Geriatric Syndromes in Action


A short time back, I posted on the issues of the medically complex senior, referring to the work of Dr. Lee Lindquist of Northwestern University and Dr. Steve Fox of Wellspring Personal Care.  Going beyond the very real issues of chronic disease management, Dr. Fox talks about the concept of geriatric syndromes – the fact that many elders have a combination of conditions that require dealing with the individual components while managing the overall syndrome for the elder.

Yesterday, our Director of Nursing visited one of Support For Home Health Care’s home care clients / patients, also meeting with several of her sons, one of whom has power of attorney.  Our DON’s assessment is a classic reflection of the issues facing many elders.  Hopefully it is educational for family and professional caregivers, as well as many seniors, themselves.

Our patient / client has the following diagnoses:

  • Hypertension
  • Possible seizure activity
  • Hypothyroidism
  • Dementia
  • Atrial fibrillation
  • Bladder spasms
  • History of TIAs (transient ischemic attacks)
  • History of UTIs
  • Pacemaker in place
  • Type 2 Insulin Dependent Diabetes Mellitus

To address these issues, the client / patient has nine (9) prescriptions, including insulin via a pump.  The opportunities for drug interactions and side effects are, of course, numerous and serious. 

Complexity of Medications

The updated care plan from our Director of Nursing to our Home Care Aides reflects the five Problems, Interventions and Goals for our caregivers to concentrate on, given the combination of medical conditions and medications involved.

The issues this wonderful woman is dealing with go way beyond the need for support of Activities of Daily Living (ADLs and Instrumental ADLs).  Does she need support with them?  Yes, of course.  But that support is “necessary but not sufficient” for her wellbeing and quality of life.  Her health and wellbeing truly require that even non-clinical caregivers understand the issues she faces medically and what they need to watch for and do to keep her well.

Caring for the medically complex senior is as challenging as it is rewarding, but we have to move beyond the traditional view of caregiving.

Best wishes.  Bert

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