Atypical Presentation of Illness in the Older Adult: Case Studies in Support of Zebras

Gerontological advance practice nurses in acute, primary, and long-term care manage the complex needs of the geriatric population. Symptom presentation is fundamental to building the differential diagnosis. However, older adults often present atypically, for example, with only functional changes, rather than with characteristic symptoms.

A significant illness in the older adult can manifest itself without traditional elements seen in younger patients. The clinician should be aware of challenges of diagnosis due to vague or non-specific presentations, under-reporting of symptoms. or atypical presentations of disease states. Non-specific presentations, such as falls, weakness, decline in function, dizziness, or alterations in mentation may be sign of an imminent acute illness in an older adult. Under-reporting occurs when a symptom is thought to be a normal part of the aging process. Atypical presentation requires the clinician to look beyond the typical sign and symptom clusters to reveal the correct diagnosis.

This presentation intends to provide the participant with unfolding case discussions of older adults with atypical presentations of illnesses. Interactive imbedded questions will enhance the learning experiences. In order to identify potentially life-threatening illness in this group, it is necessary to understand the appearance of symptoms, exam alterations, and the physiological age changes that underly them. By applying knowledge of these unique variations, gerontological advanced practice nurses can help decrease mortality and morbidity in our older adult population.