the geriatric patient p 2 Flashcards
what are the 6 key psychosocial factors
- sociodemographic characteristics
- environmental resources and constraints
- psychological influences
- Health behaviors
- Biological Pathways
- Quality of life
what are the psychosocial factors
- social resources
- psychological factors
- psychological risk factors
what psychosocial factors can have a negative impact
- depression
- dissatisfaction with life
- lack of support
what psychosocial factors can have a positive impact
- social engagement (volunteering, lifelong learning, intergenerational programs)
- social environment promoting aging in place
- aging services
- hospice
what may be the cause of late life depression
inflammatory and hormonal abnormalities
What is the cause of sleep disturbances in older adults
decline in melatonin secretion from the pineal gland at night
what is the cause of limitation in activities and social interaction
- decline functional status of organ systems
- reduced vision
- reduced hearing
what may prevent dementia?
purposeful efforts at social engagement may help by maintaining brain cellular integrity before gross atrophy sets in
what are the 7 key components to successful geriatric best practice models
- Enable older adults to remain safely at home
- Prevent functional disability
- Preserve patient quality of life
- Respect patient values, preferences and goals
- Consider patient safety
- Address the needs of family caregivers
- Appreciate and address patient’s psychosocial needs
THIS HAD A COMMET ON IT SO I ASSUME ITS IMPORTANT
what are the three main differences between rural and urban aging
- Rural elders have high rates of disability and poverty, thereby increasing their risk for adverse health outcomes.
- The need for geriatric health care providers in rural areas is very great. This is especially true for those with multiple chronic conditions.
- The federal government, to increase the access to care for rural elders, has created several special programs.
what is CBLTSS
Community based long term services and support
is CBLTSS effective
the slide says:
“Innovative care delivery models funded by the Center for Medicare and Medicaid Innovation (CMMI) hold promise for improving health outcomes and controlling costs.”
sooooo i assume yes
what is the goal of the CBLTSS services?
to keep people living longer, healthier lives.
(said in class)
Who is qualifiable for CBLTSS?
- people living in assisted living facilities (ALFs), sheltered housing, and group homes
- older adults who carry privately funded LTC insurance
- Ultimately, many people exhaust their retirement savings and home equity to pay for LTSS, becoming eligible for Medicaid through this “spend-down” process
what are the 9 forms of CBLTSS
- intermittent assessment and monitoring over time that entails temporary or permanent changes in location of care
- preventative home visits
- home based geriatric assessments
- adult day care
- PACE (program of all inclusive care for the elderly)
- assisted living
- sheltered housing
- adult foster care
- group homes
what is the main form of CBLTSS
- continuing care retirement communities (CCRCs)
- this is a fully independent older adult living in a single family home or apartment
what kind of model is a CBLTSS
Life care at home model
what is unskilled care?
services provided by unpaid caregivers
what percent of home care and CBLTSS services are provided by unskilled care?
66-92%
what is skilled home health care
formal services delivered by professional providers, such as nurses or physical, occupational, or speech therapists.
who provides skilled home health care
Medicare certifies and reimburses home health care agencies (HHAs) to provide this type of care when a patient is homebound and has a skilled need.
HHAs may also provide formal personal care services (bathing, dressing, etc.) under the Medicare home health care benefit while a patient is receiving skilled care.
what are the two formal home-based medical care models?
- Home-based primary care model
- hospital-at-home model
what are the three high points of Home-Based primary care models
- Physicians, PAs and NPS provide ongoing longitudinal medical care at home
- Can play an important role in providing access to routine and urgent care for older adults who have difficulty getting to a medical office
- Home-based primary care programs have been increasing in prevalence in recent years and have been shown to be effective
what are the 3 high points of hospital-at-home model
- An emerging care model that provides hospital-level care in a patient’s home
- Substitutes for an acute hospital admission
- Has been shown to be associated with better care quality and lower costs than typical hospital care
How do the HHA (health care agencies) asess a patients need for care?
The HHA must catalog each patient’s medical, functional, and socioeconomic characteristics in the Outcome and Assessment Information Set (OASIS)
what is a consumer-directed or cash and counseling model?
allows selected patients to choose, train, and pay their personal care providers directly with designated state funds (usually from Medicaid programs).
care providers in these programs can be family members or other previously unpaid caregivers.
what are the recent technology and social advances in health
- Telemedicine
- Point-of-care diagnostic and therapeutic technology
- Social, medical, and financial support
- Care Management for High-Cost Beneficiaries (CMHCB)
what are the emerging models of CBLTSS
- Physician house calls
- Team-based primary care coordination
- Population-based pay-for-performance
- The current fragmented system of CBLTSS will be untenable in the coming years as the number of older adults with complex multimorbidity and functional disability increases.
oml this test is gonna be interesting… flip for doggo!!!
