Gerontology and Long-Term Care

A comprehensive set of QUESTION_AND_ANSWER flashcards covering aging demographics, gerontology, APRN specialties, major organizations, Medicare/Medicaid, long-term care, and interdisciplinary geriatric teamwork.

What proportion of physician resources does healthcare for elders account for in the United States?

One third of physician resources and one quarter of medication use.

What is the age group referred to as the 'oldest-old'?

Age 85 years or older; the most rapidly growing segment of the elderly.

List the leading causes of death among older adults.

1) Heart disease 2) Cancer 3) COVID-19.

What is the average life expectancy for both sexes in the United States?

76.1 years.

At age 65, how many years of life remain on average in the United States?

18.4 years.

What are the life expectancy figures for women and men at birth/aging?

Women: 79.1 years; Men: 73.2 years.

Which gender is more likely to live alone in old age?

Elderly women.

Are most elderly men married or not?

Most elderly men are married; most elderly women are not.

What is driving the aging of America?

Baby boomers.

By what year will older adults first outnumber children in the United States?

2034.

What is ageism?

The belief in negative societal stereotypes about aging.

Name actions to avoid when speaking with an older/elderly adult.

Speaking in a loud voice; speaking slowly; using terms like 'sweetie,' 'granny,' or 'old guy'.

When did the American Nurses Association publish the first scope of practice for gerontological nursing?

1981.

When was the gerontological nursing scope revised?

1987.

When did ANA offer certification for geriatric NPs and gerontological CNSs?

1998.

What change occurred in 2008 regarding gerontological nursing education and certification?

The 'adult-gerontological' specialty was introduced to replace 'gerontological' programs by 2015; first group to certify in December 2012.

What is a Gerontological Nurse Practitioner (GNP)?

A APRN specialty focusing on the aged (healthy and ill) in settings such as hospitals, clinics, SNFs, LTCFs, hospices, and homes.

What is the combined APRN model called for GNP and ANP roles under the National Consensus Model?

Adult-Gerontology (AG) Nurse Practitioner; fully implemented in 2015.

What is AGPCNP an acronym for and what does it focus on?

Adult-Gerontology Primary Care Nurse Practitioner; focuses on adolescence through death; roles include clinician, advocate, teacher, etc.

Name the six population foci of APRNs.

Entire life span (family NP); Adult-gerontology; Neonatal; Pediatrics; Women’s health; Psychiatric/mental health.

What is the minimum educational requirement for nurse practitioners?

Master’s degree; DNP is clinical; PhD is research-oriented.

Differentiate geriatrics and gerontology.

Geriatrics = medical care of the aged; a medical specialty. Gerontology = study of aging and problems of the elderly; preferred by nurses.

What is geropsychology?

Branch of psychology focusing on the psychology and mental health of the aged; psychologists may have a PhD or PsyD.

What is social gerontology?

Focus on the social aspects of aging; typically requires a degree in social work, sociology, or related fields.

What is AGACNP?

Adult-Gerontology Acute Care Nurse Practitioner; provides advanced nursing care to adults and older adults with acute, chronic, or critical conditions.

What is the Administration on Aging (AOA) and its mission?

A principal agency of HHS/ACL designated to carry out Older Americans Act of 1965; funds states for supportive services; aims to provide home- and community-based services.

What is the American Bar Association Commission on Law and Aging?

Interdisciplinary organization to strengthen the legal rights and quality of care of elders; members include social services, law, academics, etc.

What is Adult Protective Services (APS)?

State-administered program protecting the safety of elders and adults with disabilities; APS TARC provides resources and support.

What is the Alzheimer’s Association?

A voluntary health organization aimed at eliminating Alzheimer’s disease and supporting those affected.

What is AARP?

The American Association of Retired Persons; nonprofit advocacy and services for Americans 50+.

What is the American Geriatrics Society (AGS)?

A nonprofit, multidisciplinary organization of health professionals focused on geriatrics; aims to improve quality of life and independence for the elderly.

What is the Centers for Medicare & Medicaid Services (CMS)?

Federal agency responsible for the Medicare and Medicaid programs.

What is the John A. Hartford Foundation Institute for Geriatric Nursing known for?

Funds educational programs/grants addressing elder care; hosts the GITT program for geriatric interprofessional training.

What is the Green House Model?

A nationally recognized long-term care model: a house with 8–10 older adults and CNAs functioning as a family; alternative to traditional LTCFs (created 2004 by William Thomas).

Name common residence types for older adults and a key characteristic of each.

SNFs (nursing homes): 24-hour custodial/medical care; Assisted-Living Facilities: minimal assistance with ADL; Group Homes: private residential setting; Independent Living/Retirement Communities: age 55+, minimal help; CCRCs: spectrum of care on one campus; Subsidized Senior Housing: HUD housing for low-income seniors.

What is Adult Day Care?

Community-dwelling older adults receive supervision and socialization during the day; supports caregivers and improves quality of life.

What is Home Healthcare vs In-Home Care?

Home Healthcare: skilled nursing care at home (RNs/LPNs; ADL/IADL help by CNAs); In-Home Care: non-medical assistance with daily tasks (shopping, grooming).

What is Respite Care?

Short-term relief for primary family caregivers; alternate caregiver temporarily assumes care.

Name some examples of long-term care payment terms and tools.

Accelerated death benefit; Assignment of benefits; Authorized representative/payee; Benefit maximum; Benefit period; Conservatorship; Copay; Deductible; Out-of-pocket expenses; Third-party administrator (TPA).

What does Medicare Part A cover and what does Part B cover?

Part A covers inpatient hospital, SNF, hospice, home health; Part B covers medically necessary services, outpatient care, labs, DME with prescription, ambulance, selective drugs and preventive services.

What is Medicare Advantage (Part C) and Part D?

Part C (Medicare Advantage) is a private plan option providing Medicare benefits; Part D is voluntary prescription drug coverage through approved plans.

What is Medigap?

Medicare Supplemental Insurance that covers gaps in original Medicare Part B (e.g., some drug coverage) and is sold by private insurers.

What is the Program of All-Inclusive Care for the Elderly (PACE)?

PACE provides comprehensive medical and social services to frail elderly in the community; interdisciplinary team; funded by Medicare/Medicaid; includes day care, home care, hospital care, labs, meals, therapies, and transportation.

What is Medicaid?

Federal/state program that pays for healthcare for low-income individuals, including nursing home care; eligibility varies by state.

What is conservatorship?

A legal arrangement where a court appoints someone to manage the incapacitated person’s finances and/or care.

What is a living will?

A document stating an individual's wishes regarding medical care if they are in a persistent vegetative state or terminal condition.

What is a durable power of attorney for healthcare?

A legal document designating a healthcare proxy to make medical decisions if the patient is incapacitated; must be signed with witnesses; limits power to healthcare decisions.

What are the three types of clinical teams in geriatric settings?

Multidisciplinary (different disciplines, independent treatment plans); Intradisciplinary (same discipline, different levels); Geriatric Assessment Interdisciplinary Team (several disciplines working together to maximize care, continuity, and quality of life).

Who are typical members and roles on a geriatric interdisciplinary team?

Geriatrician; Physicians/NPs/PAs; Registered Nurse (RN); Director of Nursing (DON); LPNs; Medical Assistants/CNAs; Registered Dietician; PT; OT; ST; Activity Director; Clergy; Social Worker; Psychologist; Psychiatrist/NP; Pharmacist.

What are the phases of team formation in the GITT program?

Forming, Norming, Confronting/Storming, Performing, Leaving.

What are common ineffective team behaviors and how can they be mitigated?

Ineffective behaviors: interrupting, late meetings, sarcasm, poor leadership, unclear roles, constant interruptions, long breaks; mitigation: strong leadership, clear roles, address conflicts, respect, avoid interruptions, schedule follow-ups.