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HDAL - Post Midterm > Introduction to Geriatrics > Flashcards

Introduction to Geriatrics Flashcards

1
Q

What is geriatrics?

A

Medical specialty, including PT, that includes the care & treatment of older individuals

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2
Q

What is gerontology?

A

Study of the process of aging (physiological processes)

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3
Q

What is aging? (senescence)

A

The time-related deterioration of physiological functions that are necessary for survival

Characteristics of aging affect all the individuals of a species, yet varies between individuals

General decline in number, structure, and function of cells

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4
Q

What are some consistent aging characteristics?

A

Increased homeostatic imbalance
Increased mortality
Consistent changes in biomedical composition & aspects of the body
Broad spectrum of progressive deteriorative changes
Reduced ability to respond adaptively to stress & environmental change

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5
Q

What is the slippery slope of aging?

A
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6
Q

What types of aging do we as practitioners need to differentiate between?

A

“normal” aging vs “pathological” aging

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7
Q

What is the most likely determinant of successful aging?

A

Physical activity

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8
Q

What are the components of successful aging?

A
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9
Q

Why are people in developed countries aging more more as a demographic?

A

People are living longer and dying slower
Due to technology & modern advancements in medicine, infant and childcare, nutrition, sanitation, lifestyles, vaccines, research, infrastructure….

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10
Q

What are the 10 most common chronic diseases for ages 65+?

A

Hypertension
Hyperlipidemia
Arthritis
Ischemic heart disease
Diabetes mellitus
Chronic kidney disease
Heart failure
Depression
Alzheimer’s disease & dementia
Chronic obstructive pulmonary disease

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11
Q

What are the leading causes of death of ages 65+ in the United States?

A

Heart disease
Malignant neoplasm (cancer)
Chronic lower respiratory disease
Cerebrovascular diseases (stroke)
Alzheimer’s disease
Diabetes mellitus
Accidents (unintentional injuries)

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12
Q

What stopped a more than decade-long increase in life expectancy across more than 31 high income countries?

A

COVID-19

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13
Q

What are some of the numerous factors effecting ages?

A
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14
Q

What are the age categories of the elderly?

A

65 – 74 years: “young-old”
75 – 84 years: “middle-old”
85+ years: “oldest-old”
Often considered “frail elderly”

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15
Q

What are the current generations?

A
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16
Q

When was the greatest generations born? And how old are they?

A

Born before 1928
Currently 95+ years old
Fought (and won) WW2 (1939-1945)

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17
Q

When was the Silent Generation born? How old are they?

A

Born 1928 – 1945
Currently 77 – 94 years old

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18
Q

What is the Silent Generation also known as and what are their defining differences?

A

Traditionalists, Children of the Great Depression (1929-1941) and WW2 (1939-1945)
“Obedience over individualism”
Age = seniority
Hierarchy

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19
Q

When was the boomer generation born? How old are they?

A

Born 1946 – 1964
Currently 58 – 76 years old

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20
Q

What are some of the defining differences for the Boomer generation?

A

Oldest members part of fertility spike from 1946 (the end of WW2)
Youngest members born right before oral contraception became popular after it was approved by the FDA in 1960
Civil Rights movement (1954-1968)
Vietnam War (1955-1975)
“Pay your dues”
“Sacrifice for success”
Specific goals and deadlines

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21
Q

What years were generation X born? And how old are they currently?

A

Born 1965 – 1980
Currently 42 – 57 years old

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22
Q

What are some of the defining differences for Gen X?

A

HIV/AIDS epidemic (1981- early 1990s)
Fall of Berlin Wall (1989)
Introduction of computers and video games
Efficiency
Immediate feedback
Flexibility
Skeptical

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23
Q

What years were Millennials born? How old are they currently?

A

Born 1981 – 1996
Currently 26 – 41 years old

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24
Q

What are some of the defining characteristics of the millennial generation?

A

Internet & technology
9/11 Terrorist attacks (2001)
Hurricane Katrina (2005)
Seek challenge, growth, development
Competitive
Achievement-oriented

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25
Q

What years were Gen Z born? How old are they?

A

Born 1997+
Currently 25 years old or younger

26
Q

What are some of the defining characteristics of Gen Z?

A

Social media influences
The most racially and ethnically diverse group to date
Each group is typically more diverse than the previous generation
Value independence & individuality
Innovative

27
Q

What are the common cultural views of aging in the United States?

A
28
Q

What are the common cultural views of aging in asian cultures?

A
29
Q

What are the common cultural views of aging in arab/muslim cultures?

A
30
Q

What is the best practice when addressing cultural differences?

A

Best practice – when in doubt, just ask
Respectfully ask patients about their health beliefs and customs. For example: “Is there anything I should know about your culture, beliefs, religious practices, or preferences that would help me take better care of you.”
Avoid stereotyping based on religious or cultural background. Recognize each person as an individual who may or may not adhere to certain cultural beliefs or practices common to his or her culture.

31
Q

What are the two major categories of aging theories?

A

Genetic (programmed): focus on mechanism for aging located in the nucleus of a cell
Non-genetic (non-programmed), also stochastic: focus on other areas, including organs, body systems, environmental causes

32
Q

What is Hayflick limit theory?

A

“Doubling” or “biological clock”
Limited amount of cell population doublings, with the average being 50 per life cycle of the cell
Functional changes (alteration & degeneration) within cells are responsible for aging

33
Q

What is evolutionary aging theory?

A

An expansion of Darwin’s theory of natural selection
Each successive generation is more resistant to mutations
When mutations occur, it is at a later age

34
Q

What is stress theory of aging?

A

Survival into old age is enhanced by high vitality and resilience due to underlying resistance to stress by the genes
An evolutionary model

35
Q

What is Neuroendocrine & Hormonal theory of aging?

A

Functional decrements in neurons and their associated hormones are central to the aging process

Endocrine changes evolve with aging and some physiological manifestations of aging are related to the effects of declining “protective” hormone levels (estrogen, testosterone, growth hormone, adrenal DHEA) and increased “damaging” hormones (cortisol)

Hypothalamic-pituitary-adrenal axis is the “master timekeeper” for the organism and the primary regulator of the aging process

36
Q

What is immunological theory of aging?

A

The functional capacity of the immune system declines with age as a result of reduced t-cell (immune system) function

The immune system declines with age as evidenced by the age-associated increase in autoimmune disease

37
Q

What is free radical theory of aging?

A

Aging changes are due to damage caused by free radicals
Most popular and widely tested theory
Free radical: highly charged ions whose outer orbits contain an unpaired electron
Have been shown to damage cell membranes, mitochondria, lysosomes, nuclear membranes
The net result of free radical reactions is a decline in cellular integrity

38
Q

What is caloric restriction theory?

A

A life committed to a high-nutrient and low-calorie diet is a longer one
Possibly operating through neuroendocrine system
Calorie-restricted diet influences the rate of aging and susceptibility to disease in a positive manner

39
Q

What is Error theory of aging?

A

Error catastrophe theory
Any accident or error in either the mechanism or the process of making proteins would cascade in multiple effects that would be incompatible with life

40
Q

What is Redundant DNA theory?

A

Biological age changes are a result of errors accumulating in genes

41
Q

What is Somatic mutation theory?

A

Mutations or genetic damage result from radiation, and these accumulate and create functional failure and death

42
Q

What is transcription theory of aging?

A

A control mechanism responsible for the appearance and sequence of aging exists in the nuclear chromatic complex

43
Q

What is cross-linkage theory of aging?

A

Large, reactive proteins (like collagen) cross-link and are responsible for aging

44
Q

What is the connection between sleep and aging?

A

Prolonged sleep loss affects homeostasis and a species’ ability to repair tissue
The human species repairs tissues and synthesizes neuroendocrine cells that contribute to homeostasis in the hormonal system

45
Q

What is the connection between Dehydroepiandrosterone (DHEA) 4 and aging?

A

Failure of the enzymatic machinery in the adrenal gland disrupts lifelong adrenal cortisol feedback
This is theorized to exacerbate the age associated loss in neuronal synapses and brain plasticity

46
Q

What is the connection between telomeres and aging?

A

Protective cap” located on the ends of chromosomes
Shorten with each cell division and with increasing chronological age
The length of the telomere is predictive of lifespan for that cell and, therefore, that organism

47
Q

What is Werner syndrome?

A

Progeria of young adults
Rare, autosomal recessive disorder characterized by the premature development of the aging phenotype, as well as many age-related diseases
Due to mutation of a helicase gene on the 8th chromosome
Helicases: substances that unwind the double helix of DNA
Normal people carry variants of the gene that influence their life spans or predispose them to an early death

48
Q

What are the negative effects of ageism in healthcare?

A

reduced mental health, mortality, poor health, and slower recovery from sickness

49
Q

What are the three levels of agism?

A

3 levels: micro- (individual), meso- (social network), macro- (institutional/cultural)

50
Q

What did Jimmo vs. Sebelius settle?

A

Skilled care can be necessary to:
Improve a patient’s current condition
Maintain a patient’s current conditions
To prevent or slow further deterioration of the patient’s condition

Coverage of skilled therapy services by Medicare are NOT dependent on the patient’s ability to improve, but rather that there is a need for skilled care by the provider

51
Q

What are the 8 tenets of the APTA code of ethics?

A

respect the inherent dignity & rights of all individuals.

be trustworthy & compassionate in addressing the rights and needs of patients & clients.

be accountable for making sound professional judgements.

demonstrate integrity in their relationship with patients, clients, families, colleagues, students, research participants, other HCPs, employers, payers, & the public.

fulfill their legal and professional obligations.

enhance their expertise through the lifelong
acquisition and refinement of knowledge, skills, abilities, & professional behaviors.

promote organizational behaviors & business practices that benefit patients, clients, & society.

participate in efforts to meet the health needs of people locally, nationally, or globally.

52
Q

What are the six APTA guidelines for Geriatric patients?

A

Utilize person-centered care to elicit & prioritize the individual’s preferences, values, and goals to drive the plan of care.

Strive for anti-ageist practice.

Conduct a holistic assessment and evaluation utilizing sound outcome measures that help inform the treatment plan & relate to the patient’s stated goals.

Provide positive outcomes of PT care by completing interventions that are based on the best available evidence.

Prioritize physical activity to promote health, well-being, chronic disease management, and enhance mobility.

Champion interprofessional collaborative practice that is inclusive of patients and their caregivers.

53
Q

What are the competing core ethical principles to consider in medical practice?

A
54
Q

What are the types of elder abuse?

A
55
Q

What are the physical warning signs of abuse?

A
56
Q

What are the behavioral signs of abuse/neglect?

A
57
Q

What are the isolation signs of abuse/neglect?

A
58
Q

On average who is more at risk of elder abuse?

A
59
Q

What types of people/professionals commit the abuse?

A

Family
Friends
HCPs
Caregivers
Other nursing home resident
Self

60
Q

What is self-neglect?

A

The failure, either by an adult’s action or inaction, to provide the proper or necessary support or medical, surgical, or any other care necessary for their own well-being
Does not include a person with recognized religious methods of healing in lieu of medical treatment, e.g., Jehovah’s Witness & blood products

61
Q

What are the mandatory reporting laws for HCPs and vulnerable population abuse?

A

State specific - Louisiana
RS 15:1504(A)
Any person, including but not limited to a health, mental health, and social service practitioner, having cause to believe that an adult’s physical or mental health or welfare has been or may be further adversely affected by abuse, neglect, or exploitation shall report in accordance with R.S. 15:1505.
RS 14:403.2(A)
Any person, who under R.S. 15:1504(A), is required to report the abuse or neglect of an adult and knowingly and willfully fails to so report shall be guilty of a misdemeanor and upon conviction shall be fined not more than five hundred dollars or imprisoned for not more than six months, or both.
Report incidents of abuse, neglect, and exploitation involving adults60 and oldertoElderly Protective Servicesat1-833-577-6532 or 225-342-0144.

62
Q

What is an Ombudsman?

A

Ombudsman: individual trained to respond to the problems and needs of residents of nursing homes and long-term care facilitates
Protect and promote the rights of the residents
Respond to any complaint, problem, or concern a resident may have
Quality of care
Food
Finances
Activities
Visitation

HDAL - Post Midterm (4 decks)

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