Aging Flashcards
Normal aging
Universal to all members of a species
Primary aging
Change associated w disease, disuse, or abuse
Secondary aging
Rapid losses that occur shortly before death
Tertiary aging
What are some qualities that emerge w aging?
more confidence more empathy/generosity improved reliability/organization improved problem solving improved emotional regulation less anxiety/negative affect more contentment
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?
shipley vocab
antonym vocab
synonym vocab
Who prefers emotional ads, younger or older folks?
older
Young people are more inclined to remember (blank)-related slogans. Old people, on the other hand, are more likely to remember (blank) meaningful slogans.
knowledge-related; emotionally
Balance of emotional consequences and (blank) seems to be critical for healthy aging
resource allocation
*declines in resources (i.e. worse memory) can be compensated for by allocated resources differently
What did the study on positive vs negative faces reveal about younger vs older populations?
older people recognized positive faces more frequently than younger people, and payed less attention to negative faces *positivity bias
What are the upsides of the positivity bias in older folks?
greater contentment :)
calm -_-
more pleasure, less conflict in relationships :)
Old people report lower levels of serious (blank)
psychological distress
*those ages 45-64 had the highest levels of psych distress, while those 65+ had much lower levels
Characteristics of older couples vs younger couples?
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
What is the downside of a positivity bias in older folks?
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
List some concerns of older adults
health/well-being of loved ones staying independent avoiding nursing homes finances enjoy a high quality life *even w chronic disease
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?
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
So, there is a difference bw life extension and compression of morbidity. Discuss.
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
Give an example of the two different morbidity trajectories
- man has first fatal heart attack at 50 *early mortality, minimal morbidity
- 95 yo woman dies asymptomatically in her sleep *late mortality, minimal morbidity
What were the findings of the vigorous exercise, health and longevity study?
Regular running slows the effects of aging
Who had a greater probability of survival, those in the runners club or those in community controls?
*runners club (woohoo)
Who had slower progression of disability, those in the runners club or those in community controls?
*runners club, baby
What are some factors from individual to individual that affect state of disability vs health?
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
What is the greatest predictor of depression in older adults?
functional impairment related to disease *not disease diagnosis
What are some psychological attributes that contribute to good health?
positive affect
spirituality
Some aspects of the physician’s role in promoting quality of life?
listen *don't assume respect choice and autonomy become informed promote behavioral health respect and communicate w other providers
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.
True
With older pts, should there be more emphasis on increasing healthy behaviors or reducing symptoms?
increasing healthy behaviors
Something to consider w older pts is that several providers may be involved in their overall care. What should you be sure to do?
communicate w other providers
seek information from them
comply w requests for release of med info
What is polypharmacy referring to in older pts?
a large % of pts 60yo+ are taking more than 5 medications
What is the main concern w polypharmacy?
it increases the risk of adverse events *drug interactions that result in an unwanted effect
What are estimates of medication nonadherence rates in elderly?
30-60%
Adherence becomes less likely as number of (blank) increases
medications
What are some strategies for increasing adherence?
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)
What are the priorities when caring for an elderly pt w dimentia whose deterioration/death is inevitable?
prevent, detect, reduce excess disability
provide safe and effective care
respond to challenging behaviors using “restraint free” methods
When does this occur:
Premature reduction in behaviors that will inevitably be lost due to the disease process
in neurodegenerative dementias
What is this considered:
When impairment in functioning exceeds what is expected due to disease
excess disability
What are some self-stigmatizing behaviors that occur in the early phase of dementia?
metamemory *increasingly monitoring performance
social interactions become anxiety provoking
leads to social withdrawal and isolation
depression
What % of pts w early phase dementia are depressed?
30%
What are some ways that other people stigmatize pts w dementia?
people are uncomfortable when interacting w them
give corrective feedback during conversation
assume all behavior is due to the dementia
What begins to happen in middle and late phase dementia?
environment becomes increasingly confusing
less environmental control of behavior (?)
emergence of behavioral disturbances
What are some behavioral disturbances associated w the middle/late stages of dementia?
aggression
disruptive vocalizations
wandering
paranoia
Is there a cure for dementia? So how do you go about treating it?
no cure :(
there are 5 meds out currently that slow the progression but do not stop it
*meds have side effects, like nausea, headache
In treating pts w behavioral symptoms (i.e. wandering) there is an overemphasis on (blank) approaches
restraint-based
*behavioral symptoms are “eliminated” by meds and mechanical restraint :(
According to the FDA, elderly people using conventional antipsych meds had higher (blank) than those receiving a placebo
death rates
*there is a nationwide effort being made to reduce use of antipsych drugs among dementia pts in nursing homes
What kinds of negative effects can psychotropic interventions have on older pts?
sedation increased cognitive impairment incontinence increased risk of falls delirium ***higher mortality rate
Do pts receiving long term antipsych meds have an increased mortality rate?
yes
So how should you treat these pts if meds are so bad?
promote quality of life
maintain skills for as long as possible
prevent EXCESS disability
prevent (NOT ELIMINATE) behavioral disturbances
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.
True
“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
elder abuse
What are the categories of elder abuse?
physical psychological neglect of basic needs self-neglect exploitation isolation
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
Signs of abuse in the elderly
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?
1/4; 95%; 30%
What is the most commonly reported form of abuse?
neglect
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.
mandated reporter
Who can be a mandated reporter?
physician dentist eye doc medical examiner social worker police EMT etc
Should you report any concerns regarding elder abuse/neglect to EPS even if you are unsure if abuse is occurring?
yes
