Common Geriatric Problems in the Home

1. Common Geriatric Problems in the Home

2. Home Care of Stroke Patients • To help stroke patients reach realistic functional goals • assessment of medical status, extent of neurologic deficit, functional performance, psychosocial factors & family support • The physician as health care provider should address various medical problems of stroke patients and provide appropriate management

3. IMMOBILITY • Assessment to determine self-care and home maintenance • PE: patients sitting balance and ability to rise from sitting position • Evaluation of balance through neck turning • ROM of joints and presence of contractures

4. IMMOBILITY • Consequences: • dec.general conditioning, dec CV fitness • Joint stiffness, contractures, muscle wasting, accelerated osteoporosis • Pneumonia,venous stasis, pulmonary emboli • Decubitus ulcers

5. Treatment/ Management • Objective: maintain ADL and achieve functional independence • NON-PHARMACOLOGIC • PHARMACOLOGIC

6. NON-PHARMACOLOGIC • PATIENT EDUCATION • Px must be taught to modify the use of their affected joints, reduce stress, optimal periods of rest • PHYSIOTHERAPY &OCCUPATIONAL THERAPY • ROM exercises w/o excess stress on joints must be performed slowly and smoothly for flexibility and to avoid contractures • If ambulatory- progressive daily work programs w/o overtaxing help promote CV fitness

7. PHARMACOLOGIC • ANALGESICS • For pain and inflammation • Transcutaneous Electrical Nerve Stimulation • May be used for painful shoulder

8. Assistive devices • Crutches, canes, contour pillow • Adaptive devices • For enhancement of ADL • Rehab program is warranted starting from the bed phase, stand-up phase, step-up phase, ambulation phase

9. INCONTINENCE • 5 Clinical Classifications: • Urge, Stress, Reflex, Overflow, Functional • If stroke px is an elderly there may be more than 1 type of incontinence • Management depends on the cause

10. Evaluation of Incontinence

11. Management of Incontinence