Medsci - Chapter 4

What is the difference between activities of daily living and Instrumental activities of daily living

ADL = Basic skills required to independently care for oneself: (Eating, bathing, dressing, maintaining personal hygiene, and mobility)

IADLs = Complex self-care activities that are used to evaluate independence of disabled persons or older adults (shopping, preparing meals, managing finances, and taking medications prescribed)

What is the most common form of dementia and what does it affect?

• Alzheimers = most common form of dementia

• causes a decline in cognitive function that affects memory, language, and problem solving

True or false? chronic diseases are short in duration, don’t reoccur frequently, and progresses quickly.

false. chronic diseases are long in duration, reoccurs frequently, and progresses slowly.

what does a skilled Nursing Facility do?

it’s a nursing home that provides the level of care closest to hospital care.

health literacy

ability of to obtain, process, and understand health information and services needed to make appropriate health decisions. (people who don’t know English struggle cs of this)

what is LTSS?

long term services and support, System of providing health and personal care support for the disabled, elderly, or others with chronic health problems in people’s homes instead of an institution.

What do geriatricians do?

Primary care physicians who specialize in the care of those 65 years of age and older and focus on common health and social issues related to the aging process.

explain Adult Daycare Services

Program for the disabled or elderly who require health and/or support services; used to supplement home care services or a less costly option to being institutionalized

what kind of services does a home health agency provide?

Agencies that provide nursing and medical care at home.

explain a senior center

senior recreation center (bingo, movie nights, etc)

who funds senior centers?

the federal government as a result of the Older Americans Act.

what are Residential care communities similar to?

assisted-living facilities

what are the TWO leading causes of kidney failure and ending up on dialysis

Diabetes and hypertension

who will end up needing care coordination?

Medicare beneficiaries with multiple chronic conditions, especially the frail elderly who also have functional or cognitive impairments

 what do RN case managers and social workers do?

manage and coordinate a person’s treatments (there’s also a higher need for these jobs)

true or false? By 2034, the amount of people 65 or older are going to outnumber the amount of children under 18

true

what is the cause of the overall aging of the population

 increasing life expectancy and decreasing fertility

what requires ongoing medical attention and can limit activities of daily living?

chronic diseases

What are the most common chronic diseases in the elderly?

• Arthritis

• stroke

• Diabetes

• Chronic lower respiratory diseases

• dementia - Alzheimer’s disease

  (Parkinsons is on the rise)

What pre-existing health problems may people with chronic diseases have?

• alcoholism

• substance abuse

• mental illness

• developmental disabilities

what are the most common loss of functional abilities with aging?

limitations in:

• vision

• hearing mobility

• communication

• cognition

• self-care

what are the most debilitating conditions accompanied by functional impairments among older adults?

Stroke and dementia

Who does Medicare covered benefits apply to?

mostly to patients with acute illnesses who require hospitalization and short-term skilled nursing care (Rehabilitation centers, nursing homes, home healthcare)

where do patients with acute illnesses go after being discharged from the hospital?

subacute facilities in which they are treated on a daily basis for 6-8 weeks. (Physical therapy, etc.)

What group of people go to subacute facilities after being ischarged from the hospital?

People of older age (80 yrs and up) 

What parts of medicare do people automatically get?

• part a: hospital insurance

• part b: medical insurance

What parts of medicare are optional and you have to pay extra for it

• part c: medicare advantage

• part d: prescription drug coverage

what does MedicAID for Older Adults cover?

• a broad range of services not covered by Medicare

• Acts as a supplemental insurance for the elderly and disabled.

• Pays their Medicare Premiums

why does Medicaid cover more than Medicare?

because its main demographic is the elderly and the disabled, who typically don’t have the means to get any form of income

what is the medicaid program the primary payer for, and what is the program that it is a safety-net for?

• (LTSS)- long-term services and supports

what is the Medicaid spousal impoverishment provisions

a program that allows a certain amount of the couple’s combined resources to be protected for the spouse living in the community

what are some examples of privately funded long-term care providers that are regulated by federal and/or state governments in addition to nursing homes?

• Adult day care

• Residential care communities

• Home health agencies

• Hospice 

what are the most common diagnoses in nursing homes? (in order of most to least common)

• Alzheimer’s Disease (most)

• Depression

• Heart Disease

• Diabetes

• Arthritis (least)

what are the most common diagnoses in home health agencies? (in order of most to least common)

• Arthritis (most)

• Heart Disease

• Diabetes

• Depression

• Alzheimer’s Disease (least)

What do Residential Care Communities/Assisted-Living Facilities provide?

• room or apartment

• meals

• housekeeping

• medication management

• assistance with ADLs as needed

• recreational activities

  (might also provide transportation for shopping or doctor visits)

what do Home Health Agencies do and provide??

• Part-time nursing and medical care in patients homes

• Physical therapy

• Speech therapy

• Occupational therapy and social services

• Medical supplies and equipment (Wheelchairs, walkers, etc.)

what is PACE and why does it do what it does?

• Program of All-Inclusive Care for the Elderly

• encourages states to provide the benefits of Medicaid and Medicare benefits through one system for those who qualify for both of them

• Why? Because this would improve care coordination, and reduce administrative burdens for those elders (basically just makes it way easier for the old people to work it out)

who does limited health literacy affect and what is it associated with?

• people of all ages, races, incomes, and education levels.

• Disproportionately impacts lower socioeconomic and minority groups, those with low English proficiency, and older adults.

•  associated with worse health outcomes and higher costs.

how much will caring for older people take up of a healthcare worker’s regular workload in the future?

approximately one-third to two-thirds of the workload of healthcare personnel.