1 / 45

Introduction to Geriatrics: Demographics, Normal Aging, Healthcare Issues

Integration Unit: Geriatrics Dr. R. Ellen March 31, 2014. Introduction to Geriatrics: Demographics, Normal Aging, Healthcare Issues. Disclosure.

fala
Télécharger la présentation

Introduction to Geriatrics: Demographics, Normal Aging, Healthcare Issues

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Integration Unit: Geriatrics Dr. R. Ellen March 31, 2014 Introduction to Geriatrics: Demographics, Normal Aging, Healthcare Issues

  2. Disclosure You may only access and use this PowerPoint presentation for educational purposes. You may not post this presentation online or distribute it without the permission of the author. Integration Block: Geriatrics – Dr. R. Ellen

  3. Integration Block: Geriatrics – Dr. R. Ellen

  4. In 2025 those over 65 will represent what % of the population? 12% 15% 20% 22% 25% Integration Block: Geriatrics – Dr. R. Ellen

  5. In 2025 those over 65 will represent what % of the population? • 12% • 15% • 20% • 22% • 25% Integration Block: Geriatrics – Dr. R. Ellen

  6. Canada: Δ in Age / Sex over Time Integration Block: Geriatrics – Dr. R. Ellen

  7. Percent of your medical practice caring for older persons? • 30% • 44% • 50% • 70% • 90% Integration Block: Geriatrics – Dr. R. Ellen

  8. Remaining life expectancy for an 65year old woman. • Another? • 8 years • 10 years • 12 years • 15 years • 22 years Integration Block: Geriatrics – Dr. R. Ellen

  9. Remaining life expectancy for an 80 year old woman. • Another? • 2 years • 4 years • 6 years • 8 years • 10 years Integration Block: Geriatrics – Dr. R. Ellen

  10. 2020 Canadian Population  current Florida population. 1/5th of Florida is > 65 years of age. Florida State Census Integration Block: Geriatrics – Dr. R. Ellen

  11. A man & woman are both 65. Odds that they both will reach 90? • 99% • 94% • 63% • 36% • 11% Integration Block: Geriatrics – Dr. R. Ellen

  12. CMA Task Force: Principles Drs. Leon Richard, JohnO’Brien-Bell, and Roy Romanow – 1980s Care of the elderly should be seen as mainstream health care No elderly person should be denied health care because of age Elderly persons must have the right to choose to live at risk The elderly should have the right to die in their own home Integration Block: Geriatrics – Dr. R. Ellen

  13. Which of the following is NOT a normal aging change? A Big Mac®may ↓ blood pressure Benzodiazepine clearance is ↓ Insulin resistance is ↓ Creatinine clearance ↓ 1%/year Epinephrine levels are unchanged Integration Block: Geriatrics – Dr. R. Ellen

  14. Which of the following is NOT a normal aging change? • ↓ VO2 max • ↓ Heart Rate • ↑ Systolic Blood Pressure • ↓ Stroke Volume • ↓ Cardiac Output in stress response Integration Block: Geriatrics – Dr. R. Ellen

  15. 82 yo Runs 3:41 Marathon • Ed Whitlock • 2013 • Toronto Marathon • Canadian Integration Block: Geriatrics – Dr. R. Ellen

  16. % Women 80 yo≥ 2 Chronic Diseases? 10% 30% 50% 70% 100% Integration Block: Geriatrics – Dr. R. Ellen

  17. Prevalence of Chronic Disease Integration Block: Geriatrics – Dr. R. Ellen

  18. Integration Block: Geriatrics – Dr. R. Ellen

  19. Age is the greatest risk factor for most diseases. Integration Block: Geriatrics – Dr. R. Ellen

  20. 75-84 yo with no significant functional impairments? • That is, they are independent. • 10% • 30% • 50% • 70% • 90% Integration Block: Geriatrics – Dr. R. Ellen

  21. Health care needs of elders increase annual costs in Canada? 1% 3% 5% 10% 15% Integration Block: Geriatrics – Dr. R. Ellen

  22. How age affects the cost of care.Provincial spending per capita (2008). Canadian Institute For Health Information Integration Block: Geriatrics – Dr. R. Ellen

  23. Drivers of Health Care Spending Integration Block: Geriatrics – Dr. R. Ellen

  24. ≥ 65 yo & Acute Care Hospital Days? 20% 30% 50% 60% 80% Integration Block: Geriatrics – Dr. R. Ellen

  25. In Ontario Older persons account For 63% of all acute care Hospital days. Integration Block: Geriatrics – Dr. R. Ellen

  26. A week of bed rest = muscle strength lost? 1% 5% 10% 35% 60% Integration Block: Geriatrics – Dr. R. Ellen

  27. 10 leg lifts, 6x’s/day ↑ Quad strength over 8 weeks? Fiatarone et al,JAMA 1990 12% 31% 55% 100% 175% Integration Block: Geriatrics – Dr. R. Ellen

  28. The “frail” elderly represent approximately 3% of the overall population. What % of the overall population health care costs do they “consume”? 1) 5% 2) 10% 3) 20% 4) 30% 5) 40% [Unit name – Lecture title – Prof name]

  29. Frailty & Health Care Costs • The frailelderly represent approximately 3% of the overall population. • What % of the overall population health care costs do they consume? • 5% • 10% • 20% • 30% • 40% Integration Block: Geriatrics – Dr. R. Ellen

  30. Do most businesses (eg. Healthcare) not FOCUS on primary customer segments? [Unit name – Lecture title – Prof name]

  31. A disconnect? Do successful business focus on serving their largest demographic? Is this true for Canadian Healthcare? Integration Block: Geriatrics – Dr. R. Ellen

  32. Is Frailty static? • Many think that frail seniors health trajectory is static or slowly deteriorating. • In Canadian health surveys of frail elderly, what % who had earlier reported “activity dependence” 4 years later reported improvedor no ADL dependency? • 5% • 13% • 19% • 32% • 50% Integration Block: Geriatrics – Dr. R. Ellen

  33. Not a BADL? • Which of the following is not a BASIC or PERSONAL Activity of Daily Living (BADL)? • Katz scale • Walking • Eating • Toileting • Continence • Transfer (e.g. lying to sitting) Integration Block: Geriatrics – Dr. R. Ellen

  34. Which tool screens for depression? Folstein Yesavage Tinetti Katz CAGE Integration Block: Geriatrics – Dr. R. Ellen

  35. Attitudes:Grey’s Anatomy 1 episode • Izzie Stephens: • “Maybe I should have gone into geriatrics. No one minds when you kill an older person.” • Another Intern: • “Geriatrics is for freaks who live with their mothers and never had sex.” Integration Block: Geriatrics – Dr. R. Ellen

  36. Canada & Geriatricians • If the same ratio of Geriatricians per 65+ as Pediatricians for <14 we would have approximately 16000 Geriatricians. • How many Geriatricians are there in Canada? • 1 • 120 • 210 • 520 • 1000 Integration Block: Geriatrics – Dr. R. Ellen

  37. Percent of hospital admissions for the elderly are medication related? 2% 5% 10% 15% 25% Integration Block: Geriatrics – Dr. R. Ellen

  38. Older Persons in Canada • Percent of population • 13% of population • 25% by 2025 • Life expectancy increasing • 1900 – 47 years • 2010 – 80 years • Disability increasing or decreasing? Integration Block: Geriatrics – Dr. R. Ellen

  39. Older Persons in Canada Aging = decreased reserve. Aging does NOT = symptoms. Heterogeneity increases Aging IS a state of mind. Boomers RULE (1946-62) (now aged 52-68; their parents = 72-90 yo) Integration Block: Geriatrics – Dr. R. Ellen

  40. Older Persons in Canada Aging = increased risk (problem list). Healthcare will notgo bankrupt by seniors. Significant mismatch education to real life practice. No Symptoms approach (focus on Frailty) Lots of room for improvement and change. Integration Block: Geriatrics – Dr. R. Ellen

  41. Geriatrics Curriculum • Healthy aging • Geriatric Assessment &Management • Geriatric Giant – Falls • Frailty • Medications • 15% admissions • INTERdisciplinary Teamwork Integration Block: Geriatrics – Dr. R. Ellen

  42. Geriatrics Curriculum Geriatric Giant: The Dizzies Geriatric Giant: Atypical Presentation of Disease Gender CHF & hypertension Geriatric Giant: Dementia Chronic Illness Elder Abuse Integration Block: Geriatrics – Dr. R. Ellen

  43. Geriatrics Curriculum Geriatric Giant: Delirium Geriatric Giant: Depression Capacity Behaviour Challenges Ethical Issues Driving Integration Block: Geriatrics – Dr. R. Ellen

  44. Excellent Resource Geriatric Medicine Survival Handbook - McMaster http://fhs.mcmaster.ca/medicine/geriatric/docs/Geriatric_Handbook08.pdf Integration Block: Geriatrics – Dr. R. Ellen

  45. Any questions? Thank you! Integration Block: Geriatrics – Dr. R. Ellen

More Related