Exam 1 week 1(yash)

What are the 4 definitions of aging?

Biological, Psychological, Social, Chronological

What is geriatrics vs. gerontology?

Geriatrics = medical care for older adults. Gerontology = study of aging.

What % of adults 65+ have ≥1 chronic disease? ≥2?

85% have ≥1; 60% have ≥2 chronic diseases.

What is polypharmacy in older adults?

90% take ≥1 med; 40% in nursing homes take 9+; 59% take unnecessary meds.

What is the Free Radical (Wear and Tear) Theory?

Cellular damage from free radicals accumulates over time, causing aging.

What is Life-Span Development Theory?

Development continues birth to death; no stage is supreme; plasticity decreases with age.

What are the 3 mechanisms of SOC Theory?

Selection (narrow goals), Optimization (enhance strategies), Compensation (use alternatives when capacity lost).

What is Socioemotional Selectivity Theory?

As time horizon shrinks with age, emotionally meaningful goals are prioritized over future-oriented ones. Counters stereotype of despair in late life.

What is the Life Course Perspective?

To understand older adults now, you must know their past — early life pathways shape later health.

What is the Weathering Hypothesis?

Accelerated aging from cumulative damage due to discrimination and structural stressors — NOT lifestyle factors.

What is Continuity Theory?

Past experiences/behaviors form the foundation for the present; adaptation maintains existing patterns.

What are the 8 factors that influence aging?

Gender, social factors, cohort effects, public policy, SES, residence, personal characteristics, cultural factors.

What are cohort effects?

Historical events that impact an entire generation (e.g., Greatest Generation shaped by WWII).

What are the 4 themes of meaning in late life?

Instrumental (daily life support), Existential ("Was life worth living?"), Evaluative ("Am I happy?"), Identity ("We are what we do").

What is occupational deprivation?

Unable to do what is necessary/meaningful due to EXTERNAL restrictions.

What is a life crisis and its 3-part resolution?

Stressful period challenging coping/identity. Resolution: Separation → Transition → Reincorporation.

What is a "Sponsor" in life crisis resolution?

A person who supports the individual's REINCORPORATION back into society.

Hana refuses therapy, is withdrawn, and angry after her stroke. Which phase of life crisis is this?

Separation — separated from her familiar environment and former occupations.

What are the consequences of hospital-to-home transition?

Physical: weakness, dizziness, fatigue. Psychological: apathy, fear of falling. Social: less help, isolation.

What are the nervous system changes with aging?

Neuron/myelin loss, frontal lobe atrophy, unbalanced neurotransmitters, altered motor skills, diminished sensory input.

What are the nervous system consequences?

Slowed processing/reaction time, reduced executive function, less deep sleep, slower fine motor, reduced proprioception.

What are the cardiovascular changes with aging?

Atherosclerosis, decreased cardiac output and max HR, endocardium scarring, increased adiposity.

What are the cardiovascular consequences?

HTN, quick fatigue, dyspnea, orthostatic hypotension, stroke, heart attack, thrombus.

What is syncope and its 2 main types?

Fainting — temporary drop in blood flow to brain. Types: Vasovagal (most common), Orthostatic (position change).

A client gets lightheaded every time they stand up. What is most likely?

Orthostatic hypotension — OT should modify transfer technique and educate on slow position changes.

What are the respiratory changes with aging?

Decreased vital capacity, lost elastic recoil, reduced alveolar surface area, stiffened rib cage, decreased O2 sat.

What are the respiratory consequences?

Decreased activity tolerance; susceptibility to COPD and pneumonia.

What are the endocrine changes with aging?

Decreased thyroid activity, declined Vitamin D, decreased insulin/insulin resistance, elevated cortisol.

What are the endocrine consequences?

Decreased cognition/strength, poor thermoregulation, hyperglycemia, immunosuppression, HTN, diabetes risk.

What are the digestive changes with aging?

Dry mouth, altered taste/smell, decreased gastric acid, decreased Vit D/B12/iron absorption, decreased liver detox, slowed motility, sphincter weakening.

What are the digestive consequences?

Dysphagia/aspiration, decreased appetite, osteoporosis, peptic ulcers, medication overdose, constipation, fecal incontinence.

What are the genitourinary changes with aging?

Lost nephrons, weakened pelvic floor/sphincters, decreased bladder capacity, enlarged prostate, reduced hormones.

What are the genitourinary consequences?

Urinary incontinence, renal failure risk, dehydration, UTI, difficulty excreting drugs, sexual dysfunction.

What are the musculoskeletal changes with aging?

Reduced bone density, vertebral collapse, sarcopenia (decreased muscle fibers), decreased synovial fluid, thinned cartilage.

What are the musculoskeletal consequences?

Fracture risk, decreased height, kyphosis, slowed reaction time, decreased strength/endurance/flexibility.

What are the integumentary changes with aging?

Less collagen/elastin, decreased tactile/thermal sensitivity, poor sweat gland function, fat layer thinning.

What are the integumentary consequences?

Prone to abrasions/skin cancer, thermoregulation issues, increased pain threshold, foot conditions.

What are the special senses changes with aging?

Decreased tastebuds/saliva, hyposmia (decreased smell), decreased tactile processing.

What are the special senses consequences?

Decreased appetite/malnutrition, dry mouth, decreased hand function/strength.

What are geriatric syndromes?

Multifactorial conditions from accumulated impairments across systems that make older adults vulnerable. Original Giants: Immobility, Incontinence, Instability, Intellectual incapacity.

What is frailty (definition)?

Age-related loss of physiologic reserve → vulnerability to stressors → impairments, limitations, disability. ≠ comorbidity or disability alone.

What are Fried's 5 Frailty Phenotype criteria?

Unintentional weight loss, Exhaustion, Low physical activity, Slow walking speed, Weakness. Robust = 0; Pre-frail = 1-2; Frail = 3+.

A client has exhaustion, low activity, and unintentional weight loss. What is their frailty level?

Pre-frail — 2 of 5 Fried's criteria.

What cognition changes are NORMAL aging vs. pathological?

Normal: slower processing, more time needed, episodic memory decline. Pathological: changes that IMPAIR FUNCTION — not normal aging.

What are the steps of the OT process?

Occupational Profile → Screen/Assess → Goals + Plan of Care → Intervention → Re-evaluate/Discharge → Outcomes.

What does an occupational profile identify?

Client's interests, strengths/weaknesses, barriers to occupation, and goals. Includes history, roles, routines, environment.

What are examples of client factors assessed in OT?

Cognition, vision, sensation, pain, swelling/skin, values/beliefs/spirituality.

What are the 5 criteria for a good OT goal?

Timely, Measurable, Reimbursable, Client-centered, Occupation-centered.

What are the 6 OT intervention approaches?

Adaptation, Compensation, Habilitation, Maintenance, Prevention, Rehabilitation/Remediation.

What is the difference between Adaptation and Compensation?

Adaptation = modify the SETTING/task demands. Compensation = strategies that work AROUND limitations.

What are CPT codes?

Common Procedural Terminology codes used to BILL for OT services. OTs must select the correct code.

What are the 3 criteria for CPT evaluation complexity?

1. Profile and History 2. Assessment of Occupational Performance 3. Clinical Decision Making — each rated Low/Moderate/High.

What is the rule for selecting CPT complexity level?

Defaults to the LOWEST rated component. All 3 must be high to bill high.

An evaluation has High profile, High assessment, Low clinical reasoning. What do you bill?

Low complexity (97165) — defaults to the lowest component.

What are the 3 OT evaluation CPT codes?

Low = 97165. Moderate = 97166. High = 97167.

What are emerging geriatric syndromes?

Sarcopenia, polypharmacy, polyprovider, pain, frailty. 2007 additions: falls, delirium/dementia, functional decline, pressure ulcers.

What is the OT's role in life transitions?

Identify occupational barriers, support new roles/routines, provide compensatory strategies, address physical/psychological sequelae, promote reintegration into meaningful occupations.

What does the Life-Span Development Theory say about the second half of life?

Individual plasticity and differentiation characterize late life — opportunities for change become more limited but development still occurs.

What role does culture play in aging (per sociological theories)?

Values, cultural resources, "ethnic ethics," and stigma of health conditions shape how aging is experienced and perceived.

What is the OT's role when a client has experienced occupational deprivation?

Identify external barriers, advocate for access, modify environment/tasks, and support re-engagement in meaningful occupations.