Nurb Test 1: complex care in the community

Question 1

agonizing concerns of families have about their aging relatives?

Answer 1

Loneliness, losing independence=decline in health, can’t drive, may feel like a burden, finances= living with family member, hard to maintain house

Question 2

national concerns regarding health care and our aging population:

Answer 2

Medicare=reduction in services, social security, affordable care act= still expensive

Question 3

-Progressive loss of function.
-Decreases along with decreasing fertility and increased mortality.
Etiology Undetermined.
-Genetics, oxidative stress, diet, environment.
Therapies-to slow down or reverse age
– related changes that result on chronic illness and disability.
Research :Rats and calorie restriction-live longer with restriction=doesn’t translate to human/ not many resources to recover
Having enough for tissues to regenerate free radical: Vitamin A, B-Carotene, Selenium, Ginkgo, Chromium.

Answer 3

Biologic Theories of Aging

Question 4

Aging result of lifelong genetic damage.

• Faulty copying in dividing cells or the accumulation of errors in information-containing molecules.
• Body cells develop spontaneous mutations – similar to germ cells.

Answer 4

Stochastic Theories-

Question 5

-Breakdown of human genetic constitution diminishes throughout life resulting in functional failure.

Answer 5

Intrinsic mutagenesis

Question 6

• Programmed theory of cell death.

- Impaired ability for cells to continue to divide.

Answer 6

Non stochastic Theories

Question 7

-Aging occurs because of functional decrements in neurons and associated hormones. Loss of response to tissue – wearing out.
Decline in T cell functioning.
Self-destruction of immune system.
-don’t have resources like before to fight off disease process

Answer 7

Neuro-endocrine Theory

Question 8

-the most complex health problems
-One or more chronic health problems
-Multiple chronic conditions (MCC)
3 of 4 Americans 65 years and older
Acute illness may exacerbate chronic conditions
-Acute illness may extend recuperation – longer hospital stays → rehabilitation
-Decreased function
Ex: Restrict fluid intake because they don’t want to get up and go to the bathroom

Answer 8

Older Adult patients

Question 9

• Model to predict likelihood of someone who will participate in an activity
• Bring health practices with them
• perceive the benefit= will try harder
• see a barrier= discomfort, friend sick don’t want to go along
• make sure they are able to do it
• Peers influence them: family friends
• Situational influences
• Change to positive to help commit to doing later (is this something you will do)
• Immediate demands: can’t go because doc app

Answer 9

Nola Pender

Question 10

Housing designs and renovations that allow elderly citizens to remain in their homes longer, less expensive

Answer 10

Aging-in-Place”

Question 11

• Trying to maintain their own jobs, home, children while caring for an aging parent.
  a. Communication B. Continuity of care C. Aging in Place D. Health Care reform E. Long term care housing assessment

Answer 11

Complex health problems: The Families

Question 12

• U.S. federally mandated process
• all residents in Medicare or Medicaid certified nursing homes.
• Comprehensive assessment of functional capabilities-signficant ppl, previous residence, functionally able to do, dress self, eating
• Helps identify health problems -Create plans of nursing care
• required for residents on admission and periodically
• Assessments by Registered Nurses
• Transmitted electronically to state database =care plan is generated

Answer 12

Minimum Data Set (MDS)

Question 13

• Investigates abuse, neglect, self neglect, and exploitation
  Endangered Adults: At least eighteen (18) years of age;
  Mental illness, mental retardation, dementia, or other physical or mental incapacity
  A. To manage the individual’s property
  B. provide or direct their self care;
  C. harmed or threatened with harm of neglect, battery, or exploitation

Answer 13

ADULT PROTECTIVE SERVICES (APS)

Question 14

• Indiana law requires anyone who has reason to believe that another individual is an endangered adult to make a report to the local Adult Protective Services Unit, or Law Enforcement.
• All reports are confidential

Answer 14

Abuse, Neglect, Exploitation

Question 15

Any touching (battery) of a person in a rude and insolent manner.
Verbally an individual is also a punishable offense.
-contact manager

Answer 15

Abuse:

Question 16

: The intentional withholding of essential care or service.

Abandonment of an individual is also considered

Answer 16

Neglect

Question 17

: The intentional misuse of a person’s property, person or services for financial gain.

Answer 17

Exploitation

Question 18

• Eye contact
• Caring without condescending tone of voice
• LISTEN
• Speak clearly.
• Speak more slowly and articulate.
• Use reliable sources
• Textbooks
• Websites: cdc, try this, nih, universities, med centers
• Consider “elder culture”
• Different values and beliefs
• Less likely to be tech savvy
• Not “You Guys”; Mr. Mrs. Miss – unless invited otherwise
• Avoid medical jargon
• Patient must participate actively in goal setting ( What do you want out of this?)
• Consider availability of adequate resources

Answer 18

Teaching Strategies for Older Adults

Question 19

• Emphasize concrete rather than abstract material.
• Reduce environmental distractions
• Must be individualized to fit the needs and lifestyle
• Patient must participate actively in goal setting
• Consider availability of adequate resources.

Answer 19

General Strategies

Question 20

• Adequate diffused light
• Avoid having the older patient face a direct source of light.
• Prescription glasses on
• Use large print for labels and instructions.
• 14 point font

Answer 20

Compensating for impairments Impaired Vision

Question 21

• Speak in a low tone of voice
• Speak clearly and slowly
• Face the patient while talking.
• Encourage hearing aid-use it if available
• Ask questions to verify understanding, return demonstration

Answer 21

Compensate for Hearing Loss

Question 22

• Joint stiffness and reduced reaction time
• Never rush the older person
• Do not set time limits on task performance.
• Return demonstrations -ability do psychomotor skills independently.

Answer 22

Physical Ability & Endurance

Question 23

• More likely to remember information heard
• Repeat the message
• Question the patient - retention.
• Select clear, simple, terminology,
• Highly educated may prefer medical explanations
• Others prefer information short and simple.
• Return demonstration

Answer 23

Compensating for Memory Problems

Question 23

:1956 Atoms and molecules carry unpaired electrons and therefore combine with other molecules. Causing oxidation. =cells begin to change

Answer 23

-Free radical theory