Common Problems in Geriatrics for Orthopedic Surgeons

Common Problems in Geriatrics for Orthopedic Surgeons
Presentation by
Steven Zweig, MD

Family and Community Medicine
MU School of Medicine

Goals

* Recognize the importance of aging physiology in the development and treatment of specific problems
* Prevent and treat delirium
* Recognize the significance of polypharmacy
* Identify patients at risk for elder abuse

Case 1 - 80 year old woman with hip fracture
Delirium
* Physical exam for VS, neuro, skin, infections
* Mental status exam
* Lab and x-ray for infections (lung, urine), fluid and lytes, hypoxia, BS, new trauma, systemic dx

Mental Status Evaluation

Case 2 - 76 year old woman with osteoarthritis
Altered Drug Distribution
Altered Drug Metabolism
Altered Renal Excretion
Common Adverse Drug Reactions
Principles of Geriatric Prescribing


Case 3- 75 year old woman with upper arm pain

X- ray and lab findings
Elder Abuse
Risk factors
Management

Tips for Coordinating Care

* Medicare home care - requires need for skilled nurse or PT
* Admission to SNF requires 3 day hospital stay - contact the NH physician to plan
* PPS means capitated reimbursement to SNFs
* Medicare does not cover costs of drugs
* Get SW involved if any care problems anticipated

Common Problems in Geriatrics for Orthopedic Surgeons.ppt