T4: Older adults Flashcards
teaching strategies for those diagnosed with dementia (4)
- Provide education and support early to prepare for future events
- Encourage families and caregivers to work together
- Educational programming should be culturally sensitive
- Use technology to reach out to families; Zoom, skype, or facetime
teaching strategies for older adults (8)
- Ensure the patient is ready to learn; Be alert for cues of pain and fatigue
- Create a comfortable environment
- Adapt teaching materials for culture, language, and health literacy
- Focus on concrete information about the topic and relate to past experiences as appropriate
- Use printed materials with large black font on either cream or white paper
- Use clear, concise language; avoid medical terminology
- Use pictures, demonstrations, videos, and other methods to augment spoken language
- Allow the patient time to process information and ask questions
how to evaluate education of older adults
teach-back
common physiological changes with age assessment
SPICE
- sleep disorders
- problems with eating or feeding
- incontinence
- confusion
- evidence of falls
- skin breakdown
common changes to integumentary system with age (6)
-Loss of skin elasticity with fat loss in extremities
-Pigmentation changes
-Glandular atrophy; Oil, moisture, sweat glands
-Thinning hair/ hair turning gray-white
Men: facial hair decreases
Women: facial hair increases
-Slower nail growth
-Atrophy of epidermal arterioles
common changes to respiratory system with age (4)
- Decreased cough reflex and ciliary activity
- Increased anterior-posterior chest diameter
- Increased chest wall rigidity
- Few alveoli, increased airway resistance
common changes to cardiovascular system with age (8)
- Thickening of blood vessel walls
- Narrowing of vessel lumen -Loss of vessel elasticity
- Lower cardiac output
- Decreased number of heart muscle fibers
- Decreased elasticity and calcification of heart valves
- Decreased baroreceptor sensitivity
- Decreased efficiency of venous valves
- Increased pulmonary vascular tension
- Increased systolic blood pressure
- Decreased peripheral circulation
common changes to gastrointestinal system with age (10)
- Periodontal disease
- Decrease in saliva, gastric secretions, and pancreatic enzymes
- Smooth muscle changes with decreased peristalsis and small intestinal motility
- Gastric atrophy
- Decreased production of intrinsic factor
- Increased stomach pH
- Loss of smooth muscle in the stomach
- Hemorrhoids
- Rectal prolapse
- Impaired rectal sensation
common changes to musculoskeletal system with aging (5)
- Decreased muscle mass and strength
- Decalcification of bones
- Degenerative joint changes
- Dehydration of intervertebral disks
- Fat tissue increases
common changes to neurological system with aging (3)
- Degeneration of nerve cells
- Decrease in neurotransmitters
- Decrease in rate of conduction of impulses
common changes to eye site with aging (6)
- Decreased accommodation to near/far vision (presbyopia)
- Difficulty adjusting to changes from light to dark
- Yellowing of the lens
- Altered color perception
- Increased sensitivity to glare
- Smaller pupils
common changes to hearing with age (4)
- Loss of acuity for high-frequency tones (presbycusis)
- Thickening of tympanic membrane
- Sclerosis of inner ear
- Build up of earwax (cerumen)
changes to taste with aging (2)
- Often diminished
- Often fewer taste buds
changes to smell with aging
often diminished
changes to touch with aging
decreased skin receptors
changes to proprioception with aging
decreased awareness of body positioning in space
changes to genitourinary system with aging (5)
- Fewer nephrons
- 50% decrease in renal blood flow by age 80
- Decreased bladder capacity
- Males have enlargement of prostate
- Females have reduction of sphincter tone
male reproductive changes in older adults (3)
- Sperm count diminished
- Smaller testes
- Erections less firm and slow to develop
female reproductive changes in older adults (4)
- Decreased estrogen production
- Degeneration of ovaries
- Atrophy of vagina, uterus, and breasts
- Dryness of vaginal mucosa
change to general endocrine system of older adults
§ Alterations in hormone production with decreased ability to respond to stress
change to thyroid of older adults
Diminished secretions
change to cortisol, glucocorticoids of older adults
Increased anti-inflammatory hormone
changes to pancreas in older adults (3)
- Increased fibrosis
- Decreased secretion of enzymes and hormones
- Decreased sensitivity to insulin
changes to immune system of older adults (3)
- Thymus decreases in size and volume
- T-cell function decreases
- Core temperature elevation is lowered
standard assessment forms for determining a patient’s mental status (3)
- mini mental state exam 2 (MMSE-2)
- mini-cog
- clock drawing test
three common conditions affecting cognition
- delirium
- dementia
- depression
acute confessional state
delirium
delirium is characterized by
§ acute change in attention and awareness that develops over a relatively short time interval
delirium is associated with additional cognitive deficits such as:
- memory deficit
- disorientation
- perceptual disturbances
delirium occurs in ______% of patients
20-70%, very common
characterized by agitation, restlessness, emotional lability, and psychotic features such as hallucinations and illusions that often interfere with the delivery of care
hyperactive delirium
T/F: It is possible for delirium and dementia to occur at the same time
true
generalized impairment of intellectual functioning that interferes with social and occupational functioning
dementia
dementia is characterized by
gradual, progressive, and irreversible decline in cerebral function
dementia behaviors are expressions of an unmet need, including (4)
hunger
pain
anxiety
void/defication
person centered care of person with dementia
- Know the person as an individual
- Recognize and accept the person’s reality, don’t try to reorient the person
- Support opportunities for meaningful interactions
- Nurture authentic, caring relationships
- Maintain a supportive community for the person with dementia, the person’s family, and staff
most common, yet most undetected and untreated, impairment in older adulthood
depression
scale used to screen for depression in older adulthood
geriatric depression scale
geriatric depression can be treated with
medication, psychotherapy, or both
sometimes used for treatment of resistant depression
electroconvulsive therapy
highest suicide rate of any age-group
85 and older
T/F suicide attempts in older adults are often successful
true
Healthy People 2030 objectives for older adults
- general health
- dementia
- foodborn illness
- injury prevention
- oral conditions
- osteoporosis
- respiratory disease
- sensory or communication disorders
health people 2030: general health
- Improve physical activity for older adults with physical or cognitive health problems
- Reduce rate of pressure injuries during hospitalization
- Reduce hospital admissions among older adults with diabetes
health people 2030: dementia
- Improved awareness
- Prevention of hospitalizations
health people 2030: food borne illness
- Reduce infections caused by Listeria
- Reduce rate of hospital admissions for UTIs
health people 2030: injury prevention
- Reduce fall-related deaths
- Reduce the proportion of older adults who use inappropriate medications
- Reduce emergency department visits due to falls
health people 2030: oral conditions
Reduce the proportion of older adults with untreated root surface decay, loss of all teeth, and moderate and severe periodontitis
health people 2030: osteoporosis
- Reduce hip fractures among older adults
- Increase the proportion of older adults who get treated for osteoporosis after fractures
health people 2030: respiratory disease
Reduce the rate of hospital admissions for pneumonia and asthma
health people 2030: sensory or communication disorders
Reduce vision loss from age-related macular degeneration
barriers for older adults (7)
- Previous health care experiences
- Personal motivation
- Health beliefs
- Culture
- Health literacy
- Transportation
- Finances
all physiological concerns of older adults (12)
Heart disease Cancer Chronic lung disease Stroke Smoking Alcohol abuse Nutrition Dental problems Exercise Falls Sensory impairment Pain Medication use
leading causes of detain in older adults
heart disease and cancer
3rd leading cause of death in older adults
COPD
4th leading cause of death
stroke
risk factor associated with top 4 leading cause of deaths in older adults
smoking
communication technique that makes an older adult more aware of person, place, and time
reality orientation
alternative approach to communication with an older adult who is confused by accepting the description of time and place as stated by the older adult
validation therapy
method or technique to recall past memories
reminiscence
two types of restorative care
- continuation of recovery from acute illness or surgery that began in the acute care setting
- Support of chronic conditions that affect day-to-day functioning
complex, multifaceted, and encompasses a broad range of abuses of older adults
elder mistreatment
occurs when older adults experience illness, pain, or injury as the result of physical force or the threat of physical injury
physical abuse
verbal and nonverbal behaviors that inflect mental pain, anguish, fear, and distress
Psychological and emotional abuse
illegal taking, misuse, or concealment of money, benefits, property, or assets belonging to an elderly person
financial abuse
nonconsensual sexual contact or activity of any kind’ coercing an elder to witness sexual behavior
sexual abuse
refusal or failure by those responsible to meet basic needs
neglect
most perpetrators of elder abuse are:
family caregivers
