Older Persons CH.25

Question 1

how does one define QOL and concept of health?

Answer 1

• perception of their well-being and functional ability

Question 2

healthy older adult

Answer 2

engaged in ADLs

Question 3

What affects an older person’s susceptibility to “proper” aging (4)

Answer 3

-health
-lifestyle
-stressors
-environmental

Question 4

Common (“normal”) physiological changes with aging (system - 10)

Answer 4

-integumentary
-respiratory
-cardio
-GI
-MS
-Neuro
-GU
-Reproductive
-endocrine
-immune

Question 5

integumentary

Answer 5

• loss of skin elasticity
• fat loss in extremities
• pigmentation changes
• glandular atrophy
• thinning hair
• slow nail growth
• epidermal arteriole atrophy

Question 6

Resp

Answer 6

• decreased cough reflex + cilia
• increased chest diameter + rigidity
• few alveoli
• more airway resistance
• high risk of resp infections

Question 7

cardio

Answer 7

-thickened blood vessel walls + narrowed lumen
-lost elasticity
-lower cardiac output
-heart valve calcification
- more systolic BP (increased BP)
- less circulation

Question 8

GI

Answer 8

-periodontal disease (infection of the gums caused by plaque buildup
- less saliva + digestive enzymes
- slow peristalsis
- gastric atrophy
- increased stomach pH
- hemorrhoids
- impaired rectal sensation

Question 9

MS

Answer 9

-muscle mass loss
- bone decalcification
- joint degeneration
- dehydration of intervertebral disks
- increased fat tissue
- postural kyphosis

Question 10

Neuro

Answer 10

• nerve cell degen
• decrease NT
• slower nerve impulse conduction

Question 11

GU

Answer 11

-few nephrons
-50% decrease in renal blood flow by age 80
-decreased bladder
-Male: prostate enlargement
-Female: reduced sphincter tone

Question 12

Reproductive

Answer 12

• Male
  
  • lower sperm count
  • smaller testes
  • weaker erections
• Female
  -decreased estrogen
  
  • ovarian degen
  • vaginal/uterine/breast atrophy

Question 13

endocrine

Answer 13

• altered hormone production
• reduced stress response
• decreased thyroid secretions
• increased glucocorticoids
• pancreatic fibrosis
• reduced insulin sensitivity

Question 14

Immune

Answer 14

• thymus shrinks
• decreased T cell function
• lower core temp response

Question 15

Common (“normal”) physiological changes with aging (sensory- 6)

Answer 15

-eyes
-ears
-taste
-smell
-touch
-proprioception

Question 16

eyes

Answer 16

• presbyopia (ability to focus on close objects b/c less flexible lens)
• difficulty adjusting light/dark
• yellow lens
• altered colour
• perception
• glare sensitivity
• smaller pupils

Question 17

ears

Answer 17

• Presbycusis (high frequency hearing loss)
• thickened tympanic membrane
• inner ear sclerosis
• earwax buildup

Question 18

taste + smell

Answer 18

often diminished, fewer taste buds

Question 19

touch + proprioception

Answer 19

-decreased skin receptors
-reduced body position awareness

Question 20

functional status (older persons)

Answer 20

-capacity + safe performance of ADLs
-sensitive indicator of health/illness

Question 21

FANCAPES

Answer 21

-fluids
-aeration
-nutrition
-communication
-activity
-pain
-elimination
-socialization

Question 22

description of each element of FANCAPES

Answer 22

-fluids: assessing hydration + func capacity to obtain fluids
-aeration: assess O2 exchange, resp rate + breath sounds
-nutrition: ability to eat –> diet + oral health
-comm.: hearing, vision, comprehension
-activity: capacity to toilet, groom, ambulate + balance
-pain: physical, psychological/spiritual pain
-elimination: bowel + bladder
functioning
-socialization: relationships

Question 23

true or false: forgetfulness is an expected consequence of aging.

Answer 23

false

Question 24

what are abnormal cognitive changes

Answer 24

-disorientation
-loss of language skill
-loss of ability to calculate
-poor judgement

Question 25

common conditions affecting cognition (3)

Answer 25

delirium, dementia, depression

Question 26

delirium

Answer 26

- acute + sudden onset confusional state - potentially reversible - USUALLY physiological cause

Question 27

physiological causes of delirium

Answer 27

meds, dehydration, malnutrition, infection, pain, stress

Question 28

types of delirium (5)

Answer 28

-hypoactive -hyperactive -mixed -subsyndromal (only some symptoms present) -persistent (lasts longer than days + assoc w/more cog impairment + loss of functional ability

Question 29

dementia

Answer 29

umbrella term for disease that cause irreversible changes in brain

Question 30

types of dementia (5)

Answer 30

-alzheimers -lewy body -frontotemporal -Creutzfeldt-Jacob (CJD) -vascular

Question 31

how many older persons live with dementia in Canada? (%)

Answer 31

6.9%

Question 32

alzheimers cause

Answer 32

unknown

Question 33

alzheimers symptoms + progression

Answer 33

gradual and progressive -loss of memory -loss of ability to recognize objects + ppl (agnosia) -loss of ability to perform familiar tasks (apraxia) -loss of language skills

Question 34

Lewy Body cause

Answer 34

abnormal protein deposits in the brain

Question 35

Lewy Body symptoms

Answer 35

progressive -fluctuating cognition -visual/auditory hallucinations -motor symptoms like parkinson's disease

Question 36

frontaltemporal cause

Answer 36

degen of frontal + temp lobes

Question 37

frontaltemporal symptoms

Answer 37

-slow and progressive poor hygiene, lack of social awareness, compulsive behaviours (e.g. wandering), early incontinence

Question 38

CJD causes

Answer 38

infectious prions (abnormal proteins)

Question 39

CJD symptoms

Answer 39

-rapid + fatal rapid memory loss, movement + speech difficulties, sudden behaviour changes

Question 40

vascular cause

Answer 40

-reduced blood flow to brain (stroke, ischemia, hemorrhage)

Question 41

vascular symptoms

Answer 41

-stepwise decline (happens in a pattern of distinct, noticeable stages rather than gradual) or progressive -symptoms vary based on affected brain area

Question 42

depression

Answer 42

reduces happiness + well-being -contributes to physical + social limitations -complicates treatment of concomitant med conditions -increase risk of suicide

Question 43

what % of older persons drank more than the low-risk drinking recommendations in 2017?

Answer 43

9%

Question 44

true or false: from that statistic, men were 1.2 times more likely than women to drink heavily

Answer 44

true

Question 45

heavy drinking (men and women)

Answer 45

on occasion at least once a month: 5+ drinks men 4+ drinks women

Question 46

patterns of alcohol addiction in older persons (2)

Answer 46

1. lifelong pattern of frequent heavy drinking 2. late-onset pattern (heavy drinking occurs late in life)

Question 47

frequent causes of excessive alcohol use (3)

Answer 47

-depression -loneliness -lack of social support

Question 48

what is sub use associated with?

Answer 48

chronic health challenges

Question 49

when should alcohol dependence be suspected?

Answer 49

-repeated history of falls + accidents -change in behaviour/personality -socially isolated -memory loss + confusion -history of skipping meals/meds -can't manage household tasks + finances

Question 50

older persons are a risk for ________________________ because of age-related changes in pharmacokinetics

Answer 50

adverse reactions

Question 51

true or false: sedatives and tranquilizers prescribed for acute confusion can cause or make confusion worse in an older adult.

Answer 51

true

Question 52

in what situation of confusion can nonpharmacological measures be used?

Answer 52

when confusion varies by time of day and related to enviro factors - e.g. can change environment to include familiar things