Educating LTC Residents About Geriatric Syndromes
Despite advances in our understanding of “geriatric syndromes,” this important concept remains somewhat ill-defined, as Sharon K. Inouye, MD, MPH, and coauthors note in their excellent analysis of the clinical, research, and policy implications of geriatric syndromes in the May 2007 issue of the Journal of the American Geriatrics Society. “The lack of formal criteria to define geriatric syndromes,” they write, “has limited progress in the field.”1
This is a growing problem. These complex, multifactorial, interrelated health conditions are extremely common among older adults—particularly those who are frail.1 The prevalence among older people in long-term care is especially high. Depending on the definition of hearing loss used, between 50% and 100% of those in long-term care are affected. At least half of LTC residents are incontinent. And roughly 50% of residents fall over the course of a year.
Geriatric syndromes such as malnutrition, dizziness, urinary incontinence, falls, delirium, and dementia are associated with significant declines in quality of life and increased morbidity and mortality. The syndromes often involve multiple organ systems. And one can set the stage for others: urinary incontinence may lead to a bladder infection accompanied by delirium, for example. creating a domino effect of declining health and well-being.1
As Dr. Inouye and colleagues point out, much additional research is needed to shed further light on the mechanisms—which are likely shared—underlying these syndromes. Efforts to overcome obstacles to translating research concerning prevention into clinical practice and policy are also imperative, they note.1
Helping older adults and their loved ones understand what geriatric syndromes are and how they may be prevented and treated, I would add, is a critical element of these efforts. Why? For much of the public, “geriatric syndromes” doesn’t ring a bell at all.
Research has identified strategies for preventing syndromes such as osteoporosis and pressure ulcers. And there are effective treatments for vision and hearing problems and urinary incontinence, among others. But older adults aren’t necessarily aware of this. Studies have found, for instance, that many older people assume urinary incontinence is an inevitable part of aging that simply has to be endured. Clearly, we need to raise awareness of geriatric syndromes among those most likely to experience them.
Greater public awareness affords an additional benefit: Since public perceptions and grassroots advocacy play leading roles in shaping policy, helping older adults and their loved ones understand what geriatrics syndromes are all about can advance policy supporting further research and dissemination of findings.
To help acquaint older adults and their caregivers with geriatric syndromes, the American Geriatrics Society’s Foundation for Health in Aging (FHA) recently released an easy-to-understand, two-part “Guide to Geriatric Syndromes” for the public. Prepared by experts in the field, this “tip sheet” is available on the FHA’s public education website at http://www.healthinaging.org/public_education/latest_tip_sheets.php.
The tip sheet begins with a basic introduction to geriatric syndromes. The introduction explains that these health conditions, common among older people, typically have more than one cause, involve more than one “body system,” and are interrelated. The introduction also explains that geriatric syndromes can limit older adults’ abilities to carry out actives of daily living, threaten their independence, and undermine their quality of life.
Descriptions of each of the 14 geriatric syndromes included in the 6th edition of the Geriatrics Review Syllabus follow. For each syndrome, the tip sheet offers advice designed to facilitate early detection in a subsection entitled “What you should do,” and an overview of treatment options. The “What you should do” advice for vision problems, for example, suggests that older adults “get a comprehensive eye exam at least once a year” and notes that early treatment of vision problems such as glaucoma, diabetic eye disease, and macular degeneration could help prevent an estimated one-third of new cases of blindness among aging adults.
The tip sheet is the latest in the FHA’s ongoing series of health tip sheets for older people. Fifteen other tip sheets, all posted at http://www.healthinaging.org/public_education/latest_tip_sheets.php, cover a wide range of health topics of interest to older people and their caregivers, including recommended vaccinations, hot weather safety, maintaining cognitive vitality in late life, and avoiding caregiver burnout. The tip sheets, like all of the information on the FHA’s public education website, www.healthinaging.org, can be printed and distributed at no cost. We hope you’ll share them with your patients/residents and their loved ones.