Specific Populations Final

What is true about the aging process?

Aging occurs within biological and genetic parameters. 

Which of the following is the result of primary aging?

Hair loss

Secondary aging changes:

are neither a normal or usual part of aging

What is the best way for an OTA to determine if physiological, psychosocial, or cognitive changes are a result of pathological aging?

By having knowledge of normal aging process 

Primary aging changes in the skeletal system include a decline in bone density, lowered resistance to skeletal stress, and loss of skeletal flexibility and mobility. These aging changes are most pronounced in

women following due to decreased estrogen following menopause. 

Which cognitive components are essential to assess in order to determine the older adult's ability to learn and safely engage in ADL and IADL throughout the rehab process?

Problem-solving and divided attention

Which type of intelligence is crucial in the ability of an older adult to "think on their feet" and solve problems?

Fluid intelligence

This system is considered the largest organ in the body providing protection to internal organs and serving as a barrier to infectious organisms.

Integumentary system

Which of the following is a degenerative change of the skeletal system that causes pain and decreased mobility generally in weight-bearing joints, affects 50% of those 65 years and older, and can be clinically treated?

Osteoarthritis

How can an OTA promote successful aging for older adults?

By optimizing occupational engagement through a process of selection and compensation

What is the age-associated loss of muscle mass responsible for functional declines in older adults?

Sarcopenia

In regard to primary aging changes in the cardiopulmonary system, what must the OTA keep in mind when designing therapeutic interventions for older adult patients?

Avoid unnecessary exertion

Secondary aging changes result from a disease process, an impairment, or a dysfunction. Secondary aging is an abnormal change, such as after a stroke

Loss of strength or balance 

What is the physiological impact from the decrease in lung volume and loss of elasticity in the lungs that result from aging?

Effective gas exchange is comprised

Ms. Bell has symptoms of urinary incontinence, including uncontrollable loss of urine when she coughs, laughs, and sneezes. Which type of incontinence does she have?

Stress Incontinence 

A COTA is working on a toileting program for a frail elder who has recently experienced a cognitive decline. This elder has had previous problems with skin breakdown related to incontinence, so it is imperative to avoid accidents as much as possible. Which of the following would be the best strategy for the COTA to include?

Prompted Voiding

Your client is experiencing incontinence only at night and in the early morning when she hears water running. She also has some dribbling when she laughs or coughs. Which type of incontinence does she have?

Mixed incontinence

Your client is having symptoms of urinary incontinence, including the ability to hold her urine until she gets to the bathroom. What type of incontinence does she have?

Urge incontinence 

Your client is a 77-year-old homebound woman living with her daughter and son-in-law in a house. The client has her own large room that serves as a bedroom and living room in one, with an attached large bathroom. The client has a new complaint of incontinence, especially at night. Which of the following adaptations would be most appropriate for this client's needs?

Place a commode near the bedside and a night light on the wall outlet near the commode. 

What is the first step to correcting stress, urge, and mixed incontinence?

Bladder training

How does reimbursement from private and government health insurance programs (Medicaid and Medicare) affect elders with urinary incontinence?

Poor reimbursement for evaluation and treatment of urinary incontinence encourages management of the problem instead of treatment

How many elders in the community relay incontinence problems to their physicians for treatment?

1 in 2

The caregivers of a skilled nursing facility are working with Mr. Jones to decrease episodes of incontinence. When Mr. Jones feels the need to urinate, his caregivers tell him to resist the urge for at least 10 minutes longer than yesterday. What type of strategy is this?

Badder Training

Which of the following is a major cause of constipation?

Lack of exercise

Which of the following health care professionals would treat incontinence by determining the family dynamics and support systems available to elders and help determine the effect that incontinence has on the involvement of elders in social activities and relationships?

Social service specialists

VRE can spread from one person to another, often via contaminated hands, or through contact with contaminated surfaces (toilet seats, doorknobs, grab bars, & walkers).

True

VRE

vancomycin-resistant enterococcus

What is vancomycin?

Antibiotic 

After providing OT tx to an acute care patient that has C-diff, the use of gel-based hand sanitizer or proper hand-washing should be completed before leaving the room.

False

Which of the following strategies would be helpful for an elder who has perceptual difficulties?

Use hand-over-hand guiding to provide tactile cueing while bringing food to the mouth

Which of the following is a safe swallowing technique during the pharyngeal phase of swallowing for elders with dysphagia?

Check for voice clarity after swallowing to make sure no food was left on the vocal folds

Which of the following strategies would be useful to the elder who is on a ventilator or has difficulty breathing?

Limit conversation while eating

Which elder would benefit from the use of an assistive device for self-feeding?

An elder with slight tremors of both hands and history of stroke in the dominant arm; an elder with severe dementia who only has a sucking reflex; an elder with no grasp in the dominant arm; ALL OF THE ABOVE

You are considering making a few suggestions for improving the dining experience for elders in an assisted living facility. Which of the following would you recommend as an environmental change to improve social interaction during mealtimes?

TURN OFF THE tv DURING THE MEALS AND USE AGE-APPROPRIATE SOFT MUSIC 

You are preparing to feed a frail 70-year-old resident at breakfast in a long-term care facility. Which of the following would you do first?

Collect information about the elder such as presence of dysphagia, any recent medical or medication changes, and the current diet order 

Select the phase of swallowing where the bolus passes enters the pharynx and the soft palate elevates to seal the entrance to the nose and the vocal folds close.

Pharyngeal phase

Select the phase of swallowing where the bolus is prepared and formed by the tongue and then propelled by the tongue to the back of the mouth and over the base of the tongue.

Oral phase

In frail elders, which age-related swallowing change would you expect to see in the pharyngeal phase?

The time of passage of the bolus increases, increasing risk of aspiration

Alex is a COTA who is completing a self-feeding treatment session during breakfast when they notice that another resident across the table loses a great deal of food out of the front of his mouth during feeding. Alex concludes that this resident may have deficits in which phase of the swallow?

Oral

What is the preferred seating method for an elder during mealtime?

Dining room chair with armrests 

Which of the following activities would be appropriate for an entry-level COTA?

Correct meal preparation 

What is least likely a compensation that elders may make spontaneously to assist themselves in eating safely and efficiently?

Thicker drinks

In healthy elders, which age-related swallowing change would you expect to see?

Muscle tone decreases in the lips, tongue, and esophagus 

When feeding an elder, how would you know when they are ready to take another spoonful or bite of food?

When they have swallowed the last bite of food and signals that they are ready for the next bite of food

Clive was referred for an occupational therapy evaluation for weakness and deconditioning. When reviewing the electronic medical record (EMR), the COTA notices that the he has lost weight over the last 3 months, and she begins to wonder if Clive has dysphagia which is contributing to the weight loss. What information in the EMR might indicate dysphagia or aspiration?

Recurrent pneumonias

Vo Nguyen takes her medications with sips of water every morning. However, she states that at times she feels they get stuck after she swallows and requests more water to wash them down. How much liquid is recommended following each pill to ensure adequate transport to the stomach?

45 mL

Santiago is a COTA who is providing intervention for self-feeding with an elder during breakfast. During the meal, he notices that after the client swallows, there are small bits of food on the back of her tongue. What strategy could Santiago try to help remove food residue after the swallow?

Alternating solids and liquids

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