Old Age Care and Geriatric Health
Old Age Care and Geriatric Health
This domain tests your ability to distinguish normal ageing from disease, prevent falls and pressure sores, manage medicines safely, and protect dignity and autonomy in older adults.
Core rules
- Ageing changes are normal: greying hair, presbyopia, reduced hearing for high tones, slower gait, reduced muscle mass. Delirium, weight loss, incontinence and falls are not normal - investigate.
- Falls prevention: adequate lighting, grab bars, non-slip footwear, review of sedatives and blood pressure medicines, vision check, strength and balance exercise.
- Pressure ulcers: assess risk, reposition every 2 hours, keep skin clean and dry, use pressure-relieving support, ensure protein and fluids.
- Polypharmacy is a major risk: review every medicine for indication, dose and interactions; change one medicine at a time.
- Constipation and dehydration are common and preventable: fibre, fluids and movement.
- Respect autonomy: involve the older person in decisions; do not infantilise.
- Recognise elder abuse and neglect; report according to local protocol.
Worked example
An 82-year-old becomes confused and agitated two days after a new sleeping tablet and a mild chest infection. Reasoning: acute confusion with fluctuating course suggests delirium, not dementia. Look for causes: infection, dehydration, constipation, pain, new drug. The care response is to stop the sedative after medical review, treat infection, hydrate, orient the person, and involve family - not to restrain or sedate further.
Traps that cost marks
- Labelling all confusion as dementia and missing reversible delirium.
- Using bed rails or restraints as first-line falls prevention.
- Ignoring hearing and vision loss, which can mimic cognitive decline.