With the onslaught of winter and frigid temperatures spreading across the country, now is a good time to think about one of our most vulnerable populations: the elderly. Although geriatrics make up a clear majority of our patients, winter weather can pose additional challenges for these high-risk individuals.
Before we address some of the common winter health issues involving geriatric patients, let’s discuss the physiological changes that take place in the human body as it ages.
The Aging Body
The older you get, the more you will appreciate significant changes that take place as the body ages. These changes must be considered when responding to elderly patients. They affect our assessments, our treatments, and our overall approach to patient care. Here are a few of the effects aging has on the geriatric patient:
- Delay of symptoms: Older bodies may take longer to develop common symptoms, such as fever, pain, or tenderness. Medications may mask certain symptoms, such as changes in blood pressure or pulse, so be sure to consider the patient’s past medical history when evaluating their condition.
- Alertness and orientation: Although we depend on these factors to gauge a patient’s condition, elderly patients may be affected by dementia or a previous stroke, both of which will alter their normal level of consciousness. Utilize a family member or caregiver when assessing the patient’s level of consciousness and keep in mind confusion may be their normal state.
- Skeletal degeneration: The normal deterioration of muscles and bones during aging will make these patients especially susceptible to fractures and injuries. Arthritis, brittle bones, and muscle weakness can mean higher risk of falls. Be sure to perform a thorough assessment, since injuries may go unnoticed by the patient.
Assessing the Elderly
As with pediatric patients, geriatrics require a tailored approach. Here are a few considerations for assessing your elderly patients:
- Employ patience: Assessing the elderly may take longer than assessing younger patients. Be patient as you question geriatrics, and use clear, concise language. Open-ended questions may confuse some patients, so provide clear parameters, such as a pain scale (1-10), or clear definitions, such as sharp, dull, or stabbing, when discussing pain.
- Engage caregivers: With the patient’s permission, include caregivers when gathering information during your assessment. However, be sure not to exclude the patient, especially if they are oriented and able to answer. Do not treat the elderly like children. They may be fully capable of providing their chief complaint and detailed history, so start with the patient and engage caregivers when necessary.
- Consider the senses: Many elderly patients have diminished hearing and sight, so be sure to consider their sensory abilities during assessment and treatment. Speak clearly and loudly to the hearing impaired, or write down your questions for those who are deaf. If the patient is blind, be sure to explain your actions before touching them to reduce their anxiety and improve communication.
Winter Health Woes
As cold weather moves in, elderly patients—especially those with preexisting conditions—can be at increased risk. Here is a sample of some of the winter hazards affecting geriatrics:
- Respiratory ailments: Pneumonia and flu can be lethal for the elderly, especially if they already suffer from COPD, asthma, or emphysema. Common winter ailments can compound preexisting respiratory disorders, making it that much harder for the elderly to stay oxygenated.
- Falls: Icy conditions will make it difficult for the elderly to walk, so expect an uptick in the number of falls and fractures.
- Extreme weather: Snow and ice may make it impossible for the elderly to venture out for medications and food, leaving them susceptible to underlying conditions and hunger. Isolation may also intensify depression, so be sure your elderly patients have someone they can call for help, or connect them with social services that can provide transportation, meals, and support.
- Hypothermia: The elderly are already challenged when it comes to body temperature regulation; a drop in temperature can put them at risk for hypothermia. Be sure to keep them warm during transportation, and if the patient is not being transported, ensure their homes have heat and remind them to bundle up.
Winter weather can make life challenging, especially for our geriatric patients. As healthcare professionals, we are responsible for the health and well-being of those we serve. It is our job to ensure those at greatest risk are taken care of, especially during the coldest months.