Geriatrics

Question 1

What is the maximum human lifespan, and has it changed over time?

Answer 1

About 100 years. It hasn’t changed, but average life expectancy has increased.

Question 2

What was the average life expectancy in 1900 vs. 1990?

Answer 2

47 years in 1900; 75 years in 1990.

Question 3

What is the primary reason for increased life expectancy?

Answer 3

Dramatic increase in infant survival.

Question 4

What factors contributed to increased life expectancy?

Answer 4

Better sanitation, nutrition, medical care, disease prevention, and living standards.

Question 5

What percentage of the population was over 65 in 1900 vs. now?

Answer 5

4% in 1900; now 12–13%. Expected to double in 50 years.

Question 6

What is the first-level assessment in geriatric care?

Answer 6

Done on initial contact to determine perceived health threats and necessary actions.

Question 7

What is the second-level assessment?

Answer 7

Ongoing assessment during the entire time with the patient.

Question 8

What organ systems show signs of aging?

Answer 8

Neurological, cardiovascular, respiratory, GI, GU, musculoskeletal, integumentary.

Question 9

Why are geriatric trauma cases more dangerous?

Answer 9

Injuries tolerable for younger patients can be fatal; falls cause 70% of geriatric deaths.

Question 10

How common is elder abuse?

Answer 10

32 per 1,000 elderly patients.

Question 11

Who most often commits elder abuse?

Answer 11

Adult male children who are financially dependent and primary caregivers.

Question 12

What is elder neglect?

Answer 12

Deprivation of medical treatment, food, heat, medication, or safety—intentionally or passively.

Question 13

What issues complicate drug therapy in elderly patients?

Answer 13

Polypharmacy, forgetfulness, affordability, and adverse drug interactions.

Question 14

What is a common medication mistake in Alzheimer’s or dementia patients?

Answer 14

Double-dosing or forgetting to take medications.

Question 15

Why might elderly patients not complete antibiotic therapy?

Answer 15

They feel better and stop early, which can worsen the infection.

Question 16

What changes may signal mental health issues in geriatric patients?

Answer 16

Insomnia, cognitive dysfunction, anorexia, weight loss, mood changes, hallucinations.

Question 17

What does psychiatric assessment focus on?

Answer 17

Appearance, thought, mood, perception, cognition (memory, attention), judgment.

Question 18

What can contribute to worsening psychological health in elderly?

Answer 18

Polypharmacy, isolation, past mental health issues, new medication changes.

Question 19

What are best practices for communicating with elderly patients?

Answer 19

Speak at eye level, slowly, clearly, use surname, ensure glasses/hearing aids are on, be patient.

Question 20

What does GEMS stand for in geriatric assessment?

Answer 20

Geriatric, Environmental, Medical, Social.

Question 21

What does the ‘E’ in GEMS assess?

Answer 21

Home hazards, living conditions, heating, hygiene.

Question 22

What ADLs can paramedics observe during calls?

Answer 22

Med management, meal prep, laundry, errands, financial management, using tech.

Question 23

What challenge may arise when collecting information in a nursing home?

Answer 23

Staff unfamiliar with the patient; CNA may know them better than nurse.

Question 24

What must paramedics confirm at nursing homes?

Answer 24

Full code status, medication history, signs of neglect.

Question 25

Why can assessing elderly patients be more difficult?

Answer 25

Chronic illnesses overlap with acute ones, pain responses may be blunted.

Question 26

What emotional concerns might elderly patients have?

Answer 26

Fear of losing autonomy, financial stress, emotional isolation.

Question 27

What should you evaluate before moving an elderly patient?

Answer 27

Mobility, home layout, pathways, need for equipment (e.g., stair chair, mega mover).

Question 28

How can you ensure comfort during transport?

Answer 28

Pre-medicate if needed, pad hard surfaces, keep warm, plan the move.

Question 29

What cognitive changes can occur with aging that affect paramedic care?

Answer 29

Memory loss, reduced attention span, slower thought processing, impaired judgment.

Question 30

What mental health changes might mimic physical illness in elderly patients?

Answer 30

Fatigue, weight loss, sleep disturbances, or constipation may stem from depression or anxiety.

Question 31

Why might elderly patients underreport mental health symptoms?

Answer 31

Fear of stigma, generational beliefs, or fear of institutionalization.

Question 32

Why is it difficult to identify new acute illness in elderly patients?

Answer 32

Acute symptoms may blend into baseline symptoms from chronic illness (e.g., SOB in CHF vs. pneumonia).

Question 33

How does aging affect pain perception in elderly?

Answer 33

Pain may be diminished or absent due to altered pain pathways or neurological decline.

Question 34

Why is it important to observe subtle changes in function?

Answer 34

Small deviations in mobility, behavior, or mood can signal serious new illness.

Question 35

What are underlying causes of falls in elderly patients?

Answer 35

Cardiac dysrhythmias, neurological issues (stroke, Parkinson’s), medications, metabolic disorders.

Question 36

What does 'falls can be the tip of the iceberg' mean?

Answer 36

The fall is often a symptom of a deeper issue—such as infection, hypotension, or stroke.

Question 37

What social factors impact geriatric health outcomes?

Answer 37

Isolation, lack of support, caregiver stress, poverty, neglect, or abuse.

Question 38

How can paramedics assess an elderly patient’s environment?

Answer 38

Look for hazards (loose rugs, stairs), hygiene, temperature control, medication organization, and food availability.

Question 39

How should you adjust communication for confused or cognitively impaired patients?

Answer 39

Use short sentences, simple words, nonverbal cues (touch, facial expression), and reassurance.

Question 40

Why should you speak using the patient’s surname?

Answer 40

It maintains respect and dignity, especially for older generations.

Question 41

What are the risks of polypharmacy in elderly patients?

Answer 41

Adverse drug interactions, increased falls, cognitive impairment, and medication non-compliance.

Question 42

What clues suggest medication-related illness?

Answer 42

Confusion, dizziness, nausea, changes in consciousness, or recent change in prescriptions.

Question 43

Why is padding hard surfaces during transport important?

Answer 43

Elderly patients have fragile skin, bony prominences, and lower fat stores—risking pressure ulcers and discomfort.

Question 44

What tools can improve geriatric patient transport?

Answer 44

Stair chairs, mega movers, binder lifts, blankets, slide boards.

Question 45

Why should premedication be considered before moving a geriatric patient?

Answer 45

To minimize pain and anxiety during difficult extrications or long transports.

Question 46

What should paramedics confirm when responding to nursing home calls?

Answer 46

Code status (full, DNR), medication list, allergies, and if staff have recent vitals or change reports.

Question 47

Why is code status especially important in geriatrics?

Answer 47

Many elderly patients have DNR or advanced directives — resuscitation could violate their wishes.

Question 48

What are common signs of elder abuse or neglect?

Answer 48

Unexplained bruising, poor hygiene, malnutrition, frequent injuries, fear of caregiver, withdrawn behavior.

Question 49

What is the difference between active and passive neglect?

Answer 49

Active: intentional harm or deprivation. Passive: due to caregiver's lack of knowledge, resources, or capacity.

Question 50

What should paramedics do if they suspect elder abuse?

Answer 50

Document findings, report to appropriate authorities, and protect the patient’s safety and dignity.