introduction and demographics

geriatric 5 M's

1. what Matters Most

2. Mind

3. Mobility

4. Medications

5. Multi-complexity

*Medicare

what is aging?

- hallmark is the variability of individuals

- challenging, complex

- dynamic and fluctuating w/ a wide range of responses

what is a generation

- cohort born in a specific time period

- often will rebel against generation before

how does generational identity affect our patients

- goals, needs, and wants may differ from ours

- different approaches to healthcare

- different beliefs about body, exercise

silent generation

1928-1945

- healthcare is an entitlement

- paternalistic

- increased health conditions

- prefer clear explanations

baby boomers

1946-1964

- increased responsibility for health

- alternative health

- individualized approach

- may use WebMD

generation x

1965-1980

- less access to PCP

- dislikes bureaucracy and paperwork

- questions knowledge or recommendations

- more exercise/nutrition conscious

millenials

1981-1996

- increased obesity

- informal

- least likely to be insured

- not impressed by authority

- needs feedback

generation z

1997-2012

- pragmatic

- well informed

- values honesty

- realistic

Medicare definition of older adult

65+ y/o

Older Americans Act definition of older adult

60+ y/o

4 F's of slippery slope of aging

Fun - no restrictions in home, work, community

Function - self-limit and/or require modifications

Frailty - majority of energy utilized in completing ADLs

Failure - may be bedridden, assistance w/ Basic ADLs and instrumental ADLs

ageism

bias, discrimination or bullying of individuals based off their age

whole person approach

- successful aging is individually perceived

- cultural and spiritual influences

- personality traits

- motivation and engagement

- life transitions

- sex and intimacy

- trauma-informed care and mental health conditions

successful aging

perceived state

- outcome w/ subjective and objective elements

cultural and spiritual influences

- unique understanding within each community and interactions w/ aging differently

- spirituality involves recognition of a feeling, sense or belief that there is something greater than oneself

motivation and engagement

- enhance engagement through pt centered goals

- increased pt participation in goal-setting and treatment planning improves outcomes and pt satisfaction

- incorporate pt goals into conversation

- address beliefs, unpleasant physical sensations, individualized care, social support and goal identification

life transitions

when a person adapts and adjusts to a new life role

sex and intimacy

core dimension of life across lifespan and should be considered as they relate to psychosocial implications and activity restrictions

- can be emotional, intellectual, physical, experiential and spiritual

trauma-informed care and health conditions

awareness of a pt prior trauma as well as any existing mental health conditions can:

- encourage a whole-body approach

- trigger collaboration w other disciplines

- may increase PT empathy

true or false: US population is getting more ethnically diverse over time

true

who's more likely to be living alone at 65+ y/o

women

is poverty status increasing or decreasing as we age

poverty is increasing

are older adults working more or less as they age

a lot more, and women especially

- healthier

- longer life expectancy

- better educated

- increase in social security and pension benefit ages

physical activity levels as we age

lessen

- < 20% of older adults aren't meeting ACSM

is there a universally accepted theory of aging?

no

aging is associated w/

- reduced physiologic adaptability

- increased vulnerability to disease

- whole body inflammation

- effects of normal vs pathological aging must be differentiated

- increased mortality

- consistent change in biochemistry and biomechanics of body

2 categories of factors that affect rate of aging

1. genetic (programmed)

2. non-genetic (lifestyle)

role of the PT for aging adults

- clinician

- educator

- advocator

- community colloborator