Rayhana Yamini
Apa itu Geriatri?
• SEARO/WHO
Individu berusia 60 tahun atau lebih DAN
Memiliki ≥ 2 masalah kesehatan atau dengan disabilitas.
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Karakteristik Pasien Geriatri
1. Multipatologi (<1 penyakit, kronik, degeneratif)
Soejono CH. Pengkajian Paripurna Pada Pasien Geriatri. In: Setiati S, Alwi I, Sudoyo AW, Simadibrata M, Setiyohadi B, Syam AF, eds. Buku Ajar Ilmu Penyakit Dalam. Vol 3. 6th ed. Interna Publishing; 2014:3707-3715.
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Pendekatan holistik/ paripurna
(Comprehensive Geriatric Assesment)
• Prosedur evaluasi multidimensi; identifikasi masalah & aset (kondisi akut, hendaya, kemampuan
fungsional, anggota keluarga, finansial, kondisi mental/fungsional), jenis pelayanan yg diperlukan,
pengembangan rencana asuhan yg terkoordinasi (diagnostik, terapeutik, edukasi) berorientasi pada
kepentingan pasien (individually-tailored) derajat kesehatan optimal & kemampuan fungsional
tertinggi.
Soejono CH. Pengkajian Paripurna Pada Pasien Geriatri. In: Setiati S, Alwi I, Sudoyo AW, Simadibrata M, Setiyohadi B, Syam AF, eds. Buku Ajar Ilmu Penyakit Dalam. Vol 3. 6th ed. Interna Publishing; 2014:3707-3715.
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Sindroma Geriatri
• Immobility • Isolation (depression)
• Instability • Inanition (malnutrition)
• Incontinence • Impecunity (poverty)
• Intellectual impairment • Iatrogenesis
• Infection
• Insomnia
• Impairment of vision & hearing
• Immune deficiency
• Irritable colon (/ impaction)
• Impotence
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Kane R, Ouslander J, Abrass I, Resnick B, eds. Clinical Implications of The Aging Process. In: Essentials of Clinical Geriatrics. 7th ed. McGraw-Hill; 2013:3-21.
“Geriatric Giants”
Imobilisasi Instabilitas
Postural
Inkontinensia Intelectual
Urine impairment
Isolasi Inanition
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Williams GR, Sanoff H. Adjuvant Chemotherapy
in Older Adults with Colon Cancer. Am J
Hematol Oncol. 2015;11(3):5-10.
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Status Fungsional
• Mobilitas, keseimbangan
• Activity of daily living
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9 India. Journal
Gupta S, Yadav R, Malhotra AK. Assessment of physical disability using Barthel index among elderly of rural areas of district Jhansi (U.P),
of Family Medicine and Primary Care. 2016 Oct-Dec;5(4):853-857. DOI: 10.4103/2249-4863.201178.
https://clas.uiowa.edu/socialwork/sites/clas.uiowa.ed
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u.socialwork/files/NursingHomeResource/documents/
Katz%20ADL_LawtonIADL.pdf
https://clas.uiowa.edu/socialwork/sites/clas.uiowa.ed
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u.socialwork/files/NursingHomeResource/documents/
Katz%20ADL_LawtonIADL.pdf
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Subbe CP, Burford C, Le Jeune I, Masterton-Smith C, Ward D. Relationship between input and output in acute medicine - Secondary analysis of the Society for Acute Medicine’s
benchmarking audit 2013 (SAMBA ’13). Clin Med J R Coll Physicians London. 2015;15(1):15-19. doi:10.7861/clinmedicine.15-1-15
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https://www.papdi.or.id/berita/info-papdi/1009-rekomendasi-papdi-
tentang-pemberian-vaksinasi-covid-19
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https://www.yumpu.com/en/document/view/11496233/timed-up-and-go-tug-test-unmc
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https://www.hopkinsmedicine.org/institute_nursing/models_to
ols/JHFRAT_acute care original_6_22_17.pdf
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Broderick JM, Hussey J, Kennedy MJ, O’Donnell DM. Patients over 65years are assigned lower ECOG PS scores than younger patients, although objectively
measured physical activity is no different. J Geriatr Oncol. 2014;5(1):49-56. doi:10.1016/j.jgo.2013.07.010
Status Fisik Medik
• Kondisi komorbid & keparahan penyakit
• Daftar obat yang dikonsumsi
• Riwayat tindakan/ pengobatan
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Charlson Comorbidity Index
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Chuang MH, Chuang TL, Huang KY, Wang YF. Age-adjusted Charlson Comorbidity Index scores predict major adverse cardiovascular events and all-cause mortality among systemic lupus erythematosus patients. Tzu Chi Med J. 2017;29(3):154-158.
doi:10.4103/tcmj.tcmj_57_17
Reilly, Eugene & Karakousis, G. & Schrag, Sherwin & Stawicki, Stanislaw. (2007). Pressure ulcers in
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the intensive care unit: The 'forgotten' enemy. OPUS 12 Scientist. 1.
Status Kognitif
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https://www.apsf.org/article/perioperative-brain-health-its-not-all-positive-attitude-exercise-and-superfoods/
MMSE
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Status Emosional/
Psiko-Afektif
Geriatric Depression Scale
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https://www.mna-elderly.com/
Status Sosial Ekonomi
• Support system : keluarga, teman
• Aktivitas social, hobi
• Kemiskinan
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Lingkungan
• Rumah: kenyamanan, fasilitas, keamanan
• Transport
• Aksesibilitas ke layanan setempat
• Teknologi telehealth
Welsh TJ, Gordon AL, Gladman JR. Comprehensive geriatric assessment - A guide for the non-specialist. Int J Clin Pract. 2014;68(3):290-293. doi:10.1111/ijcp.12313
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TERIMA KASIH