Week 2 - Long Term Care Flashcards

1
Q

Describe some physiological effects of aging.

A
Decreased bone density
Lowered immune system
Decrease in mentation
thinner skin
Slower metabolism
lower muscle and higher fat content
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2
Q

How does ageing change life views and goals?

A

Getting prepared for the empty nest
Preparing for LTC or moving to a retirement home
losing friends

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3
Q

Describe how the WHO describes how ageing shifts relationships, goals, etc.

A

Older adults tend to select fewer and more meanginful goals and activities
Older age may be a stimulus for a shift from materialistic perspectives to more transcendent ones

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4
Q

Desrcribe how the typical trajectory toward death has occured.

A

Years ago people lived and then there was a precipitous drop to death
Now, we see more of a gradual decline with ups and downs

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5
Q

Why do clients move to LTC?

A

unable to care for themselves

- e.g. incontinence issues, frail, care needs exceed support they have, mobility issues, kids unable to care for them

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6
Q

What do you risk losing with old age or transition to LTC?

A

Independence, privacy, connectedness

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7
Q

Who regulates LTC facilities?

A

MOHLTC

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8
Q

What is the difference between a retirement home and LTC?

A

Retirement home – more independent, can do a lot of things autonomously, but unable or unwilling to live at home; still have support here – can have PSWs bathe them, but they only for 45 minutes a day for the full 7 days – maximum time allotment

LTC home – need around the clock, more intensive care

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9
Q

Is it easier to move to LTC from home or from the hospital?

A

Much easier to move to LTC from home

If assessed at home and the forms are complete, which states this patient is not fit to return home – go to critical status – need a bed now

In the hospital, they are still safe – less critical to move them

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10
Q

Describe the process of getting into LTC.

A

o CCAC or LHIN does an assessment – approved
o Get to choose up to 5 homes and whichever of those homes comes up first, you have to take it
o If you elect not to take that home, kicked out of the system, and need a whole new assessment
o RN or physician can do the assessment, usually an RN – see what supports are needed and applicability to LTC

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11
Q

Ontario’s LTC residents - 2018

  • 9/10 residents have _________ impairment; 2 out of 3 have been diagnosed with ____
  • Over the past 5 years, the proportion of residents needing ________ support with ADLs increased from 77% to 85%
  • 46% exhibit some level of ________ behaviour
  • 61% take ___ or more prescription medications
  • 38% need monitoring for a(n) ________ medical condition
A
cognitive
AD
complete
aggressive
10
acute
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12
Q

What is the typical LTC patient?

A

Cognitive abilities have decreased, needs lots of ADL support, polypharmacy, and most likely AD or other dementia

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13
Q

What is the wait list for long-stay beds in ontario?

What is the average time to placement in LTC?

A

34 000

143 days

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14
Q

What are the 10 myths of LTC?

A
  1. I’ll lose my “skills”
  2. Backwater of nursing
  3. Easy and slow paced
  4. Pay is bad
  5. Spinning my wheels
  6. Patients go there to die
  7. No bedside care
  8. Not the gold standard of care
  9. Isolating
  10. Not fulfilling
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15
Q

What skills, if any, may one lose if entering LTC?

A

IV and venupuncture skills

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16
Q

Leadership - Relationships and Trusts (RNAO):

  • Maintain an ____ _____ policy and post times of availability
  • Practice management by walking around and _______ time on the unit
  • _____-__ at meetings and open forums to hear issues and concerns and what’s going on in peoples lives to foster _________ and provide ________
  • Communicate support to staff by determining and clarifying what staff expects of _______
  • providing ongoing _______ feedback for a job well done
  • Build a network of advisors and informants who will provide an honest and unbiased perspective when seeking information and advice
A
open door
spending
check-in
relationships, support
leaders
informal
17
Q

more effective and responsive way to honour each person’s uniqueness and to provide people what they need for their own health and healing

A

SBN

18
Q

What kind of activities promote QOL, autonomy and dignity in LTC patients?

A

Activities with young children

Asking the family what type of foods the patient prefers

19
Q

How can a family be included in care?

A

Implement them in decisions
Inform family of progress
Give the family the option to help with care

20
Q

What is on the nurse’s radar for LTC clients?

A

Constipation, continence, falls, pain, pressure ulcers, 3 Ds, End-of-life care, oral health

21
Q

The RNAO, in working with the 3 Ds, suggests that the nurse’s role is to assess for all 3 conditions within the context of the following tenets of care.

A

Know the person
relate effectively
recognize retained abilities
manipulate the environment

22
Q

For the following descriptions, discern which of the 3 Ds is being described.

A - Memory changes from baseline
B- Decline in function
C - Anhedonia
D - Vegetative changes, such as sleep and nutrition
E - Abrupt onset
F - Memory impairment
A
A - delirium
B - dementia
C - depression
D - Depression
E - Delirium
F - dementia
23
Q

For the following descriptions, discern which of the 3 Ds is being described.

A - Lack of eye contact
B - Aphasia, Apraxia, agnosia
C -  Disorganized thinking
D - consciousness altered
E - Alterations in executive functioning (e.g. planning)
F - Decreased self-care
A
A - depression
B - dementia
C - Delirium
D - delirium
E - dementia
F - depression
24
Q

For the following descriptions, discern which of the 3 Ds is being described.

A - Fluctuating course
B - inattention
C - Vague physical symptoms
D - Feelings of sadness/depression

A

A - delirium
B - delirium
C - depression
D - depression

25
Q

Difficulty with the motor planning to perform tasks or movements when asked

A

Apraxia

26
Q

Inability to interpret sensations and recognize things

A

Agnosia

27
Q

When considering dementia, what is important to rule out?

A

Other reversible causes of cognitive decline

28
Q

What are the important risk factors that should be urgently attended to when worrying about delirium?

A
Hearing/visual defecits
Dehydration
Sleep disturbances
Cognitive impairment
↓mobility/immobility