Gero exam 1

Hartford institute of geriatric nursing

shape the quality of healthcare for older adults

NICHE program

a hospital based initiative improving geriatric care outcomes

Medication discrepancies

meds that do not match up from either what the pt says vs their chart or vice versa

medication reconciliation

know what is being taken and when

senescence

process of growing old biologically

activity theory

continued activity and ability to “stay young” indicates successful aging; greater sense of well being

continuity theory

maintaining familiar routines and relationships to help cope with aging; consistent pattern of behavior

disengagement theory

for elders to let go of their previous roles and pass them onto younger ppl

Where do many older adults live?

their own homes mostly or retirement communities

_________ are culturally constructed expectations of what is considered acceptable behavior and internalized by the individual

stereotypes OR application of limited knowledge about one person w/ specific characteristics to other persons with the same characteristics

Mutations found in normal aging cells have been associated with…

Alzheimers

Social exchange theory

considers aging from an economic perspective; older one gets the fewer economic resources they have to contribute to society

Inflamm-aging prevention/treatment

regular exercise which can increase levels of antioxidants

wellness based model - functional

independent actions

wellness based model - environmental

supportive surroundings and good access; ex. clutter free home w/ good lighting

wellness based model - intellectual

maintaining cognitive stimulation and life long learning; ex. retired teach apart of a book club

wellness based model - psychological

support groups

wellness based model - spiritual

finding meaning, purpose, or connection; ex. church, meditation

wellness based model - social

maintaining satisfying relationships and community

wellness based model - biological

physical health, genetics, physiological function (ex. staying healthy through meds, exercise, or food)

epigenetic

how environment factors (ex.diet, exercise, exposure toxins) can switch genes on or off; lifestyle could prevent disease from occurring despite having the genetic disposition for it

underutilized preventative services due to

lack of trust

feeling they are healthy and don’t need it

lack of education

lack of access

cost of meds

pt may choose affording food rather than meds or choose cheap alternative

implicit bias

unconscious bias; ex. taking more time to explain to one pt than another due to assuming they wouldn’t understand

acculturation

process of adapting to a new culture

magico religious

illness caused by spiritual imbalances, seek healing from pastor or physician

naturalistic/holistic

rely on acupuncture, chi tee, and herbs

Learn model

L - listen to pt

E - explain perception of problem

A - acknowledge their perception

R - recommend plan

N - negotiate plan

ethnocentrism

belief that one group is superior to another

greatest increase in aging by group percentage is occurring among

85+

Baby boomers access

better for medication and treatment

immunization became standard from 1960 on

lack of importance placed on healthy living as they grew

supercentenarian

110 yrs +; most are functionally independent or require minimal assistance

centenarians

100-109 yrs

rising rapidly

genetic markers for disease not activated until later

healthy ppl 2020 recommendations for aging boomers

coordinate care, research and analyze appropriate training to equip providers, and identify minimum levels of training for ppl who care for older adults

primary payer for nursing home care

medicaid

benefit of continuing care retirement community (CCRC)

they have all levels of care in one location, allowing for easy transition between levels

PACE program

provides services to older ppl who would otherwise need a nursing home

provides medications, eyeglasses, and transportation to care

provides urgent and preventative care

DPOA-HC (durable power of attorney)

person you name to make health care decisions for you when you can’t yourself

medicare a

65+, acute care, short term rehabilitation, hospice

medicare b/c

outpatient medical services

medicare d

drug coverage

medigap

provides coverage in specific geographic areas

medicaid

covers cost of health services for low income children, pregnant women, those permanently disabled, and persons age 65+

undue influence

result of psychological abuse of an older person for the purpose of financial or sexual exploitation

public perceptions of aging

someone else’s problem

undesirable, inescapable decline

isolated

fatalistic - fear causes dread which impedes policies

out of sight, out of mind - lack of enhancement for experience

elder speak

associated with lower rates of comm ability, social isolation, increased dependence, and cognitive decline

reminiscence

improves quality of life, increases socialization and connectedness

provides cognitive stimulation, improves comm, faciliates personal growth, and can decrease depression

life review

occurs most frequently as an internal review of memories; formal therapy

allows for changes and new goals

story telling

complementary/alt therapy good to enhance comm and trust with older adults

Barthel index (BI)

reliable instrument for recognition of cues related to ability to perform ADLs

functional independence measure (FIM)

useful when working with those who have had strokes or spinal cord injuries

Geriatric syndromes

falls and gait abnormalities

frailty

delirium

urinary incontinence

sleep disorders

pressure injury

FANCAPES

Fluids

Aeration

Nutrition

Communication

Activity

Pain

Elimination

Social skills

Fulmer SPICES

Sleep problems

Problems w/ eating or feeding

Incontinence

Confusion

Evidence of falling

Skin breakdown

simple and overall assessment tool for older adults

alerts nurse of the most common problems that occur in elders health

Meds not recommended for elders

anticholinergics

benzodiazepines

International center for life story innovations and practice

resources for nurses interested in integrating life stories

Functional assessment staging tool (FAST)

outlines stages of mental decline, important in dementia pts

1 - no decline

2 - personal awareness of some decline

3 - noticeable deficits in demanding situations (early alzheimers)

4 - requires assistance in complicated tasks

5 - requires assistance in choosing proper attire

6 - requires assistance with ADLs

7 - speech declines and progressive loss of motor function

mini mental state exam

detailed screening of cognitive status

completion requires functional vision, hearing, and manual dexterity

Psychoactive med issues

malignant syndrome

movement disorders: acute dystonia, akathisa, parkinsonian symptoms, tardive dyskinesia

brown bag approach

asks pt to bring in all meds being taken, herbals, and supplements