Midterm Flashcards
What are some things that can happen from aging to the GI tract
- decreased appetite
- reduction in active metabolic mass lowers energy needs
- decreased absorption of nutrients
- constipation
- ulcerative colitis, Crohn’s, Small Bowel Obstruction, Gastro esophageal reflux disease
- slow changes over time
What are the most common causes of vision loss among the elderly
- age-related macular degeneration (loss of central vision)
- glaucoma
- cataracts
- diabetic retinopathy
How can vision impact mobility in the elderly
balance and coordination
Which of the following is NOT a risk factor for falls
- incontinence or urgency
- prescription medications
- changes in health
- pain
- neuropathy
- visual impairments
- age
Age
What happens after a fall?
- Many individuals who have reported a fall do suffer an injury afterwords
- individuals who fall once are at risk of falling again in the next 6 months
- individuals who fall, even if they don’t get injured, develop a fear of falling again
- individuals who fall can sustain broken bones to various parts of the body as well as head injuries such at TBI’s
Fall recovery steps for getting back up as the caregiver/ provider
- assess the situation
- get the person ready
- position a chair
- assist to kneel
- help them stand
- sit them down
Fall prevention techniques
- staying active with activities to boost strength and balance.
- review medications for potential fall risks
- ensure good vision with regular eye check-ups
- Home modifications
- maintain foot health with proper footwear and hydration
- assistive devices
- maintain bone health with calcium, vitamin D, and exercise
- Stay connected and informed about fall prevention strategies through community programs
what is the OT role in fall prevention?
- mobility
- pre functional mobility: the skills associated with strength, balance, and performance
- caregiver education
- identify appropriate DME
What are the components of recommending DME
- identify the type of equipment
- educate
- assess and re-assess
- considerations
Mobility interventions for fall prevention
- therapeutic exercises and activities
- pain management techniques
- functional training and ADL retraining
- home safety and environmental modifications
- education and training
What are the components of a mobility evaluation for fall prevention
- observe ADL performance, patterns and routines
- ROM/MMT
- Balance (sit to stand, Berg, TUG)
- cognition
- vision
- vestibular
What are the most common causes of death in the older adult population (excluding covid)
- heart disease
- cancer
- unintentional injuries
- stroke
- chronic lower respiratory diseases
- Alzheimer’s
- diabetes
- influenza and pneumonia
- kidney disease
- suicide
How can the effects of social determinants of health be exacerbated for older adults?
contributes to:
- risk for frailty
- mental health concerns
- oral health
- vascular disease
- cognitive impairment
environmental factors affecting the experience of aging
- place of residence
- aging in place
- institutionalization
- domestic migration
- international migration
- homelessness
what are the four dimensions of occupation
- doing
- being
- becoming
- belonging
Theories for supporting meaning
MOHO: individual must identify actions that are meaningful
Meaningful Activity and Life Meaning Model (MALM)
Assessments to support meaning
- occupational profile
- COPM
- life satisfaction instruments
intervention to support meaning
- encourage expression and management of identity and connect the older adult to the past, present and future
Activities should emphasize:
- wellness
- reminiscing
- self reflection
- connection to nature and broader world
three categories of biological theories of aging
- programmed theories
- error theories
- genetic theories
Programmed theories
the body degrades through mechanisms that fail due to programmatic deterioration throughout the life course
- programmed longevity theory
- endocrine theory
- immunological theory
Error theories
Aging as a result of accumulated “insults” from the environment
- somatic mutation theory
- free radical theory
Genetic theories
Illustrate aging and age-related morbidities as associated with inherited genetics and acquired genetic mutations
- epigenetic
Psychological theories of aging
theories seeking to explain changes in individual behavior in the middle and later years of life span
- life-span development theory
- selective optimization with compensation theory
- socioeconomic selectivity theory
- personality and aging theories
- cognition and aging theories
- neuropsychology of aging
Environmental theories of aging
- ecological model of aging
- ecological systems theory
- aging in the right place
- place integration
- person-environment-occupation
- situational model of care
Sociological theories
consider social structure, culture, and context in which aging occurs.
- life course
- social exchange
- social constructionist
- political economy of aging
- critical perspective of aging
population health
a concept of health characterized by both objective and subjective determinants and health outcomes of a population
What is OT role in end of life care
- advocate for clients
- utilize holistic treatment methods tailored to client values and beliefs
- address symptoms within scope of practice
- educating other providers
Common health issues that lead to special concerns in the aging population
Overarching diagnosis of failure to thrive
- frailty
- medication use
- oral health
- malnutrition
- dehydration
- urinary issues
- fall risk
What is there an increased vulnerability to due to frailty?
- developing increased dependency
- disability
- falls
- institutionalization
- hospitalization
- dying
What does OT intervention focus on in medication management?
- addressing barriers to adherence
- improving understanding of medication regimens
- promoting independence in medication-related task
OT intervention for medication management
- education and training
- functional skills training
- environment modification
- cognitive strategies
- adaptive equipment
- caregiver training
- follow-up and monitoring
Classifications of nutritional status
- undernutrition
- micronutrient-related malnutrition
- overweight, obesity, diet-related noncommunicable disease
What is the purpose of the MoCA
to assess how cognitive deficits may be impacting a person’s ability to perform everyday activities
What are the domains assessed in the MoCA
- executive functions (primary)
- attention and concentration
- visuospatial and visuoconstructional skills
- conceptual thinking
- memory
- calculations
- language
- delayed recall
- orientation
What are the ranges for scoring of the MoCA
normal: 26 +
mild cognitive impairment: 19-25
moderate cognitive impairment: 10-18
severe cognitive impairment: <10
clinical implications for the MoCA
- home discharge recommendations
- safety awareness
- treatment interventions
- IADLS, bill management, shopping, home care, HEP, medications
-evidence based practitioner
typical age-related changes in the neuromotor system
- proprioception (impaired integration of proprioception input)
- balance (decreased stability)
- decreased reaction time
- coordination
- upper extremity movement
Techniques to test proprioception
- joint position sense (JPS) test
- passive movement sense test
- Romberg test
- finger-to-nose test
- heel-to-shin
- functional tests (walking in a straight line, standing on one leg)
- vibration sense test
- proprioception devices
techniques to test coordination
- finger to nose
- rapid alternating movements (RAMs)
- finger opposition test
- heel to shin
- nine hole peg test
- box and block test
- Purdue pegboard test
- Jebson hand function test
- Minnesota manual dexterity test
- grooved pegboard test
- tandem walking test
- functional reach test
common neuromotor health conditions in older adults
- Amyotrophic lateral sclerosis (ALS)
- Motor neuron disease (MND)
- Myasthenia gravis
- multiple sclerosis (MS)
- stroke
- cerebral palsy
- spinal cord injury
- Guillain-Barre syndrome (GBS)
- polymyositis
ALS
progressive neurodegenerative disease that affects neurons in brain and spinal cord that control voluntary movements
typical course 3-5 years (can be 10+)
Motor neuron disease (MND)
group of progressive neurological disorders that destroy motor neurons (cells that control skeletal muscle activity such as walking, breathing, speaking and swallowing)
life expectancy and pattern of weakness depends on type
Myasthenia gravis
chronic autoimmune, neuromotor disease that causes weakness in the skeletal muscles, worsening after periods of activity and improves after periods of rest.
onset may be sudden and not immediately recognized
female onset: 20-30 years
male onset: 50 years
what is a common cause of SCI in older adults
falls
Guillain-Barre Syndrome (GBS)
rare neurological disorder where body attacks part of the peripheral nervous system
sudden and rapid onset, 70% of people recover fully
Polymyositis
group if muscle diseases known as the inflammatory myopathies
chronic muscle inflammation and weakness in the skeletal muscles starting at proximal muscles. Most people respond to therapy
most common impairments following a stroke
- postural instability
- apraxia
- hemiparesis
- ataxia
- dysarthria
- changes in muscle tone
- shoulder subluxation
common motor feature of Parkinson’s
rigidity
bradykinesia (slowness of movement)
resting tremor
How is Parkinson’s best managed
combination of medications and rehabilitation
Motor control frame of Neurodevelopmental theory
- based on belief that reflexes drive motor movement as a response to sensory input
-therapy focuses on building foundational skills to then transfer to functional activities of daily living
Assessments of body structures and functions for neuromotor conditions
muscle tone, ROM, strength, balance, coordination, upper limb function assessment
When positioning a stroke patient on their affected side what should you always remember to do?
protect the shoulder
interventions for neuromotor and neuromotor conditions
- prevention of postural and limb deformities (muscle tone, ROM, strength)
- facilitate proper positioning for affected limbs (muscle tone, ROM, strength)
- fall prevention education (balance)
- environmental modifications (balance)
- adaptive equipment (balance)
- preventing learned non-use (coordination)
- task-oriented mental practice (coordination)
Attention
foundational to problem solving and decision making
- sustained
- selective
- alternating
- divided
memory
memory deficits often mistaken for sensory changes
- sensory
- short-term
- working
executive functioning implications in older adults
underlies ability to engage in daily activities
intellectual abilities implications in older adults
decline in fluid and intelligence with aging. adaptations to compensate due to processing and memory changes
wisdom implications in older adults
knowledge gained through experience, increases with age
implicit and explicit processing implications for older adults
common to experience changes in explicit learning
explicit: common knowledge
implicit: takes more effort
functional cognition implications for older adults
- compensation for differences in memory and attention during decision-making tasks
- changes in work performance
- driving
Cognitive theories of aging
- speed of processing
- sensory deficit theory
- memory deficit and dual-process
- structural changes in aging
factors impacting functioning for persons living with dementia
- cognition
- communication
- ADL
- behavioral and psychological symptoms
OT interventions for people with dementia
- emphasis on promoting QOL and participation
- minimize behavioral symptoms and enhance functional status
- consider needs of caregiver
- education and resources for symptom management and coping