Week 3 Flashcards
Unlike their White counterparts,_____________ older adults experience significant health disparities, including lower life expectancies and an increased risk of chronic health conditions such as hypertension, diabetes, dementia, stroke, and cancer
African American
Research indicates thatbAfrican Americans—young and old—experience subtle and overt forms of ___________________
racial discrimination.
African American older adults have experienced cumulative race-related stressors that negatively impact their _______________________
physical and mental health
service providers in the aging and health-care fields need greater awareness, education, and training to competently address race-related stress in _____________ older adults
African American
For African American older adults, encounters are accumulated over the lifespan, stored in memory, and __________ with each new racist and discriminatory experience
relived
Limited access to community resources (e.g., grocery stores, pharmacies, culturally competent health and aging service providers, transportation, housing, etc.) significantly contributes to the experience of _______________ stress and creates barriers to achieving healthy and productive aging.
race-related
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
Create ______ spaces. Provide opportunities for dialogue around race, culture, gender, sexuality, and socioeconomic issues.
Create safe spaces. Provide opportunities for dialogue around race, culture, gender, sexuality, and socioeconomic issues.
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
Support, strengthen, and enhance ___________ .
resilience
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
Be mindful of __________ . Pay attention to the impact of stressful events and incidents continuously showcased in the media (e.g., television, radio, or newspaper). When possible, limit exposure.
triggers
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
Understand the impact of _________ . For African Americans, the effects of racism are felt daily. Racism also intersects with other forms of discrimination, including ageism, classism, sexism, ableism, and heterosexism.
racism
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
› Refer to ____________ services and support. Most African American older adults have developed effective coping skills (e.g., spirituality, kinship networks) to manage experiences of racism. However, when needed, culturally competent mental and behavioral health services should be made available.
mental health
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
Celebrate _________ . Organize and encourage activities that celebrate African American life, history, culture, customs, and norms
culture
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
Listen with __________. Recognize and acknowledge past and present experiences. Provide support for the thoughts, feelings, and experiences shared
empathy
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
› Be _______. Consider your own cultural background and its influence on your values, beliefs, assumptions, and biases. Seek out training opportunities on culturally competent geriatric care, with special attention to race- related stress.
aware
CORE PRINCIPLES OF PAIN TREATMENT
Base the treatment plan on the older adult’s _______. Encourage older adults to set functional goals (e.g., performing certain daily activities, including socializing and hobbies). Older adults should determine treatment goals for themselves with input from health providers.
goals
WHAT AGING AND HEALTH-CARE PROVIDERS CAN DO
› ___________. Support and promote local and national efforts to increase access to community and national resources for African Americans across the lifespan
Advocate
CORE PRINCIPLES OF PAIN TREATMENT
Every older adult deserves ____________ pain management. Certain populations, including racial minorities, people with limited ability to communicate, older adults, and people with past or current substance abuse, are at higher risk for inadequate pain management.
adequate
CORE PRINCIPLES OF PAIN TREATMENT
Use both drug and ___________ therapies. To achieve overall effectiveness of treatment, allow for reduction of drug dosages, and minimize adverse drug effects, always incorporate non-drug therapies into the pain management plan.
non-drug
CORE PRINCIPLES OF PAIN TREATMENT
Prevent and/or manage medication ___________ . Bothersome side effects are a major reason for treatment failure and non-adherence, and should be prevented when possible or managed aggressively
side effects
CORE PRINCIPLES OF PAIN TREATMENT
Evaluate the _____________ of all therapies to ensure that they are meeting the resident’s goals. Achievement of an effective treatment plan requires therapy to be individualized for each older adult, often requiring adjustments in drug, dosage, or route. Consistent reassessment is critical to good outcomes
effectiveness
CORE PRINCIPLES OF PAIN TREATMENT
Address pain using an inter-__________ approach. The multi-dimensional nature of the pain experience often requires the involvement of many disciplines. These can include psychology, physical and occupational therapy, pharmacy services, spiritual care, and multiple medical specialties, as well as complementary therapy practitioners, such as massage therapists, acupuncturists, and art therapists
disciplinary
A critical issue in aging research is whether aging is affected by ___________________ of underlying processes. If there are hundreds of different biological pathways that affect aging, then odds are slim that science could ever hope to devise a way of even understand why aging happens at all
one, several, or a multitude
Theories of aging can be divided into two categories:
those that answer the question “____ do we age?”
and those that address the question “_____ do we age?”
those that answer the question “Why do we age?”
and those that address the question “How do we age?”
The cross-linking hypothesis
Although many scientists agree that cross-linking of proteins, and perhaps the cross-linking of _______________ as well, is a component of aging, it is likely only one of several mechanisms that contributes to aging.
DNA molecules
THE EVOLUTIONARY SENESCENCE THEORY OF AGING
Natural selection, because it operates via reproduction, can have little effect on later life. In the wild, predation and accidents guarantee that there are always more younger individuals reproducing than older ones. Genes and mutations that have harmful effects but appear only after reproduction is over do not affect reproductive success and therefore can be passed on to future generations.
Natural selection, because it operates via reproduction, can have little effect on later life. In the wild, predation and accidents guarantee that there are always more younger individuals reproducing than older ones. Genes and mutations that have harmful effects but appear only after reproduction is over do not affect reproductive success and therefore can be passed on to future generations.
THE EVOLUTIONARY SENESCENCE THEORY OF AGING cont.
Because the gene’s harmful effects do not appear until after reproduction is over, they cannot be eliminated through_______________
natural selection.
THE GENOME MAINTENANCE HYPOTHESIS OF AGING
Mitochondria create damaging _________________ as a by-product of normal energy production. Somatic mutations in the DNA of the mitochondria accumulate with age, increasing free radical production, and are associated with an age-related decline in the functioning of mitochondria. Many scientists believe that mitochondrial aging is an important contributor to aging in general.
free radicals
THE GENOME MAINTENANCE HYPOTHESIS OF AGING
In fact, many scientists believe that humans have long lifespans because we are much better at _____________________ than short-lived animals like mice.
repairing our
genome
THE REPLICATIVE SENESCENCE HYPOTHESIS OF AGING
Most scientists today believe that what determines the Hayflick Limit for dividing human cells is the length of a cell’s ____________. Telomeres can be pictured as protective caps on the ends of chromosomes. Each time a
cell divides, it must first double its chromosomes, so that each daughter cell receives a full complement of genetic material. But each time a chromosome reproduces itself, it loses a small bit of its telomeres. Oxidative
damage can also shorten telomeres. When a cell’s telomeres have reached a critically short length, after 40 to 60 population doublings in young human cells, Certain skin cells produce collagen during their younger, reproductive years. When they reach senescence and can no longer divide, they produce collagenase, an enzyme that breaks down collagen. Some researchers suggest that this process may be responsible for the thinning and wrinkling of skin as we age. the cell can no longer replicate its chromosomes and thus will stop
____________. These cells with shortened telomeres become “senescent” in the sense that although they do not die, they can no longer divide
Most scientists today believe that what determines the Hayflick Limit for dividing human cells is the length of a cell’s telomeres. Telomeres can be pictured as protective caps on the ends of chromosomes. Each time a
cell divides, it must first double its chromosomes, so that each daughter cell receives a full complement of genetic material. But each time a chromosome reproduces itself, it loses a small bit of its telomeres. Oxidative
damage can also shorten telomeres. When a cell’s telomeres have reached a critically short length, after 40 to 60 population doublings in young human cells, Certain skin cells produce collagen during their younger, reproductive years. When they reach senescence and can no longer divide, they produce collagenase, an enzyme that breaks down collagen. Some researchers suggest that this process may be responsible for the thinning and wrinkling of skin as we age. the cell can no longer replicate its chromosomes and thus will stop
dividing. These cells with shortened telomeres become “senescent” in the sense that although they do not die, they can no longer divide
Polypharmacy is a common clinical issue in older adults; approximately 30% of senior citizens take at least ____ or more medications.
5
The normal changes of aging and physical changes associated with disease predispose older adults to an increased ______________ to prescription and over-the-counter medications.
sensitivity
Nurses should refer to the _______ Criteria and screening tool of older people’s prescriptions (STOPP) criteria when questioning the appropriateness of an elderly patient’s medications.
Beers
In lieu of pharmacologic measures, nurses should use patient-centered, evidence-based ______________ strategies to treat common symptoms.
nonpharmacologic
Polypharmacy in older adults is a _________ problem that has recently worsened. Approximately 30% of adults age 65 and older in developed countries take 5 or more medications.
Although older adults make up approximately 14.5% of the US population, elderly individuals purchase 33% of all prescrption drugs, and this proportion is expected to increase to 50% by the year 2040.
global
It not only includes prescribed medications but also over-the-counter and herbal preparations. Polypharmacy is most commonly defined in the health care literature as taking 5 or more medications. ________________ has been described as taking 10 or more medications
Hyperpolypharmacy
Polypharmacy is associated with the development and worsening of _________________, including cognitive impairment, delirium, falls, frailty, urinary incontinence, and weight loss. 7 Polypharmacy in older adults also increases the risk of adverse drug events (ADEs) and avoidable hospitalizations. Polypharmacy also has financial conse- quences, as it results in increased health care costs for the patient and for the health care system. Treatment for medication errors and ADEs in the older adult population is estimated to cost more than 880 million dollars per year. 8 In 2012, inappropriate polypharmacy cost 1.3 billion dollars in avoidable health care costs
geriatric syndromes,
A prescribing ___________ begins when a side effect or adverse drug reaction of a medication is misinterpreted as a new health condition, thus resulting in the prescription of a new medication
cascade
Medications should be started at _____ doses, and the nurse should monitor patients for adverse reactions
low
Half of all people age 65 and older have at least ____ medical diagnoses, and one-fifth have 5 or more medical conditions. 16 It is not uncommon for older adults with multiple medical problems to be treated by different medical specialist
3
older adults are more sensitive to many medications and are also more sensitive to medication ___________ . The bedside nurse should anticipate that older adult patients have the potential to respond differently to medications than other age groups
changes
