Module 6 - Older People and Complex Care in Practice Flashcards
What percentage of Australians are estimated to have chronic conditions?
50%
Identify common chronic conditions.
Name at least 5.
- cancer
- cardiovascular disease
- mental health conditions
- arthritis
- back pain and problems
- chronic obstructive pulmonary disease
- asthma
- diabetes
What was the leading cause of deaths for older Australians in 2015?
Cancer - 76%
What was the most common cancer to cause death in 2015?
Lung Cancer
After cancer, what is was the second leading cause of deaths in older Australians?
Coronary heart disease 13%
What percentage of deaths was attributed to Dementia is 2015?
10%
___________________ accounts for 7.8% of deaths and refers to any disorder related to the blood vessels that supply the brain and covering membranes. Stroke is the most common cause of death from cerebrovascular disease.
Cerebrovascular disease
What is frailty?
Frailty is a process of age-related decline in multiple bodily systems that predisposes an older person to sudden health status changes.
How many points are their on the clinical Frailty Scale?
9
What are some interventions to support people with frailty?
- Encouraging exercise, namely strength and balance training (which not only have benefits in maintaining a healthy weight, but also can improve mental health and preserve cognitive function)
- Referral to members of the interdisciplinary team; dietitian, speech pathologist, physiotherapist, occupational therapist, social worker
- Cognitive activities and training programs designed to stimulate short term memory, problem solving and information recall
- Consider nutritional supplementation
What happens to the Pulmonary System when we age?
- Efficiency is reduced
- Decrease in muscle fibres
- The amount of air moving in and out of the lungs is reduced (tidal volume).
- Dyspnoea when physical activity is increased.
- Mucus secretion collect more readily in the lungs, increasing risk of infection.
How would you promote health and maintaining function of the pulmonary system?
- Encourage to stop smoking
- Infection control practices, such as washing hands and avoiding people who are sick.
- Influenza and pneumococcal pnuemonia vaccinations
What happens to the Cardiovascular System when we age?
- Working capacity of the heart decreases as the rigidity and thickness of heart valves increase.
- lower resting heart rate
- slower response to stress (emotional or physical) and slower ability to return to normal
- reduced arterial elasticity, effecting bloody supply to extremities
- orthostatic/postural hypotension
- slight increase in systolic blood pressure.
How would you promote health and maintaining function of the Cardiovascular System?
- Encourage regular checking of blood pressure and cholesterol levels
- Maintaining an ideal body weight and physical exercise
- Ceasing smoking
- Promoting a healthy food intake (avoiding foods high in sodium and fat, eating plenty of fruit and vegetables)
- Avoiding stress, anxiety and depression; ensuring appropriate mental health support strategies are in place
- Considering the use of low dose aspirin .
Thickening of the heart muscle is also called___________.
Hypertrophy.
What is polypharmacy?
Polypharmacy is the use of more medications than are clinically indicated. Sometimes described as 10+ medications.
How does polypharmacy happen?
- Medications are prescribed when they are not necessary.
- Additional medications are prescribed to treat side effects of other medications, rather then reviewing the original medication and alternatives.
- Medication regimes can be complex and confusing, requiring an investment of time by the prescribing practitioner.
- Due to the nature and treatment of certain illnesses, many prescribing practitioners may be involved in an older person’s care who all prescribe from different specialty areas and don’t review or change each other’s medications.
____________________ is associated with a significantly increased risk of adverse drug reactions, even though it is largely preventable.
Polypharmacy
What is the nurse’s role in polypharmacy?
- Facilitation of a medication review by a prescribing practitioner or pharmacist.
- Encouragement of older people to self-administer medications while in hospital
- Empower an older person to ask questions of their prescriber
- Evaluation and assessment as to how an older person manages and understands their medication regime
- Being alert to unexpected drug interactions, and side effects of medications
- Providing written medication information materials with larger print and good colour contrast
- Advising on lifestyle changes that may reduce the need for medication and combat the side-effects of necessary medications
- At times of illness, older people may experience temporary cognitive problems, and nurses must be acutely aware of the need to provide prompts and aids so the patient can revise, rehearse and remind themselves about their medicines.
- Alternatively, carers may take responsibility and will need information and advice as to how to support the older person.
What are some common challenges that can impact the mental wellbeing of older Australians?
- Grief and loss of independence,
- working life and mobility.
- Chronic physical ailments
- Changes in brain function
What are areas of stress for older people in regards to mental ill-health?
- physical health struggles
- social isolation
- lack of access to treatment
- changing living arrangements
- financial stresses
Mental illness in later life is associated with:
- increased rates of chronic or serious health conditions,
- reduced capacity for independent living
- increased suicide risk.
_________________ has been compared with smoking in terms of impact on health of Older Australian.
Social Isolation
What screening tools can you use to assess older person and their mental health, as well as substance use?
- Suicide Risk Assessment
- Cornell Scale of Depression in Dementia
- Alcohol Use Tool
- Assessing Nicotine Dependence
