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Geri final Flashcards

1
Q

Acute care

A

Temple, Einstein
Stay is short

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2
Q

Sub acute care

A

Magee, SNF (Tender touch, Pheobe)
Can be residential or short term

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3
Q

Outpatient

A

Medicare PB can do at home sessions
Nova Care,
More specialized to residual effects: uq rehab, driver rehan, vision, work hardening & conditioning

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4
Q

Main goal of rehab in geri

A

Maintain independent mobility & ADLs

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5
Q

frailty

A

Age related loss of physiological reserve (how cells function)

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6
Q

COVID 19

A

Geri pop most likely to pass
-venous thrombolation: CVA
- GBS
- Fraility & multi morbidity: more likely to be effected by COVID 19

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7
Q

Sarcopenia

A

age related loss of skeletal muscle mass & strength

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8
Q

Acute Care

A

Purpose: Medically stabilize & manage
LOS: 5 1/2 days
- unnecessary days: health care infection & falls risk increased
- OT Consulted after medically stabilized
- OT/PT discharge after: independence, diagnosis, home setup & caregiver support
- OT Eval: Vital signs, cognition & vision, ROM, BADLs noting positioning of pts & attach tubes and drains
- Family present: Address & assess them, PLOF of pt
- Common conditions: CVA,TBI, CVA, pulmonary conditions requiring mechanical vent, cardiac disorders with telemetry machine, post surgical complication with resp/cardiac, systemic infections causing cardiopulmonary compromise

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9
Q

Transitional Care

A
  • LOS: 45 Days
  • Geri pop that needs time & treatment to recover from illness instead of making new hospital beds (low ratio of nurses)
  • Must have rehab need & receive daily rehab services but no specific time required
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10
Q

Inpatient Rehab (IRF) aka Acute Rehab

A
  • Pts scheduled as early as 7am for ADLs
  • Pts must be recommended for services
  • Might have to be transferred to diff facility
  • 60% must have these dx for reimbursement: Congenital deformity, CVA, SCI, TBI, Amputations, Major multiple trauma, hip fx, burns, neuro conditions: PD & MS, arthritis, hip/knee replacement in pts with BMI > 50 or over 85 y.o
  • tolerate 3 hrs of therapy for 5 days a week
  • Must keep progressing or will be d/c
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11
Q

Acute Care/ SNF

A
  • Searching for medically stable pts to see everyday
  • More intense than other OT services
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12
Q

Adult Day Care

A
  • Alt to LTC for those with physical/cog impairments
  • For those who can’t be alone during day but also don’t need 24/7
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13
Q

Home Health

A
  • Medicare Pt A &B
  • Requirements: Under MD and POC established, need doctor certif that you need intermittent skilled nursing care, rehab therapy & home bound status
  • Who can open case?: OT, PT, SL
  • Who can remain in place after end of services: SW, dietician, CM, CNA
    OT can complete initial eval & assessment if SLP/PT even without nursing
  • PCA’s and housekeeping not covered
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14
Q

Maintenance Care

A

Jimmo: Medicare beneficiaries shouldn’t be declined maintenance nursing/therapy when skilled nursing personnel must provide it

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15
Q

SNF Payment

A

PPS (perspective payment system) for SNFs (set pay per day for everything or can pay out of pocket)

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16
Q

OASIS (Home Health Outcome and Assessment Information Set)

A
  • At start of care (within 48 hrs or when pt d/c home)
  • At 30 days for re-eval
  • For resuming care
  • For d/c
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17
Q

PDGM (Patient Driven Grouping Models)

A
  • OT assessment of level of assist is crucial
  • Assessment results = payments of home health agency
  • every 30 days for LOA via OASIS for:
    UBD + LBD Dressing
    Txf
    Toilet Txf
    Ambulation & Locomotion
    Grooming
    Risk for hospitalization
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18
Q

Acute pain

A

Activation of nociceptors causing inflammtory response & hyperalgesia
COPM can address pain

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19
Q

Hyperalgesia

A

Heightened sensitivity to pain

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20
Q

Depression is…

A

Common & treatable which affects mood, thoughts, bx
Symptoms range from mild to severe
Cognitive changes such as age, brain structure & chemistry can cause depression
CVD can be risk factor

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21
Q

True or false can age be a factor for depression

A

True

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22
Q

% of adults over 65 to meet diagnostic criteria

A

8.19% but most adults meet the symptoms of depression but fail to meet diagnostic criteria

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23
Q

High incidence of depression?

A

Nursing home

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24
Q

Depression is not a part of aging

A

Depression rates decrease over lifespan

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25
True or false: cognitive declines can occur with depression
True can have decreased memory, attention, executive functioning problems
26
Suicide
Rate 3x higher in geri pop highest suicide rate in men Passive: refuse medication, tx, food
27
Pain OT assessment
COPM
28
Depression OT assessment
COPM ACS
29
OT Depression Ix
CBT cCBT: Computerized (internet based approach ie mood gym)
30
Depression Ix
Light Therapy (white- serotonin& blue): increases energy levels & alertness - don't use if bipolar disorder or agitated Psychotherapy Support Therapy Eden Alternative: Aims to reduce depression with home like environments. has plants & animals ECT: esp if hallucinations/delusions LAST RESORT IS ECT Anti depressants- FALLS RISK - older adults have lower dosages than young
31
PDGM
Patient driven grouping models
32
Theories for leisure
MOHO, OA, Rehab & Biomechanical
33
Leisure Assessments
- KELS -KTA -AMPS -Barthel ADL index - RTI - FIM - Katz Index of ADL - CPT
34
3 elements of positive leisure experience
1. Motivation 2. Control over one's life 3. Freedom from constraints
35
Retirement
Both process & life stage
36
Phase retirement
Gradually reducing effort & work time
37
Bridge employment
Changing jobs & moving to part time employment for maybe supplemental income
38
Increase in crashes in geri pop
70-74 increase, highest among 85+ and usually not related to alcohol but occurs at intersections
39
PENNDOT
20% lose driving privileges, 21% get driving restrictions -50% of this are in geri pop
40
PENN DOT Hearing Requirements
For bus drivers ONLY
41
Certified Driver Rehab Specialist
Only one to make changes to your car
42
Vision requirements to drive
20/40 and less = no need for glasses 20/70 and more= glasses
43
Cognitive Assessments for driving
- MOCA - MMSE - SLUMS - ACL - Mini Bless Test - Trail Making A & B
44
Visual Perceptual Assessments for Driving
- MVPT - Clock drawing - UFO
45
ROM, Balance, Endurance, Strength Assessment for Driving
- 6 minute walk test - Functional reach - 9 hole peg test - ROM & MMT - TUG - BERG - 30 sec chair test - Arm curl test - Rapid pace walktest
46
Most common type of dementia is?
Alzheimer's disease
47
Reversible Dementia
Caused by thyroid disorder, UTI, elecrtolyte imbalance, hormonal imbalance, presure hydrocephalus (accumulation of CSF cause ventricles to enlarge
48
Major Neuro Disorder
SIGNIFICANT COG DECLINE - Substantial impairment in cog based testing - IADL decline at min
49
Mild Neuro Disorder
MODEST COG DECLINE - Modest impairment in cog based testing - Cog deficits don't interfere with occupations
50
What is a sign of early dementia?
Difficulty completing IADLs - Can usually complete ADLs (procedural memory) until late stages
51
Dementia symptoms
Decrease in -Attention - Orientation - Sleep/wake cycle - Voice production & comprehension - Visuospatial processing - Change in activity level
52
Alzheimer's Disease
- Most common form of dementia & PROGRESSIVE - Autopsy diagnosis only - Plaques & tangles - Loss of dendritic network - Decreased production & uptake of ACH - 5% of early onset: 30 y.o - 50% FAD - 4-8 year prognosis after
53
Alzheimer's Stages
S1: No deficit S2: Not notable on tests, object recall & word finding Mild- S3: Forget appointments & loses things, diff @ work, notable on tests but tries to hide it Moderate- S4: Forget some life history, need help with community/domestic, ask same q over and over, S5: Can't dress self, can't live alone, forgets personal info like phone number, confusion S6: 24/7 SUP, BADL help, poor facial recognition, wandering, incontinence S7: DEP, may not be able to talk/swallow
54
Vascular Dementia
- 2nd most common type - Can be progressive - Symptoms may be similar to Alz or more localized - Caused by insufficient blood to brain - TIA - Risk factors: HTN, DM, 1 + strokes, Smoking
55
Lewey Body Dementia
- Progressive - Basal ganglia involvement: hallucinations & PD & motor control, planning, procedural learning - Memories may be intact @ early stages
56
Korskakoff
- Vit B deficiency & ETOH - Sx: confabulation & stm problems
57
Frontotemporal Dementia
Sx: Behavior & personality changes, empathy, foresight, aphasia
58
Huntington's Dementia
attention deficits, cognitive slowing, impaired planning and problem solving, visuoperceptual and construction deficits
59
Capable Model
Collab with nurses, ot to modify the home
60
Supine Mat Assessment Assess:
- Tilt - Obliquity - Rotation - LE: Hip flexion, knee extension in hip flexion, ankle rom - Trunk & trunk control: lordosis, kyphosis, scolosis, shoulder rotation & obliquity - Head & neck: flexion, extension, rotation
61
Pelvic Obliquity
Side of pelvis is lower than other side
62
Pelvic rotation
Side of pelvis is more in forward than other side
63
Tilt
- Anterior (tight hip flexors) - Posterior
64
ASIS
Anterior Superior Illiac Spine: Used for mat assessments
65
W.C Recommendations for Heights
Seat width: measure across and add 2 inches Depth: measure BLE, measure from buttox to back of knees and subtract 2 Height from floor to seat: 19.5, hemi is 17.5 and super low is 14.5
66
What degrees of elbow flexion when hands placed at top of rim gives most efficient propulsion
67
Air wc cushion
Best for pressure management but requires more postural control
68
Gel wc
Long term w.c users for pressure relief
69
Honeycomb
More maintenance but good for incontinence
70
SNF
- Paid by medicare/private - For rehab and/or medical needs
71
Custodial care
- Paid by medicaid - Long term residential care
72
Rehabilitative
- Goal to transition to lower level of care after weeks- months of Ix
73
OBRA created MDS (minimum data set)
- MDS is performed at admission, quarterly, after change in resident's current status and d/c - MDS screens for problems and abilities - MDS responses can be Care Area Triggers (CATs): info triggers
74
CAA (Care Area Assessments)
Further assessment, development of care plan via interdisciplinary team collab & performance of discipline specific assessments
75
PDPM - Patient Driven Payment Model
Sets limit of 25% of group and concurrent sessions - Looks at LOA at beginning to d/c for payment
76
OT Tx
- Seating & positioning: optimizes function - Modifying w.c.: prevents dysfunction - Toilet txf: promotes health
77
Wellspring Program
For memory loss
78
Eden Alternative
- Has animals, plants, children
79
What kind of team in LTC?
Interdisciplinary
80
Hospice
Specialized care for individuals with terminal illness ( SERVICES CANNOT BE INITIATED) - Pain & management - Education - Qualifications: 6 months or less of living & illness should be certified - Living will - ALS, alzheimers, ESCD, ESRD, Cancer, HIV, ESLD, ESLD, Stroke, coma - STOPS IV FLUIDS & CHEMO
81
Palliative Care
- Services can be initiated at any point - curative care ix can be used (IV, Chemo)
82
Physician Assisted Dying
Basically wanting to kill yourself.

Geriatrics (2 decks)

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