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Geriatrics > Intro to Geriatrics > Flashcards

Intro to Geriatrics Flashcards

1
Q

What has happened to the percentage of population over 80 from the years of 1950 - 2050? which population has the highest projected?

A

Started around 2% in 1950 and then goes up to about 8% for US, but all the way to 16% for Japan

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2
Q

In 2030, what percent of Americans will be 65+?

A

20%

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3
Q

As time goes on, what type of clinician will we need more of? Why?

A

Geriatrics, due to increased amount of elderly population

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4
Q

What are the statistics of life expectancy d/t sex race?

A

Women live about 6.5 years more
Blacks have a lower life expectancy than whites through age 75 and then have a higher life expectancy at age 85.

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5
Q

Who is the oldest and second oldest alive? Where are they from?

A

Maria Branya Morera
Catalonia, Spain 116 yrs 175 days

Fusa Tatsumi
116 years and 123 days

Japan

Edie Ceccarelli115 years, 202 days

Willits, California, USA

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6
Q

What are centenarians? How many now and how many by 2050? What is a disadvantage of this?

A

106 Million now
442 million, 2050

Number of chronic diseases will grow, putting more stress on the health care system

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7
Q

How does the health care system adapt to address the increasing elderly population? What is a barrier to this.

A

Medication prescribing practices
Fall reduction
Pain and symptom control
Decreasing caregiver burden
Transitions in medical care

Important to enhance older years rather than just treat

HOWEVER, a disconnect often remains between what happens in clinicians’ offices and what patients and their caregivers need at home

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8
Q

How well does the older population have support as they age?

A

Non-relative support is very low
Spousal support decreases

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9
Q

What are the 6 psychosocial factors that we check for medicine?

A

Sociodemographic
Environomental
psychological (very important, they can lose will and dwindle)
Healthy behaviors (can hide the truth)
Biological
Quality of life

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10
Q

What are the three negative psychosocial factors?

A
  1. Depression
  2. Dissatisfaction with life
  3. Lack of support (children and grandchildren are busy)
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11
Q

What are the 4 positive psychosocial factors?

A
  1. social engagement (intergenerational programs)
  2. Social environments
  3. Aging services
  4. Hospice
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12
Q

What can cause late-life depression?

A

inflammation, decreased cortisol, treated with prednisone
Hormonal abnormalities (decreased estrogen and testosterone)

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13
Q

Why do old people have issues with sleep?

A

Decline in melatonin secretion from the pineal gland

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14
Q

What can be a result of reduced vision in elderly?

A

Less social interaction

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15
Q

Why do games like wordle for the elderly?

A

Purposeful efforts at social engagement may aid in dementia prevention by maintaining brain cellular integrity before gross atrophy sets in.

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16
Q

What are the 7 components to Successful Geriatric Best Practice Models

A

Enable older adults to remain safely at home
Prevent functional disability
Preserve patient quality of life
Respect patient values, preferences and goals
Consider patient safety
Address the needs of family caregivers
Appreciate and address patient’s psychosocial needs

17
Q

What is CBLTSS?

A

Community Based Long Term Services and Supports

Home based assessment
assisted living
foster care and homes

PROVIDE good care for elderly

all of these encourage activity and health of elderly

Not everyone is prepared to live in such a complicated environment

18
Q

What are three ways we address rural aging?

A
  1. Rural elders have high rates of disability and poverty, thereby increasing their risk for adverse health outcomes.
  2. The need for geriatric health care providers in rural areas is very great. This is especially true for those with multiple chronic conditions.
  3. The federal government, to increase the access to care for rural elders, has created several special programs (might not have to pay loans).
19
Q

Who provides CBLTSS and who qualifies?

A

Rely less on physicians and more on specialized nurses or trained lay visitors
Disease management, post-acute home health care, and medical day care
Home-based geriatric assessment
Preventive home visits
Medical care in assisted living facilities (ALFs), sheltered housing, and group homes
A small number of older adults carry privately funded LTC insurance
Ultimately, many people exhaust their retirement savings and home equity to pay for LTSS, becoming eligible for Medicaid through this “spend-down” process

20
Q

What are some specific community-based supports and services

A

home delivered meals
congregate meals
transportation
personal care
homemaker services
Information and assistance
Nutrition

21
Q

How are the unskilled caregivers? What is skilled home health?

A

Unskilled = family members etc that are not paid
What is a skilled home health worker? Those that are skilled and help at home
such as nurses or physical, occupational, or speech therapists.

22
Q

What are the two formal home-based medical care models?

A

Home-based primary care model
Hospital-at-home model

23
Q

What is the MC model of home health care?

A

Formal caregivers

The provider varies with the type of CBLTSS
An HHA certified to provide care under Medicare reimbursement rules employs trained caregivers and assigns them to individual patient cases
A physician must certify that the patient is homebound and has a skilled need
A 60-day certificate
A skilled need requires care that is part-time, intermittent, and must be provided by a person with special training
Personal care assistance with ADLs such as bathing and dressing is covered during the certification period, but Medicare does not pay for it in the absence of a skilled need.

24
Q

How often do patients need to be recertified for health care agencies?

A

every 60 days

25
Q

what is a consumer-directed” or “cash and counseling” model

A

allows selected patients to choose, train, and pay their personal care providers directly with designated state funds (usually from Medicaid programs).

26
Q

What are some recent tech and social advances in medicine?

A

Telemedicine
Point-of-care diagnostic and therapeutic technology
Social, medical, and financial support
Care Management for High-Cost Beneficiaries (CMHCB)

27
Q

What are some new emerging models of CBLTSS?

A

Physician house calls
Team-based primary care coordination
Population-based pay-for-performance
The current fragmented system of CBLTSS will be untenable in the coming years as the number of older adults with complex multimorbidity and functional disability increases.

28
Q

Who is considered a geriatric patient and why?

A

65 yo or older, because this is the age that you qualify for medicare

29
Q

What is the MC cause of death in elderly?

A

1 Diseases of heart (MC)

#2 Malignant neoplasms
#3 COVID-19
#4 Cerebrovascular diseases
#5 Alzheimer disease
#6 Chronic lower respiratory diseases
#7 Diabetes mellitus
#8 Accidents (unintentional injuries)
#9 Nephritis, nephrotic syndrome and nephrosis
#10 Influenza and pneumonia
#11 Parkinson disease
#12 Essential hypertension and hypertensive renal disease
#13 Septicemia
#14 Chronic liver disease and cirrhosis
#15 Pneumonitis due to solids and liquids

30
Q

What happens to organs as you get older? What are the most affected systems?

A

Initially, baseline might not be affected, but there is reduced capacity

CV, renal, and CNS systems

31
Q

What is aging?

A

Schematic representation of the domains of the aging phenotypes, and their relationship with frailty and with the geriatric syndromes.

32
Q

What 4 things lead to physical and cognitive frailty? What does frailty lead to.

A
  1. changes in body compostion
  2. energy imbalance
  3. homoestatic dysregulation
  4. neurodegeneration

leads to falls, disability, comorbitides, ulcres, sleep disorders, delerium, cognitive impairment

33
Q

What is frailtiy?

A

A vicious cycle of declining energetics and reserves that leads to a progressive decline in health and function.

34
Q

What is the #1 cause of inflammation from what we eat?

A

Sugar

35
Q

Where does physiologic decline start?

A

Molecular level, leading to pysiological

36
Q

What is the difference between homeostasis and homestenosis?

A

In homeostasis, the body can recover from stress.

In homeostenosis, the body cannot recover from stress.

The body’s stress response is what typically generates the symptoms of an illness.

37
Q

What are atypical presentations of aging?

A

Weird s/s that are not portrayed in non-aging population. Older people may not have spiking fevers or elevated white blood cell counts with an infection.

Silent MIs, especially women

should always look for treatable things though

38
Q

What does imaging look like in elderly?

A

Imaging may reveal abnormalaities that may or may not be related to symptoms

39
Q

If getting treated, what is common in elderly?

A

Iatrogenic illnesses are common

Geriatrics (5 decks)

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