Chapters 7-9 Flashcards

1
Q

Provide residents with around-the-clock care
Usually private or semi-private rooms along a common hallway
Often a communal bathing area
Common areas where residents gather to socialize

A

nursing homes

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2
Q
  • intermediate care (long term)
  • chronically ill
  • ADL assistance
  • increased focus on rehabilitation or restorative care
  • skilled care (short term) or skilled rehabilitation care
  • acute care for illness and injury
  • some facilities provide both in separate areas of the facility
A

levels of nursing home care

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3
Q

Separate areas for special needs

  • rehabilitation
  • dementia care
  • onocology
  • ventilator-dependent
  • pressure ulcers
  • traumatic brain injury
A

special care units (SCUs)

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4
Q

Provide residents with limited assistance with

  • personal care
  • medication administration
  • transportation
  • meals
  • housekeeping
  • often live in small apartments with a kitchen, bathroom, living area, and a bedroom
  • common area for socialization
A

assisted-living facilities

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5
Q
Provide a continuum of care by including facilities for:
-independent living
-assisted living
-nursing home care
on the same campus
A

continuing care retirement communities (CCRC)

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6
Q

As residents become less independent, they are able to stay within the ____ to obtain the care needed
-may also include restaurants, facilities for worship, and health centers

A

CCRC

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7
Q

Community supported facilities that provided shelter for those without means of supporting themselves
-early 1900s: homes for the aged, rest homes, convalescent homes

A

poorhouses

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8
Q

Retired or umemployed were entitled to receive a pension

A

Social Security Act of 1935

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9
Q

Nursing homes began as _____ that hired nurses

A

boarding homes

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10
Q

One that is owed by a company or organization that is operating the facility as a business with intentions on making a profit

A

for profit facility

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11
Q

Owned and operated by a service organization like a church or charitable group, its primary focus is to fulfill a community need

A

non-profit facility

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12
Q

Independently owned and operated

A

free standing facility

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13
Q

Owned and operated by a corporation that owns multiple facilities

A

chain facility

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14
Q

As a result of the Social Security Act, older people who were retired or unemployed were entitled to receive a ____, (regular cash payments) from the government

A

pension

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15
Q

1965: president Lyndon B. Johnson signed ____ and ___ programs into law

A

medicare and medicaid

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16
Q

Late ____ and ____, new for profit nursing homes were built

  • smaller independent facilities were bought leading to chain facilities
  • quality of care provided in many nursing homes were poor
  • aides not required to receive formal training
A

1960s and 1970s

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17
Q

As a result of ___ and ___ programs, more people could afford long term care

A

medicare and medicaid

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18
Q

In the 1980s, ____ of ____ studied nursing home care

A

Institute of Medicine

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19
Q
  • improved quality of life for residents in nursing homes
  • care required to take into account residents physical, emotional, spiritual, and social needs
  • sets standards for physical environment and training and evaluation of nursing assistants
A

Omnibus Budget Reconciliation Act 1987

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20
Q

____ standards increased cost to nursing homes

  • hospitals discharged patients sooner and sicker
  • less expensive to care for sicker people in nursing homes than in hospitals
  • certification for skilled care sought by nursing homes
  • sub-acute care facilities emerged
A

OBRA

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21
Q

In the ____s, president Clinton signed the Balanced Budget Act

  • funding cut for Medicare program
  • prospective payment system (PPS) for Medicare reimbursement
  • assisted living facility as an alternative to nursing homes
  • currently home care as an alternative
A

1990s

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22
Q

A $116.4 billion cut in funding for the Medicare program over 5 years time, largest cut in Medicare history

A

Balanced Budget Act

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23
Q

In 2000 developed several models for long term care, these models are known as _____

A

Pioneer Network

Pioneer Models for Culture Change

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24
Q

In this model, each residents personal history is used as the basis for an individualized plan of care

A

individualized care

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25
Q

This model fosters a sense of community within a facility among residents, staff, families, and volunteers

A

regenerative community

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26
Q

This model focuses on the idea of creating a neighborhood

A

resident directed care

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27
Q

This model also focuses on created a sense of community, the surroundings are designed in a way to support life and eliminate loneliness, helplessness, and boredom

A

The eden alternative

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28
Q

An ongoing process that focuses on changing attitudes, goals, and practices in order to improve the long term care environment and the way care is delivered

A

culture change

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29
Q

All types of _____ facilities must follow the requirements of:

  • OSHA
  • FDA
  • Centers for Diseases and Control Prevention (CDC)
  • OBRA
A

long term care

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30
Q

Federal OBRA laws apply only to _____

A

nursing homes

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31
Q
  • make sure that facilities are following OBRA regulations and meeting government standards
  • centers for medicare and medicaid services (CMS) responsible for monitoring nursing homes
  • government payment for services depends on facilities meeting the standards
A

survey

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32
Q

Government agency responsible for monitoring nursing homes to make sure that they are following OBRA regulations and meeting the governments standards

A

Centers for Medicare and Medicaid Services (CMS)

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33
Q
  • nursing homes must make their most recent survey results available
  • CMS posts survey results on the internet
  • nursing assistants role important to ensure positive survey results
A

federal OBRA laws

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34
Q

Grants accreditation to CCRCs, as well as to some other types of organizations that provide long term care services

A

Continuing Care Accreditation Commission (CCAC)

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35
Q

Assisted living facilities and nursing homes are regulated by the ____

A

state

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36
Q

Licensure for long term care, facilities must undergo an ____

A

inspection

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37
Q

Begins when the person is hospitalized and ends when the person has not received any skilled health care services, either in hospital or nursing home

A

benefit period

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38
Q
  • needed for participation in the medicare and medicaid programs
  • inspections
  • federal and state regulations
A

certification

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39
Q

Compliance with any regulations that the local government has established for long term care facilities

A

city or county health departments

40
Q
  • continuing care accreditation commission (CCAC)
  • grants accreditation to CCRCs
  • only accrediting organization specifically for CCRCs
A

Joint Commission

41
Q

Requirements for ___ payment

  • skilled health care provided by nurses or other health care professionals
  • care must follow hospital stay
  • care must be provided in a nursing facility licensed to provide skilled care
  • benefit period
  • ending medicare coverage
A

medicare

42
Q
  • eases the financial burden for the person receiving care
  • increases the financial burden for nursing facility
  • cost of care versus medicaid payments
  • state must accommodate medicaid costs within its budget
A

medicaid

43
Q
  • purchased to pay for long term care in the future
  • expensive and risky
  • premiums increase with age
  • does not pay for all nursing home cost
  • deductible
A

long term care insurance

44
Q
  • cost approximately half of the cost of nursing home care
  • primarily private pay
  • long term care insurance may cover some expenses
A

assisted living care

45
Q

Most residents of nursing homes are ____ years or older

A

65

46
Q

_____ in medical care allows for recovery from conditions that people used to die from

A

advances

47
Q

A condition that is ongoing and often needs to be controlled through continuous medication or treatment

A

chronic illness

48
Q

A condition that gets progressively worse over time

A

degenerative condition

49
Q
  • lingering effects of an acute illness
  • need for continuous monitoring and treatment for one or more chronic conditions
  • need for help meeting physical needs because of a degenerative condition
  • no longer safe to live alone

Are some reasons for _____

A

long term care admission

50
Q

Routine task of daily life

A

activities of daily living (ADLs)

51
Q

More complex task that a person must be able to do in order to continue to live independently such as:

  • telephone
  • groceries
  • meals
  • handling money
A

instrumental activities of daily living (IADLs)

52
Q
  • related to early hospital discharge
  • receive care until able to go home
  • saves health care costs
A

short term stay

53
Q
  • physical or mental disabilities
  • ADLs
  • IADLs
  • co-existing medical condition
  • cognitive impairment
A

extended stay admission

54
Q

More than one medical condition at the same time

A

co-exiting medical condition

55
Q

Problem processing learning, or remembering information, especially with physical problems

A

cognitive impairment

56
Q
  • placement not planned
  • coping with multiple losses
  • fear and anxiety
  • loss of independence

Are some feelings a ____ may feel

A

resident

57
Q

The first step in helping a resident make the transition into a nursing home is to understand what the resident and family may be feeling, this is part of a ____ job

A

nursing assistants

58
Q

As a nursing assistant you can help family members adjust by helping them to feel ____ and ____ in the ongoing care of their loved one

A

included and involved

59
Q
  • effects how others perceive the resident
  • long term medication usage
  • lifestyle changes
  • battle for pain relief

Are effects of a ____ on a resident

A

chronic condition

60
Q
  • physical disability
  • traumatic injuries
  • developmental disabilities

Are a reason for a ____ person to be admitted to long term care

A

young

61
Q

Adjustment process in a _____ in long term care

  • longer to adjust
  • acting out to gain control
  • methods to assist the young resident to cope
  • sexuality and intimacy
A

young person

62
Q

____ protects the quality of life

  • hobbies
  • special events
  • interacting with residents
  • allow residents to assist
A

OBRA

63
Q

The permanent and progressive loss of the ability to think and remember, caused by damage to the brain tissue

A

dementia

64
Q

A person with _____ experiences:

  • problems with memory, especially short term memory
  • difficulty putting thoughts together and understanding concepts
  • problems with judgement
  • disorientation
  • inability to manage activities of daily living
A

dementia

65
Q

Temporary state of confusion, symptom of an underlying disorder such as an infection

  • once the disorder is treated, it goes away
  • if the cause of it is not treated, the person may die
A

delirium

66
Q
  • begins to experience memory loss
  • person is aware of memory changes, becomes fearful, anxious, or depressed
  • may become angry at other people

Are the ____ stages of dementia

A

early

67
Q
  • difficult communicating
  • difficulty recognizing familiar people and things
  • difficulty remembering steps necessary to complete familiar tasks
  • personality changes, behaving differently
  • incontinence

Are the ____ stage of dementia

A

middle

68
Q
  • loses ability to walk and sit independently
  • becomes bedridden
  • no longer able to speak, swallow, or smile
  • totally incontinent of urine and feces
  • death

____ stage of dementia

A

late

69
Q

Four most common types of ____ are:

  • Alzheimers
  • vascular (multi-infarct) dementia
  • Lewy body dementia
  • frontotemporal dementia
A

dementia

70
Q

Most common type of dementia, accounting for more than 60% of cases

  • more than 5 million people in the US have this disease
  • if no cure is found, it is estimated that 11 to 16 million people will have it by 2050
  • exact cause is unknown
A

Alzheimers

71
Q

Researchers have identified a number of risk factors for ____ such as:

  • age
  • family history
  • serious head trauma
  • heart disease
  • high blood cholesterol
  • diabetes
A

Alzheimers

72
Q

Abnormal deposits of protein, especially in parts of the brain that functions in memory, these deposits are called ____ and ____

A

plaques and tangles

73
Q

Damage to the blood vessels that supply the brain can affect the delivery of oxygen to the brain tissue
-mental functions are lost because multiple areas of the brain tissue die due to lack of adequate oxygen and nutrients

A

Vascular (multi-infarct) dementia

74
Q

Death of tissue due to lack of oxygen and nutrients

A

infarction

75
Q
  • thought to be the cause of dementia in approximately 20% to 25% of people, can coexist with other types of dementia
  • most often affects people between the ages of 55 and 75, most commonly in 70 year olds
  • is more common in MEN
A

vascular dementia

76
Q

Conditions that put a person at risk for _____:

  • history of myocardial infarction (heart attack)
  • hypertention
  • diabetes mellitus
  • peripheral vascular disease
  • transient ischemic attacks (TIAs)
  • obesity
  • smoking
  • high blood cholesterol levels
A

vascular dementia

77
Q
  • symptoms may appear suddenly and they may vary from person to person depending on which area of the brain are affected
  • like Alzhemiers, it is irreversible and incurable
  • keeping blood pressure, blood glucose, and blood cholesterol levels within normal limits can help to slow progression
A

vascular dementia

78
Q

Caused by the build up of abnormal protein deposits, in areas in areas of the brain that are responsible for thinking and movement

  • develop problems controlling body movements, a shuffling gait, slow movements and tremors similar to those with Parkinsons disease
  • tend to have visual hallucinations and changes in mental alterness
A

Lewy body dementia

79
Q

Caused by damage to the frontal lobe and temporal lobes of the brain

  • frontal lobe– personality and behavior
  • temporal lobe– language
A

frontotemporal dementia

80
Q
  • person may show extreme changes in personality and behavior, have difficulty with language, or both
  • challenging because the disease may cause the person to say or do things that are socially inappropriate
  • some people may become bored and listless, no longer care about anything, lack of motivation and energy
  • accounts for only 5% of all cases of dementia and occurs at younger age (40-65)
  • memory is often spared until later in disease process
A

frontotemporal dementia

81
Q
  • amnesia
  • aphasia
  • agnosia
  • apraxia

Are the 4 As of _____

A

dementia

82
Q
  • difficulty remembering
  • short term memory in early stages: provide lots of reminders, introduce self each time, structured routine
  • long term memory in later stages: living in the pass, easy to embarrass and upset
  • validation therapy
A

amnesia

83
Q
  • difficulty speaking
  • expressive
  • receptive
  • source of stress and frustration
A

aphasia

84
Q
  • difficulty recognizing information obtained through the five senses
  • unable to recognize objects, danger, people
A

agnosia

85
Q
  • difficulty coordinating steps needed to complete task
  • ADLs
  • eating

Allow person to do what they can

  • coaching
  • hand over hand cueing
  • never rush person
A

apraxia

86
Q

Types of behavior with ____:

  • wandering
  • pacing—person may have to go to bathroom or is hungry
  • repetition (perseveration)—doing something over and over
  • rummaging—go through drawers or closets
  • delusions or hallucinations
  • agitation
  • catastrophic reactions
  • sundowning
  • inappropriate sexual behaviors
A

demetia

87
Q

A false belief

-person may think they are someone else

A

delusion

88
Q

Seeing, hearing, tasting, or smelling something that is not really there

A

hallucination

89
Q

An over-react to something that would cause a healthy person minimal or no stress

A

catastrophic reaction

90
Q

Worsening of a persons behavioral symptoms in the late afternoon and evening, as the sun goes down
-exact cause unknown—may be brought on because person can not see aswell at night

A

sundowning

91
Q

Years ago the technique of ___ was used with people with dementia

  • based the importance of bringing the person back to the here and now
  • not an effective technique
A

reality orientation

92
Q

Stresses the importance of acknowledging the persons reality
-pay attention to the words, phrases, and body language of the person to better understand what they are trying to communicate

A

validation therapy

93
Q

When helping a person with dementia with their ___:

  • speak clearly
  • remind person at each step what they need to do next
  • use hand gestures
  • plan for procedure in advance
  • keep to a regular schedule
A

ADLs

94
Q

To reminisce means remember

-in ____ the person is encouraged to remember and share experience from their past

A

reminiscence therapy

95
Q

The ____ stage of dementia:

  • unable to walk—pressure ulcers, contractures, pneumonia
  • unable to swallow—feeding tubes
  • comfort care—O2 therapy
  • care for someone who is dying
  • care for the family
A

late