Advanced Old Age & Geriatrics Flashcards
What determines if someone is “old”
how person thinks/feels/behaves
what ages are young old
65-74 yrs
what ages are old
75-90 yrs
what ages are very old
+90 yrs
what is the female life expectancy
81 yrs
what is the male life expectancy
76 yrs
define a CENTENARIAN
person who is at least 100 yrs old
define LIFE SPAN
maximum # of years a species is capable of living
what is the human lifespan
120 yrs
define AGING
normal, inevitable progressive process w/irreversible changes over time @ individualized rates
define SENESCENCE
symptoms of normal aging
define AGEISM
bias/unfair treatment of older adults
define GERONTOLOGY
study of aging
describe the CLOCKWORK THEORY
biological theory of aging; connective cells are programmed to stop reproducing after certain amount of time
describe the FREE-RADICAL THEORY
biological theory of aging; unstable molecules from cellular metabolism/substances cause mutation leading to aging, can be countered by antioxidants
describe the WEAR-&-TEAR THEORY
biological theory of aging; cells wear out & stop functioning after repeated injury bc metabolic waste accumulate over time, depriving cells of nutrition leading to mlafunction
describe the IMMUNE-SYSTEM-FAILURE THEORYA
biological theory of aging; decrease immune functions cause a slow response to invaders increasing risk of infection
describe the AUTOIMMUNE THEORY
biological theory of aging; weakened immune system destroys itself, increasing chance of autoimmune diseases
describe the DISENGAGEMENT THEORY
psychosocial theory of aging; individual gradually withdraws from society leading to satisfying transfer of power between old & young
what do critics say about the DISENGAGEMENT THEORY
decrease engagement leads to decrease contentment
describe the ACTIVITY THEORY
psychosocial theory of aging; achieve satisfaction from increase social activity & involvement
describe the CONTINUITY-DEVELOPMENTAL THEORY
psychosocial theory of aging; refers to belief personality & coping pattern don’t change w/age and leads to person’s response to aging
musculoskeletal changes in elderly
- decrease in muscle mass, strength, & tone
- poor balance
- muscle weakness, spasms, stiffness
- decrease flexibility & ROM
- intervertebral disks compact
- trunk length decrease & spinal curve increase
changes in body type in elderly
- decrease shoulder width
- slight increase in chest circumference
- increase head circumference
- nose & ears lengthen
- slow decrease in weight after 55 yrs
- 30% fewer cells
changes in cardiovascular health in elderly
- heart valves thicker & more rigid
- decrease cardiac output & reserve
- poor blood flow w/activity
- increased BP (from rigid blood vessels & collagen + lipofuscin buildup)
define LIPOFUSCIN
pigmented metabolic waste product
list changes in respiratory health in elderly
- calcification of rib cage & costal cartilage
- increase residual volume
- decrease air capacity
- more work to move air
define RESIDUAL VOLUME
amnt of air in lungs after forceful exhalation
define XEROSTOMIA
dry mouth
define DYSPHAGIA
difficulty swallowing
list changes in GI health in elderly
- xerostomia & dysphagia
- diminished gag reflex
- decrease peristalsis
- decrease stomach capacity, digestive juices, enzymes
- decrease nutrient absorption
- need fewer calories & more fluid
list changes of the integumentary system in elderly
- skin = colder, thinner, drier, more fragile, & delayed healing
- decrease activity of oil & sweat glands
- nails = brittle, dyll, yellow, thick
- prone to skin breakdown after bruise/injury
- hair growth on eyebrows, nose, ears, & face (women)
- decrease ability to maintain body temp & sweat increase
- lines, wrinkles, & poor circulation
- decrease in fat
define SENILE LENGTIGO/SENILE LENTIGINES/LIVER SPOTS
irregular dark yellow, brown gray, or black pigmentation from uneven distribution of melanocytes
what are recommendation for elderly to maintain their skin health
- mild soaps, bath oils, & moisturizers
- shower 2-3 times/week & partial baths
- no hot water bottles/heating pads
list changes of the nervous system in elderly
- 5-10% neurons atrophy by 70 & increase from there
- brain lose 7% weight by 80
- cerebral blood flow decrease
- slowed motor response & reaction time
- nerve endings less sensitive
t/f: memory & learning issues can be caused by aging
false. they can only come from a specific disease
list changes in vision health in elderly
- sensitivity to glare increase
- blue & green differentiation decrease
- cataracts, glaucoma, macular degeneration, diabetic retinopathy
- blockage of lacrimal ducts & eye watering
list changes in hearing in elderly
- talk low pitched & moderately loud
- thickening of tympanic membrane & calcification of bone
- accumulation of cerumen
- presbycusis
s/s: of cerumen accumulation
fullness, itching, tinnitus
reasons for hearing loss
- obstruction/reduction of passage in inner ear
- nerve atrophy
- circulatory changes
changes in genital health in elderly women
- sex organs atrophy after menopause
- vaginal walls thinner & rigid
- protective vaginal secretions decrease
- deepening of voice, pubic hair, atrophy of breast
changes in genital health in elderly men
- gradual decrease in testicular tissue after 50
- takes longer for erection
- less semen @ ejaculation
- testosterone & sperm count decrease
- hypertrophy of prostate
changes in urinary health in elderly
- kidneys decrease in size & lose some nephrons
- decrease ability to filter, concentrate, & dilute urine
- bladder lose some elasticity & volume
changes in endocrine health in elderly
- secretory cells replace dw/connective cells
- diabetes mellitus & thyroid dysfunction
- increase parathormone & TSH
- decrease in thyroxin, estrogen, progesterone, & insulin
what counts as hypertension
systolic > 130 & diastolic at least 80
how much physical activity should elderly get
150 min/week or as much as ability & comfort allows
why are divorces more common in elderly
debilitating illnesses, disabilities, marrital distress
what are the phases of retirement
- remote phase
- near phase
- honeymoon period
- disenchantment
- reorientation phase
- stability phase
- terminates
define the REMOTE PHASE of retirement
denial period where the individual prepared little
define the NEAR PHASE of retirement
some planning goes into retirement
define the HONEYMOON PERIOD of retirement
euphoria bc do all activities could not do previously
define the DISENCHANTMENT of retirement
reality sets in & come to terms w/expectations
define the REORIENTATION PHASE of retirement
re-establish goals & change lifestyles
define the STABILITY PHASE of retirement
adjustment to reality
define the TERMINATES PHASE of retirement
person resumes to work or becomes ill/disabled
cognitive characteristics of elderly
- more reluctant to try/learn new things
- gen happier
- difficulty concentrating
- increase losses in short term memory
s/s: confusion
- talking incoherently
- not knowing their own name/recognizing others
- wandering aimlessly
- lacking awareness of time/place
- display hostile & combative behavior
- less attention to personal hygiene
- can’t respond to simple command/instruction
causes of confusion
- delirium
- CVAs
- arteriosclerosis & atherosclerosis
- dementia
- alzheimer’s
- transient ischemic attacks
what vitamins/minerals do elderly need more of
Calcium, vitamin D & B12, potassium water, & fiber
how many calories do men 51-75 yrs need/day
2000-2300
how many calories do men +76 yrs need/day
1650-2000
how many calories do women 51-75 yrs need/day
1600-1680
how many calories do women +76 yrs need/day
1500-1600
how much of an elderly’s diet should be carbs
60%
define KETOSIS
accumulation of ketones when fats improperly metabolized, disturbing acid0base balance
how much of the elderly’s diet is protein?
12-13%
how much of the elderly’s diet is fat
30%
s/s: dehydration
- confusion sunken eyes
- dry mouth & tongue
- dry, loose skin
- urine specific gravity > 1.030
- urine output is less than 500 mL/day
how alcohol beneficial for elderly
reduces coronary heart disease
s/s: malnutrition
- weight loss & muscle wasting
- poor healing
- cognitive impairment
- visual disturbances
define nocturia
nighttime urination
how much sleep should elderly get/night
7-9 hrs
what vaccines should elderly have
tetanus, shingles, pneumococcal pneumonia, flu
purpose of using GINGKO
improve circulation & brain blood flow
purpose of using SAW PALMETTO
prevent/treat prostate enlargement
purpose of using ST. JOHN’S WART
relieve stress, anxiety, & depression
purpose of using EVENING PRIMROSE
menopause & dry skin
purpose of using BLACK COHOSH
menopause
purpose of using CHONDROITIN SULFATE & GLUCOSAMINE
cartilage
purpose of using CELERY SEED
treat gout & arthritis
purpose of using garlic
decrease BP & cholesterol & prevent blood clots
purpose of using VITAMIN E
prevent heart attacks & dementia
purpose of using VITMAIN C
reduce cold severity
define delirium
acute impairment in cognition & attention that can happen at any age
s/s: delirium
- disorientation
- emotional lability
- hallucinations & delusions
- disturbance of sleep-wake cycle
- restlessness, hyperactivity, hypoactivity
potential causes of delirium
systemic, mechanical, & psychosocial
define dementia
loss of cognitive abilities caused by over 70 diseases & diagnosed by Mini-Mental State Examination
purpose of Mini-Mental State Examination
test memory, judgment, abstract thinking, attention, & calculation w/some control & routine
define polypharmacy
use of multiple medications & can cause pseudodepression
describe Alzheimer’s
form of dementia leading to change in brain cells; lack of neurotransmitters lead to death of neurons, development of amyloid plaques, & neurofibrillary tangles
possible causes of Alzehimer’s
- genetic defect
- missing enzyme
- virus
- faulty metabolism of glucose
- toxic affects of aluminum
when is alzheimer’s considered terminal
lasting 3-10 yrs
s/s: early alzheimer’s
- self-centeredness
- decrease interest in social activities
- memory loss
- anxiety, depression, agitation
- mood & personality changes
- poor judgment
- inability to plan & complete daily tasks
- confusion about time place
s/s: progressive Alzheimer’s
- nighttime restlessness & wandering
- frequent mood swings
- ignore personal hygiene
- severe confusion & forgetfulness
- perseveration/repetitive behaviors
- decrease ability to understand other/speak coherently
- weight fluctuations
- increase paranoia & hallucinations
s/s: terminal Alzheimer’s
- total disorientation regarding person, time & place
- incoherent & can’t communicate w/words
- loss of bladder & bowel control
- seizures
- weight loss despite balanced diet
- total dependency on caretaker
- coma & death