Aging Final Flashcards
Does elder abuse have to b e physical?
No, it can be financial
Where do Its most likely to encounter elder abuse?
Home Settings
What is a risk factor for abuse
It’s a scenario that could lead to abuse
What are different types of signs that an elder is being abused?
physical
psychosocial
emotional
Is there a universal screening tool for elder abuse?
no, not very valid
What are the principles of Universal Design?
- equitable use
- flexibility of use
- Simple and Intuitive
- Perceptible Information
- tolerance for error
- low physical effort
- Size and space for approach and use
What is the new definition of universal design
A process that enables and empowers a diverse population by improving human performance, health, and wellness and social participation
What are the goals of universal design
- Body Fit
- Comfort
- Awareness
- Understaning
- Wellness
- Social Integration
- Personalization
- Cultural Appropriateness
What is difference between universal design and ergonomics
it applies to more than just the built environment
According to the OTPF, should OT be involved in Sexuality?
Yes, Sex is an ADL of social participation
What are barriers for expressing sexuality?
- physiological changes: older adults are seen as asexual
- communication: older men and women are hesitant to talk about sex with providers
Dysprunia?
painful intercourse for women
How has family and social structures changed over the years
- people have smaller families
- people have blended families i.e. Brady bunch
The relationship you have with Kin is stable throughout lifetime T/F
T
For Native American families, caregivers tend to be the spouse vs children and tend to contribute monetary support over practical support
T/F
F, White
Which racial group tends to engage in positive health behaviors and influence their families with physical activity?
Asian
This group has religion effecting matters related to health
Latino
Latino families have stronger expectations of co-residence compared to whites, social support network is resiliant
T/F
F, African American
This community often tolerates illness because the needs of the community matter over the personal matter
Native American
SAGE and Openhouse are agencies and organizations you would refer _____ to
LGBT older adults
SAGE is Services and Advocacy for Gay Lesbian and Transgender Elders
The challenges LGBT elder adults include
- stigma
- reliance on informal families of choice
- unequal treatment under laws and programs
LGBT adults are twice as likely to delay or not get needed prescription medicine
T/F
T
transgender adults are much more likely to have suicide ideation
T/F
T
What model would an OT traditionally use to approach the topic of sexuality?
EX-PLISSIT
What are the components of the EX-PLISSIT MODEL?
EX: Extended, you're constantly asking for permission P: Permission LI: challenge assumpations SS: Specific suggestions Stops at specific suggestions
Community mobiiilty is an IADL that includes?
walking, bicycling, using public transportation and driving
Most seniors live in suburbs or rural areas where public transportation is easily and readily available
F, they live in suburbs (56) and rural areas(23)
What’s the preferred choice for senior drivers and non-drivers?
Personal automobile
Number of accidents involving older adult drivers decreases as age increases
T/F
T they drive when conditions are the safest, use seatbelts, are not impaired
Its are ethically obligated to address driving
T/F
T
How does a generalist differ from a specialist in driving
generalists: determine if there is a need for specialist to address
specialist
determine whether person is medically fit to drive
What are the specialization credentials to become a driving specialist
Certified Driving Rehabilitation Specialist (CDRS)
examination
Specialty Certification in Driving and Community mobility(SCDCM)
AOTA portfolio
is age by itself a factor that affects driving?
no the changes that occur with aging, vision, medications, cognition, physical function changes are what affect driving
What conditions can interfere with driving?
Cataract, Age Related Macular Degeneration, Glaucoma, Diabetic Retinopathy, Stroke
What’s the difference between cataract and glaucoma
deterioration of lens vs optic nerve pressure build up
Contrast sensitivity or the capacity to distinguish between objects similar in color occurs commonly in ____
cataracts
isi color vision seem to be related to crash risk involvement?
does not seem to be
Describe useful field of view
Area that can be seen and cognitively processed, Reduction of UFOV greater than 40% increases risk of car crash 16x
What is the failure to respond to stimuli on one side opposite brain lesion , inability to attend to vehicles or pedestrians
lateralized Deficit or neglect
Working memory declines in old age but procedural memory remains relatively intact
T
What are the causes of older adult crashes?
inattention and slowed visual processing speed vs inexperience and risk taking for younger people
How does physical function of aging impact driving
Reduced muscle mass, osteoporosis, neuropathies, diabetes, limit range, causes arthritis
Tranquilizers, Narcotics, sleep medicines, cough medicines, antihistamines, decongestants, benzodiazaphines
meds that impact driving
What are California’s rewewal laws regarding vision
u must renew license every 5 years, until age 70 you can make 2 renewals by mail. People 70 and older must apply in person
How do you treat the performance skills underlying driving
activity and exercise programs that address deficits in strength, range of motion and coordination
activities and games that challenge memory attention and decision making
What is Car Fit
-and education program developed by the American age of Society of Aging in collaboration with Aaa, AARP and AOTA
trained technicians and professionals provide a 12 point check of how a senior fits with their personal vehicle
You have a. client who needs to be assed for transportation options?What steps do you take?
Eligibility-
Affordability
Accessibility
What is the definition of healthy aging?
growing older in ideal health with the ability to adapt and compensate in the face of age-related changes as to function optimally in all life domains
Obectives of the Healthy People National Agenda
reduce the proportion of older adults who have severe functional limitations, increase proportion of older , increase proportion of healthcare workforce with geriatriccertificaiton, , ,
What were the time frames of the wall elderly studies
1994-1997
2004-2009
What does the well elderly intervention consist of?
- Group Meeting (Instructional presentation, peer exchange, direct experience, personal)
- Individual Sessions (personal goals, new habits, traditional OT, Individualize )
What are some modules of WE 1
Occupation, transportation, dining, time, home and community, relationships, outings
What were the two most drastic findings of the WE 1
adults participating in WE! had drastically higher scores in vitality and absence of health based role limitations, social functioning, mental heath
9 month
subsidized apartment complexes for indedenent seniors
What’s the difference between WE I and WE II
-extended focus from efficacy to effectiveness
What did the well elderly studies demonstrate?
the importance of OT professional judgement and leadership
What were the WE II Key Findings
-positive outcomes: mental health, social functioning, vitality, bodily pain, life satisfaction, depression, cost-effective, improved treatment effect (with a min 5 individualized
Vivir Mi Vida goals
optimize health outcomes of Latino patient through lilfestye intervention implemented in a public health system
What are the modules of Vivir Mi Vida
Weight management,
disease management,
mental and well-being,
personal finances,
family friends and co
What are the modules were added to Well Elderly Study 2
Community Mobility, Longevity, Stress and Inflammation, Nutrition, Thriving, Navigating Healthcare, Sexuality
People tend to get happier as they get older
T/F
T
What age is the greatest risk for any mental illness
26-49
In a German study that pitted d200 younger (21-31) people vs older (65-80) on 12 different tasks what were the results
Older adults made less serious errors that would be expense, younger people were not more productive, and higher consistency among older adults
What is a dignosis mentioned by stiffer et al that is specific to old age? and how do you treat
delirium
reduce painkillers?
A disturbance in consciousness, attention cognition and perception in medical settings.
delirium
What condition results in the highest rates suicide
Bipolar
Is Interpersonal therpy ( focus on interpersonal events and roles better than other types of therapy?
No
What s the framework of CBT
Focuses on internal biases that result in cognitive distortions, challenge distortions to achieve goals, explore meaning, consistent themes and connecting present and past experiences
Is CBT less effective as individuals age?
yes
Should CBT be used for adults long -term?
Studies suggest that it should only be used short term.
What are one of the weaknesses of CBT in relation to older adults
Despite using CBT many older adults still have a fear of falling
In cases of mixed anxiety and depression what did researchers find was the key for outcomes
non-specific effects of group participation is key to outcomes with CBT vs discussion?
What type of interventions have worked best for carer stress for dementia
CBT with highly trained instructors
Studies show that CBT is less effective with lower income populations T/F
T
What is the concept of mindfulness
leraning to let things go and accept it rather than analyze it
What is referred to as the forgotten psychological tool?
Forgiveness
What does the mindfulness based forgiveness group treatment entail?
visual imagery, cognitive restructuring, forgiveness, mindfulness education
What are the ways that mindfulness works?
attention regulation, body awareness, emotional regulation
reprisal, extension and reconsolidation
What tx intervention and brain structures are related to attention regulation for ADHD, bipolar, post-concussion syndrome, TBI?
- ACC, insula, temporo-parietal junction, front-limbic network,
- Mindfullness
What is body awareness and the brain areas its associated with? What conditions is it associated with?
- ability to notice body sensations
- increased insulat TPJ
- eating disorders, substance abuse at PTSD
What is emotional regulation and what disorders is it relevant to?
- return to baseline following reactiveness
- PFC ACC, Decrease amygdala
- relevent to depression, bipolar, PTSD, borderline, OCD phobias and anxiety
What is an unexpected/unintentional event in which the person comes to rest on the ground, floor or lower level
fall
What’s the difference between a slip and a trip
slip: occurs when too little friction or traction between surface
trip when foot strikes and object or irregular surface and momentum throws u off
In older adults what is the leading cause of fatal injuries, nonfatal injuries and hospital admissions for trauma?
Fall
Muscle weakness, History of falls, gait deficits, use of an assistive device are ____ risk factors for fall
significant
Balance deficit, visual deficit, arthritis, depression, cognitive impairments are significant risk factors for falls
T/F
F, they so so
One risk factor increases your chances of falling by 27%, 4 risk factors increases your changes of falling by 78%
T
injuries, costs, loss of independence, psychological trauma, death are
Outcomes of Falls
Hip fractures occur more often in males or females?
females b/c osteoporosis
males are more likely to sustain fatal injury d/t infection post-fall and risky behaviors
80 percent of hip fractures are due to a fall T/F
F 90
Describe FOF
lasting concern about falling that can lead to an individual avoiding activities that he/she remains capable of performing
Falls efficacy vs FOF
Falls efficacy: confidence you have to avoid a fall
FOF: how afraid you are of falling
What consists of prospective fall history
fall diary, calendar , performance testing, to see whether they are ready for discharge
TUG, GAIT speed, 6 minute walk, Tinetti Performance Oriented Mobility Assessment, Dynamic Gait Index are all measures for
Gait and Mobility
Maximum Step length, Functional reach test, unipedal tandem, berg Balance scale, postural sway and 30 sec chair stand are all measures of
Balance
Which assessment tool is an OT relevant one for falling?
Survey of Activities and Fear of Falling in the Elderly
SAFFE
The Mini Mental Status Exam (MMSE), Dual task performance, Routine Task Inventory and Executive Function Performance test are all measures for
Cognition
Which t assessments are great for home health clinicians
WeHSA Westmead Home Safety Assessment
Westmead Home Safety Assessment (WeHSA), Comprehensive Assessment and Solution Process for aging residents (CARPAR), Home Falls and Accidents Screening Tool (HOME FAST), Falls Behavioral Scale (FAB) are
home assessment tools
Resistance and aerobic training are great options for elder adults
not a lot of evidence
Balance training has strong evidence for older adults
T/F
T
What are some environmental modifications for the restroom?
Grip surfaces, high contrast colors, high lighting, bars
Universal design
the design of products and environments to be usable by all people to the creative extent without need for adaptation or specialized design
a process that enables and empowers a diverse population by improving human performance, health and wellness and social participation
What are the principles of universal design?
- Equitable Use
- Flexibility in Use
- Simple and Intuitive Use
- Percpetible information
- Tolerance for Error
- Low Physical Effort
- Size and space for approach and use
This universal design principle states that the design should be marketable and appealing to all users, and available
- equitable use
This universal design principle accommodates a wide range of user preferences and abilities (l-hand, R-hand, accuracy and precision, adaptability)
Flexibility in Use
This universal design principle states that design should be easy to understand
- Simple and intuitive use
This uinversal design principle states that the design must communicate information effectively to users (legibility, adequate contrast, differentiate elements)
- Perceptible Information
This design principles minzes hazards and adverse consequences. (minimize hazards and error)
- Tolerance for error
this design principle states that the design can be used efficiently and comfortably
- Low Physical Effort
This design principle states that appropriate size and space is provided for approach reach, manipulation and use regardless of the user’s body size, posture or mobility?
- size and space for approach and use
Body Fit, Comfort, awareness, understanding, wellness, social integration, personalization, cultural appropriateness are the what?
goals of universal design
This condition results in the loss of elasticity in the ciliary muscle and suspensory ligament, difficulty with near vision
Presbyopia
This condition is the build up of lens protein that leads to cloudiness, blurriness, faded colors and halos of light
cataracts
This condition damages the macula(central vision and sharp details)
Age-related macular degeneration
what are the two forms of age-related macular degeneration?
Dry: thinning, white/yellow deposits of fatty protein
Wet: growth of abnormal blood vessels
What condition results from and excesss of fluid that leads to pressure on the optic nerve and leads to peripheral blindness and tunnel vision?
Glaucoma
This condition results in damaged retinal capillaries ( leaks fluid into macula, grows blood vessels, hemorrhaging blood vessels) and causes changes in near and distance vision as well as scotomas( area of partially/completely degenerated vision)
Diabetic Retinopathy
age-related hearing loss, is the cumulative effect of aging on hearing.
Presbycusis
What are the two types of presbycusis?
conductive: blockages, infections
sensorineural: loud environments, head trauma, medications, tumors, HTN(hypertension), diabetes
This symptom is described as “Ringing in the ears”
Tinnitus
Any item pice of equipment or product system whether acquired commercially off the shelf, modified or customized that is used to increase maintain or improve functional capabilities of individuals with disabilities
AT device
Any service that directly assist and individual with a disability in the selection, acquisition or use of an assistive technology device
AT Service
Using subtitles in movies, reading books on tape and using braille (tactile language) are all examples of
alternative pathway assistive technology for age related sensory loss
Elder abuse could mean
-physical abuse, neglect, financial abuse, abandonment, isolation, abduction, deprivation of care
There is a universally accepted screening tool for elder abuse
T/F
F
What are some tools for elder abuse
OT elder abusechecklist
elder assessment Instrument revised
Indicators of abuse screen
Nursing Home Abuse Prevention Checklist
What are the steps to address elder abuse?
- address medical problems
- secure safety
- restore sense of control, empower the victim
- identify and eliminate the case
What’s the difference between palliative and hospice care
hospice: terminal, 6 months to life, control symptoms
palliative: any stage of the disease and you can still seek a cure, dementia, cold
