7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
1/38
Geriatric Imaging
11 7 10
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
2/38
Geriatrics
Branch of medicinedealing with aged andproblems of aging
Geriatric patients arepersons over age 65
Population isincreasing
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
3/38
Radiographers Role
Adapt procedures to accommodatedisability and disease
Understand physiology and pathology ofaging
Be aware of social, psychological,cognitive, and economics of aging
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
4/38
Most common health complaints of elderly
Decrease in balance, coordination, strength, andreaction time
Weight gain
FatigueLoss of bone mass
Joint stiffness
Loss of hearingPresbycusis - gradual, progressive hearing loss of tone
discrimination
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
5/38
Problems Facing Seniors
Depression-
1 in 5 persons over age 65 shows signsofclinical depression
Fixed income
Few choices in personal living arrangements
Dependency
LonelinessMedical emergencies
Illness
Senility
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
6/38
Rheumatoid Arthritis
Commoninflammatory joint
disease
Causes severe
deformity
Limits flexibility
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
7/38
Osteoarthritis
Degenerative jointdisease caused primarilyby wear and tear on joints
Body creates additionalbone tissue in responseto stress on joints
Can lead to completefusion of joints
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
8/38
Osteoporosis
Loss of bone volume and mass- Often, kVp must bereduced for x-ray exams
4 times more common in women(menopause), butcanappear in men
Increased risk of fxs, kyphosis
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
9/38
Alzheimers Disease
Chronic, organic mental disorder
Due to atrophy of frontal and occipitallobes
Occurs between ages 40 and 60
Progressive loss of memory leads tocomplete loss of intellectual function
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
10/38
Vision Problems
Presbyopia - age-relatedfarsightedness (lensless flexible)
Cataracts
Distorted color
perception
Decreased ability toadapt to light
changes
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
11/38
Decline in sensitivity to taste and smell
Taste loss- due to decrease in number of tastebuds, decrease in saliva, and dry mouth
Hyposmia - loss of smell- accounts for decreased appetite and
irregular eating habits
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
12/38
Anemia
Symptoms:
Pale skinShortness of breathFatigue easily
Caused by:
Insufficient dietary intakeInflammation or destruction of GI lining to absorb
vitamin B12
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
13/38
Cardiovascular System Disorders
Most common cause of death worldwide
Loss of arterial elasticity increases systolic blood pressure -greater risk for heart disease and stroke
Postural hypotension - fall in blood pressure when rising fromsupine to standing position
Atherosclerosis(build up of fatty plaques in arterial walls-increasing riskof aneurysm, blood clot formation- which may cause embolism, heart attack,
stroke)
Congestive heart failure- inability of heart to propel blood atsufficient rate and volume
Cerebrovascular Accident (CVA) -stroke
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
14/38
Gastrointestinal System Disorders
Peptic ulcer disease
Bleeding
PancreatitisGallstones
Hepatitis
Colorectal cancer- 2nd to lung cancer as cause ofcancer-related mortality
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
15/38
Gastrointestinal System Disorders contd
Diverticulitis
Gastric outlet obstruction
Esophageal foreign bodiesConstipation
Fecal incontinence
Dehydration
Difficulty swallowing
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
16/38
Immune System Declines
Increases vulnerability to:
Diabetes mellitus
Pneumonia
Nosocomial infections
Influenza
Pneumonia
Tuberculosis
Meningitis
Urinary tract infections
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
17/38
Respiratory System Disorders
Lungs lose elasticity:
Decreases oxygencarbon dioxideexchange
Breathing muscles and rib cage stiffen:
Increases shortness of breath
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
18/38
Respiratory System Disorders contd
Emphysema
Chronic bronchitis
Pneumonia
Lung cancer -mostcommon cancer-related death inmen and women
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
19/38
Integumentary System Disorders
Skin membranes flatten,wrinkle and thin out - morevulnerable to abrasions andblisters
Horrid age spots!
Gradual loss of function insweat glands and skinreceptors-increases risk ofheat stroke
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
20/38
Integumentary System Disorders contd
Most common skin diseases
Herpes zoster (shingles)
Malignant tumors
Decubitus ulcers- bedsores
Varicose veins
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
21/38
Integumentary System Disorders
Decrease in fat pad onfeet increases footconditions
Graying, thinning, andloss of hair
Skin tumors
Basal cell carcinoma Malignant melanoma
Squamous cell carcinoma
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
22/38
Vitiligo
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
23/38
Genitourinary System Disorders
Benign prostatic hyperplasia (BPH)common in men over age 70
Enlargement of prostate gland -obstructsurine flow
Prostate cancer is 3rd most commoncancer in males Over 80% of tumors are found after age 65
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
24/38
Genitourinary System Disorders
Acute and chronic renalfailure not uncommon
Incontinence Leads to social and
hygiene concerns
Number of nephrons inkidneys decrease Can cause normal dose of
medicine to be anoverdose in elderly
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
25/38
Awareness of death closing in
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
26/38
Radiographic Positioning forGeriatric Pts
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
27/38
Chest
PA- wrap arms aroundupright device- increasessupport and security
Lateral- provide supportand stability in movingarms up and forward
Perform exam inwheelchair -note projection
change
Hyperkyphosis changespositioning landmarks
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
28/38
Spine
Use sponges andtable pad
Upright morecomfortable if able
Or Seated positionmay be used for exam
requiring uprightposition
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
29/38
Pelvis/Hip
Fxs common -do notrotate limb until fx. ruledout!
Cross-table lateral oftenmore comfortable
In nontrauma pts,sandbags useful tosupport rotation of limbs
MRI- fx would have been
missed by radiograph
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
30/38
Upper extremity
Limited flexibility andmobility presentpositioning challenge
Contracture of limbscaused by strokemust not be forcedinto position
Sponges, sandbags,and use of cross-table projectionsuseful
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
31/38
Lower extremity
Limited flexibility andmobility presentpositioning challenge
Cross-tableprojections useful
Feet and ankle examscan be performed inwheelchair
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
32/38
Pt Care of Elderly: Quick Tips
Explain everything you areabout to do
Decreases pt stress andanxiety
Increases compliance andsatisfaction
Treat pt with respect and
dignity Communicate with warmth,
empathy, and positive attitude
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
33/38
For the hard of hearing:
Give one instruction at a time
Reduce background noise
Speak slowly, distinctly, and directly topt
Not allelderly patients are hard of
hearing Adjust voice volume as needed
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
34/38
Exposure time becomes more critical
Why use shorter times?
- reduce risk of imaging involuntary and voluntary motion
- elderly may have difficulty maintaining required position
Breathing instructions must be carefullycommunicated and practiced
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
35/38
Technical factors
Adjust toaccommodatedisease and normal
age-related changes
Radiographer mustknow whetherdisease/change isadditive or destructive
Emphysema
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
36/38
Patient Care of Elderly
Provide rest time betweenprojections andprocedures
Avoid use of adhesivetape-Can easily damage skin
Use table pads,blankets, sponges,and hand rails-Increases comfort and
compliance
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
37/38
Pt Care of Elderly: Quick Tips contd
Carefully check pt history before administeringcontrast!
Reduces adverse reactions:
-dehydration, induced kidney failure
Assess for swallowing difficulty
Administer drinking liquids in upright positionto reduce risk of aspiration
7/31/2019 10 Geriatric_Imaging Nov 7 10 Online
38/38
Conclusion:
Successful imaging of elderly pts depends uponradiographers competence and knowledge of
this special population