Gerontology Flashcards
What is Delirium?
aka: acute confusion; abrupt onset of confusion and a reversible cause
What is Dementia?
a global impairment of cognitive function that usually is progressive and may be permanent; interference with normal social and occupational activities
CAM
Confusion Assessment Method
Part one is an assessment instrument that screens for overall cognitive impairment. Part two includes only four features that were found to have the greatest ability to distinguish delirium or reversible confusion from other types of cognitive impairment, namely: Onset and course; Attention; Thinking; and Level of consciousness
Risk Factors for Delirium
lmmobilization, UTI, infection, ETOH, med illness, environmental change, polypharmacy, dehydration
Delrium Signs
disorientation to time and place (usually with illusions and hallucinations); hyper-alert or difficult to arouse; reduced ability to focus,
Duration of delirium
Temporary; Ranges from hours to days; Onset is short and sudden
Dementia Onset
Slow, chronic, gradual, irreversible
Hyperactive delirium
restless, agitated, and disoriented
Hypoactive Delirium
quiet, confused, disoriented, apathy (which is often confused with depression)
Mixed Delirium
Client has symptoms of hyperactive delirium at night and hypoactive delirium in the day
AD
Alzheimer’s Disease - progressive dementia, memory loss and inability to care for oneself
Young Old Ages
60-74
Old Ages
75-84
Old-Old
85-100
Centenarians
Over 100 y/o
Ageism
negative attitudes toward aging or older adults
Sarcopenia
steady decrease in muscle fibers, occurring mostly with age
Wear and Tear Theory
proposes that humans have vital parts that run down with time leading to aging and death;cells wear out through internal and external stressors
Endocrine Theory
events occurring in the hypothalamus and pituitary glands lead to changes in hormone production resulting in decline
Free-radical theory
unstable free-radicals result from the oxidation of organic materials like proteins and carbohydrates; the radicals casue biochemical changes in cells and cell cannot regenerate
Genetic Theory
organism is genetically programmed for certain # of cell divisions; damage to protein synthesis means faulty cells will be synthesized and will gradually accumulate causing decline
Cross-link Theory
irreversible aging of proteins, like collagen, is responsible for ultimate tissue and organ failure
Immunologic Theory
immune system becomes less effective with age resulting in reduced resistance to infectious disease and viruses; an increase in autoimmune response causing the body to produce antibodies that attack itself
Why are older adults at greater risk of dehydration?
intracellular fluid decreases and leads to reduced total body fluid
Increased skin dryness is a result of
decreased sebaceous gland activity
Increased skin pallor is a result of
decreased vascularity
Increased skin fragility is a result of
reduced thickness and vascularity of the dermis; loss of subcutaneous fat
Progressive wrinkling and sagging of the skin is a result of
loss of skin elasticity, increased dryness, and decreased subcutaneous fat
Slower nail growth and thickening with ridges is a result of
increased calcium deposition
Decreased speed and power of skeletal muscle contractions is a result of
decrease in muscle fibers
Slowed reaction time is a result of
diminished conduction speed of nerve fibers and decreased muscle tone
Loss of bone mass is a result of
bone reabsorption outpaces bone reformation
Impaired balance is a result of
decreased muscle strength, reaction time, and coordination, change in center of gravity
Reduced filtering ability of the kidney and impaired renal function is a result of
decreased number of functioning nephrons and arteriosclerotic changes in blood flow
Less effective concentration of urine is a result of
decreased tubular function
Nocturnal frequency and retention of residual urine is a result of
decreased bladder capacity and tone
Orthostatic Hypotension in older adults is a result of
reduced sensitivity of the blood pressure-regulating baroreceptors
Presbyopia is a result of
inelasticity of the eye, vision loss
Presbycusis is a result of
changes in the structures and nerve tissues in the inner ear, thickening of the eardrum
What is kyphosis?
humpback, curvature of the upper spine
Pathological fractures
spontaneous fractures occurring without fall or trauma; seen in osteoporosis
Loss of skin receptors leads to
increased threshold for sensations of pain, touch, temperature
UI
urinary incontinence is never normal
Xerostoma in older adults is a result of
(dry mouth) caused by reduced production of saliva and make the oral mucosa more susceptible to infection
The decrease in the intrinsic factor
(needed for B-12 production) leads to pernicious anemia
Older adult BP changes
it is not unusual to have a slight increase in the systolic pressure while the diastolic pressure remains the same
Respiratory efficiency decline with age but TIDAL VOLUME
(the air moved in and out during normal respiration) remains the same
Disengagement Theory
aging involves mutual withdrawal between the older person and others in the older person’s environment
Activity Theory
the best way to age is to stay active physically and mentally
Continuity Theory
people maintain their values, habits, and behavior in old age
Dementia is clinically defined as
- development of multiple cognitive deficits including memory impairment and at least one of the following: aphasia, apraxia, agnosia, amnesia, disturbed execution functioning
- severe enough to impair occup/social functioning
- slow decline from prior fx
- not occurring exclusively during a course of delirium
