is one of the traditional functions of the general internist, and with the “greying” of the population, geriatrics will become a larger part of the practice of all physicians who care for adults. The student should understand the unique health care needs and presentation of the elderly, key management strategies, and the importance of an interdisciplinary approach to care.

Prerequisites

Required courses in anatomy and physiology, physical diagnosis, and nutrition.

Specific Learning Objectives

  1. Knowledge: Each student should be able to describe:
    1. functional implications of aging organ systems.
    2. special nutritional needs of the elderly.
    3. key illnesses in the elderly, focusing on their often atypical presentation (e.g., urinary tract infection, pneumonia, tuberculosis, depression, thyroid disease, myocardial infarction, acute abdomen).
  2. Skills: Each student should be able to:
    1.  take a history from a geriatric patient with special emphasis on physical and mental functioning.
    2. perform a physical examination and functional assessment on an elderly patient, adapting it to possible conditions of frailty, immobility, hearing loss, memory loss, and other impairments.
    3. perform a mental status examination to evaluate confusion and/or memory loss in an elderly patient.
    4. identify patients at high risk for falling.
    5. practice an interdisciplinary approach to management and rehabilitation of elderly patients.
  3. Attitudes: Each student should:
    1. always obtain historical information from significant others, whenever possible.
    2. respect the increased risk for iatrogenic complications among elderly patients by always taking into account risks and monitoring closely for complications.
    3. demonstrate respect to older patients by making efforts to preserve their dignity.