For many reasons, older people may “put up” with symptoms for longer — stoicism, decreased pain receptor sensitivity, social isolation, cognitive impairment. As a result, they may arrive in the ED “sicker than they look”:
- “feeling a bit weak” –with a new Q-wave from the MI that happened three days ago;
- “just not right” from the systemic sepsis which started as a simple UTI;
- “just dizzy” because of dehydration and postural hypotension from the vomiting of the painless cholecystitis;
- “just not feeling good” from the peritonitis of the ruptured appendicitis.