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Psych of Adulthood and Aging 319 200 > Unit 4 > Flashcards

Unit 4 Flashcards

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1
Q

Institutional Facility

A

Group residential setting that provides medical or psychiatric care

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2
Q

Long-Term Care Process

A

-O-A lives on their own, or in group setting(assisted living facility)
*They receive homecare.
-acute health event (such as broken hip or stroke) may require hospitalization.
*acute rehab facility and either return home or to the assisted living facility.
-More care needed, a nursing home

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3
Q

Nursing Home

A

Medical institution provides a room, meals, skilled nursing and rehabilitative care, medical services, and protective supervision.
-treatment for cognition, communication, hearing, vision, physical functioning, continence, psychosocial functioning, mood and behavior, nutrition, and dental care
-Medication taking
-feeding and mobility, rehabilitative activities, and social services
-State and federal certified

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4
Q

Skilled Nursing Facility

A

Nursing home provides intensive nursing care available outside hospital
-apply dressings or bandages, help residents with daily self-care tasks, and provide oxygen therapy.
-Taking vital signs, temperature, pulse, respiration, and blood pressure

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5
Q

Intermediate Care Facility

A

Health-related services for those who do not require hospital or skilled nursing facility care
-health and rehabilitative services, food, but do not have intense nursing care services available

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6
Q

Common diagnosis among nursing home residents

A

Hypertension, followed by neurocognitive disorder and depression.

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7
Q

Residential Care Facility

A

24-hour supportive care services and supervision for those who don’t require skilled nursing care.
-Meals, housekeeping, and assistance with personal care such as bathing and grooming.
-Management of medications and social and recreational activities.

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8
Q

Board and Care Home

A

For those who cannot live on their own in the community and need nursing services.
-help with ADLs

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9
Q

Assisted Living Facilities

A

O-A live independently in their own apartments.
-Regular monthly rent, usually includes meal service in communal dining rooms, transportation for shopping and appointments, social activities, and housekeeping services.

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10
Q

Aging in place

A

O-A live in their own homes, or at least in their own communities, with appropriate services

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11
Q

Home Health Services

A

assistance to O-As within their residences
-Meals on Wheels
-friendly visiting
-Shopping assistance, light house keeping
-PT, speech therapy, occupational therapy, rehabilitation, and interventions targeted at particular areas of functional decline

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12
Q

Pros & Cons of HHS

A

Pro:
-O-A can stay home
-CG can work to maximize independence
Con:
-CG is not a RN
-No heavy maintenance or bill paying

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13
Q

Geriatric Partial Hospital

A

O-As living in the community provided psychiatric care with a range of mental health services

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14
Q

Adult Day Services

A

O-A assistance or supervision during the day in a setting that is either attached to another facility, such as a nursing home, or is a standalone agency
-Medication management, physical therapy, meals, medical care, counseling, education, and opportunities for socialization.

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15
Q

Respite Care

A

Provides family CG a break while allowing the O-A to receive support

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16
Q

Government-Assisted Housing

A

Housing for those with low-to-moderate incomes who need affordable housing or rental assistance.
-Apartment complexes and have access to help with routine tasks such as housekeeping, shopping, and laundry.

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17
Q

Accessory Dwelling Unit/in-law apartment

A

2nd living space in the home allows O-A to have independent living quarters, cooking space, and a bathroom.
-may also take advantage of day treatment services to receive support when the rest of the family is at work or school

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18
Q

Continuing Care Retirement Community (CCRC)

A

Housing community that provides different levels of care based on resident needs
-homes or apartments in which residents can live
-Usually expensive w/ DP & monthly fee
-Relative ease of moving from one level of care to another
-Range of services (social activities, transportation, companionship, ect.)

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19
Q

CCRC payment options

A

-Unlimited nursing care for a small increase in monthly payments
-Predetermined amount of long-term nursing care; beyond this the resident is responsible for additional payments
-Residents pay fees for service, which means full daily rates for all long-term nursing care.

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20
Q

Financial problems of Medicare

A

Current U.S. health care financing crisis is a function of the huge expenses associated with the long-term care of older adults. Insecurity over the financing of health care can constitute a crisis for adults of any age, but particularly so for older persons with limited financial resources or those who fear losing their savings in order to pay for long-term care. The ability to receive proper treatment for chronic conditions is therefore a pressing social and individual issue.

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21
Q

Medicare

A

Federal health care funding agency
-Passed and signed into law in 1965
-Designated as “Health Insurance for the Aged and Disabled.”
-Split into 4 parts: A, B, C, & D

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22
Q

Medicare Part A (Hospital Insurance or HI)

A

Coverage that includes all medically necessary services and supplies provided during a patient’s stay in the hospital and subsequent rehabilitation in an approved facility
-semiprivate hospital room, meals, regular nursing services, operating and recovery room, intensive care, inpatient prescription drugs, laboratory tests, X-rays, psychiatric care, and inpatient rehabilitation
-Skilled nursing facility is included in Part A if it occurs within 30 days of a hospitalization of 3 days or more and is certified as medically necessary.
-Rehab services and appliances (walkers and wheelchairs) + services normally covered for inpatient hospitalization.
COST:
-Usually free, those self-employed & who have paid Medicare taxes for less than 10yrs pay up to almost $700 worst case

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23
Q

Medicare Part B

A

Range of medical services available to people 65 and older who pay a monthly insurance premium
-preventive treatments, including glaucoma and diabetes screenings as well as bone scans, mammograms, and colonoscopies.
-one-time physical examination
COST:
-varies by a person’s yearly income, highest $460/m

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24
Q

Part C of Medicare

A

Medicare Advantage; provides coverage in conjunction with private health plans.

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25
Q

Part D of Medicare

A

Prescription-drug benefit plan that provides coverage for a portion of the enrollee’s costs

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26
Q

Medicare Modernization Act (MMA)

A

Legislation passed in 2003 that created the prescription drug benefit in Medicare. Has four phases of coverage over the course of the calendar year
-Beginning of year, enrollee pays a deductible of up to $415. Pay a reduced amount for their prescriptions of 25%.
-Part D will count the total value of the drugs (not what plan members pay) until a limit is reached of $3,820 for the actual drug costs
-pay more for generic drugs (37% instead of 25%)
-Once their drug costs total $5,100, out-of-pocket payments for enrollees become reduced to 5% of the drug’s costs

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27
Q

Donut Hole

A

Coverage gap in Medicare Part D within each calendar year when patients pay a higher percentage of certain drugs until they reach a certain threshold

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28
Q

Medicare Facts

A

-Medicare is a pay-as-you-go system. Tax revenue must be able to fund benefits paid out to Medicare recipients.
-Hospital Insurance Trust Fund (HI), which covers Part A
-Supplemental Medical Insurance Trust Fund (SMI), which funds Parts B and D.
-Part C of Medicare is paid for via premiums by the insured through their individual Medicare Advantage plans.
-By 2026 the Medicare Trust Fund will be brought to, or close to, zero.

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29
Q

Affordable Care Act (ACA)

A

Legislation by President Barack Obama in 2010 intended to expand health care insurance to all Americans.
-Fails, fines you if you don’t have insurance

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30
Q

Medicaid

A

Federal and state matching entitlement program that provides medical assistance for certain individuals and families with low incomes and resources.
-services for older adults cover inpatient and community health care costs not included in Medicare, such as skilled nursing facility care beyond the 100-day limit covered by Medicare, prescription drugs (without a premium), eyeglasses, and hearing aids.

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31
Q

Nursing Home Reform Act (NHRA)

A

Federal law mandating that facilities meet physical standards, provide adequate professional staffing and services, and maintain policies governing their administrative and medical procedures.
-nursing homes must be licensed in accordance with state and local laws, following all regulations
-Physical services & providers always available
-Qualified administrator to regulate legal policies & proceedures
-Patients must be admitted regardless of race, ect.

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32
Q

1998 Nursing Home Initiative

A

Developed by President Clinton intended to improve enforcement of nursing home quality standards
-More frequent inspections, background checks, ect
-Monetary penalties on homes that violate the resident’s rights

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33
Q

2002 National Nursing Home Quality Initiative

A

Federal program combined info on individual nursing homes with resources available to improve the quality of care in their facilities.
-Quality improvement organizations (QIOs) contracted to assist skilled nursing facilities and improve their services.
-ombudspersons help families and residents on a daily basis find nursing homes that provide the highest possible quality of care needed

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34
Q

2007 GAO report

A

GAO issued a major report analyzing the effectiveness of the online reporting system based on data from 63 nursing homes in California, Michigan, Pennsylvania, and Texas institutions that had a history of serious compliance problems.
-Efforts to fix the problem didn’t go well

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35
Q

Online Survey, Certification, and Reporting system (OSCAR)

A

Where information about nursing homes and nursing home residents comes from
-collects info on certified NHs from state surveys
-Assess the status/process of NHs
-Gives fines/deficiencies to failing NHs

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36
Q

Competence–press model

A

An optimal level of adjustment institutionalized persons experience when their levels of competence match the demands, or “press,” of the institutional environment.
-An environment low in press will be relatively low in stimulation.

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37
Q

Green House model

A

NH offers O-As individual homes within a small community of 6 to 10 residents and skilled nursing staff.
-open-plan layout of shared spaces, medical equipment stored away, rooms are sunny and bright, and outdoor environment accessible

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38
Q

Death

A

Irreversible end of circulatory and respiratory functions, or when all brain structures have irreversibly ceased to function.

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39
Q

Dying

A

When the organism loses its vitality

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40
Q

symptoms that death is imminent

A

-Being asleep most of the time, disorientation, irregular breathing, visual and auditory hallucinations, being less able to see, slow urine production, and mottled skin, cool hands and feet, overly warm trunk, and excessive secretions of bodily fluids
-unable to walk or eat, recognize family members, suffer constant pain, and feel that breathing is difficult (BIG)

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41
Q

Dying Trajectory

A

The temporal pattern of the disease process leading to a patient’s death
-Sudden death- people in good health whose death was accidental
-Terminal Illness- people who have advance warning terminal illness such as cancer
-Organ Failure- death due to organ failure as in COPD and chronic heart failure
-Frailality- Declines in functioning among frail individuals & those w limited physical reserves.

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42
Q

Anorexia-cachexia syndrome

A

End of life when individual loses appetite (anorexia) and muscle mass (cachexia).
-Common in those w AIDS and/or neurocognitive disorder

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43
Q

Physical and Psychological symptoms of Death

A

Physical:
-Nausea, difficulty swallowing, bowel problems, dry mouth, and edema, or the accumulation of liquid in the abdomen and extremities that leads to bloating

Psych:
-Anxiety, depression, confusion, and memory loss

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44
Q

Crude death rate

A

of deaths / by population alive during a certain time period

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45
Q

Age-specific death rate

A

crude death rate for a specific age group
-# of deaths within a particular age group / by # of people in that age group in the population

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46
Q

Age-adjusted death rate

A

Mortality rate statistically modified to eliminate the effect of different age distributions in the different populations

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47
Q

Hispanic mortality paradox

A

longer life expectancy of people of Hispanic (or Latino) ethnicity despite living in harsher conditions within the United States
-less likely to smoke and may have more robust social support networks

48
Q

Risk Factors that contribute to Death

A

-education, marital status, SES, and geography
-Political, economic, and social climates
-exposure to air pollution
-sex, age, race/ethnicity, social class, and region, the presence of fine particulate matter in the local area
-Exercise, injuries (hip fracture), better health habits (good diet, no smoking, morning chronotype, ect)

49
Q

Death ethos

A

The prevailing philosophy of death of a culture

50
Q

Tamed Death

A

prevailing view until the Middle Ages in which death was viewed as familiar and simple, a transition to eternal life

51
Q

Beautiful Death

A

death and dying became glorified, and it was considered noble to die for a cause

52
Q

Invisible death

A

Western attitude of a desire for death to retreat from the family and to be confined to hospitals

53
Q

Social death

A

Dying become treated as nonpersons by family/health care workers as they spend their final months or years in a hospital or NH

54
Q

Kubler Ross’ Stages of dying

A

Universally among terminally ill patients including denial, anger, bargaining, depression, and acceptance
-ignores other emotions such as curiosity, hope, relief, and apathy.
-the dying person must be allowed to talk openly with family members and health care workers

55
Q

Death with dignity

A

Death should not involve extreme physical dependency or the loss of control of bodily functions.

56
Q

Good death

A

Patients have autonomy in making decisions about the type, site, and duration of the care that they receive at the end of life

57
Q

Legitimization of biography

A

steps to leave a legacy that will continue to define oneself after one is gone

58
Q

Awareness of finitude

A

Thoughts about mortality when individuals pass the age when other people close to them had themselves died

59
Q

Terror Management Theory (TMT)

A

when thoughts of death are activated, either consciously or unconsciously, we get wide range of beneficial effects
-adopt better health habits, more focus on intrinsic rather than extrinsic goals, more compassionate, and more motivated to have close interpersonal relationships.
-more creative, less likely to hold stereotypes, and feel greater attachment to their community
-can come at a price

60
Q

Patient Self-Determination Act (PSDA)

A

1990, guarantees the right of all competent adults to have an active role in decisions about their care

61
Q

Advance directive (AD)

A

legally binding document in which patients express their wishes for end-of-life care
-Living will
-Durable power of attorney for health care (DPAHC)
-ensuring patients play an active role in deciding on their treatment but they also facilitate communication among patients, health care staff and families, protect an individual’s resources, alleviate anxiety, and reduce the chances of the patient’s being maltreated

62
Q

Living Will

A

an advance directive that stipulates the conditions under which a patient will accept or refuse treatment
-Document directing wishes when life-threatening situation & unable to make decision
-NO flexibility
-Access is hard to get

63
Q

Durable power of attorney for health care (DPAHC)/Proxy

A

AKA health care proxy, is appointed to make decisions to act on a person’s behalf should that person become incapacitated
-33% disagreement

64
Q

Do not resuscitate (DNR) order

A

directs health care workers not to use resuscitation if the patient experiences cardiac or pulmonary arrest

65
Q

Overtreatment

A

When patients do not have their DNRs respected but instead receive active life support that includes resuscitation

66
Q

Medical Order for Life-Sustaining Treatment (MOLST)

A

Advance directive that contains orders for a physician’s assistant or nurse practitioner

67
Q

Physician’s Order for Life-Sustaining Treatment (POLST)

A

An advance directive that contains orders for the physician

68
Q

Physician-assisted suicide (PAS)

A

Terminally ill individuals decides, while they are still able to, they want their lives to end before dying becomes a protracted process
-physicians can prescribe medications to hasten death without being subject to prosecution. The individuals must have a terminal illness and a prognosis of 6 months or less to live

69
Q

Hospice

A

Medical and supportive services for dying patients
-needs for physical comfort and psychological and social support and given the opportunity to express and have their spiritual needs met
-controlling pain and other symptoms

70
Q

“SUPPORT” (“Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments”)

A

the best end-of-life care is adapted to the nature of the patient’s needs, rhythms, and situations as these vary over the dying trajectory
-Discussion w patient, provide comfort and respect the patient’s end-of-life wishes, assurance of dignity, and attention to the individual’s goals.
-Minimizing burden to family and assisting bereaved through stages of mourning and adjustment.
-Addresses organ procurement and transplantation, which are intended to protect the interests of living and deceased donor

71
Q

Bereavement

A

people cope with the death of another person
-anger, depression, anxiety, feelings of emptiness, and preoccupation with thoughts of the deceased
-impaired attention and memory, a desire to withdraw from social activities, and increased risk of accidents

72
Q

Attachment view of bereavement

A

Bereaved can continue to benefit from maintaining emotional bonds to the deceased. the deceased person becomes a part of the survivor’s identity

73
Q

Dual-process model of coping with bereavement

A

Practical adaptations to loss are as important to the bereaved person’s adjustment as the emotional
-Taking on new tasks or functions, called the “restoration-oriented”. The “loss-oriented” involves -coping with the direct emotional consequences of the death.
-may allow individuals to remain optimistic and feel a greater sense of personal control.

74
Q

Whitehall II & Morality

A

Survey of a large sample of British adults focusing on the relationships among health, social class, and occupation
-to investigate specifically social and occupational influences on health and illness including psychological work load, control over work pacing and content, opportunity for using one’s skills, and social support at work

75
Q

Palliative Care

A

controlling pain and other symptoms, and it is likely to take place within the home, beginning when the patient no longer wishes to receive active disease treatment.
-As illness worsens, more palliative care
-Hospice

76
Q

Rowe and Kahn definition of successful aging

A

the absence of disease, high cognitive and physical function, and engagement with life
-Is incomplete/flawed, excludes the many variations that exist among successful agers who do not meet every single criterion
-Those from disadvantaged backgrounds may not be able to achieve all three conditions due to stressful early lives or lack of access to health care and other resources in later life
-Doesn’t account that individuals think they have aged successfully

77
Q

Active aging AKA active and healthy aging (AHA)

A

According to the WHO, maximizing opportunities related to health, participation, and safety in order to improve quality of life.
-Economics
-Health & social services
-Behavior
-Personal
-Physical environment
-Social
role of autonomy and independence, placing greater emphasis on the individual’s ability to get around in the environment, rather than on whether the individual needs physical accommodations due to disability

78
Q

Successful cognitive aging

A

Cognitive performance that is above the average for an individual’s age group as objectively measured
-High cortical thickness
-Great brain plasticity
-High white matter density
-Faster encoding
-“Super-aging” phenotype
-Improved network connectivity
engage individuals, families, and policy makers in discussions of the factors that promote health, rather than those that focus solely on diagnosis and treatment of neurocognitive disorders

79
Q

Superagers

A

Those 80 years and older with episodic memory that is comparable to, or superior than, that of middle-aged adults
-cortical thickness, greater brain plasticity, an activated inflammatory response that protects the brain’s white matter, improved connectivity in the default mode and information filtering networks in the brain, faster electrophysiological encoding, and a “super-aging” phenotype

80
Q

Positive psychology

A

View intended to provide a greater understanding of the strengths and virtues that enable individuals and communities to thrive.

81
Q

Life satisfaction

A

Overall assessment of an individual’s feelings and attitudes about one’s life at a particular point in time

82
Q

Subjective well-being

A

An individual’s overall sense of happiness

83
Q

Paradox of well-being

A

O-As maintain high subjective well-being despite facing challenges from their objective circumstances.
-Subjective well-being (happiness) ↔ Life-satisfaction
-Contradicts the belief that well-being is determined by social indicators, or objective measures of social and economic welfare.

84
Q

Social indicator model of well-being

A

Demographic and social structural variables account for individual differences in levels of well-being

85
Q

Set point perspective

A

People’s personalities influence their level of well-being throughout life

86
Q

Age-friendly environment

A

People of all ages participate in their communities, treat everyone with respect, regardless of age, makes it easy for older people to maintain their social connections, and helps people maintain their health and activity even at the oldest ages.

87
Q

Communicative ecology model of successful aging (CEMSA)

A

How O-As communicate about aging influences their feelings about aging and their ability to age successfully.

88
Q

Creativity

A

The ability to generate products or ideas that are original, appropriate, and have an impact on other
-the idea or products are novel rather than being copies, precise renderings from a set of instructions, or mass-produced

89
Q

Big-, little- and mini-c creativity

A

“Big C”- eminent, famous
“Little C”- everyday
“Mini-C”- Constructing personal, or self, understanding

90
Q

Planck hypothesis

A

the tendency of peak scientific productivity to occur in early adulthood

91
Q

Creative potential

A

of works a person could hypothetically produce in a life span with no upper limits.
-Someone w low creative potential may continue to bake the very same cake, year in and year out, without variation

92
Q

Career Age

A

The age when individual begins to embark on their career.
-Those w high degrees of creative potential (or total number of ideas) who start out early in life will peak earlier than those who start out later.
-Age at death not factored, the model still suffers from not counting the works of people who might have been productive into later adulthood

93
Q

Equal odds rule

A

Creative individuals who produce more works are more likely to produce one or more of high quality than are those who produce fewer works.
-people are most likely to produce their best work during their peak period of productivity on the basis of probability alone

94
Q

Blind variation and selective retention (BVSR) theory

A

True creativity requires producing a large number of ideas in trial-and-error fashion, the best (most creative) of which will remain in the wake of all the failed ones.
-Contemporary older adults have an even better chance of remaining productive throughout their later years than those living in previous centuries

95
Q

Old age style

A

A special quality common to O-A artists and writers.
-The themes that emerge in the works of late-life artists are more likely to express tragic rather than uplifting themes, and they may stem from feelings of social isolation and the need to deal with physical limitation

96
Q

Swan song

A

Last burst of creativity of an older musician

97
Q

Lastingness

A

Quality of an older artist’s work that allows it to persist over time

98
Q

Biopsychosocial of Successful Aging

A

Bio- Activation of relevant brain areas & physical changes and diseases
Psycho- Personality flexibility & ability to work from past experiences
Social- Educational background & Definitions of eminence that exclude minorities (women, not-white races, poor, ect)

99
Q

World Report on Ageing and Health

A

a comprehensive public response is needed if older individuals around the globe are able to achieve active aging

100
Q

Creativity & Prefrontal cortex

A

Connections between the brain’s default brain network and the executive functions carried out in the prefrontal cortex
-pathways involved in the default network may be involved in successful cognitive aging

101
Q

Monet & Successful Aging

A

Claude Monet, famous for his impressionistic paintings of water lilies, developed cataracts at a time when cataract surgery was far less common and more complicated than today. However, at the age of 85, he had successful cataract surgery and went on to complete an enormous water lilies project that was installed in a Paris museum after his death.

102
Q

Impact of CG on CG

A

INC depression, demoralization, grief, despair, hopelessness, & physical illness.
-Issues w family (time, $, resources)

103
Q

Impact of CG on patient

A

Guilt & Overdependence

104
Q

CG stress signs

A

Denial, Irritability, Anger, Lack of Concentration, Social withdrawal, Health Problems, Anxiety, Depression Note similarity to stress model, Exhaustion, Sleeplessness

105
Q

Types of CG abuse

A

-Physical – using Conflict Tactics Scale – at least one act of violence since 65
-Psychological – repeated threats & insults (chronic verbal aggression) 10/yr
-Neglect – deprivation of assistance needed for important activities of daily living (meals, housework, personal care, etc.)

106
Q

Abuse report rates

A

Spouses: 3/5
Adult child: 2/5
When being cared for by a spouse or child, poor health is more likely to be abused.
-Abuse is more likely to happen when staff is less educated, less well paid, less
supervised

107
Q

M Victims of CG abuse

A

Equal #s of M & F report, M more at risk for abuse
-Less likely to report, feels seen as weak
-Even more unwilling if abuser is a F or police is F

108
Q

CG abuse explanations

A

-Abuser was or believes they were abused by patient
-Personality disorder
-Substance abuse
-Stress response

109
Q

Preventing CG abuse

A

*Intergenerational counseling
* Caregiver support groups
* Respite care
* Caregiver networks
* Available services (e.g., Meals on Wheels; home health care aide, etc)

110
Q

Physiological Death

A

Lack of respiration and cardiac functioning

111
Q

Total Brain Death

A

-Lack of EEG in cerebral lobes and brainstem 10 min
–Rule out conditions imitating death - hypothermia
–Re-evaluate 24 hours later

112
Q

Cerebral death

A

(Karen Ann Quinlan)
– Only evaluate cerebral lobe function - brainstem
function irrelevant

113
Q

Psychological death

A

-Lack of personhood (not functioning as
integrated, “whole” person)
-Usually occurs after physiological death, but
can occur before as in Alzheimer’s and deep
coma

114
Q

Social Death

A

-Relinquishing of relationship as in wake/funeral
-Also may occur before death

115
Q

Euthanasia

A

“Mercy killing”
You don’t decide to be euthanized
-Passive is more accepted
-Y-A more accepting of active, O-A are more religious, less educated, & think it will hasten death

116
Q

Active VS Passive Euthanasia

A

Active:
-Deliberate life ending (injection, shooting, ect)

Passive:
-Treatment restraint (no life support, no life surgery, ect)

117
Q

Proxy Decisions on Euthanasia

A

Passive:
-Cognitive status
-Burden
-Age/survival potential
-Treatment cost
-Amount of pain

Active:
-Life quality
-Likelihood of recovery
-Public outcry
-Possible legal action

Psych of Adulthood and Aging 319 200 (4 decks)

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