Geriatric care or geriatric nursing is a specialty that deals with treating and managing illness in older adults. The Geriatric Care is one of several possible transitional care settings that allow the patient to be discharged from an acute care facility and still receive supervision and support. The senior population has specific needs that differ from the typical hospitalized adult or child, such as daily living (ADL) limitations, cognitive impairment, sensory loss, and pain/discomfort management. Thus, it is not surprising that many geriatric patients will require some form of care from a McKinney geriatric care specialist after hospitalization to ensure continued independent function and safety.
Who Needs Geriatric Care?
The care of elderly patients is not regulated, and there are no specific criteria to determine the need for such service. However, you can infer that a patient may require geriatric home care if they:
- Has had an extended hospitalization (5-7 days), and nursing home placement is not immediately appropriate
- Has multiple chronic conditions, especially if cognitive impairment is present
- Is unable to perform at least two major ADLs without assistance from a family member or caregiver
- Has an unstable mental status with fluctuating levels of consciousness/awareness
- Requires frequent monitoring to ensure patient safety & security during transitional care (e.g.falls, fractures)
Common Geriatric Conditions
1. Urinary Incontinence
Urinary incontinence (UI) is one of the most common complications of aging, and it affects up to 50% of hospitalized geriatric patients. It has been identified as a predictor of falls, functional decline, healthcare utilization, and mortality in this population. Incontinence can result from multiple factors, including failure to avoid (urinary retention ), weak urinary sphincter tone, inadequate bladder capacity, poor hygiene, and cognitive impairment.
2. Upper Extremity Disorders
Older adults are at high risk for upper extremity disorders, shoulder pain, frozen shoulder, adhesive capsulitis, particularly if they have had a previous injury or surgery to the affected joints. This can lead to mild to severe impairment in shoulder movement, increasing the risk for falls and subsequent fractures.
3. Sleep Apnea
Between 30-50% of older adults have some form of sleep apnea associated with increased risk for cardiovascular disease, weight gain, and cognitive impairment. It is more common in individuals who are overweight or obese but can also result from pre-existing craniofacial abnormalities (e.g., facial structure, large tongues) or decreased muscle tone (e.g., after stroke).
Osteoarthritis (OA) is the most common chronic joint disorder in adults, and it has a higher prevalence in older age groups due to degenerative changes. It is typically progressive, non-inflammatory, and affects multiple joints simultaneously. The symptoms can be mild to debilitating, and it leads to significant functional decline in patients.
Osteoporosis is prevalent in the elderly population and has been associated with increased mortality. It is estimated that women experience an average decrease of bone mass of 3-5%/decade after menopause, while men lose bone at a rate of 1-2%/decade after age 50.
To summarize, geriatric care is the specialty of nursing that treats and manages illness in older people. You may need it if you have had an extended hospital stay, multiple chronic conditions, or have trouble performing major ADLs. Common geriatric conditions include osteoporosis, osteoarthritis, urinary incontinence, and sleep apnea.