Geriatric Nursing Assessment and Aging Concepts

Vocabulary flashcards covering geriatric nursing assessment tools, normal physiological age-related changes, pain scales in dementia, and conceptual models of well-being.

Westberg Conceptual Model

A conceptual framework proposing that the sense of well-being in older adults is determined through a process of cognitive mediation operating on affective factors and circumstantial factors.

Cognitive Mediation (Westberg Model)

The central process in the Westberg Model that determines an older adult's perception of autonomy and control relative to affective and circumstantial factors along a well-being continuum from dissatisfaction to satisfaction.

Affective Factors (Westberg Model)

A component of the Westberg Conceptual Model comprising emotional/social support, meaning/life purpose, and spiritual contentment.

Circumstantial Factors (Westberg Model)

A component of the Westberg Conceptual Model comprising cognitive/physical health, environmental safety, and financial security.

Mini-Nutritional Assessment Short-Form (MNA-SF)

A 6-item screening tool used to identify older adults aged > $65$ years who are malnourished or at risk of malnutrition based on food intake, weight loss, mobility, psychological stress/acute disease, neuropsychological problems, and BMI or calf circumference.

MNA-SF Score Categories

Nutritional status classifications derived from the MNA-SF total score: $12-14$ points indicate normal nutritional status, $8-11$ points indicate at risk of malnutrition, and $0-7$ points indicate malnourished.

Calf Circumference (MNA-SF)

An alternate physical measurement substituted for BMI in the MNA-SF when height and weight cannot be assessed; scored as $0$ points for CC < $31\,\text{cm}$ and $3$ points for CC $\ge 31\,\text{cm}$.

Senile Lentigines

A normal age-related skin change characterized by brown macules appearing on the back of the hands and forearms.

Seborrheic Keratoses

A normal age-related skin change presenting as brown, raised, flat, slightly greasy areas on the trunk, face, and hands.

Arcus Senilis

A normal age-related ocular change characterized by a grayish line around or at the edge of the cornea that is not related to cholesterol levels.

PMI Shift in Aging

An age-related cardiovascular change where the point of maximal impulse shifts to approximately the $6^{\text{th}}$ intercostal space, $2\,\text{cm}$ to the left of the left midclavicular line.

Age-Related SA Node Changes

A normal cardiovascular age change involving a decrease in the number of pacemaker cells in the sinoatrial (SA) node, contributing to irregular heartbeats and dysrhythmias.

Normal Age-Related Respiratory Changes

Physiological shifts in aging including increased anterior-posterior chest diameter, chest wall rigidity, loss of lung elastic recoil, hyperinflation of apices with underinflation of bases, and a decreased cough mechanism.

Normal Age-Related Genitourinary Changes

Renal and urinary alterations in aging including loss of renal mass and nephrons, decreased glomeruli count, lower urine creatinine clearance, loss of diurnal urine rhythm (nocturia), and prostate enlargement in males or decreased bladder capacity in females.

Normal Age-Related Cognitive Functioning

Cognitive pattern in normal aging where verbal skills, creativity, judgment, and wisdom remain high or improve, while data retrieval from long-term memory and new learning occur more slowly; decreased cognition or confusion is abnormal.

Pain Assessment in Advanced Dementia (PAINAD) Scale

A 5-item observational pain rating tool assessing breathing, negative vocalization, facial expression, body language, and consolability on a scale from $0$ to $10$ for cognitively impaired older adults.

PAINAD Cut-Off Score

A total score threshold of $2$ or higher on the PAINAD scale that serves as a clinical signal to trigger pain treatment interventions.

MOBID-2 Pain Scale

The Mobilization-Observation-Behaviour-Intensity-Dementia Pain Scale; a two-part observational tool evaluating musculoskeletal pain during guided movements (Part 1) and internal organ/head/skin pain over time (Part 2) in advanced dementia.

Verbal Descriptor Scale (VDS)

A standardized pain intensity assessment tool that asks patients to select a phrase describing their current pain (from no pain to worst pain imaginable), often showing greater reliability than numerical scales in older adults with dementia.

Katz Index of Independence in Activities of Daily Living

An assessment instrument measuring functional independence in six basic activities of daily living: bathing, dressing, toileting, transferring, continence, and feeding.

Katz ADL Scoring System

A binary scoring method awarding $1$ point for independence and $0$ points for dependence across 6 items, where a total score of $6$ indicates full function, $4$ indicates moderate impairment, and $\le 2$ indicates severe functional impairment.