Older patients present “atypically” for several reasons. Some of them relate to the physiologic, anatomic, and social realities of being old. Each of the following reasons is examined in-depth in the next sections
Older people may have sensory impairment, cognitive impairment, multiple active problems, or have inadequate social support.
Often the “vague complaint” represents a change from normal and thus an indicator of something new, and potentially serious.
Older people may have had a lot of previous health problems – they may arrive in the ED, convinced that they have a specific problem “just like the last time.”
Older people may “put up” with problems for longer periods of time than younger patients.
Older people often have several different chronic conditions that mimic or exacerbate each other.
Drugs can cause symptoms which mimic disease, interact with other drugs to cause symptoms or may interact with diseases to cause symptoms.
For several reasons older people may not become tachycardic, febrile, or hypotensive when “they’re supposed to!”