Geriatric Conditions and OT Flashcards
List at least 5 ways that the growing number of older adults will impact OT practice.
- More people want to age in place (more home health and home mods)
- People are living longer (larger population to treat)
- Need to provide preventative treatment
- Lot more community services (adult day care centers)
- Might lead to decrease in health care coverage, might not be able to get as many services as they need
According to Pedretti, successful aging is contingent on what 3 elements?
- Freedom from disease and disability
- High cognitive and physical functioning
- Social and productive engagement
List motivating principles of OT intervention with older adults
- Maintain an environment of mutual trust, respect and acceptance of differences.
- Treatment activities should always be age appropriate.
What percentage of OAs have psychiatric disorders? Major depression?
- 22% of OA who are 65 years or older meet diagnostic criteria for a mental disorder with anxiety being the most common (11.5%)
- 5% or less in older adults have major depression
Be able to list at least three typical mistakes an entry-level therapist may make in assessing the functional performance of an older adult
- Unusual for an entry-level therapist to attempt to evaluate all aspects of ADLs, perhaps following a checklist from top to bottom without regard for the client’s needs. The experienced clinician is able to select a few key ADLs from the checklist or a key standardized assessment that efficiently covers an array of tasks.
- may focus on the newly acquired disability and not consider the ways in which other age-related changes, pathological conditions, or performance contexts affect function
Be able to list at least five age-related physical changes that an OT would consider in assessing a person older than 85 who has a sedentary lifestyle
- Sensory losses : hearing and vision
- Lungs are less elastic and efficient in the exchange of gases making breathing more difficult
- Decreased cardiovascular capacity on exertion affects endurance for demanding activity.
- Decreased bone density and muscle mass; decreased muscle strength
- Compromised skin integrity leads to skin breakdown, tearing, and infection.
- Changes in the CNS; slower response time
- Somatosensory changes lead to decreased sensitivity to smell, taste, and vestibular systems; risk for poisoning and falls, thermal and mechanical injuries.
List five client factors you would immediately observe or screen for when meeting an older adult client for the first time
- Changes in cognition, especially memory
- Attention
- Global mental functions
- Orientation
- Temperament
- Energy
- Neuromusculoskeletal
- Postural alignment
- Righting and supporting
- Control of voluntary movements
- Rate, rhythm, depth of respiration
List several ways that an OT can help an older adult age successfully “in place”
- Home modifications
- DME
- therapeutic exercise for strengthening and endurance
- Caregiver education
What are the DSM-V criteria for neurocognitive disorder (NCD)?
- Significant decline from previous performance in at least one cognitive domain (complex attention, executive functioning, learning and memory, language expression, perceptual motor, social cognition)
- Dx of delirium or other mental disorder excluded
- Interference with independence in everyday activities [MAJOR NCD]
- Greater effort involved in IADL independence (needs accommodations, compensatory strategies) [MILD NCD]
Define power of attorney
The authority to act for another person in specified or all legal or financial matters.
Define guardianship
Office or duty of one who legally has the care and management of the person, or the estate, or both, of a child during its minority
List 5 risk factors for Alzheimer’s Disease
- Genetics, especially if early onset (more common in people with Down Syndrome)
- Previous head trauma
- Depression, anxiety, PTSD, loneliness, neuroticism, jealousy, lack of purpose
- Lack of cognitive engagement (lower risk for bilingual individuals)
- Lack of environmental stimulation (e.g. poor vision)
- Vascular problems, inflammation, elevated homocysteine
- Poor health habits: Lack of physical activity; higher BMI; abdominal fat; smoking/second-hand smoke; excessive alcohol consumption; unhealthy diet; no sleep
- Not enough antioxidants (vitamin E and C, omega 3 fatty acids, beta-carotene, caffeine, red wine, grape juice, apple juice, black/green tea)
Why are “senility” and “dementia” considered inappropriate terms to describe neurocognitive disorder in an aging person?
offensive, hold negative and inaccurate connotations
Impaired memory is the signal feature of AD, but what other cognitive-perceptual functions can be damaged by this disease?
- confusion/disorientation
- problems with word-finding, and in moderate-severe stages impairment/loss of communication
- vision/spatial issues
- impaired reasoning/judgment
- personality and behavioral changes (& disinhibition)- repetitive behavior, inappropriate
Describe changes in ADL-IADL performance across the four stages of AD
Stage I : very mild cognitive decline = symptoms affect IADLs including community navigation, money management; ADLs may take longer to complete
Stage II : mild-moderate decline = moderate impairment in ADL/IADL, need compensatory/environmental adaptations for ADLs
Stage III: moderate- severe cog. decline, physical decline = mod assistance for ADLs, max impairment/unable to perform most IADLs
Stage IV: severe cognitive decline, mod-severe physical decline: severe impairment in ADLs
