The elderly are often afflicted with numerous health problems that make assessment difficult. Because of the ‘normal’ changes outlined in the previous section, older persons, especially those who are debilitated, are more likely to develop health problems than those who are younger. Furthermore, acute illnesses may be manifested differently in older persons, and the onset may not be detected. For example, fever is not a frequent early symptom of respiratory infection in the older person, and many of the elderly experience heart attacks without chest pain — the so-called ‘silent MI’. Older persons, as well as caregivers, may ignore ‘aches and pains’, seeing them as a normal, even expected, part of the ageing process.
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