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Block 5 Week 5 Meg > Aging > Flashcards

Aging Flashcards

1
Q

Normal aging

Universal to all members of a species

A

Primary aging

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2
Q

Change associated w disease, disuse, or abuse

A

Secondary aging

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3
Q

Rapid losses that occur shortly before death

A

Tertiary aging

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4
Q

What are some qualities that emerge w aging?

A 
more confidence
more empathy/generosity
improved reliability/organization
improved problem solving
improved emotional regulation
less anxiety/negative affect
more contentment
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5
Q

As we age, our processing capacity (pattern comparison, letter rotation, etc) declines, while our world knowledge increases. What are 3 components that increase as we age?

A

shipley vocab
antonym vocab
synonym vocab

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6
Q

Who prefers emotional ads, younger or older folks?

A

older

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7
Q

Young people are more inclined to remember (blank)-related slogans. Old people, on the other hand, are more likely to remember (blank) meaningful slogans.

A

knowledge-related; emotionally

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8
Q

Balance of emotional consequences and (blank) seems to be critical for healthy aging

A

resource allocation

*declines in resources (i.e. worse memory) can be compensated for by allocated resources differently

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9
Q

What did the study on positive vs negative faces reveal about younger vs older populations?

A

older people recognized positive faces more frequently than younger people, and payed less attention to negative faces *positivity bias

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10
Q

What are the upsides of the positivity bias in older folks?

A

greater contentment :)
calm -_-
more pleasure, less conflict in relationships :)

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11
Q

Old people report lower levels of serious (blank)

A

psychological distress

*those ages 45-64 had the highest levels of psych distress, while those 65+ had much lower levels

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12
Q

Characteristics of older couples vs younger couples?

A 
older couples:
less conflict
better negotiation
more pleasure
~levels of mental/physical health
fewer gender differences in sources of pleasure
more ++ emotions
more empathetic listening
more patience/flexibility
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13
Q

What is the downside of a positivity bias in older folks?

A

less likely to consider potential risks, and more likely to consider benefits
*can be a problem in financial decision making and health care decision making

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14
Q

List some concerns of older adults

A 
health/well-being of loved ones
staying independent
avoiding nursing homes
finances
enjoy a high quality life *even w chronic disease
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15
Q

As pts live longer lives, they may be more susceptible to suffering additional yrs of long term illnesses. What is the goal w these pts?

A

Goal is “compression of morbidity,” or pushing back the initial onset of illness so that they are in a morbid condition for a shorter period of time

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16
Q

So, there is a difference bw life extension and compression of morbidity. Discuss.

A

Extending life would simply increase the amount of time the pt must suffer from a morbid condition, while compression of morbidity would push back the initial onset of illness = less time living w disease

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17
Q

Give an example of the two different morbidity trajectories

A
  1. man has first fatal heart attack at 50 *early mortality, minimal morbidity
  2. 95 yo woman dies asymptomatically in her sleep *late mortality, minimal morbidity
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18
Q

What were the findings of the vigorous exercise, health and longevity study?

A

Regular running slows the effects of aging

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19
Q

Who had a greater probability of survival, those in the runners club or those in community controls?

A

*runners club (woohoo)

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20
Q

Who had slower progression of disability, those in the runners club or those in community controls?

A

*runners club, baby

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21
Q

What are some factors from individual to individual that affect state of disability vs health?

A

lifestyle/behavioral changes in the face of disease
psychological attributes & coping
activity accommodations *choosing activities and how they are done to ensure that they are gratifying

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22
Q

What is the greatest predictor of depression in older adults?

A

functional impairment related to disease *not disease diagnosis

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23
Q

What are some psychological attributes that contribute to good health?

A

positive affect

spirituality

24
Q

Some aspects of the physician’s role in promoting quality of life?

A 
listen *don't assume
respect choice and autonomy
become informed
promote behavioral health
respect and communicate w other providers
25
Q

T/F: You should never assume that an older pt is not competent to provide consent. Furthermore, involve the family ONLY w consent of the older person, unless a legal rep is authorized to make health care decisions.

A

True

26
Q

With older pts, should there be more emphasis on increasing healthy behaviors or reducing symptoms?

A

increasing healthy behaviors

27
Q

Something to consider w older pts is that several providers may be involved in their overall care. What should you be sure to do?

A

communicate w other providers
seek information from them
comply w requests for release of med info

28
Q

What is polypharmacy referring to in older pts?

A

a large % of pts 60yo+ are taking more than 5 medications

29
Q

What is the main concern w polypharmacy?

A

it increases the risk of adverse events *drug interactions that result in an unwanted effect

30
Q

What are estimates of medication nonadherence rates in elderly?

A

30-60%

31
Q

Adherence becomes less likely as number of (blank) increases

A

medications

32
Q

What are some strategies for increasing adherence?

A

minimize meds
written instructions
link taking meds w daily events (i.e. after getting the mail)
utilize resources (i.e. geriatric pharm med review services)

33
Q

What are the priorities when caring for an elderly pt w dimentia whose deterioration/death is inevitable?

A

prevent, detect, reduce excess disability
provide safe and effective care
respond to challenging behaviors using “restraint free” methods

34
Q

When does this occur:

Premature reduction in behaviors that will inevitably be lost due to the disease process

A

in neurodegenerative dementias

35
Q

What is this considered:

When impairment in functioning exceeds what is expected due to disease

A

excess disability

36
Q

What are some self-stigmatizing behaviors that occur in the early phase of dementia?

A

metamemory *increasingly monitoring performance
social interactions become anxiety provoking
leads to social withdrawal and isolation
depression

37
Q

What % of pts w early phase dementia are depressed?

A

30%

38
Q

What are some ways that other people stigmatize pts w dementia?

A

people are uncomfortable when interacting w them
give corrective feedback during conversation
assume all behavior is due to the dementia

39
Q

What begins to happen in middle and late phase dementia?

A

environment becomes increasingly confusing
less environmental control of behavior (?)
emergence of behavioral disturbances

40
Q

What are some behavioral disturbances associated w the middle/late stages of dementia?

A

aggression
disruptive vocalizations
wandering
paranoia

41
Q

Is there a cure for dementia? So how do you go about treating it?

A

no cure :(
there are 5 meds out currently that slow the progression but do not stop it
*meds have side effects, like nausea, headache

42
Q

In treating pts w behavioral symptoms (i.e. wandering) there is an overemphasis on (blank) approaches

A

restraint-based

*behavioral symptoms are “eliminated” by meds and mechanical restraint :(

43
Q

According to the FDA, elderly people using conventional antipsych meds had higher (blank) than those receiving a placebo

A

death rates

*there is a nationwide effort being made to reduce use of antipsych drugs among dementia pts in nursing homes

44
Q

What kinds of negative effects can psychotropic interventions have on older pts?

A 
sedation
increased cognitive impairment
incontinence
increased risk of falls
delirium
***higher mortality rate
45
Q

Do pts receiving long term antipsych meds have an increased mortality rate?

A

yes

46
Q

So how should you treat these pts if meds are so bad?

A

promote quality of life
maintain skills for as long as possible
prevent EXCESS disability
prevent (NOT ELIMINATE) behavioral disturbances

47
Q

T/F: It’s important to support family caregivers of the disabled elderly, and assess whether or not the caregiver is providing quality care. If not, refer them to some services.

A

True

48
Q 
“Any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult” (NCEA, 2007)
Includes infliction of  :
Pain   
Injury or 
Mental anguish on an older person
Deprivation of :
Food 
Shelter
Clothing or services necessary to maintain physical or mental health
A

elder abuse

49
Q

What are the categories of elder abuse?

A 
physical 
psychological
neglect of basic needs
self-neglect
exploitation
isolation
50
Q

What are these:
Inadequately explained bruises, cuts or injuries
Dehydration or malnutrition
Overly medicated or extremely sedated
Unusual confinement (Closed off in a room, tied to furniture)
Lack of cleanliness, grooming
Fear of speaking for oneself in the presences of the family or caretaker; anxious to please
Anxiety, confusion, withdrawal, depression
Shame, fear, embarrassment
Sudden change in financial activity

A

Signs of abuse in the elderly

51
Q

What % of older adults are at risk of some type of abuse? What % of cases occur w/i families? What % of nursing homes are cited for abuse?

A

1/4; 95%; 30%

52
Q

What is the most commonly reported form of abuse?

A

neglect

53
Q

What’s this?
someone who is required by Nevada Law to notify a particular state or local agency when the person, in his/her professional or occupational capacity, knows or has reason to believe that a person 60 years or older is being abused, neglected or exploited.

A

mandated reporter

54
Q

Who can be a mandated reporter?

A 
physician
dentist
eye doc
medical examiner
social worker
police 
EMT
etc
55
Q

Should you report any concerns regarding elder abuse/neglect to EPS even if you are unsure if abuse is occurring?

A

yes

Block 5 Week 5 Meg (10 decks)

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