Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OT 401: OP & Context for Older Adults > Exam II > Flashcards

Exam II Flashcards

1
Q

Cognitive aging is what kind of lifelong process?

A

Developmental, occurring from birth to death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cognitive aging occurs within a frame work of what?

A

Gains, declines, and stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cognitive aging is impacted by what?

A

Diet, exercise, health habits, and education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are other factors that affect cognition?

A

-Neurobiological influences (related to disease process, sensory systems, auditory/visual systems)
-Affective influences (anxiety, fatigue, pain, depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sensory processes

A

Transmits stimuli from environment to neutral structures, older age declines auditory and visual processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Perception

A

Assign meaning to stimuli, older adults utilize situational context and experience to maintain perceptual abilities necessary to function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sustained attention

A

Direct to single task, no change comparing younger to older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Selective attention

A

Direct to a task while simultaneously using resources to ignore distracting info, probably no age change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Alternating attention

A

Switching between two or more tasks, older adults have more difficulty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Divided attention

A

Allocate attentional resources to two or more tasks at the same time, declines with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of memory

A

Sensory, short-term, working, long-term
MOST decline with age!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sensory memory

A

Stores incoming info for a very short time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Short-term memory

A

15-20 seconds stored without rehearsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Working memory

A

Stores, maintains, actively manipulates information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Long-term memory (2 kinds)

A

Declarative- verbal based memory
Semantic- general world knowledge not linked to a specific learning episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Procedural (non-declarative) memory

A

-Stores information for motor based skills and behaviors
-Well preserved in later life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Prospective memory

A

Remember future oriented or scheduled tasks without the use of external memory aids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Executive functioning

A

-Reasoning, decision making, problem solving, judgement, abstract thought, and logic
-SIGNIFICANT differences from younger to older as task complexity increases as additional cognitive resources are needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Problem-solving

A

Older adults tend to use less efficient strategies, persist longer in using erroneous solutions, and produce more errors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Everyday cognition

A

Utilize cognitive processes in real world contexts, fewer age related differences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Language production and speech comprehension

A

Older adults OUTPERFORM younger in message production and discourse- like storytelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Expertise

A

-High level of skill/knowledge in one area – problem solving, reasoning, memory
-Maintains in later life and helps compensate for other deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Implicit processing

A

-Unintentional, occurs with awareness, effortful- requires moderate to substantial cognitive resources
-Minimal age young to old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Explicit processing

A

-Intentional, occurs with awareness, effortful – requires moderate to substantial cognitive resources
-Some age related decline in skill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Intellectual abilities (2 types)

A

-Fluid intelligence – ability to use abstract reasoning, flexibly shift mental set (decline begins around age 70)
-Crystallized intelligence- accumulation of knowledge, experience, acculturation (increases throughout life and maintains in old age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How do we optimize cognition in later life?

A

-Physical activity (aerobic, strengthening, balance, and flexibility)
-Mentally stimulating activities
-Social engagement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Benefits of physical activity

A

Increased cerebral flow, increased neural growth hormone, increased insulin-resistant growth factor, increased brain volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Benefits of mentally stimulating activities

A

-Novel and mentally challenging to promote neural growth, development, and plasticity
-Building cognitive reserve reduces chance that ADLs will surpass available resources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Benefits of social engagement

A

-Promote connectedness by maintaining social contacts and participating in social activities
-Social isolation and lack of perceived support has a detrimental effect on psychological well-being

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Mild Cognitive Impairment (MCI)

A

-The changes in memory and other areas of cognitive function that may be seen in healthy older adults of at least average intellectual functioning
-Not a strong impact on ADLs, IADLs, or leisure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Dementia demographics

A

4.3% of adults age 70-74 diagnosed with dementia
47.5% of adults over 90 diagnosed with dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the most common form of dementia?

A

Alzheimer’s disease (5.2 million living with AD data from 2014)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the characteristics of dementia?

A

-Cannot meet everyday demands of life
-Affects cognition, behavior, and occupational performance
-Irreversible and often progressive
-Memory loss not always first sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

(T/F) Is dementia the inevitable part of aging?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

(T/F) Dementia is an acquired, persistent impairment in multiple areas of intellectual functioning due to delirium.

A

False- NOT due to delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the impact of dementia on behavior and occupational performance?

A

-Deterioration in their day to day functioning, ability to engage in meaningful occupations decreases
-Safety becomes a concern, increase in need for assistance, support, or supervision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What impact does dementia have on family?

A

-Informal caregivers have an increase in stress as well as an impact on physical, mental, and emotional well-being
-Financial situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are some reasons individuals with dementia are admitted to long term care?

A

Need skilled care, deterioration of caregiver health, dysregulation and psychotic behaviors/symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Delirium definition

A

Alteration of mental status characterized by an inability to appreciate and respond normally to the environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Difference between delirium and dementia

A

Delirium is often reversible, viewed as a medical problem that can be diagnosed and treated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Delirium makes up ___% of all dementias, ___% are not reversible

A

13%, 87%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Causes of delirium

A

-Thyroid disorders
-UTI
-Electrolyte imbalances
-Hormonal imbalances
-Normal Pressure Hydrocephalus (NPH)
-Tumors
-Stroke
-Intoxication
-Withdrawal from substances
-Depression
-Systemic illness
-End stage liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

While delirium makes up 13% of all dementias, what are types that make up the remaining 87%?

A

-Alzheimer’d disease
-Vascular dementia
-Frontal-temporal dementia
-Lewy-body dementia
-Korsakoff’s syndrome
-Huntington’s disease
-AIDS related
-Parkinson’s with dementia
-Multiple sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Cause of vascular dementia (VaD)

A

-Strokes or other vascular disorders that decrease blood flow to the brain
-Single brain infarct or multiple lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Can a person have VaD and AD? (mixed)

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Subcortical ischemic vascular dementia (SIVD)

A

Numerous discrete subcortical lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Vascular cognitive impairment (VCI)

A

-Cognitive changes that occur due to vascular lesions
-Can be treated and doesn’t always turn into VaD
-Recognition of VCI may allow for early diagnosis to avoid progressive cog impairment to dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Dysexecutive syndrome

A

-Hallmark of VCI and VaD
-Problems with attention, working memory, planning, and sequencing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Who is at risk for VCI or VaD?

A

10-30% of all dementias
Advanced age, male, history of stroke, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Cause of dementia with Lewy bodies (DLB)

A

Presence of leeway bodies, damaged nerve cells, amyloid and plaque formation similar to AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are Lewy bodies?

A

Clumps of abnormal protein particles
Hallmark- round neurofilament inclusion bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Core features of DLB

A

-Hallucinations (recurrent and well formed)
-Parkinsonian symptoms (gait, tremors, rigidity, bradykinesia)
-Cognitive fluctuations (prominent attention deficits)
-Progressively worsens
-Cognitive features preceded Parkinsonian features (motor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

With DLB what becomes apparent over time?

A

Memory impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

More prominent features of DLB

A

Deficits on attention, visuospatial and executive function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How is clinical diagnosis strengthened for DLB?

A

-Repeated falls
-Nonvisual hallucinations
-Delusions
-Fainting
-Transient losses of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Who is most likely to be diagnosed with DLB?

A

Men over 65 2x more like

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

DLB is ___% of all dementias

A

14-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Frontotemporal dementia (FTD) age onset

A

57 years
Range 51-63

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Symptoms of FTD

A

-Gradual but prominent changes in personality
-Behavioral disturbances and changes in how they interact socially
-Can fail to demonstrate basic emotions
-Neglect personal hygiene or dress inappropriately
-Loss of insight and difficulty planning, problem solving
-Little initiation, lack of spontaneity, difficulty regulating behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

(T/F) FTD is not a common dementia

A

False- most common after AD and DLB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

(T/F) Patients with FTD have better cued recall and recognition than patients with AD

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

When does dementia typically develop in patients with Parkinson’s?

A

-Slowly, roughly 10 years after Parkinson’s diagnosis, cognitive skills diminish first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the distinguishing feature between PDD and DLB?

A

Time sequence of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Parkinson’s disease with dementia (PDD) cognitive impairments

A

-Global, attention
-Executive function
-Poor performance on speed tests
-Difficulty initiating
-Decreased tasks requiring delayed recall
-Semantic knowledge
-Frontal executive functions
-Speech/language/visiospatial functions
-Difficulty with specific areas of memory
-Changes in executive function (planning, initiation, organization, memory retrieval)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Alzheimer’s disease (AD)

A

Intellectual impairment/behavior and personality
Irreversible and progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Risk factor for AD

A

Advancing age, serious head injury with loss of consciousness. genetic factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Diagnosis of AD

A

Must demonstrate a decline in three or more of the following
-Memory
-Language
-Perception (especially visuospatial)
-Praxis
-Calculations
-Conceptual or Semantic Knowledge
-Executive Functions
-Personality or social behavior
-Emotional awareness or expression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Is memory impairment a required symptoms for diagnosis of AD?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Pathology of AD

A

-Neuritic plaques and neurofibrillary tangles in neocortex and hippocampus of the brain (seen on autopsy) can see shrinkage in brain
-Neurotransmitter deficits primarily in the cholinergic and noradrenergic and serotonergic systems are also evident
-7-20 year course

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What happens over time to the brains of patients with AD?

A

The brain shrinks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Important AD facts

A

-AD is highly associated with aging, but not income
-Doesn’t discriminate
-Most of the AD population is female
-The elderly population with AD is less educated than the general elderly population
-51% of nursing home residents suffer from dementia, 1/3 have AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the scale used to assess functional abilities in a patient diagnosed with AD?

A

Functional Assessment Scale (FAST)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Stage 1 of FAST

A

No difficulty either subjectively or objectively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Stage 2 of FAST

A

-Complaints of forgetting location of objects
-Subjective work difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Stage 3 of FAST

A

-Decreased job functioning evident to co-workers
-Difficulty in traveling to new locations
-Decreased organizational capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

State 4 of FAST

A

-Decreased ability to perform complex tasks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Stage 5 of FAST

A

-Requires assistance in choosing proper clothing to wear for day, season, or occasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Stage 6 of FAST

A

-Occasionally or more frequently over the past weeks for the following:
A. Improperly putting on clothes w/out assistance or cueing
B. Unable to bathe properly
C. Inability to handle mechanics of toileting
D. Urinary incontinence
E. Fecal incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Stage 7 of FAST

A

A. Ability to speak limited to approx. less than or equal to 6 intelligible different words in course of average day or in intensive interview
B. Speech ability is limited to use of single intelligible word in an average day or in intensive interview
C. Ambulatory ability is lost
D. Can’t sit up w/out assistance
E. Loss of ability to smile
F. Loss of ability to hold up head independently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Neuromuscular changes with age

A

-Decrease in muscle strength and power
-Decrease in skeletal muscle mass
-Decrease in number of functional motor units
-Changes in postural alignment
-Bone and cartilage changes
-Changes in balance and gait
-Decrease in max speed of movement and initiation in response to stimuli
-Increase in threshold for vibration sensation (decreased sensitivity)
-Decrease in proprioception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Continuum of functioning

A

Physically elite, physically fit, physically independent, physically frail, physically dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Physically elite

A

Train on a regular basis in sports competitions, continue to work in demanding occupation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Physically fit

A

May still work, may participate in activities with folks younger than them, continue to exercise regularly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Physically independent

A

Participates in IADLs and is still active in leisure and hobbies. May have one+ chronic conditions, function independently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Physically frail

A

Lives independently with some assist, may be unable to engage in some IADLs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Physically dependent

A

Cannot perform some ADL/IADL, requires institutional care or full-time assistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Definition of strength

A

Force of muscle contractions and ability to generate force quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Definition of power

A

Timing and coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Why do strength and power decrease with aging?

A

-Decrease in number and diameter in myofibrils and certain types of muscle fibers
-Neurological changes that control muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What changes occur in strength with aging?

A

-Minor until age 60, then becomes more rapid
-Isometric & Concentric strength in UE declines less than LE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What changes occur in power with aging?

A

-Decreases more quickly than strength
-10% greater rate of decrease than strength
-Example of functional activity that requires power is walking or standing up from a chair – timing and coordination of that muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What contributes to slowness and incoordination of muscle contractions?

A

Age related changes in muscle composition

93
Q

Sarcopenia

A

Progressive muscle wasting and decrease in strength with aging

94
Q

Changes in muscle with aging

A

Less elasticity, more fat, neurological changes, atrophy of some fibers, hypertrophy of others, number of myofibrils

95
Q

Difference between muscle atrophy and sarcopenia

A

-Sarcopenia – age related
-Atrophy – shrinking

96
Q

Difference between muscle atrophy and sarcopenia

A

-Sarcopenia – age related
-Atrophy – shrinking

97
Q

What reduces the tension a contracting muscle can generate?

A

The loss of muscle tissue in combination with decline in skeletal muscle fiber

98
Q

Physical function

A

Strength+power+endurance+coordination+balance+flexibility

99
Q

What are some ways loss of strength affects the physical function of older adults?

A

-Raking, snowblowing, stairs, get out of bed, cross a street, exit a car, climb stairs etc – all take power and strength
-Reduced ability to balance with decreased base of support and recover from postural perturbation
-Walking speed slowed, stride length decreased

100
Q

Why are impairments in muscle power more influential than decreased strength on an older adult’s ADL function and mobility?

A

Decreases more quickly, standing or getting up from a chair requires muscle power…lose ability to do simple movements

101
Q

What has decreased LE muscle power been correlated with?

A

Getting out of chairs, stairs

102
Q

Impaired balance leads to…

A

More disability…risk increases when combined with muscle weakness

103
Q

Age related changes to bones

A

-Loss of bone density
-More susceptible to fracture

104
Q

Age related changes to the cartilage, joints, and tendons

A

-Cartilage is more dense, stiff, thins out, deteriorates
-Joints and tendons: tighter, less flexible, has profound effect on ROM
-Matrices of collagen become denser, the collagen structures become stiffer, and the cellular movement of nutrients and wastes becomes impaired

105
Q

ROM decreases ___% between ages of ___

A

20-30%, ages 30-70

106
Q

Osteocytes

A

Cells in mineralized bone, direct remodeling when fatigue damage and changes in mechanical environment are detected

107
Q

Osteoblasts

A

Cells responsible for bone formation

108
Q

Osteoclasts

A

Cells responsible for bone resorption

109
Q

Nonmodifiable factors that contribute to bone health

A

-Age
-Cellular regulation and vitality
-Gender
-Ethnicity

110
Q

Modifiable factors that contribute to bone health

A

-Nutrition
-Exercise
-Body weight
-Hormones
The rate at which bone is lost may be reduced by targeting these factors

111
Q

(T/F) As elastin decreases, elasticity of the tissue is increased

A

False- elasticity also decreases

112
Q

The cartilage in what kind of joints thins and deteriorates the most?

A

Weight bearing joints

113
Q

What contributes to joint stiffness?

A

-Decreased water content
-Decreased hydration
-Decreased elasticity of the joint capsule
-Increased fibrous growth

114
Q

Functional consequences of connective tissue changes

A

-Loss of flexibility/increased stiffness
-Loss of ROM
-Associated loss of IADL, ADL, and mobility
-Increase in fall risk

115
Q

Postural changes/alignment with age

A

-Flexed posture becomes more common
-Thoracic Hyperkyphosis with a forward head position is typical
-Many older adults develop an altered lordotic curve (flattened or exaggerated), rounded shoulders, and flexed hips and knees

116
Q

Causes for postural alignment changes

A

-Muscle weakness
-Decreased ROM
-Loss of spinal flexibility
-Vertebral compression fractures

117
Q

Age related changes to the nervous system

A

-Cerebral atrophy
-Increased cerebrospinal fluid space
-Specific neuronal loss
-Reduced dendritic branching
-Increased lipofuscin granules
-Decreased effectiveness of neurotransmitter systems
-Reduced cerebral blood flow
-Diminished glucose utilization

118
Q

Lipofuscin granules

A

Considered to be one of the aging or “wear-and-tear” pigments, found in the liver, kidney, heart muscle, retina, adrenals, nerve cells, and ganglion cells

119
Q

Lipofuscin granules

A

Considered to be one of the aging or “wear-and-tear” pigments, found in the liver, kidney, heart muscle, retina, adrenals, nerve cells, and ganglion cells

120
Q

Causes of age-related changes to the nervous system

A

-Biochemical and morphological changes in the neurons and receptors
-Loss of neurons
-Defects in neuronal transport mechanisms
-Decreases in myelin
-Gradual decreases in the conduction velocity of nerves
-Defects in protein synthesis
-Cumulative trauma
-Oxidative stress and vascular changes

121
Q

Functional consequences of age-related changes to the nervous system

A

-Altered gait
-Increased fall risk
-Impaired sensation
-Consequences are highly individual, with some having significant NS changes without associated functional deficits.

122
Q

Balance, coordination, movement, and function age related changes

A

-Slowing of eye–hand coordination
-Decreases in interlimb coordination
-Decreases in homolateral hand and foot movements
-Decreases in motor coordination
-Decreases in manual dexterity

123
Q

Typical changes in gait

A

-Decreased step length
-Decreased stride length
-Slower walking velocity
-Decreased cadence
-Decreased ankle range of motion
-Decreased push-off with the toes
-Increased double-stance time
-Decreased vertical displacement of center of mass

124
Q

Assessment of ROM, flexibility, strength & power

A

-Goniometry
-Observation, especially of specific functional actions
-“Sit-and-reach test” or “back-scratch test”
-Manual muscle test
-“Break” test
-Dynamometer

125
Q

Break test

A

Break testing in manual muscle testing, is when resistance is applied to the body part at the end of the available range of motion. It’s called the break test because when a therapist provides resistance the objective for the patient is to not allow the therapist to “break” the muscle hold.

126
Q

Back scratch test: equipment

A

Ruler or yardstick

127
Q

Back scratch test: pre-test

A

Explain the test procedures to the subject. Perform screening of health risks and obtain informed consent. Perform an appropriate warm-up

128
Q

Back scratch test: procedure

A
  1. Standing position.
  2. Place one hand behind the head and back over the shoulder, and reach as far as possible down the middle of your back, your palm touching your body and the fingers directed downwards.
  3. Place the other arm behind your back, palm facing outward and fingers upward and reach up as far as possible attempting to touch or overlap the middle fingers of both hands.
  4. An assistant is required to direct the subject so that the fingers are aligned, and to measure the distance between the tips of the middle fingers.

If the fingertips touch then the score is zero. If they do not touch, measure the distance between the finger tips (a negative score), if they overlap, measure by how much (a positive score). Practice two times, and then test two times. Stop the test if the subject experiences pain.

129
Q

Back scratch test: scoring

A

Record the best score to the nearest centimeter or 1/2 inch. The higher the score the better the result.

130
Q

Back scratch test: scoring

A

Record the best score to the nearest centimeter or 1/2 inch. The higher the score the better the result.

131
Q

Precautions with assessing elders

A

-Caution regarding osteoporosis, potential for fracture
-Concern about standing endurance/balance
-Avoid valsalva maneuver because of possible cardiovascular problems.

132
Q

Precautions with assessing elders

A

-Caution regarding osteoporosis, potential for fracture
-Concern about standing endurance/balance
-Avoid valsalva maneuver because of possible cardiovascular problems.

133
Q

Management of neuromuscular impairments

A

Exercise that is tailored to the individual’s goals and needs
Facilitated by self-efficacy and outcome expectations

134
Q

Barriers to treatment plans for managing impairments

A

-Fear of falling or injury
-Lack of time
-Lack of social support
-Lack of a physical space to exercise or transportation to the exercise site
-Insufficient resources to either buy exercise equipment or join an exercise facility

135
Q

Components to include in an exercise plan

A

Strength and resistance
Flexibility and balance

136
Q

Strength and resistance components for an exercise plan

A

-Requires careful monitoring
-Demonstrated to be effective in increasing strength and endurance
-Isometric, isotonic, and isokinetic muscle all shown to be effective
-Simple interventions like walking are effective

137
Q

Flexibility and balance components for an exercise plan

A

-Static
-Ballistic
-Proprioceptive neuromuscular facilitation
-Dynamic
-Include a variety of elements
-Provide adequate challenge

138
Q

What is the most common type of joint disease among older adults and is also a leading cause of disability?

A

Osteoarthritis (OA)

139
Q

Cause of OA

A

Unknown, but related to wear and tear on joints

140
Q

Nonmodifiable risk factors for OA

A

Age and family history

141
Q

Modifiable risk factors for OA

A

-Obesity
-Physical occupations
-Participation in contact sports

142
Q

Most common OA sites

A

-Hip
-Knee
-Spine
-Metatarsophalangeal joint of big toe
-Carpometacarpal joint of thumb
-Interphalangeal joints fingers

143
Q

Ways to manage OA

A

Address modifiable risk factors (weight, activity)
Strength training
Medications (analgesics, anti-inflammatories)
Joint replacement

144
Q

Osteoporosis

A

Compromised bone density predisposing to risk of fragility fracture

145
Q

Common fracture sites for osteoporosis

A

Vertebrae, hip, and wrist
Increased mortality risk following fracture

146
Q

Management of osteoporosis

A

-Multicomponent exercise program (resistance and balance training)
-Consultation with PT to ensure precautions are followed

147
Q

Most common type of amputation

A

Lower limb, most frequent in older individuals

148
Q

Greatest risk factor for amputations

A

Long-term diabetes

149
Q

Other risks for amputations

A

Peripheral vascular disease, trauma, cancer

150
Q

Post amputation difficulties

A

All aspects of life, psychosocial issues, bereavement

151
Q

Management of amputations

A

Team approach
Goals- pain management, return to function, psychosocial issues, reducing risk of recurrence
Interventions- exercise, pain management, functional interventions, psychotherapy

152
Q

Parkinson’s disease

A

Progressive, age-related neurodegenerative disease

153
Q

Cause/characterization of PD

A

Unknown cause
Characterized by voluntary and involuntary movement dysfunction, resting tremor and rigidity (difficulty in initiating motion)

154
Q

Nonmotor symptoms of PD

A

Pain, depression, anxiety, apathy, fatigue, memory impairments, sleep disturbances, and autonomic dysfunction

155
Q

Management of PD

A

-Pharmacological (Levodopa)—and/or Deep Brain Stimulation (DBS), thalamotomy, or pallidotomy
-Rehabilitation by both PT (focused on movement strategies) and OT (focused on function)
-Assistive devices

156
Q

Management of PD

A

-Pharmacological (Levodopa)—and/or Deep Brain Stimulation (DBS), thalamotomy, or pallidotomy
-Rehabilitation by both PT (focused on movement strategies) and OT (focused on function)
-Assistive devices

157
Q

Definition of a fall

A

Any unplanned descent

Event that results in a person coming to rest inadvertently on the ground or floor or other lower level (bed, chair) with or without injury

158
Q

About __/__ of adults will fall each year

A

1/3

159
Q

Outcomes of suffering a fall

A

High personal and societal costs
Function, quality of life, cost of care

160
Q

Where do most falls occur

A

In the home (bedroom and bathroom)

Most common among people living in long term care or during hospital stay

161
Q

What season are falls most common

A

Winter

162
Q

Consequences of falls

A

About ¼ of falls result in injury
Many people never fully recover to pre-fall functional status
Most common injuries:
-Bruises, contusions, lacerations
-Sprains
-Fractures of pelvis, hip, UE, distal radius, spine, skull, ankle
Death

163
Q

Consequences of falls

A

About ¼ of falls result in injury
Many people never fully recover to pre-fall functional status
Most common injuries:
-Bruises, contusions, lacerations
-Sprains
-Fractures of pelvis, hip, UE, distal radius, spine, skull, ankle
Death

164
Q

Intrinsic risk factors for falls

A

Internal to older adults such as medical conditions

165
Q

Extrinsic risk factors for falls

A

External, environmental, such as slippery floor

166
Q

Fear of falling

A

-May be present regardless of whether or not the person has fallen
-Results in anxiety and self restricting activity, diminished quality of life
-May lead to deconditioning which increases fall risk

167
Q

Fall risk and fall prevention: assessment

A

Screening :
Previous falls, physical activity, difficulty walking and doing daily activities.
Assessment :
Subjective (e.g., medical and fall history, medications) and objective (e.g., mental status, s strength and balance) measures.

168
Q

Fall risk and fall prevention: intervention

A

Process includes:
Identification
Assessment
Management
Implementation
Monitor and review

Fall prevention education has been found to be effective.
Multifactorial interventions are most successful.

Types of intervention: exercise (resistance and balance) and functional interventions (AT, ADL, gait and balance)

169
Q

Fear of falling interventions

A

-Improve balance
-Improve muscle strength
-Eliminate environmental hazards using a room-by-room checklist, outside the home or facility (sidewalks, public areas)
-Education and counseling
-Behavioral modification

170
Q

Global interventions

A

Environmental
-Assess community risks (e.g., uneven sidewalks)
-Work to remediate these risks
Reduce other risk factors
-Minimize waking up during the night to urinate
-Address postural hypotension
-Manage medications

171
Q

Goal of rehabilitation

A

To provide people with the tools they need to attain the highest possible level of independence

172
Q

Keys to successful rehab

A

A broad perspective

Accurate identification and management of
-Medical
-Social
-Psychological problems
-Occupational performance
-Physical functioning issues

A thorough understanding of the differences between “normal aging” and pathological changes

An understanding of how these “normal aging” and pathological changes interact with the disablement process.

173
Q

Relationship of age and disability

A

Disabilities may be relatively minor, they may be limiting enough to cause older people to require assistance to attend to their personal needs

174
Q

___% of those aged 70 and older, ___% of those aged 85 and older, have some sort of disability

A

20%, 50%

175
Q

Definition of loss

A

Defined as irrevocable and can be any valued object—a loved person, a job, status, home, a cherished possession, and health.

176
Q

What is our response to loss?

A

Grief is our response to loss and often includes the loss of the future as we expect it.

177
Q

Losses can be…

A

Losses can be sudden, gradual, anticipated, temporary, or permanent.

178
Q

Impact of trauma and illness

A

Loss of sense of self
Loss of connectedness that results from stigma and discrimination
Loss of power from the loss of one’s sense of agency and loss of belief in oneself
Loss of valued roles```````

179
Q

(T/F) Helping the client process a loss should be focused on the process of healing as opposed to the outcome

A

True

180
Q

Ways to help a client process loss

A

-Dialogue and relationship, discussing grief
-Focus on healing process
-Life review
-Confrontation of the nature of absence and emptiness
-Being present to what is experienced rather than the need for change

181
Q

Individuals with intellectual disease

A

-Living longer and have same age-related changes
-Emphasize health promotion

182
Q

Challenges for individuals living with intellectual disease

A

-May have had previous negative experience with care providers
-Parents may have been primary care providers and now themselves are aging or dead

183
Q

Issues for individuals with serious mental illness

A

-Shorter life expectancy (problems with care access or worse health behaviors)
-Physical issues may be overlooked

184
Q

Issues for individuals with long-standing physical disabilities

A

Musculoskeletal problems
Declining energy and strength
Osteoporosis
Stress
Higher levels of pain

185
Q

Rehab team

A

Patient and family are essential team members

Multi, inter, and transdisciplinary

186
Q

Multidisciplinary team

A

Discipline oriented, with each team member responsible for his or her own unique scope of practice, and the team’s outcome is the sum of each team member’s efforts

187
Q

Interdisciplinary team

A

Involve team members in problem solving beyond the scope of their own discipline. The whole team identifies goals for the client; once identified, each team member then works toward goal attainment within their scope of practice

188
Q

Transdisciplinary team

A

One team member is chosen to be the primary leader or therapist depending on the specific needs of the client

189
Q

Benefits of team approach

A

Improved patient care and outcomes
Improved access to health care
Improved recruitment and retention of health providers
Improved communications among health providers
More efficient and effective employment of health human resources
Improved satisfaction among patients and health providers

190
Q

Case management

A

A process comprising a culmination of consecutive collaborative phases that assist clients to access available and relevant resources necessary to attain identified goals

191
Q

Key elements of case management

A

Client identification (screening)
Assessment
Stratifying risk
Planning
Implementation (care coordination)
Monitoring
Transitioning
Evaluation

192
Q

Role of case manager

A

Facilitates communication between health care providers and ensures that services are not duplicated, while required services are provided, as a means to ensure that case management offers a practical, one-step approach to helping clients coordinate their care

193
Q

Acute hospitalization setting

A

Associated with decrease in occupational performance
Disability/injury/illness that requires hospitalization for care

194
Q

Transitional care facilities

A

Provide intermediate care or post-acute care

195
Q

Day hospitals

A

Assessment, rehab, maintenance, provision of medical, nursing, and social services

196
Q

Geriatric rehabilitation units (GRUs)

A

Distinct units housed within community hospitals,
Free-standing rehabilitation hospitals, or
Long-term care facilities
And are staffed by multidisciplinary teams specializing in the management of the medical, social, physical, psychological, and economic well-being of older adults

197
Q

Geriatric assessment units (GAUs) and geriatric rehabilitation units (GRUs)

A

Both provide rehab with interdisciplinary team trained in care of the elderly
Attention to medical, psychosocial, and functional issues
Emphasis on medical tx and eval, short term goals

198
Q

Other settings

A

Home health
Outpatient/ambulatory care
Respite care
Palliative care

199
Q

Evaluation (comprehensive geriatric assessment)

A

Multidimensional, interdisciplinary process that is used to determine an elderly person’s medical, psychosocial, functional, and environmental needs, resources, and problems, and is linked with an overall plan for management and follow-up

200
Q

Factors that may affect rehab

A

Personal:
Age
Frailty
Motivation
Depression
Cognitive status
Comorbidities

Environmental:
Family members/caregivers
Living arrangements
Therapist/client relationship

201
Q

Patient-Driven Payment Model (PDPM)

A

New payment system for all skilled nursing facilities
-Supports and promotes patient-focused care as the most appropriate way to pay for services
-Based care on unique goals and needs of each patient

202
Q

(T/F) Medicare limits the amount of therapy Medicare beneficiaries can receive

A

False- it is not limited and your therapist’s judgement is the key factor in determining the amount of therapy that is received

There are computer programs that predict the amount of therapy needed but these should not be relied on for care

203
Q

Medicare view on treating cognitive issues

A

Medicare refers to state law and scope of practice of the treating clinician- therapy can be provided as long as the therapist addresses issues within their scope of practice

204
Q

(T/F) Medicare does not require patients to receive group therapy in an SNF setting

A

True- Medicare expects that the needs of the patient are met and therapist implements the most effective interventions to drive the decision of using individual, concurrent, or group tx

205
Q

Medicare coverage for maintenance therapy

A

Medicare will pay for services designed to improve or maintain function of patient, improvement or progress is not required

206
Q

(T/F) Medicare does not pay for therapy for certain diagnoses

A

False- certain diagnoses trigger additional payments for therapy, but Medicare requires SNFs to provide all medically necessary services regardless of diagnosis

207
Q

SNF care

A

Health care given when you need skilled nursing or therapy staff to treat, manage, observe, and evaluate your care

208
Q

Does Medicare cover custodial care if its the only kind of care you need?

A

No

209
Q

Time length of benefit period staying in an SNF

A

100 days

210
Q

Medicare coverage- short term care

A

-For days 1–20, Medicare pays the full cost for covered services. You pay nothing.
-For days 21–100, Medicare pays all but a daily coinsurance for covered services. You pay a daily coinsurance.
-For days beyond 100, Medicare pays nothing. You pay the full cost for covered services. The coinsurance is up to $170.50 per day in 2019. It can change each year

211
Q

Medicare coverage- long term care

A

Medicare and most health insurance, including Medicare Supplement Insurance (Medigap), don’t pay for long-term care. This type of care (also called “custodial care” or “long-term services and supports”) includes medical and non-medical care for people who have a chronic illness or disability

212
Q

Why would someone need skilled nursing or therapy care?

A

Help improve your condition.
Maintain your current condition, or prevent or delay it from getting worse

213
Q

Medicaid

A

A joint federal and state program that helps with medical costs for some people with limited incomes and resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid

214
Q

Original Medicare

A

Fee-for-service health plan that has 2 parts: Part A (Hospital Insurance) and Part B (Medical Insurance). After you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share (coinsurance and deductibles)

215
Q

Medicare Part A

A

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care

216
Q

Medicare Advantage Plan (Part C)

A

A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits

217
Q

Medicare Advantage Plans

A

Include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan, and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage

218
Q

Medicare Preferred Provider Organization (PPO) Plan

A

A type of Medicare Advantage Plan (Part C) available in some areas of the country in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost

219
Q

Medicare Private Fee-for-Service (PFFS) Plan

A

A type of Medicare Advantage Plan (Part C) in which you can generally go to any doctor or hospital you could go to if you had Original Medicare, if the doctor or hospital agrees to treat you. The plan determines how much it will pay doctors and hospitals, and how much you may pay when you get care. You must follow the plan rules carefully when you go for health care services.

220
Q

Medigap Policy

A

Medicare Supplement Insurance sold by private insurance companies to fill “gaps” in Original Medicare coverage

221
Q

Benefit period

A

The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services.

You must pay the inpatient hospital deductible for each benefit period. There’s no limit to the number of benefit periods

222
Q

Coinsurance

A

An amount you may be required to pay as your share of the cost for services after you pay any deductibles. Usually a percentage

223
Q

Custodial care

A

Non-skilled personal care, like help with activities of daily living like bathing, dressing, eating, getting in or out of a bed or chair, moving around, and using the bathroom.
In most cases, Medicare doesn’t pay for custodial care.

224
Q

DICE

A

Describe, Investigate, Create, and Evaluate

Nonpharmalogic management of neuropsychiatric symptoms

225
Q

Describe

A

Caregiver describes the problematic behavior. (Context, Social/Physical Environment, Patient perspective, Degree of distress to caregiver and patient)

226
Q

Investigate

A

Possible causes of problematic behavior: Patient – side effects of meds, pain, functional limitations, medical conditions, psych comorbidity, severe cognitive impairment/executive dysfunction, poor sleep hygiene, sensory changes, fear, loss of control, boredom.

227
Q

Create

A

Provider, caregiver, and team collaborate to create and implement treatment plan. Respond to physical problems, Strategize behavioral interventions. Provide caregiver education/support, enhance communication with patient, create meaningful activities for patient, simplifying tasks, ensuring a safe environment, increase/decrease stimulation in environment.

228
Q

Evaluate

A

evaluate if the CREATE interventions have been implemented by caregiver, if they are safe and effective

OT 401: OP & Context for Older Adults (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions