An article by Iván García Pérez,
nurse and director of the Embajadores day center
Health education is a basic and very useful tool so that our elders can benefit, since knowledge of this matter is basic to be able to prevent and promote lifestyle habits that lead to the improvement of the health status of our elders.
The geriatric syndromes They are the set of symptoms and signs linked to one or more pathologies of different causal processes, associated with old age. They can also be defined as the set of pictures caused by the conjunction of a series of diseases that reach an enormous prevalence in the elderly and that frequently lead to social or functional disability, thus resulting in a loss of personal autonomy and therefore in the quality of life.
It is very important to understand that a geriatric syndrome can appear for various reasonsor what a single cause triggers several geriatric syndromes, cascading etiology can even occur where some syndromes develop others. Known as the four giants of geriatrics, are the most common geriatric syndromes in the elderlywhich are: urinary incontinence, falls, cognitive impairment and immobility.
Geriatric syndromes are the set of symptoms and signs linked to one or more pathologies of different causal processes, associated with old age.
The urinary incontinence It is the involuntary loss of urine that causes an alteration of the day to day in the elderly. During old age, a series of changes in structures involved in urinationthat is to say in the kidneys, the bladder, the urethra and the pelvic floor:
- The kidneys decrease their filtering, altering the dilution and concentration of the urine.
- The bladder loses muscle tone, so it loses its ability to contract, this causes an increase in residual volume, which can favor the appearance of urinary infections.
- The organs of the Pelvis also undergo changes, which contribute negatively to the containment of urine.
The falls It is one of the geriatric syndromes that harms the elderly person the most, due to its subsequent consequences. Is very important to know the factors that cause them, since in this way they can be reduced if these risk factors are affected. There are intrinsic and extrinsic factors. The first of them refer to the physiological alterations of the elderly, diseases they suffer from, as well as drugs that increase the risk of falls. Over the years, people present ocular, vestibular, proprioception and musculoskeletal alterations, which can come from diseases they suffer from or from their own age.
All this unique to taking drugs such as hypotensives, beta-blockers, hypoglycemic agents, etc. can cause falls. The extrinsic factors have to do with the environment that surrounds the elderly person, the architectural barriers they encounter when moving around, both at home (carpets, plants, furniture in transit areas, etc.,) and in public spaces (stairs, projections, bollards, etc.,).
He cognitive decline It is the reduction or loss of higher mental functions, which also entails a great loss of personal autonomy, and other types of syndromes or conditions are associated with it, such as anxiety and depression. Cognitive impairment is identified in the elderly when there is an alteration in the following levels: “Attention and concentration, language, gnosias, memory, praxias, visuospatial functions, executive functions and behavior”.
Finally, immobility, is the restriction of movement due to physical, functional or psychosocial problems, therefore affecting all activities carried out on a daily basis. Due to changes that occur during aging, older people tend to immobilitywhich causes consequences at the musculoskeletal level (joint stiffness, muscle weakness, atrophies…), at the respiratory level (accumulation of secretions that lead to respiratory infections), gastrointestinal (slowdown in intestinal transit that can lead to constipation, fecal impactions), at the cardiovascular level (less effective pumping, orthostatic hypotension, thromboembolism), nervous system (loss of bodily reflexes, greater cognitive deterioration), urinary system (calculi and urinary tract infections), metabolic alterations, dehydration (due to less intake of fluid due to cerebral hypoperfusion that decreases thirst), hypothermia (due to inactivity) and skin lesions (pressure ulcers).
Due to the great relationship that all syndromes have, it is very important approach them from a holistic and multidisciplinary point of view. From the STIMA centers we carry out a comprehensive geriatric assessment where the person is assessed by a multidisciplinary team (occupational therapist, physiotherapist, doctor, nurse, neuropsychologist, nursing assistants) to identify those risk factors that may develop or initiate geriatric syndromes, as well as to treat those that are present.
We believe that the problems are not the problem, but the attitude we have towards them. For that same reason, we teach our elders that if they are not able to find a solution to a difficulty, they will have to see it. “from outside”from “another perspective”, and the latter is achieved by asking for help. We make them understand that asking for help is not a sign of weakness, but of good sense. As has been reflected, these syndromes affect the functional, physical and cognitive level, so therapies are necessary when it comes to preventing and promoting activities that promote good health in our elderly.