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Geriatrics > 9. Long Term Care > Flashcards

9. Long Term Care Flashcards

1
Q

in elders will spend some part of their lives in institutions

A

1 in 4

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2
Q

Majority of nursing facility reimburstment in the US comes from

A

medicaid (then self pay then medicare)

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3
Q

The number of institutionalized people will increase by … during your career

A

200-300%

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4
Q

Characteristics of chronic disease are

A
  • Long term
  • Course is uncertain
  • Involves discomfort, pain, disability, and restricted activity
  • Multiply themselves
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5
Q

Staffing at nursing homes is mostly made up of (percentage)

A

Nurses aides (90%)

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6
Q

What percent of workers in nursing homes don’t provide any care

A

32%

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7
Q

What is the most common reason for referral to a nursing home

A

poor physical health

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8
Q

What is the most common reason for application to nursing home

A

excessive burden on family

Also are

  • New health problem
  • Wrosening of existing health problem
  • Gradual deterioration
  • Urging by physician
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9
Q

Effects of nursing home confinement

A
  • Deindividuation
  • Disculturalation
  • Emotional, social, physical damage
  • Estrangement
  • Isolation
  • Stimulus deprivation
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10
Q

For patients in NH who are fully edentulous what % of them

  • Have a prosthesis that needs repairing
  • Are without a prosthesis
A
  • Have a prosthesis that needs repairing 40%

- Are without a prosthesis 30%

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11
Q

For patients in NH who are fully edentulous what % of them

  • Have poor OH
  • Have advanced perio
  • Have an urgent need
  • Have Caries
A
  • Have poor OH= 77%
  • Have advanced perio = 70%
  • Have an urgent need = 77%
  • Have Caries= 84%
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12
Q

What federal regulation are in place for NH for patient access to dental care

A
  • Routine and 24 hr emergency care access
  • Assist in making appointments
  • Arrange transportation
  • Refer residents with lost/damaged dentures to a dentist
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13
Q

T/F in NYS NHs must contract with a dentist

A

t

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14
Q

In NYS is dental care a part of a resident’s care plan

A

yes

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15
Q

Know this

A

the decision to defer treatment of identified dental conditions should be documented based on physical or mental contraindications for care or the resident’s informed choice

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16
Q

What are the reason’s many resident decline dental treatment

A
  • If it doesn’t hurt there isn’t a problem
  • Leave me alone I feel bad
  • why should I care
  • Cynical interpretation of dentist’s motives
  • Frugal
17
Q

NH must have a written policy stating what about dental care

A
  • How oral hygiene is part of the “care plan”
  • The who and how of OH
  • How emergencies are dealt with
  • How all decisions on treatment or no treatment will be made
18
Q

T/F People that work at NH must provide daily oral hygiene

A

t

19
Q

What can be used to mark a patient’s denture with their name

A

Identure (Geri)

20
Q

An oral exam conducted by a dentist or hygienist must occur within _ (days/weeks/months) of patient admission

A

30 days

21
Q

How frequent (at minimum) must residents receive oral exams

A

yearly

22
Q

If after an oral exam- it is determined the patient needs treatment the treatment must begin before when

A

before 30 days after the exam

23
Q

The NH patient records must be kept where

A

at the NH facility

24
Q

What are the elements of informed consent

A
  • Dx (if known)
  • Nature and purpose of proposed tx
  • Risk and benefits
  • Alternatives (regardless of cost and insurance)
  • Risks and benefits of alternatives
  • Risk and benefits of not receiving treatment
25
Q

If a pateint doesn’t have the capacity to consent who can speak for them

A

power of attourney (POA) or health care proxy

26
Q

Who can verify if a patient is capable of consenting

A

MD (NOT the court)

27
Q

Different sources of bringing patients into your office are

A
  • Word of mouth
  • Advertising
  • Provided by employer/senior dentist
  • Arranged via caregivers/advocates
  • Referals from (social wrokers, MDs, Nurses, etc.)
28
Q

Fewer dentists compete for what types of patients

A
  • NH patients
  • Frail elderly
  • Mentally retarded
  • Other developmentally disabled
  • Homebound elderly
29
Q

Sources of facilities (in other words ways you can obtain space to do dental work without owning your own office)

A
  • Rent
  • Buy
  • Share space with another dentist
  • Work for another dentist or a hospital
  • Work for a facilitiy when you can use your own portable equipment

Geriatrics (11 decks)

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