Older Adults

Question 1

The young old:
The middle old:
The old old:
The elite old:

Answer 1

The young old: 65 to 74 years of age
The middle old: 75 to 84 years of age
The old old: 85 to 99 years of age
The elite old: 100 years of age or older

Question 2

Most older adults need an increased dietary intake of …

Answer 2

vitamins D, C, and A and an increase in calcium

• Vitamin D and calcium are essential components of bone health.

• Taste buds change with age, and older adults may use more salt or sugar to add more flavor
• Many older adults have dentures, and poor dentition affects nutritional intake

Question 3

What aging factors increase fall risks

Answer 3

Changes in Reaction Time and Balance
Changes in Vision
Changes in Sensation and Perception
- decreased awareness of body orientation
- declining thermoregulation.
- Older adults cannot conserve heat or dissipate heat as well as younger adults can; as a result, they are more at risk for hyperthermia and hypothermia.

Question 4

Agining on Medication use

Answer 4

half-life of many drugs is increased in older adults, which can lead to an increase in side effects and a greater risk for toxicity

Question 5

Most older adults administer their own medications. This can lead to errors.

Answer 5

Older adults may forget to take the drug as prescribed.
They may not be able to see the drug bottle clearly.
They may not have heard (due to alterations in hearing) or clearly understood the provider instructions regarding the medication.
They may not be able to afford all their medications, so they are selective about which drugs they take.

Question 6

Five risks of older adults in a rural community

Answer 6

Limited transportation
Limited supply of health care workers
Lack of health care quality
Social isolation
Financial limitations

Question 7

Oral nutrition with old age

Answer 7

Assess the oral cavity, focusing on dentition.
Ask about changes in taste and dental hygiene practices.
Assess for fit of the dentures to the gumline and irritation of the gums.
Older adults should be reminded to seek routine dental care.
Changes in mobility and dexterity can affect an older adult’s ability to brush his or her teeth well.

Question 8

What scale is used to help identify older adults with depression.

Answer 8

Geriatric Depression Scale—Short Form
A score >5 points is suggestive of depression.

A score ≥10 points is almost always indicative of depression.

A score >5 points should warrant a follow-up comprehensive assessment.

Question 9

Confusion Assessment Method (CAM).

Answer 9

screen for delirium

1. Acute onset and fluctuating course (e.g., Is there evidence of an acute change in mental status from the patient’s baseline?)
2. Inattention (e.g., Does the patient have difficulty focusing attention or keeping track of what is being said?)
3. Disorganized thinking (e.g., Is the patient’s thinking and conversation disorganized or incoherent?)
4. Altered level of consciousness (e.g., Is the patient lethargic, hyperalert, or difficult to arouse?)

Question 10

Beers Criteria

Answer 10

The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults is an evidence-based list of medications that are generally avoided in the older adult patient \

Examples of medications included on the Beers Criteria include meperidine, promethazine, cyclobenzaprine, digoxin, ticlopidine, diazepam, and ketorolac.

Question 11

Medication safety questions

Answer 11

Do you take more than five prescription medications?
Do you take over-the-counter (OTC) medications?
Do you get all your medications from the same pharmacy?
How many health care providers prescribe medications for you?
Do you have trouble seeing or opening your medication?
Do you always remember to take your medication?

Teach the patient and caregiver to keep a current list of all medications and to share the list with each health care provider.
Encourage the patient to use the same pharmacy for all medications because the pharmacist can often detect potential drug interactions.
Provide verbal and written information regarding new medication. Use the teach-back method, encouraging the older adult or caregiver to verbalize the teaching.
Remind older adults never to share or borrow medications.
Teach patients to take all medication exactly as prescribed. Encourage the patient to call the provider before changing medications.
Provide suggestions for reminders for medication. Pill planners work well for some patients. Newer electronic devices can be programmed to verbally remind patients.