Week 12 Flashcards
What is aging in place?
aging in the place of the individual’s choice
(Autonomy, support, substitution)
List aspects of moving in space
adaptability, social interactions, function to fun
List the life space levels
0: bedroom
1: home
2: outside house
3: neighborhood
4: town
5: unlimited
What are some community resources to aid the geriatric population?
adult day care
Faith community
Recreation/senior center
Meals on wheels
How can alert systems help the geriatric population?
It decreases the time to be found by someone if they are injured and/or unable to call for help
List examples of living environments
1) Home:
Family/community support
Paid caregiving
2) Facility:
Independent living (apartment)
Assisted living
Long term care (nursing home)
List examples of acute and post acute medical environments
1) acute:
Intensive care unit
Intermediate care unit
Acute care unit
2) post acute:
Long term acute care
Inpatient rehabilitation facility
Skilled nursing facility
What are reasons for transition into long term care (LTC)?
cognitive decline
Incontinence
Falls
Financial coverage:
Non skilled, not covered by Medicare
Medicaid (majority)
Out of pocket (private pay)
LTC insurance
List some strategies to use when communicating with older individuals with hearing loss
Face patient; make eye contact
Say the person’s name before beginning a conversation
Talk clearly, at a normal pace, when in front of the patient Slightly project voice, as in speaking to a group Incorporate visual aids
Change hearing aid batteries on a regular schedule (~2-week intervals)
Avoid chewing gum or covering mouth when speaking, to allow the individual to use visual cues Do not speak into the person’s ear
Eliminate background noise or visual distractions
Use rephrasing if repeating isn’t effective
When giving specific directions (such as an appointment), write it down
Minimize side conversations
Describe presbycusis (sensorineural)
damage to cochlea or 8th cranial nerve
High pitched consonants (s, t, f, g) unintelligible with background noise
Amplification limited benefit
Describe conductive hearing impairment
damage to external/middle ear
Impairment across sound frequencies
Amplification benefit
Give examples for visual accommodations
1) Visual field:
Lower height for directional and informational signs
2) Acuity:
Visual aids (glasses, contact lenses); magnifiers; large-print books and devices; large-print computer software
3) Illumination:
UV-absorbing lenses; increased task illumination; gooseneck lamps; 200- to 300-watt light bulbs
4) Glare:
Lamp shades, curtains, or blinds to soften light, cove lighting to conceal light source, indirect lighting to bounce off ceiling before redirecting into the room; nonglare wax on vinyl floors; carpeting; wallpaper or flat paints; avoid shiny materials such as glass or plastic furniture and metal fixtures
5) Dark adaptation:
Nightlights with red bulbs; pocket flashlights; automatic light timers; light switches at point of entry to a room; lights under
stairs and cabinets
6) Color:
Bright, warm colors (reds, oranges, yellows); avoid pastel hues; avoid monotones
7) Contrast:
Bright detail on dark backgrounds (white lettering/black background); warm colors to highlight handrails, steps; place mats or table coverings that contrast with plates, floor
8) Depth perception:
Avoid patterned floor surfaces; toilet seat and counter surfaces in bathrooms should contrast to floor
Give examples for hearing accommodations
Hearing aids; pocket amplifiers; increasing bass and turning down treble on radios, televisions; smoke alarms, telephones, and doorbells with visual cues such as flashing lights; insulating acoustic materials to minimize background noise.
Acoustically absorbent window sheers help with glare but also now have acoustical noise reduction properties
Give examples for taste and smell accommodations
1) Taste:
Color to increase perceived flavor intensity; use of spices, herbs, and flavorings to enhance foods; feel for bulges in canned goods to detect spoilage; check date stored of frozen foods
2) Smell:
Adapt smoke detectors with loud buzzers; safety-spring caps for gas jets on stoves; vent kitchens in institutions to allow residents to experience cooking aromas; place flowers in living areas
Give examples for touch accommodations
1) Tactile sensitivity:
Introduce texture into the environment through wall hangings, carpet, textured upholstery; use soft blankets and textured
clothing
2) Thermal sensitivity:
Avoid temperature extremes from air conditioning, hot bathwater, heating pads
What are the symptoms of the visual impairment cataracts and what are the accommodations?
Vision becomes cloudy, blurred, or dim. Harder to see at night. Sensitivity to glare and light. Halos may be seen around lights. Fading or yellowing of colors
Accommodations: Bright light on object of focus Limit night driving
What are the symptoms of the visual impairment macular degeneration and what are the accommodations?
Blind spot in the center of the visual field
Printed words and images may appear to be distorted or blurred in the
center of vision
Colors are washed out or dull
Haziness to visual field
Difficulty transitioning from low-light to bright-light conditions
Side vision is not affected
May only affect one eye
Accommodations: Bright light on object of focus
What are the symptoms of the visual impairment glaucoma and what are the accommodations?
Blind spots develop in visual field with a gradual loss of side vision
Increased sensitivity to light and glare
Difficulty discriminating between shades of color
Reduced night vision
Affects both eyes
Accommodations:
Low visual aids (e.g., magnifiers or telescopes, visors, filters, reading slits, stands, etc.)
Long cane
Signature guides
Computer screen enlargement software
What are the symptoms of the visual impairment diabetic retinopathy and what are the accommodations?
Spots (floaters) in vision
Blurred vision
Fluctuating vision
Impaired color vision
Dark or empty areas in vision
Usually affects both eyes
Accommodations: Monitor and maintain blood sugar levels
What are some modifications that can be done to steps/stairs/thersholds?
- Solid – no pattern
- Colored paint or tape (red /orange/ yellow)
Step edges
Handrails - LED strip lights
- Non-multifocal lens glasses (fall risk with multi-focal)
What are the considerations when using canes?
- Indications: mild balance
impairment, unilateral leg pain, ankle/foot proprioception - Challenges: coordination, style
(acceptance), single tip does not
stand on its own - Fit: align with wrist crease (if upright
posture), adjust for shoulder
elevation if flexed posture - Pattern: cane opposite hand of leg
impairment to move with it.
What are the considerations when using walkers?
- Indications: moderate balance
impairment (mild for rollator),
weakness or pain in leg(s), weight
bearing limitations - Challenges: style (acceptance),
energy expenditure, maneuvering
in environment (home doorways,
stairs, travel in vehicle) - Fit: align with wrist crease (if
Image source: UTMB PT Lab
upright posture), adjust for
shoulder elevation if flexed
posture, pediatric height (< 5’5”)
What are some assistive modifications that can be done to toilets?
- Grab bars – chrome/reflective
- Elevated toilet height –
easier to get up, less
effective emptying - Floor surface – ideally
contrasting color
without pattern
What can help a patient function at the toilet?
Hips flexed > 100
- Facilitates relaxation of pelvic floor
- Improves emptying
- Prevention of urinary retention/ urinary tract infections
What are some commonly accepted sleep hygiene tips?
goal: 7-8 hours/night of quality sleep
Go to bed and get up at the same time every day.
Drink caffeinated drinks only in the mornings.
Avoid alcohol.
Avoid smoking, especially in the evenings.
Lose weight if overweight.
Exercise regularly, but not before bedtime.
Use your bed only for sleep and sex.
Avoid looking at a screen before bedtime.
Get out of bed if you cannot get to sleep in 20 minutes and return
when sleepy.
Create a comfortable, quiet, and cool environment in your bedroom.
Avoid daytime napping.
What two aspects need to be balanced to enhance prognosis?
1) adaptation/modification in the environment
2) improved physical performance
