DEFINITIONS

• Micro- or macroscopic perforation of a diverticulum caused in most patients by erosion of the diverticular wall by increased intraluminal pressure
• Complicated diverticulitis: presence of a perforation, obstruction, fistula or an abscess (25 percent of patients diagnosed for the first time present); nearly all require surgery.
• Uncomplicated diverticulitis treated with bowel rest and antibiotics needs surgery only in up to 30% of patients.
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Symptoms and signs

They are frequently milder and less specific than in younger adults.

An accurate history is more difficult to obtain because of:

• fear of loss of independence
• dementia
• cerebrovascular disease
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Challenges to obtain informed consent in the geriatric patient:

• Increased risk of dementia: it is important to determine whether the patient is able to understand, process and retain the information
• Significant dementia: representative (usually familly member) must be consulted regarding decisions about surgery and other treatments or end of life discussions.
• Hearing impairment and other sensory deficits difficults communication

Scheetz, Linda J.: Life-Threatening Injuries in Older Adults AACN Advanced Critical Care. 22(2):128-139, April/June 2011.

Boltz, Marie: A System-Level Approach to Improving the Care of the Older Critical Care Patient AACN Advanced Critical Care. 22(2):142-149, April/June 2011.

Casey, Colleen M.; Balas, Michele C.: Use of Protocols in Older Intensive Care Unit Patients: Is Standardization Appropriate? AACN Advanced Critical Care. 22(2):150-160, April/June 2011.

Grimm, Dawn; Mion, Lorraine C.: Falls Resulting in Traumatic Injury Among Older Adults: Nursing Care Issues; AACN Advanced Critical Care. 22(2):161-168, April/June 2011.