Some problems of the elderly aren't getting enough attention, nurses hear

Posted: November 12, 2012

When an elderly person shows up in a doctor's office or hospital, doctors and nurses know to pay attention to chronic conditions such as heart disease and diabetes that often lead to health crises.

But they should be paying more attention to "geriatric syndromes" - a group of aging-related problems that are not caused by a specific illness but can make older patients more vulnerable when something else happens.

Patients with these syndromes take longer to heal, use more resources, and face a higher risk of death, Barbara McLaughlin, head of Community College of Philadelphia's department of nursing, told fellow nurses last week at a conference on improving care for older patients sponsored by the Independence Blue Cross Foundation.

Some of these conditions, such as delirium, a tendency to fall, incontinence, and eating and sleeping problems, have long been part of every nurse's training, McLaughlin said.

Others, such as sarcopenia (loss of muscle mass), frailty, or uncontrolled pain are now getting a lot more attention. She also included system problems that lead to patients seeing multiple doctors who don't coordinate care or taking so many medicines that the drugs themselves affect their well-being.

"We're hoping that people recognize [the syndromes] more as being significant contributors to problems that older adults have on top of their chronic conditions," McLaughlin said. "These are things that change quality of life issues for older adults."

As snow swirled outside, McLaughlin spoke to about 100 people on the 44th floor of Independence Blue Cross's Center City headquarters building. The workshop also highlighted the National League for Nursing's Advancing Care Excellence for Seniors (ACES) program and initiatives that have received funding from the IBC foundation. Those include an effort to improve care for Philadelphia-area Asians with dementia and primary care for the elderly in general.

The year-old foundation's goal is to fund about $7 million in projects a year, foundation president Lorina Marshall-Blake said. It now focuses on clinics that serve the uninsured and underinsured, nursing programs, and projects to improve community health.

While many of us picture a tiny old lady with a cane when we think of frailty, McLaughlin said such a woman might be quite hardy. True frailty refers to patients who have lost muscle mass or strength, have lost weight and endurance, may have problems with balance and mobility and just generally do things more slowly than they used to. Often their cognitive functioning is declining.

Sarcopenia can occur even in overweight patients, causing obvious problems with getting around.

Contact Stacey Burling at 215-854-4944 or

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