chapter 1,2,5 Objectives
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| The medical speciality that deals with the physiology of aging and with the Dx and treatment of diseases affecting the aged. | Geriatrics
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| the study of all aspects of the aging process, including clinical, psychologic, economic, and sociologic problems of older adults and the consequences of these problems for older adults and society. | gerontology
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| a complex process that can be described chronologically, physiologically, and functionally | aging
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| the least meaningful measurement of aging | chronologic
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| the single most important factor that influences how poorly or how well a person will age is | attitude
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| the fear of aging and the refusal to accept older adults into the mainstream of society is known as | gerontophobia
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| the extreme forms of gerontophobia are __ & __ | ageism and age discrimination
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| the disliking of aging and older people based on the belief that aging makes people unattractive, unintelligent, and unproductive | ageism
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| a negative belief pattern that can result in irrational thoughts and destructive behaviors such as intergenerational conflict and name calling | ageism
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| Myth or fact: most older people are pretty much alike. | Myth
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| Myth or fact: they are generally alone and lonely | Myth
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| Myth or fact: the are sick, frail, and dependent on others | myth
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| Myth or fact: they are often cognitively impaired | myth
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| Myth or fact: they are depressed | myth
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| Myth or fact: they become more difficult and rigid with advancing years | myth
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| Myth or fact: they barely cope with the inevitable declines associated with aging | myth
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| Myth or fact: they are a very diverse age group | fact
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| Myth or fact: most older adults maintain close contact with family | fact
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| Myth or fact: most older people live independently | fact
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| Myth or fact: for most older adults, if there is decline in some intellectual abilities, it is not severe enough to cause problems in daily living | fact
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| Myth or fact: community dwelling older adults have lower rates of diagnosable depression than younger adults | fact
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| Myth or fact: personality remains relatively consistent throughout the life span | fact
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| Myth or fact: most older people successfully adjust to the challenges of aging | fact
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| ___ results in different treatment of older people simply because of their age. This reaches beyond emotions and leads to action | age discrimination
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| the statistical study of human populations. concerned with a population's size, distribution, and vital statistics. | demographics
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| include birth, death, age at death, marriage(s), race, and many other variables | vital statistics
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| one important piece of demographic information is | life expectancy
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| these centers combine privacy with easily available services. Most consist of private apartments that are either purchased or rented. Most are privately operated and cost are significant | independent or assisted-living centers
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| different levels of medical, nursing, and personal care services are available. health care services may include assistance with hygiene, routine medication administration, and preventive health clinics. | independent or assisted-living centers
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| for a large initial investment and substantial monthly rental and services fees, older persons or couples are guaranteed a residence for life. | life lease or life contract facilities
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| these apartment units have extended-care units that are either attached to this apartment complex or located nearby for residents who require skilled nursing services. The cost are high and may be out of range of the average older adult. | life lease or life contract facilities
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| Meet certain financial standards and limits. may be simple apartments without any special services, or they may have limited services, such as access to nursing clinics and special transportation arrangements. waiting list of 1-2 years | government subsidized housing
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| not related to each other. 2 or more people share a house with private bedrooms but common recreational and leisure areas, as well as task involved in home maintenance | group-housing plans
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| for a monthly fee that may be paid by the individual or may be provided by county or state agencies. Provide facilities with private or semiprivate rooms with community areas for dining and socialization. | community based residential facility (CBRF)
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| provides services such as room and board, help with daily activities, assistance with medications, yearly medical exams, information and referrals, leisure activities, and recreational or therapeutic programs | community based residential facility (CBRF)
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| more extensive assistance. provide room and board, personal care, and medical and nursing services. 3 levels of care are provided | nursing homes or extended care facilities.
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| ___ care facilities provide the level of care and supervision necessary to maintain the residents' safety and well being | basic
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| __ care facilities provide skilled nursing care on a regular bases. | skilled
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| __ care facilities provide comprehensive inpatient care designed for individuals who have an acute illness, injury, or exacerbation of a disease process | subacute
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| __ is the government program that provides health care funding for older adults and those with disabilities | medicare
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| medicare has __ distinct programs and __ pays all of the cost | 4. 0
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| _ covers inpatient hospital care; extended care in a skilled nursing facility following hospitalization, some home health services such as visiting nurses and occupational, speech, or physical therapists; and hospice services. deductible, co-pay. | medicare part A
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| medicare instituted the ___ system in an attempt to contain hospital costs. Under this, a hospital is paid a set amount based on the Pt's admitting Dx. | Diagnosis-related group (DRG)
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| __ is optional. covers 80% of the 'customary & unusual' rates charged by physicians after deductibles are met. includes ambulance, PT, Speech, OT, home health, medical supplies and equipment, outpt surgery and Bld transfusions. | medicare part B
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| in 1997, optional __ was available to those who are eligible for part A and enrolled in part B. includes 'advantage or choice' plans. | medicare part C
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| prescription drug coverage | medicare part D
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| assistance may be available for those older adults who meet certain financial need requirements. | supplemental medicaid
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| what 2 formal types of advance directive are recognized in most states | 1- durable power of attorney for health care
2- the living will
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| in general, __ are recognized and respected, but various agencies, individual physicians, or health care providers may have beliefs or policies that prohibit them from honoring certain advance directives. | advance directives
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| __ for health care transfers the authority to make health care decisions to another person, called the _ | durable power of attorney
health care agent
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| __ informs the physician that the individual wishes to die naturally if he or she develops an illness or receives an injury that cannot be cured. | living will
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| They prohibit the use of life-prolonging measures and equipment when the individual is near death or in a persistent vegatative state. | living will
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| __ may occur when the aging person is no longer able to live alone | family crisis
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| ___ is probably the most significant issue that aging parents and their children must face. feeling of grief, anger, frustration, and loss are common. | loss of independence
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| __ is more likely to be seen when an older person has few or no close family or friends, but can occur despite their presence. | self neglect
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| __ is defined as the failure to provide for the self because of a lack of ability or lack of awareness. | self neglect
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| ___ occurs when any person deliberately plans to mistreat or harm another person | intentional abuse
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| ____ is most likely to occur when the caregiver lacks the necessary knowledge, stamina, or resources needed to care for an older loved one. | unintentional abuse or neglect
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| forms of abuse can be __, __, __, or __. __ and __ can also constitute forms of abuse. | physical, financial, psychological, or emotional. Neglect and abandonment
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| ___ is any action that causes physical pain or injury | physical abuse
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| bruising,lacerations,broken teeth,broken glasses,sprains,fractures,burn marks,wounds in various stages,unexplained injuries,torn or bloody underwear,vaginal trauma,delay in medical treat,Hx Dr shopping,refusal to allow visitors,failure adequate food-H2o. | physical abuse
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| __ is a passive form of abuse in which the caregiver fail to provide for the needs of the older person under their care. | neglect
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| accounts for almost half of verified cases. fails to meet hygiene or safety needs. exposure because they lack adequate clothing from the elements. failure to provide medical care. | neglect
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| __ is more subtle and difficult to recognize | emotional
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| emotional abuse can be __ or __. | verbal or nonverbal
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| __: shouting, voicing threats of punishment or confinement | verbal
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| _ often threaten older adults with all manners of horrors. | emotional
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| Displeasure, disgust, frustration, or anger via sighing, head shaking, door slamming, or other negative body language. repeatedly ignoring, avoiding social interaction | emotional, nonverbal
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| signs include: lack of eye contact, trembling, agitation, evasiveness, or hypervigilance | emotional abuse
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| __ exist when the resources of an older person are stolen or misused by a person whom the older adult trust | financial abuse
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| signs: unusual banking activity; large or frequent withdrawals,missing bank statements, missing personal belongings, particularly those of value, and signatures on checks or documents that do not match the elderly person | financial abuse
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| _ occurs when dependent older persons are deserted by the person or persons responsible for their custody or care under circumstances in which a reasonable person would continue to provide care. | abandonment
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| Leaves elderly physically, emotionally, & financially defenseless. usually become wards of the state. | abandonment
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| _ allows the primary caregiver to have time away from the constant demands of caregiving, thereby decreasing caregiver stress and the risk for abuse. Can be provided by family members, volunteers, or agencies. Nurse should encourage! | respite care
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| _ is not always the most reliable way to measure aging because the number of yrs a person has lived provides little information about his or her physiologic or functional ability. | chronologic age
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| a large segment of today's aging population lives a more _, _ lifestyle than ever before | dynamic, positive
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| the US will face significant challenges to meet the cost of providing adequate health care to _ | aging population
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| __ & __ perceptions of aging and older persons appear to be on the decline, yet subtile forms of ageism still exist and need to be addressed. | stereotyping and negative
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| as older adults become increasingly _ segment of the population, they are having a significant impact on politics, economics, housing, and social family dynamics | larger
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| providing quality care for an increasingly large aging population places increased demands on both _ and _ caregivers | family and professional
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| although many positive changes have occurred, the frailest older adults remain vulnerable to __, __, and __ abuse | physical, emotional, and financial
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| _ is best looking at as a series of changes that occur over time, contribute to loss of function, and ultimately result in the death of a living organism. | aging
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| __ theories of aging attempt to explain why the physical changes of aging occurs | biologic
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| each __ attempts to describe the processes of aging by examining various changes in cell structures or function | theory
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| __ proposes the existence of one or more harmful genes that activate over time, resulting in the typical changes seen with aging and limiting the life span of the individual | gene theory
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| __ provides one explanation for cell damage. They are unstable molecules produced by the body during the normal processes of respiration and metabolism or following exposure to radiation and pollution. | free radicals
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| excessive accumulation of __ in the body is purported to cause or contribute to the physiologic changes of aging and a variety of diseases such as arthritis, circulatory diseases, diabetes, and atherosclerosis. Also, lipofuscin, buildup fatty= age spots. | free radicals
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| individuals who support the free radical theory propose that the number of free radicals can be reduced by the use of __ | antioxidants
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| vitamins A,C,E, folic acid, carotenoids, zinc, selenium, and phytochemical are an example of what? Found in fruits and vegetables | antioxidants
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| _ presumes that the body is similar to a machine, which loses function when its parts wear out | wear and tear theory
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| _ focuses on the complicated chemical interactions set off by the hypothalamus of the brain. | neuroendocrine theory
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| when hypothalamus appears to be less precise in reg endocrine function,changes such as decreased muscle mass,increased body fat, and changes in reproductive function. __ may be designed to delay or control age related changes in the neuroendocrine theory. | hormone supplements
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| __ was developed to explain why aging persons separate from the mainstream of society. Highly controversial! | disengagement theory
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| _ Proposes that activity is necessary for successful aging | activity theory
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| __ identifies eight stages of developmental task that an individual must confront throughout the life span | Erikson's theory
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| 1- trust v/s mistrust 2- autonomy versus shame and doubt 3- initiative versus guilt 4- industry versus inferiority 5- identity versus identity confusion 6- intimacy versus isolation 7- generatively versus stagnation 8- integrity versus despair | Erikson's 8 stages
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| _of aging do not explain why the physical changes of aging occur; rather they attempt to explain why older adults have different responses to the aging process | psychosoial
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| _ proposes that development continues throughout life by a process of searching, questioning, and setting goals that are consistent with the individual's personality | Jung's theory
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| _ proposes that significant calorie reduction can extend life | calorie-restricted diet
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| In Erikson's developmental theory, the 1 step of 4 on the syllabus | 1- accepting self
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| In Erikson's developmental theory, the 2 step of 4 on the syllabus | 2- understanding self
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| In Erikson's developmental theory, the 3 step of 4 on the syllabus | 3- wisdom and integrated self image
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| In Erikson's developmental theory, the 4 step of 4 on the syllabus | 4- negative outcomes
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| seeking opinion of others, comparing self to others indicates person is experiencing __ | doubt and gloom. The last in Erikson
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| why has many biologic, environmental, and psychosocial theories been proposed | to explain why we age
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| why do these stay theories | the exact reason of aging are not completely understood
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| to day, _ therapy appears to have more risks than benefits | hormone replacement
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| The most effective way to bridge the gulf between the generations is | good communication
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| __% of communication comes from the actual words we use | 7
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| __ have specific intent and purpose | formal or therapeutic
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| _ are less specific and are used for socialization | informal or social
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| listen and get to know your Pt | empathetic
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| in nonverbal communication, __ help Pts distinguish the various caregivers | symbols
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| in nonverbal communication, speaking in a __ of voice close to the person's good ear is much more effective | low tone
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| in nonverbal communication, __ shows us what one is saying. | body language
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| in nonverbal communication, __ refers to how close we allow someone to get to us before we feel uncomfortable | personal space
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| what is the distance in public space | 12 feet away or more
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| what is the distance in social space | between 4 and 12 feet
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| what is the distance in personal space | 18 inches to 4 feet
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| a nurse who communicates within __ space is usually viewed as concerned and interested | personal space
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| what is the distance in intimate space? Entering without permission is usually perceived as a threat. | within 18 inches
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| in nonverbal communication, __ are a specific type intended to convey ideas. | gestures
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| after a stroke, many individuals suffer from __. | aphasia
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| because of brain damage, individuals with aphasia may not be able to recognize words or 'find' the words they want to use. in nonverbal communication, we should use | gestures
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| in nonverbal communication, ___ have been shown to communicate across cultural and age barriers | facial expressions
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| in nonverbal communication, ___ is often interpreted to be a sign of attentiveness and acceptance. __ contact also maximizes the chance that an older adult with hearing problems can read lips, if necessary | eye contact
face to face
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| in nonverbal communication,___ can be disrespectful and demoralizing if rushed. The slower the better! | space or speed of communication
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| in nonverbal communication, __ is important to reduce the response that may lead to anger, displeasure, anxiety, fear, and many other feelings. | time and timing
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| in nonverbal communication, __ is a common method of expressing concern and caring | touch
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| in nonverbal communication,__ permits older adults to focus on the point of discussion while continuous talking is distracting | silence
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| __ is defined as the willingness to attempt to understand the unique world of another person | empathy
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| 1-instead of saying diapers, say_ 2- instead of saying blind or deaf, say 3- instead of saying senile or dementia, say 4- instead of saying nursing home, say | 1- briefs, pads, or depend
2- visually or hearing impaired
3- cognitively challenged
4- care facility
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| __ listening skills are needed in all areas of nursing, but particularly in dealing with older adults | active
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| __ listening skills requires sensitivity to the strengths and limitations of the aging individual | empathetic
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| ___ uses direct statements regarding facts | informing
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| ___ is the least effective form of communication because the patient is not actively involved. | informing
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| ____ is helpful when nurses need to obtain specific information or in emergency situations when time is precious. Included words: who, what, when, where, do you , and don't you | direct questioning
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| ___ is closed- ended. If overused, Pts become defensive | direct questioning
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| ___ techniques include reflective statements, clarifying statements, and paraphrasing. Pt feels like nurse is interested. MOST information by using this. Can also verify information being relayed in accurate | open-ended
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| __ is used when there are inconsistencies in information or when verbal and nonverbal messages appear contradictory. ONLY to be used when a good rapport has been established. NEVER use on highly agitated or confused person. Be careful using this one | confronting
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| when communicating with family and visitors, protect ___. however, they are often able to detect subtle changes before trained nurses. | patient information
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| adult learners are oriented toward ___ and view learning as most desirable when __ | problem solving
relevant to their own life
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