Deck 03_Managing the older adult

Question 1

Identify different late adulthood subgroups

Answer 1

• Young old: 65-74 years old
• Middle old: 75-84 years old
• Old old: 85-99 years old

Question 2

What are issues that impact nutrition and hydration for the older adult?

Answer 2

• Decreased/slowed down metabolism can lead to weight gain and constipation
• Diminished ability to store, use, and absorb vitamins and other nutrients
• Reduced mobility/more sedentary lifestyle can lead to weight gain
• Loss of teeth decreases the number and types of foods that can be eaten
• Effects of psychological stress (depression, loneliness, etc.) can lead to diminished appetite/anorexia
• Issues that impact hydration: less body water content can lead to dehydration

Question 3

What are issues that impact physical safety and medication safety for the older adult?

Answer 3

Physical safety issues:

• higher risk for accidents and falls
• more likely to have delayed discovery after a fall (live alone, fewer people around, etc.)
• after a certain point driving becomes a dangerous activity that needs to be monitored or eliminated from routine

Medication safety:

• danger of polypharmacy (6+ medications at once)
• greater likelihood of drug interactions
• greater likelihood of drugs being taken inappropriately

Question 4

What are issues related to abuse that affect the older adult?

Answer 4

Possibility for physical and emotional abuse, neglect, and scams/financial exploitation by caretakers, family/friends, and/or strangers

Question 5

What is the difference among delirium, dementia, and depression in the elderly?

Answer 5

• Delirium: an acute state of confusion-able to be reversed and is usually a result of physical trauma
• Dementia: a generalized impairment of intellectual functioning-not reversible
• Depression: a mental illness that results in a reduction of happiness and well-being. In the elderly, this can begin to manifest with loss of function and independence/independent living. Is able to be improved with treatment, increased socialization, etc.

Question 6

Identify body systems impacted by immobility and system specific conditions that result from immobility in the older adult.

Answer 6

Respiratory system:

• Hypoventilation: Lungs don’t expand well, decreased respiration
• Atelectasis: Alveoli collapse (can be a result of hypoventilation)
• Pulmonary embolism: a blood clot that has gotten into the bloodstream and traveled into the lungs

Cardiovascular:

• Orthostatic hypotension: BP drops significantly upon standing up: can lead to dizziness and higher fall risk
• Deep vein thrombosis: blood clots that occur in veins (usually in lower extremities)

Musculoskeletal:

• Muscle atrophy: as a result of disuse-muscles being to reduce in size
• Foot drop: tendons in lower leg/ankle begin to tighten and foot drops as a result
• Bone demineralization: calcium leaves the bones

GI:

• anorexia
• constipation

Integumentary:

• pressure ulcers/pressure injuries

GU:

• urinary stasis: pooling of urine b/c it’s not moving down the urinary tract
• UTI: result of urinary stasis
• Renal calculi (kidney stones): can also be a result of urinary stasis

Question 7

What are the signs and symptoms of approaching death?

Answer 7

• coolness of extremities
• increased sleeping
• fluid & food decrease
• incontinence
• congestion & gurgling
• breathing pattern changes
• disorientation
• restlessness

Question 8

What is the difference between hospice and palliative care?

Answer 8

• Palliative care is care that aims to reduce pain/discomfort, usually of a more serious illness/condition (does not aim to cure ailment).
• Hospice is a type of palliative care, but it focuses on people in the end of life (given a prognosis of 6 months or less). The goal of both types of care is to increase comfort of the patient during a long illness or their end of life.