Aging & Care Exam Review: Overview & Ethics

• Welcome to "Aging & Care Exam Review," an audio study guide for healthy aging and geriatric care.

Overview of Aging & Health Care in Older Adults

• Older adults are diverse, experiencing biological changes such as decreased organ reserve and metabolic shifts.
• Not all changes in older adults are diseases.
• Biological theories of aging include the Free Radical Theory, Mitochondrial Decay, and Telomere Shortening.
• Psychosocial theories include Erikson's Integrity versus Despair, Role Theory, Activity Theory, and Continuity Theory.
• Cultural competence is important, and ageism/stereotypes should be countered by respecting the unique backgrounds/experiences of older adults.
• Older adults can still be active learners and contributors to society.

Ethical, Legal, and Advance Care Planning Issues

• Every older adult has the right to autonomy to make informed decisions about their care.
• Autonomy is often compromised due to diminished capacity or external pressures.
• Balance beneficence and justice in the care of older adults.
• Advance directives are essential, including Living Wills (treatment preferences), Durable Power of Attorney for Health Care (appoints decision-maker.)
• DNR orders and POLST/MOLST forms provide guidance for resuscitation and interventions.
• Nurses have a pivotal role in advocating for patients and initiating discussions early and clearly.

Medication Management, Polypharmacy, & Pharmacology

• Polypharmacy (the use of multiple medications) is common, increasing risks like drug interactions and nonadherence.
• Use guidelines like STOPP/START criteria and Beers Guidelines to determine when it's safe to deprescribe.
• Physiological changes in older adults include decreased absorption, altered distribution, slowed metabolism, and less efficient excretion.
• Medication doses and schedules often need to be adjusted.
• Patient education includes simplifying dosing schedules and ensuring patients understand their medications and potential side effects.

Cognition & Neurocognitive Disorders

• Normal aging can result in slower processing speeds and forgetfulness.
• Pathological impairments include Alzheimer's, vascular dementia, Lewy body dementia, or frontotemporal degeneration.
• Screening for cognitive changes can be done using tools like the Mini-Mental State Examination (MMSE).
• Distinguish between delirium (acute, reversible) and dementia (gradual progression).
• Interdisciplinary collaboration is necessary for comprehensive care.

Mental Health – Mood, Affect, & Depression

• Mental health in older adults is complex.
• Mood is a sustained emotional state, while affect is the visible expression of emotion.
• Late-life depression may present atypically with changes in sleep, appetite, energy, or cognition.
• Risk factors include chronic diseases, social isolation, past trauma, and neurotransmitter imbalances.
• Use screening tools like the Geriatric Depression Scale.
• Nursing interventions include nonpharmacologic strategies (counseling, support groups, lifestyle modifications) and antidepressants.
• Education about medication side effects & adherence, considering complementary therapies like bright light therapy or electroconvulsive therapy in severe cases.

Abuse, Neglect & Advocacy

• Abuse and neglect can be physical, emotional, sexual, or financial.
• Neglect can manifest as poor hygiene, malnutrition, or unsanitary living conditions.
• Warning signs include unexplained injuries, withdrawal, behavioral changes, and poor self-care.
• Nurses are mandated reporters in many states.
• Ensure patients are treated with dignity and that their rights are respected.
• Structured tools and checklists help in early recognition and prompt intervention.

Safety & Health Promotion

• Assess the patient's environment for hazards.
• Assess activities of daily living to signal underlying issues.
• Preventive measures include immunizations (influenza, shingles, pneumococcal) and screenings for vision, hearing, and nutrition.

Long-Term Care & End-of-Life Planning

• Long-term care options range from in-home care to nursing homes.
• Maintain as much independence as possible while ensuring safety and quality of life.
• Engage in ongoing conversations about preferences for interventions, palliative care, and advance directives.

Integrated Clinical Applications & Interdisciplinary Care

• Effective geriatric care requires a team approach (nurses, physicians, therapists, social workers, chaplains).
• Consider biophysical and psychosocial aspects of care.
• Provide holistic, patient-centered care that promotes wellness, safety, and dignity.

Study Tips & Exam Preparation

• Review using flashcards and practice cases.
• Engage in group discussions to explain concepts and debate case scenarios.
• Practice real-life scenarios involving ethical dilemmas, cognitive assessments, or medication management.
• Review guide frequently to integrate topics.

Audio study guide for healthy aging and geriatric care, covering biological and psychosocial theories of aging. Focus on ethical, legal, and advance care planning issues, emphasizing autonomy and informed decisions. Learn about cultural competence and countering ageism.