Lecture 16: Demography of aging Flashcards
Demography
scientific study of a population
importance of demography to physical therapists
changes in demography profoundly influence the number of persons needing physical therapy services, the types of physical therapy that will be needed, the human resources to provide it and the financial resources to pay for it
demographic pyramid
a bar graph with the population in millions on the X-axis and a full range of birth cohorts on the Y-axis
demographic projections are based on
assumptions about how past trends will affect future trends
Among older adults, life expectancy is
increasing
among older adults, age specific life expectancy is greater for __ than ___
women than men
death rates have decreased for most causes of death, but death rates caused by ___ disease have increased
Alzheimers
Among older adults, the most common chronic health conditions are (rank from most common to least common) (based on lecture)
- Hypertension
- Arthritis
- Heart disease
- cancer
- diabetes
Among older adults, the most common chronic health conditions are (based on what Irwin said)
- COPD
- Emphysema
- Bronchitis
- Pneumonia
Less than ___% of older adults in the US have significant functional limitations in vision, hearing, or mobility
<25%
most older adults don’t have:
dimentia
among older adults in the united states, increasing age is one of the strongest risk factors for
dimentia
about __% of people 65+ have dimentia
7.5%
about __% of 85+ years have dimentia
25%
older ___ are more likely to have dimentia at ages 65-74 (young-old)
men
older __ are more likely to have dimentia at older ages (75-84) (85+)
women
Most older adults do not have __ symptoms
depressive
from ages (65-84) (young-old and middle-old) the percentage of persons with depressive symptoms is fairly __
stable (10-13%)
among persons 85+ (old-old) the percentage of person’s with depressive symptoms is
~14%
at ages 55+. the rates of depressive symptoms are greater among ____ than ___
women»_space; men
most older adults do not have limitations in their ____
ADL’s
about __% of older adults have difficulty with at least one ADL
25%
the most common ADL limitation is:
inability to walk 2-3 blocks
___ have slightly higher rates of ADL limitations than ___
women»_space; men
among all age and race groups, most older adults rate their health as:
good, very good, or excellent
overall, __% of older adults report good to excellent health
78%
Caucasian older adults report higher levels of health than
Hispanic and African American older adults
Young-old adults report higher levels of health than do
middle-old and old-old adults
about __% of medicare enrollees had a hospital stay
25%
about __ of medicare enrollees had a skilled nursing stay
6.8%
most older adults have had a physician visit in the last
year
average cost of prescription has increased over the past
15 years
as age increases, the cost per enrollee per year
increases
major components of medicare healthcare costs
- physcian/outpatient hospital
- impatient hospitals
- prescription drugs
- nursing home/long term care
- other
- home health care
how will the aging of the US population impact physical therapy practice
- types of health care problems physical therapists will manage
- setting in which physical therapy services will be delivered
- criteria that payers use to determine need for physical therapy services
- first job that you take after receving your physical therapy license
the fastest growing segment of the population is
85+
difference in life expectancy between men and women means that the experience of old age for men and women:
differs in multiple ways
although chronic health conditions are common among older adults, many of the negative effects of chronic health conditions are caused by
health risk factors that can be changed
although the proportion of older adults with health-related problems increases with increasing age, most older adults report being in
good-excellent health
although most older adults report being in good/excellent health, they utilize
a large number of formal health care services
current poverty rates of older adults are less than (2 age groups)
- 18 and under
- and 18-64
those who depend on social security for their main source of income are the most likely to live in
poverty
what is the largest source of income for older adults
- social security
- the proportion of older adults with high and middle incomes in slowly increasing
there are about __ males to 100 females in the 65-84 age group
84 males
there are about ___ per 100 females in the 85+ age group
56
among all age groups, most ___ are married
older-men
more than half of ___ women are married, but that decreases for
-young-old women are married
but only 41% of middle-old women are married and 16% of old-old women are married
more older men live with a partner than older
women
most older adults (93%) live in the
community
- 3% live in community housing
- 3-4% live in nursing homes/long-term care facilites (the percentage increases dramatically with age)
the meaning of family
- historical changes
- more grandparents per grandchild
- source and solution for family stress
- emotional closeness
- resource exchange
most older adults remain socially engaged throughout
their whole lives
although mental strategies may change, the cognitive function of most older adults remains within
normal limits
mostly stable cognitive function
- verbal intelligence
- verbal skill
- sensory memory
- remote long-term memory
changing cognitive function
- problem solving
- information processing
- psychomotor skill
- encoding processes
- abstract reasoning
implications to change in cognition
- expect intellect to be varied
- concentrate on tasks one at a time
- focus on new knowledge that is consistent with previous learning
- reduce distractions
- use as many senses as possible
- assist with organizing information to be learned
Depression diagnosis criteria
5(+) symptoms most days for 2 weeks
must include depressed mood or decreased interest/pleasure in most activites
-poor appetite
-decreased energy, fatigue
-weight change
-feel worthless/guilty
-sleep change
- decreased concentration, decreased thinking ability
-recurrent thoughts of death or suicide
-psychomotor activity (increased or decreased)
dementia involves
broad global impairment of intellectual function
dementia is age associated but not
age-caused
symptoms of dementia
- decreased short-term memory due to recall problems (hallmark for alzheimer’s)
- progresses to decreases in higher function (disoriented to time, place, then people)
- aphasia (difficulty speaking)
- difficulty using common objects
- poor judgement
- personality changes
- agitation, wandering, sleeplessness
- paranoia
- eventually bedridden
- death from complications
when working with older adults with dementia work with them as patiently as you would
work with a child, while fully respecting them as adults
delirium
an abrupt change in mental status and behavior with global, fluctuating impairment in cognitive processes and alterations in attention
delirium is age associated but not
age-caused
delerium symptoms
- disturbed psycomotor activity
- disorientation
- distorted thinking
- inabiltiy to process environmental information
- memory impairment
- withdrawl or agitation
- illusions and paranoid ideations due to misinterpreation of environmental stimuli
- sleep-wake disturances
when working with older adults with cognitive impariments:
- simplify
- explain frequently
- reorient
- slow down
- avoid change
- maintain familiar objects and routines
- touch
- respect dignitiy
- educate family
changes in digestion (older-adult) include
changes in nutritional requirements as well as changes in the oral cavity, liver, small intestine, and large intestine
risk factors of malnutrition
risk of malnutrition is increased in the presence of disease, eating poorly, impaired dental health, high alcohol consumption, economic hardship, reduced social contact, multiple medications, involuntary weight loss, ADL dependence, age greater than 80
dehydration and older adult
with aging comes a change in the sense of thirst and diminished activity in the hormonal balance of fluids
-together these changes make dehydration more likely
signs of dehydration
dry lips, sunken eyes, increased body temp, decreaed BP, constipation, decreased urine output, nausea, confusion
bowel and bladder function changes due to
weakening of pelvic floor musculature; changes in renal function, urinary incontience
urge incontience
person feels the need to empty the bladder but is unable to get to a toilet before urination occurs (timing issue)
stress incontinence
a cough, strain, laugh, sneeze, or otherwise initiated by Valsalva maneuver causes involuntary loss of urine
overflow incontinence
bladder is overly distended causing bladder pressure to exceed urethral pressure no matter what the person may attempt
Ex: large prostate tumor, nerve damange, herniated disc
functional incontinence
occurs when people with normal bladder and urethral function have difficulty getting to the toilet before urination
(ex: can’t physically get to the bathroom, can’t undress themselves)
constipation changes in older adults
- no decrease in motility compared to younger adults
- may be secondary to decreased water intake, nutritional issues, lower acitivty level, living alone
paternalism
medical decision making in which health care professionals exercise unilateral authority over patients
older adults have right to information and participation in decision making
- patient self-determination act
- consumer bill of rights and responsibilites
living wills express
health care desires (when unable due to illness or incapacity)
durable power of attorney for health care
person who makes medical decisions when you can’t
DNR
Do not Resuscitate; no heroic efforts to save life
elder abuse (definition)
any 3 types of mistreatment of any illinois resident over 60 who live in the community
abuse
physical, sexual, or emotional maltreatment and or willingful confinement
neglect
failure of a caregiver to provide the older person with the necessities of life including but not limited to food, clothing, shelter, medical care (may be passive or willful)
financial exploitation
misuse or withholding of the older person’s resources by another to the disadvantage of the older person and/or profit of another
-most often reported form of elder abuse (at least 50% of reports in illinois)
PTs must report abuse within
24hrs
professionals and government employees (PTs) must report
- any suspected abuse, neglect, or exploitation of an older person to the Department of Aging Elder Abuse and Neglect Program
- where the older person because of dysfunction is unable to report for themselves (ie the person is not competent or is unable to seek assistance for him/herself)
- reporting requirement is limited to those older persons the professional sees when they are carrying out their professsional duties
- professional judgement must be used to evaluate who is unable to report
who can you report to
- Local Elder Abuse provider agency
- IL Elder Abuse Hotline
patient restraints
often a violation of human rights
-any physical or pharmalogical means used to restrict a patient’s movement, activity, or access to their body
right to be free of restraint
patients have the right to be free from any restraint imposed for purposes of discipline or convenience and not required to treat a person’s medical symptoms
the majority of older adults have Alzhemier’s disease
T or F
False
as people grow older, their intelligence rapidly declines
T or F
False
It is very difficult for older adults to learn new things
T or F
False
Personality changes with age
T or F
False
Memory loss is a normal part of aging
T or F
True
As older adults grow older, reaction time increases
T or F
True
Clinical depression occurs more frequently in older than younger people
T or F
False
older adults are at risk for HIV/AIDS
T or F
True
Alcoholism and alcohol abuse are significantly greater problems in the adult population
over age 65 than that under age 65.
T or F
False
older adults have more trouble sleeping than younger adults
T or F
True
older adults have the highest rate of suicide rate of any age group
T or F
False
high blood pressure increases with age
T or F
True and False
Older people perspire less, so they are more likely to suffer from hyperthermia.
T or F
True
all women develop osteoperosis as they age
T or F
False
a person’s height tends to decline in old-age
T or F
True
physical strength declines in old age
T or F
True
most old people lose interest in and capacity for sexual relations
T or F
False
. Bladder capacity decreases with age, which leads to frequent urination. T or F
True
kidney function is not affected by age
T or F
false
increased problems with constipation represent a normal change as people get older
T or F
False
all five senses tend to decline with age
T or F
True
As people live longer, they face fewer acute conditions and more chronic health
conditions. T or F
true
. Retirement is often detrimental to health-‐-‐i.e., people frequently seem to become ill or
die soon after retirement. T or F
False
Older adults are less anxious about death than are younger and middle-‐aged adults. T or F
True
People 65 years of age and older currently make up about 20% of the U.S. population. T or F
False
most older people live in nursing homes T or F
false
The modern family no longer takes care of its elderly T or F
False
The life expectancy of men at age 65 is about the same as that of women. T or F
False
Remaining life expectancy of blacks at age 85 is about the same as whites. T or F
True
Social Security benefits automatically increase with inflation T or F
True
Living below or near the poverty level is no longer a significant problem for most older
Americans T or F
False
most older drivers are capable of safely operating a motor vehicle T or F
True
Older workers cannot work as effectively as younger workers T or F
False
most old people are set in thier ways and unable to change T or F
False
the majority of old people are bored T or F
False
in general, most old people are pretty much alike T or F
False
Older adults (65+) have higher rates of criminal victimization than adults under 62 do. T or F
false
Older people tend to become more spiritual as they grow older. T or F
true
Older adults (65+) are more fearful of crime than are persons under 65. T or F
False
Older people do not adapt as well as younger age groups when they relocate to a new
environment. T or F
False
Participation in volunteering through organizations (e.g., churches and clubs) tends to
decline among older adults. T or F
False
Older people are much happier if they are allowed to disengage from society. T or F
false
geriatrics is a speciality in american medicine
T or F
True
All medical schools now require students to take a course in geriatrics T or F
False
abuse of older adults is not a significant problem in the US T or F
False
grandparents today take less responsibilty for rearing grandchildren than ever before T or F
false
older persons take longer to recover from physical and psychological stress T or F
True
most older adults consider their health to be good or excellent T or F
True
older females exhibit better health care practices than older males T or F
true
research has shown that old age truly begins at 65 T or F
False
