As patients live longer, it becomes essential for medical providers to focus on preventive care measures and early detection of potential health issues. This includes the early recognition of geriatric syndromes (GS), which leads to increased frailty, hospitalizations, utilization of resources, and reduced quality of life.1,2
Geriatric syndrome is the presence of concomitant medical conditions that are affected by many factors that do not fit the category of a particular disease process.3,4 The syndrome includes a number of conditions typical of aging such as delirium, depression, frail state causing functional decline, malnutrition, cognitive impairment, pressure ulcers, polypharmacy, urinary incontinence, insomnia, dizziness, and syncope. Traditionally, the identification and screening of GS symptoms have been perplexing due to their distinctive characteristics. Therefore, creating specific screening tools and treatment options to enhance the well-being of older individuals has become a complex task.5, 6
Interventions
According to the World Health Organization’s Aging and Health report,7 it is crucial for older people to preserve their functional ability. As individuals age, their bodies lose the ability to maintain balance due to a decline in reserve causing them to become more vulnerable to stressors and increasingly harder to recover from resulting impairments.8 Developing a prevention plan begins with screening for symptoms and evaluating their risk level. Failing to identify, diagnose, or treat underlying causes of GS can harm the health and lifespan of the elderly.9
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A comprehensive assessment should identify geriatric patients’ medical, psychosocial, and functional limitations through a multifaceted and interprofessional approach.10 Health care providers and geriatricians have used the comprehensive geriatric assessment (CGA) to screen complex older adult patients for GS. The programs use specific criteria to identify at-risk patients, including older age, compounded medical comorbidities, psychosocial disorders, specific geriatric conditions (dementia, recurrent falls, malnutrition, functional disability), previous or predicted high health care utilization, or changes in living situation.10 It is ideal to conduct the CGA while the patient is still functioning at their best to identify any risk factors that may lead to decline or disability. Early recognition of these factors allows for timely interventions to correct them and prevent further complications.
Health Promotion
The impact of global aging has made clear the need for a transition of geriatric care across various medical disciplines and models of care.11 A multidisciplinary approach to health promotion empowers older adults to take control of their health. Health literacy plays an integral part in that empowerment. Interventions to increase knowledge are imperative for individuals to take action and be competent to promote a healthy lifestyle, leading to a change in behavior.12 Health professionals should be included as support in the decision-making to promote these behavioral changes.12
Because most older adults live in the community, health promotion interventions should be coordinated between community partners, health professionals, family members, and the individuals. Programs should encourage healthy, successful aging and include social interaction (promotes physical and mental health), physical activity (promotes physical, emotional, and mental health, including cognition), and healthy eating (improves the ability to be physically active and endure chronic conditions).12 Programs should also focus on self-management of chronic conditions and medication regimens and knowledge of safety measures that include accident prevention.12
Conclusion
It is crucial to regularly screen and evaluate older patients for GS. Best practice will implement an interprofessional and multidisciplinary approach to appropriately assess the geriatric patient, to promote a healthier lifestyle with health promotion interventions, which will improve patient outcomes while preserving their dignity and quality of life.
Nilsa Black-Mead, DNP, CRNP, is a clinical assistant professor in the College of Nursing Graduate Program at The University of Alabama, in Huntsville, and has over 20 years of experience in the field. Lenora Smith, PhD, CRNP, CDP, is an associate professor in the College of Nursing at the University of Alabama. Her area of expertise is gerontological nursing, palliative care, and end-of-life issues.
References
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3. Möller J, Rausch C, Laflamme L, Liang Y. Geriatric syndromes and subsequent health-care utilization among older community dwellers in Stockholm. Eur J Ageing. 2022;19(1):19-25. doi:10.1007/s10433-021-00600-2
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7. World Health Organization. World Report on Ageing and Health. World Health Organization; 2015. Accessed September 13, 2023. https://apps.who.int/iris/handle/10665/186463
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9. Brown-O’Hara T. Geriatric syndromes and their implications for nursing. Nursing. 2023. 2013;43(1):1-3. doi:10.1097/01.NURSE.0000423097.95416.50
10. Ward KT, Reuben DB. Comprehensive geriatric assessment. UpToDate. Updated July 2022. Accessed September 13, 2023.
11. Cesari M, Marzetti E, Canevelli M, Guaraldi G. Geriatric syndromes: how to treat. Virulence. 2017;8(5):577-585. doi:10.1080/21505594.2016.1219445.
12. Farreira R, Baixinho C, Farreira O, Nunes A, Sousa L. Health promotion and disease prevention in the elderly: the perspective of nursing students. J Pers Med. 2022;12(2):306. doi:10.3390/jpm12020306
