Lesson 7 — Geriatric Assisting
All procedural steps, PURPOSE rationales, and topic content below are verbatim from MedCerts HLT420A Storyline modules. Quiz items have been normalized to multiple-choice format with verbatim source rationales. Reference textbook: Niedzwiecki & Pepper, Kinn's The Clinical Medical Assistant, 15th ed., Chapter 30. No outside material added.
- Describe common cardiovascular, pulmonary, endocrine, and GI changes in geriatrics
- Discuss integumentary and musculoskeletal changes potentially seen in the geriatric patient
- Distinguish common changes in the older adult related to the nervous and sensory systems
- Differentiate urinary and reproductive changes common with aging
- Summarize the role of the medical assistant and the geriatric practice
Aging and Health Promotion
Goal: To understand the age-related changes that occur with each body system, and assist in educating the patient on measures that promote good health.
Brain shrinks by 10% between ages 30 and 90; takes longer to learn new material; attention span and language remain the same; signs and symptoms may be caused by depression, vascular disease, and drug reactions. Health promotion includes aerobic exercise to increase blood flow to CNS; maintaining mental activities (e.g., reading, interacting with others)
After age 50, women have a sharp decline in estrogen; men have a more gradual decline in testosterone. Health promotion includes possible hormone replacement therapy or natural soy supplements
Hearing is intact through the mid-50s but declines by 25% by age 80; oral problems are common; skin thins and loses elasticity; presbyopia after age 40; cataracts common after age 60. Health promotion includes avoid exposure to loud noise, use hearing aids; good dental hygiene; prevention of sun damage to the skin; annual eye examinations; diet rich in dark green, leafy vegetables to prevent cataracts and macular degeneration
Arteriosclerosis and atherosclerotic plaque buildup reduces blood flow to major organs; 50% of the aging population have hypertension; CVD is the number one killer of women and men in their 60s. Health promotion includes regular exercise; weight control; diet rich in fruits, vegetables, and whole grains; cholesterol, blood glucose monitoring
Muscle mass decreases; tendency to gain weight; gradual loss of bone density; deterioration of joint cartilage. Health promotion includes strength training to increase muscle mass; stretching to remain limber; exercise; vitamin D and calcium supplements
Men: Impotence is not a symptom of normal aging; men over age 50 may have some altered function. Women: Menopause causes vaginal narrowing and dryness, resulting in painful intercourse. Health promotion includes men: maintenance of cardiovascular health with exercise, weight control, no smoking, diabetes management; women: use of vaginal lubricants or estrogen cream
Decline in gastric juices and enzymes by age 60; decreased peristalsis with increased constipation; some nutrients are not absorbed as well. Health promotion includes high-fiber diet and adequate fluid intake; regular exercise to prevent constipation
Kidneys become less efficient; bladder muscles weaken; one third of seniors experience incontinence; prostate enlargement is common. Health promotion includes pelvic exercises, drugs, or surgery for incontinence; annual PSA with digital rectal exam monitoring for men
At age 55 the lungs become less elastic and the chest wall gradually stiffens, making oxygenation more difficult. Health promotion includes quit smoking; regular aerobic exercise
Durable Medical Equipment and Supply Orders
Durable medical equipment, or D-M-E, is used to assist patients in their activities of daily living, or A-D-Ls. These activities may be impacted by acute or chronic conditions, injuries, or other physical challenges. A-D-Ls include standing, walking, eating, showering, and using the bathroom. Some D-M-E assists with basic life functions, like breathing and insulin management.
D-M-E varies based on medical necessity, such as the need for: Commode chairs and walkers; Wheelchairs, crutches, and braces; Patient lifts and hospital beds; Continuous positive airway pressure, or C-Pap, devices, nebulizers, and oxygen equipment; And infusion pumps and blood glucose meters. Equipment used repeatedly and for extended periods of time is considered durable. It may be used for a short time period; for instance, with an acute injury requiring crutches. A patient with emphysema will likely require long-term oxygen use, and an oxygen tank is a type of D-M-E.
In addition to equipment, the M-A may order and manage supplies as indicated. For example, a patient with a blood glucose monitor also requires alcohol prep pads, lancets, and blood glucose test strips. Oxygen equipment also requires supplies such as special tubing or masks.
Patients may acquire physician-prescribed equipment through their health insurance. The D-M-E vendor will process a claim for insurance reimbursement. The M-A may assist in ordering and tracking receipt of equipment and supplies.
Under the physician's guidance, the M-A may educate patients and caregivers about equipment use. The M-A ensures the patient has necessary information and supplies needed to maintain and utilize equipment. The equipment supplier may also provide training and needed supplies.
Knowledge-check items
Click an answer to lock it in — you'll see the rationale below. Reset any time to re-attempt. Items originally formatted as true/false, fill-in-blank, or drag-and-drop have been normalized to multiple choice; the source format is noted in the eyebrow.
L07-01 · Aging and Health Promotion
"Maintaining mental activities (e.g., reading, interacting with others)"
The central nervous system is promoted through aerobic exercise to increase blood flow to the CNS and maintaining mental activities. This addresses the age-related change that the brain shrinks by 10% between ages 30 and 90.
"Quit smoking; regular aerobic exercise"
The pulmonary system loses elasticity at age 55 and the chest wall stiffens, making oxygenation more difficult. Quit smoking and regular aerobic exercise are the health promotion strategies to address this change.
"Strength training to increase muscle mass; stretching to remain limber; exercise; vitamin D and calcium supplements"
The musculoskeletal system experiences decreased muscle mass, tendency to gain weight, gradual loss of bone density, and deterioration of joint cartilage. These health promotion measures directly address these age-related changes.
"High-fiber diet and adequate fluid intake; regular exercise to prevent constipation"
The gastrointestinal system experiences decline in gastric juices and enzymes, decreased peristalsis with increased constipation. A high-fiber diet and adequate fluid intake address the constipation risk.
"Avoid exposure to loud noise, use hearing aids; good dental hygiene; prevention of sun damage to the skin; annual eye examinations; diet rich in dark green, leafy vegetables to prevent cataracts and macular degeneration"
Hearing declines by 25% by age 80. Avoiding exposure to loud noise and using hearing aids are appropriate health promotion strategies for the sensory organs.
L07-02 · Durable Medical Equipment and Supply Orders
"Equipment used repeatedly and for extended periods of time is considered durable."
Durable medical equipment is designed for repeated use and extended periods. While it may be used for short-term acute conditions (like crutches for a broken leg), the defining characteristic is that it is durable—not disposable or delicate.
"DME may be used for acute needs, like a broken leg, or may be required for long-term care, like a bedridden patient."
Durable medical equipment is flexible in its use. It can serve both acute needs (such as crutches for a temporary injury) and long-term care requirements (such as oxygen for emphysema), making it versatile for various patient situations.
"DME, such as a glucose meter, requires alcohol prep pads, lancets, and test strips, for proper functionality."
Durable medical equipment often requires consumable supplies to function properly. The medical assistant may order and manage these supplies as part of patient care. Examples include test strips and lancets for glucose meters, and tubing or masks for oxygen equipment.
"A-D-Ls include standing, walking, eating, showering, and using the bathroom."
Activities of daily living (ADLs) are basic self-care skills. DME is prescribed to assist patients who have difficulty with these fundamental activities due to acute or chronic conditions, injuries, or physical challenges.
"Oxygen equipment also requires supplies such as special tubing or masks."
Oxygen equipment requires specific tubing and masks to function and deliver therapy safely. Alcohol prep pads, lancets, and glucose test strips are supplies associated with blood glucose monitoring, not oxygen equipment.