CHRONIC CONDITION Flashcards
Supports for people living with vision loss * research, public education, and vision health services * rehabilitation therapy for people who are blind or partially sighted * assists with building confidence, skills, and providing opportunities to fully participate in life
Vision Loss Rehabilitation Ontario
the third most prevalent chronic condition in older adults and the most widespread disability.
Hearing loss
4 major pathological conditions leading to visual impairment in the older adult
cataracts,
age related macular degeneration
glaucoma
retinal neuropathy
Often referred as a “Silent Thief”
OSTEOPOROSIS
What is osteoporosis?
Reduced bone quality and quantity
What are the signs and symptoms of osteoporosis?
Pain, loss of height and kyphosis
What are the assessments used for osteoporosis?
fragility fractures and bone mineral density
what is osteoporosis?
osteoporosis is a bone disease where the loss of bone is faster than the formation of new bone. Imagine your bones as a building that constantly undergoes construction and demolition. In osteoporosis, the demolition (performed by cells called osteoclasts) happens more quickly than the construction (performed by cells called osteoblasts), leading to weaker and more brittle bones. This can increase the risk of fractures and other bone-related problems.
Coomon sites for a fragility fracture
Hip, wrist, and spine fracture
impact of osteoporosis
Disability,
System cost,
Mortality
Modifiable risk factor of osteoporosis
- Inadequate calcium and vitamin
D intake - Low intake of high-quality
proteins and inadequate food
sources of vitamin B12 and folic
acid - Lack of weight-bearing activity
- Tobacco use
- Excessive alcohol consumption
Non-modifiable risk factor of osteoporosis
Hormonal changes (estrogen) in
women & early menopause
* Small bones
* Increased age
* Certain medications (i.e.
steroids, anti-seizure drugs)
* Osteopenia
* Untreated celiac disease
* Overactive thyroid
* Chemotherapy
Not everyone requires a
Bone Mineral Density…but
Those over age 50 and who have
experienced a fragility fracture
Measure height annually
Assess for falls in the past year
Look at other risk factors
Education for OP
What is it
* Risk factors
* Safety with
mobility – falls
prevention
* Self- Management
* Provide
resources
Lifestyle
Management for OP
Nutrition -Calcium – 500mg
* Vitamin D 400-2000 IU per day depending on severity
* Smoking cessation
* Exercise
Medications for OP
Bisphosphonates are first line
* Hormonal therapy but there
are risks
Bisphosphonates
slows bone osteoclast
Exercises for OP
- Weight bearing
- Resistance training
- Postural training
- Balance
PAIN MANAGEMENT STRATEGIES For OP
Relaxation techniques &
meditation
Gentle massage
Light stretching/strengthening
exercises
Applications of heat and ice
Acupuncture
Transcutaneous Electrical Nerve
Stimulation (TENS)
Ultrasound
Pain medication
Bracing or taping for temporary
relief
Physical activity
What is osteoarthritis?
osteoarthritis is a condition that affects the joints, as well as the surrounding muscles, tendons, and ligaments. It’s a type of arthritis characterized by the gradual wearing down of the protective cartilage that cushions the ends of bones in a joint. As this cartilage breaks down over time, it can lead to pain, swelling, and decreased flexibility in the affected joint. Additionally, the changes in the joint can impact the nearby muscles, tendons, and ligaments, causing further discomfort and limitations in movement. Osteoarthritis is commonly associated with aging and wear and tear on the joints, but it can also result from injury or other underlying factors.
Signs and Symptoms of OA
- Joint pain
- Swelling
- Stiffness
- Crepitus
- Fatigue
- Sleep problems
- Mood changes
Assessment for OA
- Physical exam
- X-rays
- CT scan
- MRI
- Subjective history
OSTEOARTHRITIS – RISK
FACTORS
Age (can occur at any age, but likelihood increases with age)
Family history
Gender – women more likely
Obesity
Joint injury (previous accident or injury)
Occupation - Repetitive motion or physically demanding work
Sedentary lifestyle
Lifestyle Management for OA
Nutrition – The Eat Well Plate from Canada’s Food Guide; DASH or Mediterranean diet
* Smoking Cessation
* Exercise
* Weight management
* Self management
Medications for OA
Non-Steroidal Antiinflammatory Drugs (NSAIDs) are first line
treatment, but need to be used
with caution in the older adult!
* May need to consider Tylenol
Arthritis as an option
EXERCISE FOR OA
- Neuromuscular Training-Joint remains stable with functional activity
- Muscle Strengthening * Strengthen the muscles around the
affected joints, reduce falls risk,
improve function - Aerobic Training- Large muscle groups for a sustained period, swimming, cycling, walking
best exercise for OA
Hydrotherapy
what is CHF?
refers to a condition where the heart is unable to pump blood effectively, leading to a buildup of fluid in the body. The heart’s pumping action becomes weakened, and as a result, blood moves through the heart and the body at a slower rate.
Age-related changes in
cardiac physiology are
minimal?
TRUE
Signs and Symptoms of CHF
- Increased shortness of breath (dyspnea) especially when lying flat (paroxysmal nocturnal dyspnea)
- Dyspnea at rest or on exertion
- Crackles on lung exam
- Jugular venous distension
- Fatigue
- Sudden weight gain
- Swelling of feet, ankles, Legs, sacrum, or abdomen (peripheral
edema)
Assessment for CHF
- Electrocardiogram
- Chest x-Ray
- Blood tests (clotting times, cholesterol, blood glucose, calcium,
fibrinogen) - Echocardiogram with tissue Doppler
- Stress test
- Coronary angiogram
Lifestyle Management for CHF
- Nutrition - Diet (Sodium and Fluid
Restriction) - Smoking cessation
- Exercise
Medications Surgery for CHF
- ACE inhibitors, Beta Blockers,
Diuretics, Statins etc. - Cardiac resynchronization
therapy, pacemakers
ACE inhibitors
help to relax blood vessels and lower blood pressure by interfering with the actions of a hormone called angiotensin. They are commonly prescribed for conditions like hypertension (high blood pressure) and certain heart conditions.
Beta Blockers
Blocking the effect of some hormones like epinephrine, the heart beats more slowly and Lower Blood Pressure
Exercises for CHF
- Aerobic (150mins each week)
- Resistance (2-3 x week)
- Stretching (daily)
DIABETES
is a condition where the level of sugar (glucose) in your blood becomes too high. This happens when your body either doesn’t produce enough insulin or doesn’t use insulin properly.
This occurs when the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. when the
pancreas is unable to
produce insulin
Type 1 Diabetes
This is more common and usually develops over time. It happens when the body can’t produce enough insulin or doesn’t use it effectively.
Type 2 Diabetes
excessive urination
- Polyuria
excessive hunger
Polyphagia
excessive thirst
Polydypsia
Signs and Symptoms of diabetes
3 P’s
* Weight change
* Extreme fatigue
* Blurred vision
* Frequent or recurring infections
* Cuts or bruises that are slow to heal
* Tingling in hand/feet
Assessment of diabetes
- Fasting blood glucose
- Random blood glucose
- Hemoglobin A1C
- Oral glucose tolerance test
DIABETES - IMPACT
Significant complications causing mental wellness behavior thus affecting quality of life. *
People living with diabetes
and depressive disorders
are at increased risk for
earlier all cause mortality
Lifestyle
Management for diabetes
- Nutrition: strong support for the use of the Mediterranean & DASH diet
- Smoking Cessation
- Exercise
- Community engagement
Medications for diabetes
- Metformin
- Monitor cognition re: ability to handle insulin regime
- Avoid glyburide (risk of hypoglycemia)
- Avoid sliding scale protocols
Exercises for diabetes
aerobic training
muscle strengthening
mindful of complications-neuropathy/retinopathy require modifications
CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
(COPD)
the airways in your lungs become narrower, making it difficult for air to flow in and out. This can lead to symptoms like shortness of breath, chronic cough, and wheezing. Over time, COPD can get worse and make daily activities challenging.
the air sacs in the lungs (alveoli) become damaged, making them less elastic. This reduces the surface area for oxygen exchange, making it difficult for the person to take in enough air and get rid of carbon dioxide.
Emphysema
- Airway irritation,
*constriction Productive cough
Chronic
Bronchitis
Signs and Symptoms of COPD
- Cough that lasts more than three months
- A cough with mucus
- Feeling short of breath (dyspnea)
- Lung infections that last longer then expected
- Wheezing
- Fatigue
- Weight loss
Assessment for COPD
- Spirometery (FEV1/FVC ratio below 65%)
- Oximetry (Oxygenation
saturation of the blood) - Chest X-ray
- Blood work or other Scans
COPD - IMPACT
Leading cause for hospitalization
among chronic diseases -Costly- affecting quality of life
* Function and mobility
* Exacerbations
* Mortality
COPD - Lifestyle
Management
- Smoking Cessation
- Nutrition
- Exercise
- Vaccination (flu and pneumonia)
- Adaptive equipment
- Community engagement
COPD - Medications MANAGEMENT
- Bronchodilators (Inhalers) and education for use!
- Short and long acting therapies
- Antibiotics
- Steroids (inhaled and oral prednisone)
Exercises for COPD
Aerobic training
Muscle strengthening
Flexibility
Postural and Breathing
CEREBRAL VASCULAR
ATTACK (CVA) – STROKE
commonly known as a stroke, occurs when there is a problem with the blood supply to the brain. Imagine the brain as a control center that needs a constant flow of blood to function properly. If something disrupts this blood flow, like a blocked or burst blood vessel, it can lead to a stroke.
Occurs when a blood vessel supplying the brain is blocked by a clot, cutting off blood flow to a specific area.
Ischemic Stroke
Happens when a blood vessel bursts, causing bleeding in the brain and reducing blood flow to certain regions.
Hemorrhagic Stroke
temporary interruption in blood flow due to an ischemia
Transient
Ischemic Attack
(TIA)
MODIFIABLE RISK FACTORS of CVA
Diet
* Unhealthy weight
* Physical Inactivity
* Smoking
* Excessive alcohol and drug
abuse
* Stress
NON-MODIFIABLE RISK FACTORS of CVA
- Other comorbidities
(hypertension, atrial
fibrillation, diabetes, high
cholesterol) - Genetics
- Age
- Male – younger, female older
- Ethnicity (Indigenous, South
Asian or African)
SIGNS OF STROKE – HEART AND
STROKE FOUNDATION
ACT FAST
Facial droop
Arm cant raise
Speeech is slurred
Time
CVA Lifestyle Management
- Nutrition –
strong support
for the use of
the
Mediterranean &
DASH diet - Smoking
Cessation - Exercise
- Community
engagement
EXERCISES FOR CVA
Aerobic training
Strength training
Balance
Flexibility
PARKINSON’S DISEASE
a neurological disorder that affects movement. It happens when there is a problem with certain nerve cells in the brain that produce a chemical called dopamine. Dopamine is crucial for coordinating smooth and controlled movements.
What is the
important
neurotransmitter
implicated in
Parkinson’s
Disease?
DOPAMINE
- Signs and
Symptoms of Parkinson’s disease
T-TREMOR
R-RIGIDITY
A- AKINESIA
P-POSTURAL CHANGES
Feels like feet are
“glued” to the floor
FREEZING EPISODES
PARKINSON’S DISEASE -
Lifestyle Management
- Smoking Cessation
- Nutrition – no special diet, but Vitamin D
- Exercise
- Adaptive equipment
- Community engagement
PARKINSON Medications &
Special Therapies’S DISEASE -
MANAGEMENT
- Anti- Parkinson’s
drugs (i.e.
Dopamine
(levodopa/Sinemet)
is the gold
standard) - Deep brain
stimulation - Continuous
medication delivery
EXERCISES FOR PARKINSONS
AEROBIC TRAINING
MUSCLE STRENGTHENING
FLEXIBILITY
COORDINATION AND BALANCE
SPEECH AND FACIAL EXERCISES
POSTURE
