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Geriatrics > Week 5 Lectures > Flashcards

Week 5 Lectures Flashcards

1
Q

Bring multiple considerations to learning situation:

A 
A need to know (how? why? who?)
Independent self-concept
Life experience
Readiness to learn that is life centered
Motivation that is primarily internal (how will learning help them?)
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2
Q

Adult learners require

A

Choice
Voice
Relevance
Ownership

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3
Q

Choice

A

provide options

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4
Q

Voice

A

listen to their needs

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5
Q

Relevance

A

connect learning to valued interests

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6
Q

Ownership

A

work collaboratively on goal setting

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7
Q

What does readiness to learn depend on?

A

previous learning

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8
Q

Intrinsic motivation

A

more pervasive/permanent learning

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9
Q

What is learning enhanced by?

A

repetition

meaningful tasks/materials

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10
Q

How to facilitate learning/motivation to learn?

A

A person learns what he/she wants to learn
Only patient can make decision that goal is worth striving for
Place responsibility for learning on patient, not on you

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11
Q

Age Changes in Motivation

A

self regulation
positive emphasis
stronger adherence to behavior
positive self-concept

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12
Q

Self-regulation

A

greater ability to control thoughts, emotions, behaviors with age

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13
Q

Positive emphasis

A

elderly respond better to emphasizing positive and short-term outcomes

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14
Q

Stronger adherence to behavior change

A

elderly slower to initiate change but more likely to adhere to changes

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15
Q

Positive self-concept

A

elderly less likely to conceptualize selves as personally deficient

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16
Q

How to address fear (motivational challenge)?

A

graded activity
graded exposure
cognitive behavioral therapy

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17
Q

Graded activity

A

start activity lower than painful level, slowly increase while providing positive reinforcement

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18
Q

Graded exposure

A

increased exposure to fear-causing events, can be real exposure or imagined

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19
Q

Cognitive behavioral therapy

A

address maladaptive thoughts to treat behaviors and feelings

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20
Q

Apathy:

A

lack of interest/concern, is opposite of motivation

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21
Q

Who is apathy noted in?

A

dementia/depression but can occur independently of these

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22
Q

Interventions for apathy:

A

Pharmacologic interventions may be recommended

Behavioral interventions – activities which stimulate and individual can complete

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23
Q

Transtheoretical Model of Change

A 
Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination
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24
Q

Precontemplation

A

The individual has no intention to take action within the next 6 months and is generally unaware or under-aware of the problem

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25
Q

Contemplation

A

The individual intends to take action within the next 6 months. He or she is aware that a problem exists but has not yet made a commitment to take action

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26
Q

Preparation

A

The individual intends to take action within the next 30 days and has take behavioral steps in this direction

27
Q

Action

A

The individual changes his or her overt behavior for less than 6 months

28
Q

Maintenance

A

The individual changes his or her overt behavior for more than 6 months and works to prevent relapse and consolidate the gains attained

29
Q

Termination

A

The individual has no temptation to relapse ans has 100% confidence in maintaining the change

30
Q

Aspects of Change

A 
consciousness raising
dramatic relief
environmental reevaluation
self-evaluation
self-liberation
counterconditioning
helping relationships
reinforcement management
stimulus control
31
Q

Motivational Interviewing

A

Identifies dissonance between behaviors and values

Clinician listens reflectively and empathetically

32
Q

What is the hallmark of motivational interviewing?

A

exploring client’s values and having client note mismatch between behaviors and life goals

33
Q

Key Principles of Motivational Interviewing

A

express empathy
develop discrepancy
roll with resistance
support self efficacy

34
Q

CDC guidelines for older adults exercising:

A

2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week AND weight training: muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms)…
OR
1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week AND weight training: muscle-strengthening activities on 2 or more days a week that work all major muscle groups …
OR
An equivalent mix of moderate- and vigorous-intensity aerobic activity AND weight training: muscle-strengthening activities on 2 or more days a week that work all major muscle groups

35
Q

What percentage of adults meet activity guidelines?

A

20% of adults
50% meet aerobic guidelines
fail at strength training

36
Q

What causes a loss of function?

A

Typically it is the loss of strength (impairing balance and mobility) rather than a medical condition

37
Q

Mobility disability:

A

Defined as the inability to walk a ¼ mile or climb a flight of stairs.

38
Q

What is the single most important predictor of subsequent institutionalization>

A

leg strength

muscular system is entryway to frality

39
Q

Strength components

A

Neural adaptations

Muscle adaptions

40
Q

Neural adaptations

A

strength gains less than 6 weeks
intramuscular
intermuscular

41
Q

Intramuscular:

A

improvements in ability to recruit and fire motor units in synchrony, improved rate of motor unit firing

42
Q

Intermuscular

A

coordinating components of kinetic chain

43
Q

Muscle adaptations:

A

6 weeks or more
Sarcoplasmic hypertrophy
Myofibrillar hypertrophy

44
Q

Fraility:

A

Weight loss: 10 pounds or more over year (unintentional)
Self-reported exhaustion 3 or more days/week
Grip strength lowest 20% (<23 pounds women, <32 pounds men)
Walking speed lowest 20% (<0.8 m/s)
Activity lowest 20% (<270 kcal/wk women, <383 kcal/wk men); sitting/lying most of day
Meets 3/5 criteria

45
Q

What is a decrease in grip strength associated with?

A

Every 5 kg (11 pound) decrease in grip strength associated with 17% increase in all cause mortality

46
Q

Strength

A

ability to generate force

47
Q

Power:

A

time rate of force development

48
Q

Overload:

A

If too much stress is placed on a tissue, then it is susceptible to injury or even death

49
Q

Underload:

A

If too little stress is placed on a tissue, then the tissue loses its ability to adapt to stresses; it atrophies.

50
Q

ACSM Strength Guidelines

A

60-70% of 1 RM for novice
80-100% of 1RM for advanced
1-3 sets 8-12 reps for novice
2-6 sets 1-8 reps for advanced

51
Q

ACSM Power Guidelines

A

Light load preferred, 0-60% of 1RM

1-3 sets of 3-6 reps

52
Q

ACSM Frequency Guidelines:

A

Novice: 2-3 days/week
Advanced: 4-6 days/week

53
Q

Overtraining:

A

Avoid substantial jumps in workload

Progress 2-10% of weight when can exceed by 1-2 reps current workload

54
Q

TUG cutoff for fall risk

A

13.5 seconds

55
Q

10 meter walk test cut off

A

0.8 m/s

56
Q

5 time sit to stand cutoff

A

15 seconds or greater

57
Q

Activities Balance Confidence Scale cutoff for fall risk

A

less than 80%

58
Q

6 min walk test 60-69 YOM

A

572 meters

59
Q

6 min walk test 60-69 YOF

A

538 meters

60
Q

6 min walk test 70-79 YOM

A

527 meters

61
Q

6 min walk test 70-79 YOF

A

471 meters

62
Q

6 min walk test 80-89 YOM

A

417 meters

63
Q

6 min walk test 80-89 YOF

A

392 meters

Geriatrics (17 decks)

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