PA School: Geriatrics Rotation

Sagittal Brain

I finished my geriatrics rotation last week.  It was at a nursing home for veterans. The older men were very sweet and open to letting me talk with them and even practice exams skills like the mini-mental status exam (MMSE).  Like every rotation, I was nervous when I started this one, but as usual, by the end, I ended up enjoying the experience and learning a lot of valuable things.

In particular, three lessons really stood out:

  1. Disease Presentation.  Illness presents very differently in the elderly.  For example, confusion or changes in behavior may be the first sign something is going on with a patient.  The source could be something simple to treat, like a UTI, or something much more severe, like sepsis or a stroke.
  2. Dealing with Death.  Several of our patients were on Hospice, so over the course of 5 weeks I watched many patients go from being very happy and social, to being very sick and then dying.  Honestly, I was shocked every time how quickly and suddenly the patient would deteriorate.  The doctors always seemed to know it was coming, but I held out hope that the patient would survive longer than expected.
  3. Pain Management.  This is one of the hardest things as a provider.  None of us can truly know the pain another person is experiencing.  With elderly patients especially, you need to be careful with the pain medications since their bodies handle the drugs differently. On this rotation almost every patient had pain of some sort.

Overall, I learned a lot about life and death on this rotation and I think it has made me a better person.  I am also very thankful to have a personal relationship with Jesus.  As crazy as it sounds to many people, I am thankful that my life has a higher purpose, great meaning, and security after death.   A lot of the patients seemed to be seeking that peace only found in God, and I know how wonderful that can be to find.

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