M.Cestari

O.U. Territorial Rehabilitation NHS Umbria - Terni,  Italy

Aims

Chronic oedema in the elderly may require a clinician’s skill to identify the persistent swelling (limbs, trunk, genitalia, head, neck) that has been present for more than 3 months, and to understand the different causes in order to apply the proper management with patient compliance and/or eventual caregiver’s collaboration.

Description

In the clinical assessment of chronic oedema in the elderly, a patients’s medical history, a general and local physical examination, the laboratory evaluation is required, and the ongoing drug therapy because some drugs may cause oedema.

The clinician has to consider that the swelling may be caused by coexisting or non-systemic diseases including heart failure, hepatic cirrhosis, kidney insufficiency, hypothyroidism, obesity as well as local conditions such as venous hypertension, primary/secondary lymphoedema, advanced cancer, dependency oedema (neurological problems, inactivity/muscle weakness, respiratory insufficiency).

During the physical examination signs of venous and arterial involvement may be investigated, and when present, they lead to a diagnostic instrumental evaluation to better determine the management.

Outcome

Careful clinical assessment is fundamental in order to identify chronic oedema in the elderly as well as the causes, due to often coexisting diseases, in order to schedule a prompt appropriate management, and to avoid local complications.

Evaluation of impact

An appropriate clinical assessment, with holistic approach considering patient and/or caregiver protagonists in the therapeutic process, is fundamental to avoid complications and to improve patient’s quality of life, considering that this condition has an impact on the physical, psychological and social aspects.