Quiz 1 Concepts

SPICES Acronym

• Sleep Problems

• Problems with eating + feeding

• Incontinence

• Confusion

• Evidence of falls

• Skin breakdown

What does SPICES assess for?

Aids in identifying risk factors in older adult. Alerting nurses to initiate care plans to reduce patient harm

Mini-Cog

A 3-minute test that is used to screen for cognitive impairment in older adults. Uses three-item recall test and a clock drawing test.

Geriatric Depression Scale

Short form, consists of 30-question scale used to screen older people for depression. Questions answered as indicated score for one point. A score of 5 or more may indicate depression

Katz Index of ADLs

A tool used to determine the results of treatment and prognosis in older and chronically ill people. Rating of dependence or independence is made for each of the 6 functions

Factors that keep someone living at home

• Ability to perform ADLs independently

• Strong social support system (family, caregivers, etc.)

• Adequate home environment (safe, accessible)

• Use of assistive devices or home health services (physical therapy, visiting nurse, etc.)

• Mild or well-managed chronic illnesses

Factors that increase likelihood of institutionalization

• Loss of functional independence, esp in basic ADLs

• Frequent falls or inability to ambulate safely

• Cognitive decline (dementia) affecting safety and self-care

• Lack of family or social support

• Multiple uncontrolled chronic conditions

• Need for 24-hour supervision or complex medical care

What is a decreased response to stress due to?

Less efficient autonomic NS

What is an altered pharmacokinetic/pharmacodynamic drug response due to?

Changes to liver, kidney function, body fat, plasma protein lvls

What are increased insulin resistance and glucose intolerance due to?

Reduced insulin sensitivity

What is an increased risk for syncope due to?

Baroreceptor sensitivity decline, orthostatic hypotension, and cardiac conduction changes

What is a decreased immune response due to?

Weaker immune sys function in older adults

What is the Katz index of ADLs?

Measures independence in ADLs such as bathing, dressing, toileting, transferring, continence, and feeding

What are sleep disorders?

Disturbances in sleep patterns; common in older adults

What are problems with eating or feeding?

Difficulties in self-feeding or swallowing

What is incontinence?

Loss of bladder or bowel control

What is confusion?

Altered mental status or delirium

What is evidence of falls?

History or signs of recent falls or fall risk

What is skin breakdown?

Pressure ulcers or skin integrity issues

What is comprehensive assessment in geriatrics?

Used to distinguish normal age-related changes from indicators of disease

Normal vs. pathological changes: memory

Normal: mild forgetfulness (e.g., forgetting names, remembering later)

Pathological: frequent memory loss disrupting life (e.g., repeating questions – possible dementia)

Normal vs. pathological changes: skin changes

Normal: thinner, more fragile skin

pathological: non-healing wounds or pressure ulcers (may indicate poor circulation or neglect)

Normal vs. pathological changes: mobility changes

Normal: slower walking, mild balance issues

pathological: sudden unsteadiness or falls (may signal neurological or musculoskeletal issues)

Normal vs. pathological changes: urinary function

Normal: frequent urination, decreased bladder capacity

pathological: sudden incontinence or painful urination (may indicate UTI or prostate problems)

Normal vs. pathological changes: mood changes

Normal: mild irritability or mood shifts

pathological: persistent sadness or apathy (may signal depression)

Why is a baseline assessment important in aging?

A baseline assessment is essential to determine what is 'normal' for an individual.

Example of disease indicator in the elderly

Urinary Tract Infection (UTI) may present with confusion or delirium in older adults, unlike younger patients who typically have localized symptoms

Key symptoms of disease in the elderly

Confusion and delirium are often indicators of underlying illness and should not be ignored

Importance of baseline assessment

A baseline helps distinguish between normal age-related changes and new symptoms that may indicate disease or disability