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Geriatrics > Geri final > Flashcards

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
Q

True or false: cognitive declines can occur with depression

A

True can have decreased memory, attention, executive functioning problems

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26
Q

Suicide

A

Rate 3x higher in geri pop
highest suicide rate in men
Passive: refuse medication, tx, food

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27
Q

Pain OT assessment

A

COPM

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28
Q

Depression OT assessment

A

COPM
ACS

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29
Q

OT Depression Ix

A

CBT
cCBT: Computerized (internet based approach ie mood gym)

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30
Q

Depression Ix

A

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

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31
Q

PDGM

A

Patient driven grouping models

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32
Q

Theories for leisure

A

MOHO, OA, Rehab & Biomechanical

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33
Q

Leisure Assessments

A
  • KELS
    -KTA
    -AMPS
    -Barthel ADL index
  • RTI
  • FIM
  • Katz Index of ADL
  • CPT
34
Q

3 elements of positive leisure experience

A
  1. Motivation
  2. Control over one’s life
  3. Freedom from constraints
35
Q

Retirement

A

Both process & life stage

36
Q

Phase retirement

A

Gradually reducing effort & work time

37
Q

Bridge employment

A

Changing jobs & moving to part time employment for maybe supplemental income

38
Q

Increase in crashes in geri pop

A

70-74 increase, highest among 85+ and usually not related to alcohol but occurs at intersections

39
Q

PENNDOT

A

20% lose driving privileges, 21% get driving restrictions
-50% of this are in geri pop

40
Q

PENN DOT Hearing Requirements

A

For bus drivers ONLY

41
Q

Certified Driver Rehab Specialist

A

Only one to make changes to your car

42
Q

Vision requirements to drive

A

20/40 and less = no need for glasses
20/70 and more= glasses

43
Q

Cognitive Assessments for driving

A
  • MOCA
  • MMSE
  • SLUMS
  • ACL
  • Mini Bless Test
  • Trail Making A & B
44
Q

Visual Perceptual Assessments for Driving

A
  • MVPT
  • Clock drawing
  • UFO
45
Q

ROM, Balance, Endurance, Strength Assessment for Driving

A
  • 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
Q

Most common type of dementia is?

A

Alzheimer’s disease

47
Q

Reversible Dementia

A

Caused by thyroid disorder, UTI, elecrtolyte imbalance, hormonal imbalance, presure hydrocephalus (accumulation of CSF cause ventricles to enlarge

48
Q

Major Neuro Disorder

A

SIGNIFICANT COG DECLINE
- Substantial impairment in cog based testing
- IADL decline at min

49
Q

Mild Neuro Disorder

A

MODEST COG DECLINE
- Modest impairment in cog based testing
- Cog deficits don’t interfere with occupations

50
Q

What is a sign of early dementia?

A

Difficulty completing IADLs
- Can usually complete ADLs (procedural memory) until late stages

51
Q

Dementia symptoms

A

Decrease in
-Attention
- Orientation
- Sleep/wake cycle
- Voice production & comprehension
- Visuospatial processing
- Change in activity level

52
Q

Alzheimer’s Disease

A
  • 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
Q

Alzheimer’s Stages

A

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
Q

Vascular Dementia

A
  • 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
Q

Lewey Body Dementia

A
  • Progressive
  • Basal ganglia involvement: hallucinations & PD & motor control, planning, procedural learning
  • Memories may be intact @ early stages
56
Q

Korskakoff

A
  • Vit B deficiency & ETOH
  • Sx: confabulation & stm problems
57
Q

Frontotemporal Dementia

A

Sx: Behavior & personality changes, empathy, foresight, aphasia

58
Q

Huntington’s Dementia

A

attention deficits, cognitive slowing, impaired planning and problem solving, visuoperceptual and construction deficits

59
Q

Capable Model

A

Collab with nurses, ot to modify the home

60
Q

Supine Mat Assessment Assess:

A
  • 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
Q

Pelvic Obliquity

A

Side of pelvis is lower than other side

62
Q

Pelvic rotation

A

Side of pelvis is more in forward than other side

63
Q

Tilt

A
  • Anterior (tight hip flexors)
  • Posterior
64
Q

ASIS

A

Anterior Superior Illiac Spine: Used for mat assessments

65
Q

W.C Recommendations for Heights

A

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
Q

What degrees of elbow flexion when hands placed at top of rim gives most efficient propulsion

A
67
Q

Air wc cushion

A

Best for pressure management but requires more postural control

68
Q

Gel wc

A

Long term w.c users for pressure relief

69
Q

Honeycomb

A

More maintenance but good for incontinence

70
Q

SNF

A
  • Paid by medicare/private
  • For rehab and/or medical needs
71
Q

Custodial care

A
  • Paid by medicaid
  • Long term residential care
72
Q

Rehabilitative

A
  • Goal to transition to lower level of care after weeks- months of Ix
73
Q

OBRA created MDS (minimum data set)

A
  • 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
Q

CAA (Care Area Assessments)

A

Further assessment, development of care plan via interdisciplinary team collab & performance of discipline specific assessments

75
Q

PDPM - Patient Driven Payment Model

A

Sets limit of 25% of group and concurrent sessions
- Looks at LOA at beginning to d/c for payment

76
Q

OT Tx

A
  • Seating & positioning: optimizes function
  • Modifying w.c.: prevents dysfunction
  • Toilet txf: promotes health
77
Q

Wellspring Program

A

For memory loss

78
Q

Eden Alternative

A
  • Has animals, plants, children
79
Q

What kind of team in LTC?

A

Interdisciplinary

80
Q

Hospice

A

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
Q

Palliative Care

A
  • Services can be initiated at any point
  • curative care ix can be used (IV, Chemo)
82
Q

Physician Assisted Dying

A

Basically wanting to kill yourself.

Geriatrics (2 decks)

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