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OCCUPATIONAL THERAPY > OCTA 236 (Geriatrics) Final Lecture Exam > Flashcards

OCTA 236 (Geriatrics) Final Lecture Exam Flashcards

1
Q

What is the role of OT in Hospice?

A

focus on life and death issues, prepare person/family for death

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2
Q

Medicare:

A
  • Passed into law in 1965 under president Lyndon Johnson
  • federal/consistent
  • Covers those 65+
  • Covers those under 65, disabled for 24 continuous mths and receives SSI
  • Covers those under 65 who have received social security disability for ALS
  • Covers those 65 and under that have a dialysis/kidney tranplant
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3
Q

Largest payer of healthcare in the US

A

Medicare

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4
Q

Medicare Part A:

A

Inpatient services, including stays at hospitals, SNF, home health visits, and hospice

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5
Q

Medicare Part B:

A
  • Optional but strongly recommended
  • Outpatient services, physician costs, OT/PT/SLP, MD/other healthcare providers, preventative services, home health, DME (optional-pay monthly premium)
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6
Q

Medicare Part C:

A

Medicare advantage- HMO has a contract with Medicare to provide services (ex. John Hopkins, University)

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7
Q

Medicare Part D:

A

Medication coverage

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8
Q

Medicaid:

A
  • Passed in 1965 under president Lyndon B. Johnson
  • Federal and State partnership
  • Covers income 20% federal poverty level
  • children and seniors
  • Adults with D children
  • Pregnant and severe disabilities
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9
Q

What are examples of DME?

A
  • Shower bench
  • Walker
  • Cane
  • Wheelchair
  • Hospital bed
  • Bedside commode
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10
Q

What is the Omnibus Budget Reconciliation Act (OBRA)?

A
  • Landmark Act of Congress
  • Focus on Elder’s Right
  • Focus on Quality of Care
  • Quality of Life in a Nursing Home
  • Initially went into effect 10/90
  • Revised in 1995
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11
Q

What is the Minimum Data Set (MDS)?

A
  • Screening tool
  • Strengthens/deficits recognized; OT can actively be involved in this
  • Process that covers many areas
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12
Q

Medical Model:

A
  • Individually based
  • Person enters the system when ill
  • Physician Referral Required/Team Leader
  • Services rendered in hospital/clinic or some other type of medical setting
  • Third Party Payer requirements
  • Reactive vs. Pro-active
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13
Q

Community Model:

A
  • Individually or grouped based
  • Focus is on the well population
  • Prevention is emphasized
  • Services are provided in the community ( examples: community center, shelter, church)
  • Variety of funding sources/ grant funding sought.
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14
Q

Medical Model:

A
  • Prof. Is responsible
  • Prof. Has power
  • Prof. Makes Decisions
  • Prof. Is the expert
  • Prof. Answers to the agency
  • Planning is fragmented
  • Culture is denied
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15
Q

Community Model:

A
  • Client is responsible
  • Client has power
  • Client makes decision
  • Client is the expert
  • Prof. Answers to the client
  • Planning is coordinated
  • Culture is appreciated
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16
Q

admission may be the result of an acute illness such as a CVA. Admission may be through the ER.

A

Acute care hospital

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17
Q

provides post acute care services

A

Transitional Care Units, Sub-acute units, (SNF),

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18
Q

Acute Rehab Setting UMROI or National Rehab Hospital(NRH)

A

Rehabilitation Units

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19
Q

services are provided in the person’s home

A

Home Health

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20
Q

(hospital based, free-standing setting, SNF, private practice)

A

Out-patient

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21
Q

illness is not responsive to curative treatment

A

Palliative Care

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22
Q

can be offered via hospitals, private agencies, religious groups.

A

Respite Care

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23
Q

Why the community?

A
  • Sense of familiar surroundings
  • Personal identity
  • Personal Control
  • Sense of Freedom
24
Q

any method (physical/chemical) of restricting an individual’s freedom of movement, physical activity or normal access to the body

A

restraint

25
Q

Chemical Restraint

A
  • A drug used to restrict a person’s movement or control their actions
  • Not a specific treatment for a person’s disease.
26
Q

Applying Restraints

A
  • Fasten ties so they can be released quickly in case of an emergency.
  • Always follow manufacturer’s instructions.
  • Protocol/Standards of Care should be developed for a specific condition or procedure. This should be used 100% of the time. If in place, a MD’s order is not needed. ( Example: Helmet used as a
    Protective device)
27
Q

cognitive disorders that can be caused by general medical conditions, head trauma, or the persistent effects of substance abuse

A

Dementia

28
Q

characterized by intellectual decline, disorganization of the personality and functional decline

A

Irreversible Dementia

29
Q

Symptoms of dementia:

A
  • Slow and progressive disease
  • Four stages on page 283 of AD
  • From the time of onset to death it could last approx. 10 –15 years. (Generally)
  • In the beginning , short term memory deficits noted with recent events
  • Difficulty with new learning
  • Impaired concentration
  • Decrease ability to mange self- care skills
  • As the symptoms progress , pt. can become bedridden.
  • Confabulation: reciting imaginary events to fill in gaps of memory
  • Impaired executive functioning: difficulty with abstract thinking; difficulty with planning ; and unable to sequence events
  • Memory ( Short-term)
  • Affects ability to remember old information ( retention and recall)
30
Q

Symptoms of Dementia continued:

A
  • Aphasia: language deficit ( receptive and an expressive component)
  • Inability to understand verbal/ written language.
  • Apraxia: inability to perform a task with intact motor/sensory systems. ( Motor Planning)
  • Agnosia: inability to recognize familiar objects.
31
Q

a term referring to intentional or negligent act by a caregiver or any person that causes harm or serious risk to a vulnerable adult

A

Elder abuse

32
Q

bodily harm, physical pain, hitting, slapping, kicking, burning

A

physical abuse

33
Q

unexplained venereal disease or genital infections, forced sex intimacy coerced nudity, photographs

A

sexual abuse

34
Q

upset/agitated, extremely withdrawn or non-communicative/non- responsive, verbal threats, intimidation, bullying, isolating from others

A

emotional/psychological abuse

35
Q

dehydration, malnutrition, untreated bed sores ,poor personal hygiene, untreated health issues; failure to provide basic needs ( food, water, medicine)

A

neglect

36
Q

sudden changes in bank account/bank practices, inclusion of names on accounts, unexplained transfers, unpaid bills despite the availability of adequate resources; misuse/steal a person’s funds, forgery, force an elder to sign over assets.

A

financial/material exploitation

37
Q

desertion of an elder at the hospital/SNF/public location, elders own report

A

abandonment

38
Q

dehydration, malnutrition, hazardous living conditions, inappropriate/inadequate clothing; person refuses to eat, take meds, drink fluids

A

self neglect/abuse

39
Q

OT role in elder abuse:

A
  • Report suspected abuse to the appropriated agency or department within your work organization.
  • Submit a written report
  • Adult Protective Services
  • Occupational Therapy Ethics (2000) – Principle one (1) and Principle (5) see article .
  • Advocate for your patient/client.
  • If possible connect with resources
40
Q

Older Americans Act: Title VII Vulnerable Elder Rights Protection:

A
  • When the act was re-authorized in 1992, Congress created and funded a new Title VII, Chapter 3 for prevention of abuse, neglect, and exploitation .
  • Provisions have been made for long-term care, ombudsman programs, and state legal assistance development.
41
Q

Physical Exam will show signs of abuse:

A
  • new injuries
  • poor pain management
  • poor hygiene
  • STD’s
  • bruises (especially UE)
  • fractures, dislocation, lacerations, burns
42
Q

What to observe for elder abuse:

A 
low self esteem
anxious
fearful
withdrawn
depressed
moodiness
suicidal thoughts expressed
* how elder responds to family member and caregiver
43
Q

Family Centered Approach:

A
  • This approach enables the family to take care of love one.
  • Greater therapeutic outcomes noted
  • This approach requires the OT practitioner to incorporate family education/training early in the intervention process.
  • Caregiver may be taught how to position the elder, P/ROM, assist with mobility skill,
    Transfer training, ADL training, and communication strategies.
  • The COTA may need to help identify community resources for the family.
  • Provide support to the caregiver to reduce caregiver stress.
  • COTA should function as facilitators, educators, and resource personnel.
44
Q

Tasks can be overwhelming:

A
  • Unfamiliar role
  • Role reversal – child taking care of parent
  • Difficult to meet the basic needs of the elderly
  • Provide socialization opportunities
  • Adult child may still be in workforce and raising children at home.
45
Q

Signs of caregiver stress:

A
  • deny the disease
  • anxiety about future
  • depression
  • exhaustion and sleepiness
  • irritability
  • lack of concentration
  • express anger that there is no effective tx for chronic illness
  • experience mental and physical health problems
46
Q

Ways to reduce caregiver stress:

A
  • diagnose stress early
  • take care of self
  • accept changes
  • don’t ignore behavior
  • become educated
  • know resources
  • legal’financial planning
  • respite/help
  • be realistic
  • manage stress with relaxation techniques
  • “give yourself credit, not guilt”
47
Q

Symptoms of Alzheimer’s Disease:

A
  • slow and progressive
  • from the time of onset can last 10-15 years
  • difficulty with new learning
  • impaired concentration
  • decreased ability to manage self skills
  • as symptoms progress pt can become bedridden
  • confabulation- reciting imaginary events to fill gaps of memory
  • impaired executive function- difficulty with abstract thinking, planning, and unable to sequence events
  • affects ability to remember/recall old info
  • Aphasia- language deficit
  • inability to understand verbal/written language
  • Apraxia- inability to perform task w/ intact motor/sensory systems (motor planning)
  • Agnosia- inability to recognize familiar objects
48
Q

What are the joint protection principles?

A
  • Respect for pain
  • Balance activity and Rest
  • Avoid activities which cannot be stopped
  • Use larger and stronger joints for activities
  • Avoid standing one position for long periods of time
  • Maintain or use your joints in good alignment
49
Q

What is the purpose for licensure?

A

to be able to practice/provide OT services

50
Q

Standard Precautions:

A
  • Wash hands before and after pts
  • Wear gloves
  • Wear mask, protective eye wear, and gown during splashes or sprays
  • Handle needles & other sharp instruments safely
  • Routinely clean and disinfect surfaces
  • Clean and disinfect linens & launder them safely
  • Place pts with contaminated blood or body fluids in an isolation room
51
Q

What i does GDS stand for?

A

Global Deterioration Scale

52
Q

provides caregivers an overview of the stages of cognitive function for those suffering from a primary degenerative dementia such as Alzheimer’s Disease

A

Global Deterioration Scale

53
Q

7 Stages of Dementia:

A

Stages 1-3: pre-dementia stages

Stages 4-7: dementia stages

54
Q

At what stage of dementia can a person no longer survive without assistance?

A

Stage 5

55
Q

7 Stages of Dementia

A 
Stage 1: No cognitive decline
Stage 2: Very mild cognitive decline
Stage 3: Mild cognitive decline
Stage 4: Mild dementia
Stage 5: Moderate dementia
Stage 6: Moderately severe dementia
Stage 7: Severe dementia

OCCUPATIONAL THERAPY (36 decks)

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