DepartmentAssisted Living ColumnGeriatric Zebras
Section snippets
More than a simple bruise
Imagine Mr. Johnson an elderly resident of your assisted living community (ALC) on blood thinners asking you about a large bruise he just noticed on his side. Like many times before you would assume this was the result of the combination of his anticoagulant and traumatic fall. But what if instead this bruise was the result of acquired factor VIII inhibitors (acquired hemophilia)?1 Acquired Hemophilia A or AHA is a potentially life threatening cause of acute bleeding in older adults. Because of
Not always Alzheimer's disease
Just as all bleeding is not the result of poor anticoagulation and a slight fall the same is true that not all memory loss is due to Alzheimer's disease. Picture an AL resident who has symptoms of increasingly worse gait disorder, incontinence and worst of all memory issues – of course the first thought is that of Alzheimer's dementia. But it could also be a case of normal pressure hydrocephalus.
The reported incidence of normal pressure hydrocephalus (NPH) has varied in different studies from 2
Unexpected reason for falling
Falls are a common problem in the elderly, with a host of potential causes including poor vision, balance issues, impaired judgment, and effects of medications among many others. It may not be recognized that the real reason in an AL resident might be alcohol abuse.
The typical person with alcohol abuse is thought to be younger, but elderly patients may either have already had problems that persist or may develop alcoholism when they are older. As many of the other Zebras, alcohol abuse is
Silent Zebras
There are also silent or stealth geriatric Zebras – these are conditions that not only do we not often consider but what makes these even more difficult is that often there is no outward appearance that they even exist. As a result it is only through screening that these less common conditions can be recognized early and treated. These include such conditions as HIV and HCV. Years ago these may not have been considered geriatric conditions because individuals typically passed away prior to
References (4)
- et al.
The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002
Drug Alcohol Depend
(2004) - ...