MIDTERM Flashcards
What pecentager of older adults live at home
92%
5% in homes
3% in assisted living
Most centurions will be
Female
CAM
Confusion assessment method
3 Ds for older adults
Dementia delirium and depression
BPSD
Behavioural Psychosocial/psychological symptoms of dementia
Distinguishing factors of delirium
Acute
Sudden
Temporary
Preventable
Treatable
Caused by underlying physiology
Distinguishing features of dementia
Slow
irreivereable
Decline
terminal (not cureable)
Predisposing factors for delirium
Dementia
Polypharmacy
Depression
Advanced age
Funcitonal dependency
Precipitating factors for delirium
Restrains
Surgery
Infection
Illness
Clinical features of BPSD
Agitation
Psychiatric Symptoms
Personality symptoms
Personality changes
Mood disturbances
Aberrent motor movement
Changes in sleep
Hypersexual behaviour
AD
Fasted progression
Plaque in brain
Vascular
Related to blood vessels
Lewey body
Parkinson symptoms (abnormal proteins)
Frontotemporal
CAM assessment
Must have
- Acute onset/fluctuating course
AND
- Inattention
AND
- Disorganized thinking
OR - Change in LOC
Sundowning
When symptoms appear at night, they have trouble sleeping
Best treatment fot delirium
Non-pharmocological
How to treat delirium
Treat precipitating cause
THen address aggrevating factors
Is there standardized care for dementia
No. ALways individiualized
(manifests differently in each person)
Pharm approach to dementia
Cholinesterase inhibitors
Non-Pharm approaches to dementia
Focus on safety and QOL
Anticholinergics
Meds to NOT be used for older adults with dementia
OTC cold and flu meds, ophthalmic meds
Can be causative factor for delirium, confusion etc.
Counteract the affects of cholinersterase inhibitors
Slow drug clearance due to age related changes
Increased body fat
Decreased lean muscle
Decreased body water
Reduced hepatic blood flow
Decreased serum albumin
Factors which compromise client safety
Communication gaps
Incomplete trafer of information
Inadequate pt eduction
Poor coordination of services
Ineffective med reconciliation
pt health literacy
cultural differences
Low staffing
Lack of access to essential lcare services
Pt characteristics
Categories of antidepressents
MAO inhibitors (rarely used, associated with agitation and psychosis)
Tricyclic anti-depressents: TCA
SNRIs (first line of treatment, block seratonin reuptake, fewer sideaffects)
- Sideaffect is reduced blood sodium
The stages of change model
Pre-contemplation (Pateint resistent to change)
Contemplation (intention to change)
Preperation: Patient ready to make goals
Begining steps of behaviour stage
Action (Less than six months implementation of healthy behaviours)
Maintance (More than. 6 months, continuing healthy behaviours)
Adult day center
Provide rec activitie sfor adults with cognitive deficits
Respite care
Goal to relieve caregivers from stress of caring for dependent adults
What ocntirubutes to complexities for assessing older adults
Commonly one or more interacting conditions
Illness manifestations tend to be more obscure and less predictable
Cognitive impairment makes description difficult
Treatments often aimed towards relief of symptoms
Risk factors
Increases changes of pathology
Functional consequences
Observable effects of aging
positive and negative
Pharmacokintetics
What the body does to the drug (how it is absorbed, metabolized excreted)
Pharmacodynamics
Serum half life
Homeopathy
Technique that stimulates the bodies self healing techniques
NSAIDs
Non steroidal anti inflammatory drugs
asprin
BEERS
Medications deemed inappropriate for the older population because of sideaffects and poor safety profile
Functional consequences
Good or bad observable changes as a result of actions - affect QOL or ADLs
Wellness outcomes are associated with
Ways to support HIGHEST QOL NOT cures
what is elimination half-time?
aka serum half life, which is the time required for the drug’s concentration in the blood to decrease by one half of its original value
Clearance rate
measures the volume of blood from which the drug is eliminated per unit of time
what are schemas?
assumptions/unarticulated rules that influence our thoughts feelings and behaviours
How is dementia related to de[rressoin
40-50% of people with dementia experience depression at some point in their illness
Assisted living arrangements are how common?
Increasingly more
Best predictor on a person’s ability to successfully engage
Whether or not they actively engage with life
Who is responsible for care management of seniros?
Designated family member, health care provider etc.
Can delirium be caused by loneliness
NO
What is a trademark affeect o depression on sleep
Insomnia or early morning awaking
