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UNIT 3 - Older Adults > UNIT 3 - Older Adults > Flashcards

UNIT 3 - Older Adults Flashcards

1
Q

What does FOOSH stand for?

A

Fall On An Outstretched Hand

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2
Q

What are intraarticular fractures?

A

Injury to the cartilage of the joint causing additional pain and stiffness.

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3
Q

• What is a Colles fracture?

A

A dorsal displacement and angulation of the distal radius.

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4
Q

Which movements at which joints are likely to have limitations from a Colles fracture?

A

Limited wrist (radio-carpal joint) flexion and extension as well as pronation and supination.

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5
Q

What is the most common cause of death by injury in over 65.

A

Falls

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6
Q

List some risk factors of falls

A

Medical conditions, prescribed medicine, physiological changes, environmental hazards, lifestyle (alcohol, physical activity).

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7
Q

Define Fall.

A

An event which results in a person coming to rest inadvertently on the ground or floor or other lower level. (WHO 2007, p1)

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8
Q

Fall risk factors can be divided into three categories…

A

Intrinsic (Person)
Extrinsic (Environment)
Behavioural (Occupational)

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9
Q

List conditions that are associated with having a higher incidence of falls

A
  • Balance/mobility issues.
  • Frailty
  • End of life care.
  • Neurological conditions such as stroke, Parkinson’s disease, multiple sclerosis.
  • Conditions associated with learning disabilities.
  • Mental health issues
  • Visual impairment.
  • Dementia/delirium.
  • A transition (bereavement, house move or move from/to home, hospital, care homes).
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10
Q

Define ageing

A

The accumulation of deleterious changes in the physiology and their manifestation, which occur from the time of conception until death.

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11
Q

What are the causes of age-related changes in CNS?

A
  1. Molecular changes in cell body (Changes in replication of essential molecules needed for repair and regeneration (RNA)).
  2. Changes in cell structure
  3. Changes in CNS biochemical environment
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12
Q

What happens to the CNS dendrites and myelination of neurons, how does this effect neural transmission?

A

Decrease in dendritic density (thinning) & increase in width of synaptic gaps due to shrinking. Less free branches to connect with and greater synaptic distance to travel. Loss or thinning of CNS myelin can lead to inefficient neural transmission

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13
Q

Specific loss of D______ neurons in the substantial nigra and locus coeruleus leads to P_______ symptoms (without having P____)

A

A) dopaminergic
B) Parkinsonian
C) Parkinson’s

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14
Q

List three age related changes in the CNS

A
  • Brain mass decreases with ages
  • Cell death or atrophy
  • Loss is not uniform across all brain areas
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15
Q

Changes to CNS effect on .. Motor control

A
  • Speed of visual information processing is reduced affecting hand-eye coordination.
  • Decrease in hand dominance.
  • Performance decreases on tasks requiring manual dexterity.
  • Bimanual movement performed more slowly.
  • “Later-learned” skills are more affected.
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16
Q

Changes to CNS effect on ..Vision

A
  • Changes shape in the eye and capacity of the lens.
  • Changes to retina (loss of cells, slower recovery rate after firing).
  • Reduced of variable optic nerve fibres.
  • Reduced efficiency in perceptual processing
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17
Q

Changes to CNS effect on .. Hearing

A
  • Loss of sensitivity in upper range frequencies (cell loss in inner ear).
  • Change in vestibular function due to cell loss (in semi-circular canal).
  • Impairment of discrimination in speech sounds (phonemes) in auditory cortex.
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18
Q

Changes to CNS effect on Taste and smell

A
  • Loss of discrimination for tastes and smell
  • Increased threshold for perception of taste and smells (increased amount of the same flavour to taste it).
  • More rapid fatigue of CNS olfaction cells
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19
Q

Changes to CNS effect on Memory

A
  • General decline in memory function
  • Decline in ability to perform tasks requiring sustained attention.
  • Decline in performance for tasks requiring rapid decisions or changes in task strategy.
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20
Q

Short term memory deteriorates due to ….

A

Changes in replication of essential molecules needed for repair and regeneration.

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21
Q

What are the two types of Long Term explicit Memory? Where in the brain does this occur?

A
  • Episodic memory (autobiographical; memory for personal life events; organised around landmark events) (Cortex, medial temporal lobe, hippocampus))
  • Semantic memory (general information and language knowledge)(Cortex, medial temporal lobe, hippocampus)
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22
Q

What are the two types of Long Term implicit Memory?

A

Implicit memory

  • Procedural memory (skills, action sequences) (Cerebellum, Striatum, Putamen)
  • Associative and non-associative learning (reflexive behaviours)
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23
Q

What are the aged, related changes for memory?

A
  • Memory decline is observed from 50 years +
  • Every from of memory is affected, mostly prospective memory
  • Episodic memory is less affected
  • Semantic memory most resilient
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24
Q

True or false - Ageing is an abnormality/disease

A

False

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25
Q

Ageing is a major risk factor for disease leads to RE, increased V to D and HB

A

reduced efficiency, increased vulnerability to disease and homeostatic breakdown.

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26
Q

How is efficiency reduced?

A

Reduced capacity to respond to threats, accumulation of damage and exposure to risk over many years and reduced homeostatic resilience.

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27
Q

Increase in cardiovascular disease and high blood pressure increases the risk of…

A

Myocardial infractions
Stroke
Kidney disease.

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28
Q

What happens to the blood valves and vessels during cardiovascular disease?

A

Thickening

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29
Q

Osteoporosis

A

Build up resources of bone density during younger years through diet. Can impact the thoracic cavity (breathing), hyperextension of cervical spine (interfere with spinal nerves).

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30
Q

Why is the prevalence of osteoporosis

A

Menopause

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31
Q

Diabetes definition

A

Defects in insulin secretion and insulin action (either of which may be the main feature) and liver glucose production result in the high blood glucose.

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32
Q
A 
Crumbling of the spine,
kyphosis, 
loss of height, 
restrictions respiration, 
nerve complications (compress spinal or peripheral cord), 
restricted mobility, 
falls/fractures, 
pain 
depression
inactivity
33
Q

Explain the two subtypes – amnestic and non-amnestic MCI

A
  • AMCI – single domain (episodic memory only) or multiple domain (memory +).
  • NAMCI- Single or multiple domain but memory is unimpaired.
34
Q

Define Metabolic syndrome

A

Metabolic syndrome is the presence of three or more of the following conditions: abdominal obesity (>102cm/>88cm), raised triglycerides, raised LDL, raised BP> 135/85, raised fasting glucose (insulin resistance)

35
Q

Define Multi-morbidity

A

•A person has multi-morbidity also known as comorbidity when they are diagnoses or display two or more concurrent chronic conditions.

36
Q

Define Frailty

A

A state of increased vulnerability to stressors due to age-related decline in physiological reserves across multiple systems which can be identified by symptoms such as weight loss, slow gait speed, very low energy expenditure and disability

37
Q

What are risk factors for healthcare/hospital admissions for the elderly?

A
  • Lack of physical activity (e.g. bedbound)
  • Malnutrition and dehydration (May not eat and drink due to pain)
  • Bone and muscle loss due to issues stated above
  • Cardiac deconditioning due to sedentary living
  • Disempowerment, disengagement, loss of control and autonomy due to hospital rules and recommendations by staff.
38
Q

List lifestyle changes we can make to prevent/reduce poor health in older age:

A
  • Functional rehabilitation ‘post event’ (and pre-op prep)
  • Restorative/re-enablement approaches to home care provision for older adults.
  • Life course approach – education and support for healthy lifestyle choices of all ages/life stages.
  • Early intervention for those ‘at risk’.
  • Interventions to minimise deconditioning and maintain occupational engagement in hospital.
39
Q

Why should we promote physical activity?

A
  • Can reduced or reverse the metabolic syndrome – reduced Triglyceride levels, reduce hypertension through improved CV health and reduce insulin resistance.
  • Slows sarcopenia & bone loss
  • Promotes angiogenesis
  • Promotes release of neurotrophic factors - enhance cognitive function.
40
Q

Briefly explain COPM?

A
  1. Problem definition
  2. Rating importance (1-10)
  3. Selecting Problems for scoring (Identifying the importance)
  4. Scoring Performance and satisfaction.
  5. Client reassessment – Self rate performance and satisfaction for problems addressed.
41
Q

Which ICF component is assessed during MOCA?

A

Body function (Mental-Memory function).

42
Q

MoCA Assessment area example: Difficulties accurately planning what is needed to knit a scarf.

A

Visuospatial/Executive

43
Q

MoCA Assessment area example:

Struggling to keep up with conversation at the local support group.

A

Naming

44
Q

MoCA Assessment area example:

Not turning up for routine doctors’ appointments aimed to monitor a health condition.

A

Memory

45
Q

MoCA assessment area example:

Leaving meal preparation incomplete and moving on to a different task.

A

Attention

46
Q

MoCA assessment area example:

Struggling to find right words for required items when buying items from a local shop

A

Language

47
Q

MoCA assessment area example:

Difficulties having a conversation with grandson as he uses a lot of idioms (e.g Takes two to tango).

A

Abstraction

48
Q

MoCA assessment area example:

Does not remember if already had a meal today.

A

Delayed recall

49
Q

MoCA assessment area example:

Getting confused and not being able to return home independently after going to see a friend locally.

A

Orientation

50
Q

What are the limitations of the MOCA?

A
  • Anxiety and self confidence
  • Memory recall would be challenge
  • Orientation
  • Attention going backwards
  • New challenges may not be able to complete.
  • Blindness (removal of top 3 tasks)
  • Elderly – hearing and vison
  • Fine motor skills
51
Q

Define dementia

A
  • Dementia is a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological ageing.
52
Q

Early signs of dementia.

A

Forgetfulness, Changes in behaviour (unexplained), Not completing tasks, Depression & New surrounding provides new challenges, , decreased short-term memory, decreased problem-solving skills, decreased perceptual skills, problems with communication and language, and personality changes

53
Q

Assessment tools in dementia care

A

– Large Allen’s cognitive Level screen (LACLS), Assessment of motor and process skills (AMPS), Canadian occupational performance measure, pool activity level instrument (PAL)

54
Q

Define - Arousal and orientation.

A

The level of stimulation required to elicit different level response from a patient.
Tested - Passive observation are better when assessed by spontaneous engagement, MOCA – time, location, person, or situation

55
Q

Attention, working memory, processing speed, and psychomotor function

A

Attention - condition of readiness for such attention involving especially a selective narrowing or focusing of consciousness and receptivity
Tested - Formal Mental status assessments, response speed to questions, gait, posture, facial movements.

56
Q

Executive function

A

Cognitive tasks that controlled by frontal lobes of the brain which includes cognitive abilities such as planning organisation, inhibition, shifting from one task to another, fluency and abstract reasoning.
Tested - MoCA, ACE-R, Clock drawing task, Mini mental state examination

57
Q

Language

A

Is the ability to process and understand written, spoken along with verbal and nonverbal communication. Aspects of language to be consider are fluency, comprehension, reading, writing, repeating and naming.
Tested: MoCA, ACE-R,

58
Q

Visuospatial function

A

The ability to identify integrate and analyse space and visual form, details and structure and spatial relations in several dimensions with an awareness and mental imagery of the distance, size, depth, and movement of that space.
Tested - showing a patient a picture and asking them to describe what they see. Imitating finger locking patterns made by an examiner

59
Q

Memory function

A

Memory is the capacity to form, store and retain information and experiences that can be recalled upon.
Tested - Episodic memory can be passed by asking the patient about recent events in the news/specific interests/family events.

60
Q

Define Cancer

A

When abnormal cells divide without control, creating malignant tumours

61
Q

Cancer risk factors?

Can result in?

A

Smoking, Diet, Alcohol, UV radiation ionising radiation, HRT, DES, Genetics

Pain, loss of independence, difficulty walking, reduced QoL

62
Q

Dementia definition

A

Umbrella term for signs and symptoms of degeneration/death of braincells

63
Q

Define depression.

A

A type of mood disorder.

64
Q

Risk factors of depression.

A

Often overlaps with dementia (both can cause each other)

Can also be linked to physical illnesses, Family history of depression, Poverty , Social isolation, Moving to residential care, Retirement, Bereavement

65
Q

Depression can result in?

A 
Loss of concentration and attention 
Loss of energy, psychomotor retardation 
Sleep disturbance. Feelings of guilt. 
Feelings of sadness and hopelessness. 
Suicidal thoughts or impulses 
Psychosomatic symptoms 
Memory problems.
66
Q

Define diabetes

A

Diabetes is having too much sugar (glucose) in your blood. This happens when there is not enough insulin in your body. Insulin is a hormone, produced by the Pancreases, which lets sugar into your cells from your blood to be used as energy

67
Q

Define diabetes

A

Diabetes is having too much sugar (glucose) in your blood. This happens when there is not enough insulin in your body. Insulin is a hormone, produced by the Pancreases, which lets sugar into your cells from your blood to be used as energy

68
Q

Diabetes can result in?

A

Angina, heart attack, stroke, blindness, loss of limb, nerve damage

Deteriorating vision – retina damage, kidney disease, loss of and abnormal sensation
Angina, heart attacks, stroke, ulcers and ganger exercise limiting pain can make them more sedentary and cause muscle loss and bone density loss.

69
Q

Fall definitions

A

A fall is defined as unintentionally coming to rest on the ground or a lower level – not as a result of an intrinsic event such as syncope or stroke or because of an extrinsic environmental hazard (Tinetti et al. 1988).

70
Q

Risk factors of falls…

Falls results in..

A

Age, Fall history, Muscle weakness. Mobility and gait impairment. Balance impairment. Fear of falling. Limitations in everyday activity. Visual impairment, Cognitive impairment, Depression
Musuloskeletal problems

Injury, hypothermia, pressure sore, reduced mobility, fear of falling, loss of self-efficacy, May require carers or support to complete ADLS, MAY reduced everyday activities.
Poor recovery

71
Q

Fracture definition

A

Partial or complete break in bone

72
Q

Osteoporosis definition:

A

Accelerated bone loss above that of the usual ageing process causing bones to become weak = increases risk of fractures

73
Q

Risk factors of fractures/osteoporosis…

Fractures/osteoporosis can result in…

A

Gender (women), Ethnicity (white/Asian), Decline in testosterone/oestrogen, Low body weight, Smoking, Lack of vitamin D, Lack of calcium

Increases tendency to fall. , Reduce mobility, Delayed recovery – mortality and fractures/hip fractures, May require care for ADL’s

74
Q

Heart failure

A

When heart unable to effectively pump blood. Chronic condition

75
Q

Learning difficulties and ageing

A

Decline in physical factors which result from aging, can make issues of learning difficulties greater

76
Q
A

A degenerative disease and was the
natural consequence of ageing and trauma, but it is now viewed as a metabolic,
fundamentally reparative process

77
Q

Respiratory disease

A

Overarching term for issues with respiration

78
Q

Definition of stroke.

A

Rapidly developing clinically signs of focal disturbance lasting 24 hour or more, leading to death of brain cells

UNIT 3 - Older Adults (1 decks)

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