Geriatrics Issues and EMS Complications

"Over the last thirty years, the United States has experienced an unprecedented growth in its older population. In 1970, approximately 10 percent of Americans, or twenty million in all, were sixty-five years of age or older. By 2000, the number had reached almost 13 percent, or more than thirty-five million. And the number will continue to rise with the aging of the "baby boomers," those born between 1945 and 1964. By 2020, more than 16 percent of the U.S. population will be sixty-five or older. The fastest growing age cohort, however, is those age eighty-five and older: in 2000, over four million Americans were in this age group" (Oxford Companion 1) Yes, we are living longer. That doesn't necessarily mean the elderly have no additional health issues. Even though most of the headlines concern Alzheimer's and Parkinson's, research continues to find ways to slow the detrimental effects of aging. "We continue to progress in our understanding of the basic mechanisms of the aging process. Studies are helping to define the genetic basis of aging and the basis for prolonging life. Of particular interest is that dietary restriction produces many of the hormonal changes commonly associated with aging. Two other exciting areas of research have involved the free radical theory of aging and mitochondrial DNA. Studies relating free radicals to Parkinsen's disease led to the introduction of deprenyl for treating Parkinson's. Other studies have suggested that mitochondrial DNA may play a role in aging and the degenerative diseases associated with aging, such as Parkinson's disease, diabetes mellitus and Alzheimer's disease. If this hypothesis is correct, therapies may be developed to improve functional status in old age" (Anon 1).

There are two problem areas for the aging: Social Security which, some politicians claim, will run out of money before the current generation is eligible for payments; and Medicare, whose premiums go up year after year, and whose health care may well be considered slipping- all to hold down costs and eliminate needless examinations and hospital stays. Because of both illness and frustration at getting older, some older people are very careless in the drugs they buy (and have a kindly doctor prescribe for them). "Many older Americans are getting prescription drugs that could be particularly dangerous for them. "In a large study of prescription claims filed for reimbursement, Duke University researchers found that about 21% of elderly patients had filled prescriptions for drugs that are known to cause harm or induce harmful side effects in those over age 65. They include antidepressants, painkillers such as Demerol, and sedatives such as Valium" (Reitamn F-1).

Various local and state governmental agencies are now looking ahead, as more and more people age and therefore have more medical emergencies. That means, increasing funding for, and awareness of, EMT services. "Population growth and urbanization will increase the demand for full-time paid EMTs and paramedics rather than for volunteers. In addition, a large segment of the population-the aging baby boomers-will further spur demand for EMT services as they become more likely to have medical emergencies" (US Dept of Labor 6).

If there is a concern today about longevity it is about being taken care of- medically, emotionally, and lawfully. There is debate about the right to die, euthanasia and "Do Not Resuscitate" orders. Yet, science (if not the government) is finding new resources for keeping aging people healthy, and well mentally as well as emotionally. Even living into the 80s is no longer a "death sentence." One more thought needs to be mentioned: the fear of some older persons and their family to see a geriatric specialist. "Regardless of an older person's age, a geriatrician should be consulted when: an older person's condition causes considerable impairment and frailty. These patients tend to be over the age of 75 and coping with a number of diseases and disabilities, including cognitive (mental) problems; or family members and friends are feeling considerable stress and strain as caregivers" (Anon 4)..

REFERENCES:

Reitman, Valerie: "Seniors getting risky drugs
Medicines deemed hazardous to the elderly are still too often prescribed, researchers have found" Los Angeles TIMES, Aug. 16, 2004

author listed: "A five-year review of major issues in geriatrics". The Brown University Long-Term Care Quality Letter. March 28, 1994 v6 n6 p3(2).

No author listed: "Aging and the Law" Oxford Companion to Law

Oxford Reference Online

No author listed: "Emergency Medical Technicians and Paramedics"

U.S. Department of Labor www.bls.gov/oco/ocos101.htm

No author listed: "What is Geriatrics?"

www.healthinaging.org/public_ education/what_is_geriatrics.php