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Geriatrics > L2 - part 1 > Flashcards

L2 - part 1 Flashcards

1
Q

homebound vs nursing home

A

homebound (almost 2 million over age 65) outnumber the 1.4 million residents of nursing homes

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2
Q

why homebound

A

result of physical or cognitive impairment

no access to dental care

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3
Q

scope of practice in homebound

A

assessments
simple extractions
denture fabrication and repairs
simple fillings

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4
Q

ADL’s *

A 
eating 
bathing 
dressing 
toileting 
transfer

*patients who need help with 2+ ADL’s need at home help or long term care

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5
Q

case study take aways

A
  1. importance of good communication with medical primary care providers
  2. be wary of ageism (treat if can tolerate- not by age)
  3. centenarians need dental care too *
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6
Q

100-104?
105-109?
110+

A

centenarians

semi-super-centenarians

super-centenarians

study of these began in 1994 by thomas pearls – in new england

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7
Q

compression of morbiditiy and mortality

interesting about centenarians?

A

morbidity (illness)
mortality (life-span)

have delayed onset or absence of most common age-related systemic diseases (hypertension, diabetes, CVD)
- most dont have these

live long suprinsingly good health

then at very old get something and die

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8
Q

oral health of centenarians?

A

important for eating, talking, socializing, self-esteem and had not yet been studied

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9
Q

fastest growing segment of US population? **

A

people aged 85+ constitute the FASTEST GROWING SEGMENT OF THE US POPULATION

PERCENTAGE WISE

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10
Q

Perferred term for 65+

A

older adult

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11
Q

defining geriatric today

A

a person’s FUNCTIONAL status more than chronological age defines geriatric today

AGE ALONE IS NOT ENOUGH TO DEFINE THIS POPULATION

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12
Q

functional status can be

A

affected by cognitive and / or physical impairments

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13
Q

Geriatrician

A

primary care physcians either FAMILY OR INTERNAL medicine, plus geriatric trianing

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14
Q

1 issue geriatricians deal with

A

polypharmacy

all the different rx’s and their interactions

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15
Q

IADL’s *

A

instrumental activities of daily living

  1. managing money
  2. shopping
  3. preparing meals
  4. heavy housework
  5. light housework
  6. using the telephone
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16
Q

geriatric core competency (5 M’s)

A
  1. mind
  2. mobility
  3. medications
  4. multi-complexitiy
    - someone to support them? vision? hearing? oral hygeine adequate?
  5. matters most
17
Q

mild cognitive impairment

A

slight but noticeable decline in cognitive abilities, including memory and thinking skills

may or may not interere with daily life and fucntion , may be stable for years

MAY BE RREVERSIBLE ** - Increased risk for dimentia

18
Q

mentation / mind that may be reversible

A

mild cognitive impairment

delirium

depression

19
Q

delirium

A

reversible
- altered mental status from baseline; disorientation to time place, person

causes include inappropriate medication and / or untreated infection (UTI’s), dehydration; up to 50% of hospitilized older adults

20
Q

depression

A

reversible

geriatric depression scale (15 questins)

21
Q

dimentia

A

NON REVERSIBLE
- AD’s, vascualr dimentia- daily function affected
progressive decline

rate of decline varies

22
Q

matters most / goals of care

A

adapting tx plans and sites of tx

aesthetics(family never saw this pt wthout dentures in mouth)

function

pain free

23
Q

what to consider with dimentia patients

A

dentures – careful bc if lose them they can get out of whack and wonder where you are to help and where they are

24
Q

risk factors for dental disease

A

age
retaining natural dentition – edentulous rate dcreasing over time

funcitonal impairment – physical and or cognitive

resistance to oral hygeine assistance

25
Q

risk factors for caries

A

dentin layer thickens over time and pulp recedes

decrease in saliva

increase in sugar consumption

gingival recession exposing caries prone cementum and

larger gingival interdental areas – food traps

26
Q

caregivers

A 
unpaid / paid person wo  helps another individual with his/her ACTIVITIES OF DAILY LIVING (ADL's) 
- bathing
- dressing, toileting, transfers, 
continence
feeding
27
Q

patients who need assistance with ADL’s …

A

USUALLY REQUIRE help with oral hygeine

28
Q

oral hygiene guidelines for patients at high risk for careis

A

inform patient/ caregiver hygeine is inadequate

ask caregiver to scub teeth for 2 minutes

rx prevident or 1.1 NaF gel for daily use

mouth carriers (like beaching trays) + prevident for 5 minutes / day

3-4 mouth hygience recall for patient with caregiver

29
Q
  • communicating effectively with older adults
A

TAKE MASK OFF

  • ask if they can har
  • stay eelevel, close to patient

speak slowly and in lower frequency do not screm or increase pitch

never be backlit – may be trying to read lips

30
Q

visaul impairments

A

large font

help patient in and out of chair

keep floor clean

elder friendly hallways, etc

31
Q

elder abuse

A

AFFECTS PEOPLE OF ALL RACES, ETHNICITIES, SOCIAL CALSSES AND AGE

MANDATED TO REPORT SUSCPISION

Actions of omission or commission that potentially or actually threatens the well being of the adult

patterns of assaultive and coercive behavior inluding inflicting injury, psychological abuse, deprivation, progressive social isolation, intimidation and threats

behaviors perpetrated bby someone able to establish control over another

32
Q

most common elder abuse

A

FINANCIAL
– under reported often due to co-dependency of abuser and victim

  • physical
  • emotional
  • caregiver neglect
  • self -neglect– not paying bills, not eating properly, refusing assistance
  • sexaul

many times emotiona abuse, financial abuse and neglect go together

33
Q

caregiver who insists on giving the history of a traumatic injury

A

like broken front tooth, back eye, lip laceration

  • suspect possible to abuse
34
Q

what can dentist do to help in abuse cases

A

dentist are mandated reporters of SUSPECTED ABUSE

  • can initiate an appropriate investigation and intervention

provide supportive evidence and documentation

MA abuse hotline and online information

Geriatrics (6 decks)

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