Chapter 1-9 Key Concepts in Gerontological Nursing (Lecture Notes)

Flashcards covering key aging concepts, theories, demographics, health care funding, diversity, and culturally competent nursing practice from the lecture notes.

What age defines an 'older adult' in this course?

65 years or older.

How many Americans are classified as older adults according to the lecture?

One in seven Americans.

What are the subgroups of older adults described in the notes?

Young old, middle old, and old old (65 vs 80+ differences are noted).

What is the leading cause of death in older adults?

Heart disease.

What is the second leading cause of death in older adults?

Cancer.

What is the most common chronic illness in older adults?

Hypertension.

Define 'comorbidity'.

Having two or more chronic illnesses at the same time.

What does Medicare Part A cover?

Hospital and physician services; generally no premium for Part A.

What does Medicare Part B cover?

Additional health services and supplies not covered by Part A (e.g., home health, equipment, outpatient services).

What is Medicare Part C?

Medicare Advantage Plans; private plans that cover Parts A and B and may include extra benefits.

What does Medicare Part D cover?

Prescription drug benefits.

How does Medicaid differ from Medicare regarding long-term care?

Medicaid is needs-based for low-income individuals and can pay for long-term care; Medicare typically does not pay for long-term care.

What is 'aging in place' and a related consideration?

Staying in one's home as long as possible; remodeling to be ADA-compliant can reduce caregiver and long-term care costs.

What is ageism?

Prejudice or stereotypes about older adults based on age; can be positive or negative and can undermine dignity.

Why is loneliness a significant concern for older adults?

Loneliness is closely linked to poorer health outcomes and can be worse for health than smoking.

Name the key diversity groups discussed in the notes.

Hispanic/Latino, Black Americans, Asian Americans, Native Americans, Jewish Americans, Muslims, LGBTQIA+.

What are Traditionalists (Silent Generation) and Baby Boomers known for in terms of values?

Traditionalists: hardworking, conformist, law-and-order; Baby Boomers: optimistic, team-oriented, value work and social connections.

What does Continuity Theory propose about aging?

Personality and habits persist over time; care should be individualized based on consistent patterns.

What is the Free Radical Theory of aging?

Aging results from unstable reactive molecules from oxygen metabolism; antioxidants may help protect against damage.

What is the Disengagement Theory, and what is its status?

Proposes withdrawal from social roles with aging; later research questions its accuracy and outcomes.

What is the Activity Theory in aging?

Older adults should maintain activities and independence to stay engaged in society.

What is the Functional Consequences Theory in nursing?

Nurses promote wellness by addressing the whole person (body, mind, spirit) and functioning.

What are the basics of the Theory of Thriving?

Meaningful life, purpose, and social connections contribute to thriving; nursing supports these elements.

What are the core ideas of the Theory of Successful Aging?

Well-being linked to personal control and positive affect; engagement in health-promoting activities.

Why is cultural competence a clinical safety issue in nursing?

Lack of cultural competence can create barriers and worsen health outcomes; check biases, earn trust, and adapt care.

What is the difference between chronological age, functional age, perceived age, and age identity?

Chronological: actual years lived; Functional: ability-based age; Perceived: how old others think you are; Age identity: how you identify your own age.

A nurse is conducting an orientation for new staff about geriatric care. To ensure consistent understanding, which age defines an 'older adult' in this course?A) 55 years oldB) 60 years oldC) 65 years oldD) 70 years old

C. 65 years old. The course defines an 'older adult' as an individual who is 65 years or older, which is a common chronological age marker for this population group.

According to a recent lecture on gerontology, what proportion of Americans are classified as older adults?A) One in ten AmericansB) One in seven AmericansC) One in five AmericansD) One in three Americans

B. One in seven Americans. The lecture highlighted that approximately one in seven Americans are classified as older adults, demonstrating the significant demographic shift and the growing need for geriatric care.

When discussing the heterogeneous nature of the older adult population, the notes describe which subgroups?A) Early, mid, and late older adultsB) Young old, middle old, and old oldC) Active, moderately active, and frail older adultsD) Dependent, semi-independent, and independent older adults

B. Young old, middle old, and old old. These subgroups (e.g., distinguishing between 65-year-olds and 80+-year-olds) acknowledge the significant differences in health status, functional ability, and social needs within the broader older adult population.

The nurse is providing health education to a group of senior citizens. When discussing major health risks, what should the nurse identify as the leading cause of death among older adults?A) CancerB) StrokeC) Diabetes mellitusD) Heart disease

D. Heart disease. Cardiovascular diseases, particularly heart disease, are the leading cause of mortality in the older adult population. Education on prevention and early management is crucial.

Following heart disease, what is identified as the second leading cause of death in older adults?A) Cerebrovascular accident (stroke)B) CancerC) Chronic respiratory diseasesD) Accidents and falls

B. Cancer. After heart disease, cancer is the second leading cause of death among older adults, emphasizing the importance of screening, early detection, and appropriate treatment strategies.

A nurse is assessing a 72-year-old patient who has several chronic conditions. The nurse understands that which of the following is the most common chronic illness observed in older adults?A) Type 2 DiabetesB) OsteoarthritisC) HypertensionD) Dementia

C. Hypertension. High blood pressure is the most prevalent chronic illness in the older adult population, requiring consistent monitoring and management to prevent serious cardiovascular complications.

A patient's medical record indicates a diagnosis of 'comorbidity.' How should the nurse interpret this term?A) The patient has developed an acute illness while managing a chronic one.B) The patient is experiencing unexpected side effects from multiple medications.C) The patient has two or more chronic illnesses simultaneously.D) The patient's chronic illness has led to severe functional decline.

C. The patient has two or more chronic illnesses simultaneously. Comorbidity refers to the presence of two or more co-occurring chronic diseases in an individual, a common situation in older adults that complicates care.

An older adult patient is asking about their Medicare benefits. The nurse explains that Medicare Part A primarily covers which services?A) Outpatient doctor visits and preventive careB) Prescription drug benefitsC) Hospital stays and physician servicesD) Durable medical equipment and home health services

C. Hospital stays and physician services. Medicare Part A primarily covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. For most individuals, there is no premium for Part A.

A nurse is educating a new older adult client about the different parts of Medicare. Which services are typically covered under Medicare Part B?A) Inpatient hospital care and skilled nursing facility staysB) Prescription medicationsC) Home health services, durable medical equipment, and outpatient therapiesD) Private hospital rooms and elective cosmetic surgeries

C. Home health services, durable medical equipment, and outpatient therapies. Medicare Part B covers medically necessary services and supplies not covered by Part A, such as doctor's services, outpatient care, medical equipment, and some preventive services.

A patient inquires about Medicare Part C options. The nurse explains that Medicare Part C, also known as Medicare Advantage Plans, functions how?A) It specifically covers long-term care services for low-income individuals.B) It is a private insurance plan that provides Part A and Part B benefits, often with additional features.C) It is a supplemental plan that only covers prescription drugs.D) It is a government-funded program for individuals with specific chronic diseases.

B. It is a private insurance plan that provides Part A and Part B benefits, often with additional features. Medicare Part C, or Medicare Advantage, is offered by private companies approved by Medicare and typically bundles Part A, Part B, and often Part D coverage, sometimes including extra benefits like vision or dental.

An older adult is concerned about the cost of their medications. Which part of Medicare specifically addresses prescription drug benefits?A) Medicare Part AB) Medicare Part BC) Medicare Part CD) Medicare Part D

D. Medicare Part D. Medicare Part D is a prescription drug coverage program offered by private insurance companies that are approved by Medicare. It helps cover the cost of prescription drugs.

A low-income older adult requires extensive long-term care. The nurse explains that which program is more likely to provide financial assistance for these services, and why?A) Medicare, because it covers all medical expenses for seniors.B) Medicaid, because it is needs-based and can cover long-term care.C) Medicare Part B, as it covers equipment and outpatient services.D) Medicare Part C, due to its additional benefits.

B. Medicaid, because it is needs-based and can cover long-term care. Medicaid is a federal and state program for low-income individuals that provides comprehensive health coverage, including long-term care services, which Medicare typically does not cover.

An older adult patient expresses a strong desire for 'aging in place.' The nurse understands this concept to mean:A) Moving into an assisted living facility that offers a sense of permanency.B) Staying in their current home and community for as long as possible.C) Engaging exclusively in age-segregated social activities.D) Relying solely on family members for all care needs.

B. Staying in their current home and community for as long as possible. 'Aging in place' involves maintaining independence and quality of life in one's familiar environment. Related considerations include home modifications (e.g., ADA-compliant remodeling) to facilitate safety and reduce future care costs.

The nurse hears a colleague make a comment, 'All older adults struggle with technology.' This statement exemplifies which concept?A) EmpathyB) Age identityC) AgeismD) Functional age

C. Ageism. Ageism is prejudice or stereotypes directed towards older adults based on their age. Such stereotypes, whether positive or negative, can undermine an individual's dignity and contribute to discrimination.

A nurse is assessing an older adult patient who lives alone and rarely interacts with others. The nurse recognizes loneliness as a significant concern due to its strong link with:A) Increased cognitive functionB) Improved physical enduranceC) Poorer health outcomesD) Enhanced social engagement

C. Poorer health outcomes. Loneliness in older adults is a critical concern because it is closely linked to poorer health outcomes, including increased risk of mortality, depression, and cognitive decline, and its impact can be as detrimental as smoking.

When developing culturally competent care plans for older adults, the nurse considers the various diversity groups discussed in the notes. Which of the following is NOT explicitly mentioned as a key diversity group?A) Hispanic/Latino AmericansB) Native AmericansC) European immigrantsD) LGBTQIA+ individuals

C. European immigrants. The key diversity groups explicitly mentioned are Hispanic/Latino, Black Americans, Asian Americans, Native Americans, Jewish Americans, Muslims, and LGBTQIA+ individuals. While European immigrants contribute to diversity, they were not specifically listed as one of the key groups in the notes.

The nurse is interacting with an older adult patient who strongly values hard work, conformity, and adherence to rules. Based on generational characteristics, this patient is most likely a member of which group?A) Baby BoomersB) Generation XC) Traditionalists (Silent Generation)D) Millennials

C. Traditionalists (Silent Generation). Traditionalists are known for values such as being hardworking, conformist, and valuing law-and-order. Baby Boomers, in contrast, are characterized by optimism, team-orientation, and valuing work and social connections.

A nurse is caring for an older adult who has always been very independent and particular about their daily routine. Based on Continuity Theory, what approach should the nurse prioritize in the care plan?A) Introduce new activities and routines to stimulate adaptation.B) Structure care to allow the patient's existing personality and habits to guide interventions.C) Encourage disengagement from past roles to promote new interests.D) Emphasize group activities to foster new social connections.

B. Structure care to allow the patient's existing personality and habits to guide interventions. Continuity Theory posits that personality traits and established habits tend to persist over time. Therefore, care should be individualized, respecting and building upon these consistent patterns to promote well-being.

Which theory of aging suggests that aging is caused by unstable, highly reactive molecules generated during normal oxygen metabolism, and implies that antioxidants might help mitigate this process?A) Activity TheoryB) Disengagement TheoryC) Free Radical TheoryD) Programmed Senescence Theory

C. Free Radical Theory. The Free Radical Theory of aging proposes that cumulative damage to cells and tissues from unstable reactive molecules (free radicals), produced during oxygen metabolism, contributes to the aging process. Antioxidants are thought to help counteract this damage.

A nurse reads about the Disengagement Theory of aging. Which statement accurately describes a key aspect and current standing of this theory?A) It suggests older adults should maintain active social roles for successful aging.B) It proposes a mutual withdrawal between older adults and society, but its accuracy has been largely questioned.C) It emphasizes the importance of new learning and adaptation in later life.D) It states that genetic programming dictates the timing and pace of aging.

B. It proposes a mutual withdrawal between older adults and society, but its accuracy has been largely questioned. Disengagement Theory posited that older adults and society mutually withdraw from each other, but subsequent research has largely challenged its universality and positive outcomes for successful aging.

According to Activity Theory, what is considered crucial for successful aging?A) Gradual withdrawal from social roles and responsibilities.B) Maintaining a high level of physical and mental activity and independence.C) Accepting inevitable decline and focusing on spiritual well-being.D) Prioritizing rest and minimizing strenuous efforts.

B. Maintaining a high level of physical and mental activity and independence. Activity Theory proposes that successful aging occurs when older adults remain as active as possible and maintain their social roles, interests, and independence to stay engaged with society.

A nurse utilizing the Functional Consequences Theory of aging in practice would prioritize which intervention?A) Focusing solely on managing the patient's chronic diseases.B) Promoting wellness by addressing an older adult's body, mind, spirit, and overall functioning.C) Encouraging the patient to disengage from social activities.D) Advising the patient to accept all age-related declines as inevitable.

B. Promoting wellness by addressing an older adult's body, mind, spirit, and overall functioning. The Functional Consequences Theory for nursing emphasizes that nurses proactively intervene to promote wellness and optimal function by considering the older adult's holistic needs and potential for positive functional outcomes, rather than just disease management or accepting decline.

The nurse is advocating for an older adult to participate in a community volunteer program. This action aligns with which theory, emphasizing meaningful life, purpose, and social connections?A) Disengagement TheoryB) Theory of Successful AgingC) Free Radical TheoryD) Theory of Thriving

D. Theory of Thriving. The Theory of Thriving suggests that a meaningful life, a sense of purpose, and strong social connections are essential for older adults to 'thrive.' Nurses support these elements by encouraging engagement and purposeful activities.

According to the Theory of Successful Aging, what are core components that contribute to an older adult's well-being?A) Genetic predispositions and avoidance of all risks.B) Emphasis on passive acceptance of age-related changes.C) Personal control, positive affect, and engagement in health-promoting activities.D) Complete disengagement from prior social roles.

C. Personal control, positive affect, and engagement in health-promoting activities. The Theory of Successful Aging highlights that well-being in later life is strongly linked to an individual's sense of personal control, maintaining a positive emotional state (positive affect), and actively engaging in behaviors that promote health.

A nurse recognizes that cultural competence is not just a 'nice to have' but a clinical safety issue. Why is cultural competence considered critical for patient safety in nursing?A) It ensures all patients receive the same standardized care regardless of background.B) A lack of cultural competence can lead to communication barriers, mistrust, and poorer health outcomes.C) It primarily benefits nurses by increasing their job satisfaction.D) It simplifies patient care by reducing the need for individual assessment.

B. A lack of cultural competence can lead to communication barriers, mistrust, and poorer health outcomes. Cultural competence is a clinical safety issue because failing to understand and respect a patient's cultural background can create significant barriers to care, erode trust, and directly worsen health outcomes. Nurses must check biases, earn trust, and adapt care accordingly.

A 70-year-old client who regularly runs marathons and is often mistaken for someone in their 50s identifies themselves as an 'ageless adventurer.' The nurse recognizes that 'how old others think you are' refers to which concept?A) Chronological ageB) Functional ageC) Perceived ageD) Age identity

C. Perceived age. The concepts are defined as: Chronological age (actual years lived), Functional age (age based on abilities), Perceived age (how old others perceive you to be), and Age identity (how you identify your own age). In this scenario, being mistaken for someone younger relates to perceived age.