Podcast
Questions and Answers
Which of the following is NOT a biological aging theory?
Which of the following is NOT a biological aging theory?
Everyone's aging experience is the same.
Everyone's aging experience is the same.
False
What is the population projection for individuals aged 65 and older by 2060?
What is the population projection for individuals aged 65 and older by 2060?
Will almost double.
The __________ relates to the quality of life for older adults according to Elizabeth Register.
The __________ relates to the quality of life for older adults according to Elizabeth Register.
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Stress and mental health issues can be considered challenges to healthy aging.
Stress and mental health issues can be considered challenges to healthy aging.
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What percentage of older adults have at least one chronic health condition?
What percentage of older adults have at least one chronic health condition?
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What are the 4Ms in age-friendly health systems?
What are the 4Ms in age-friendly health systems?
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Which of the following is a myth about aging?
Which of the following is a myth about aging?
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Older adults should be encouraged to have __________ in place to ease the burden on their family.
Older adults should be encouraged to have __________ in place to ease the burden on their family.
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Implicit bias refers to attitudes we are consciously aware of.
Implicit bias refers to attitudes we are consciously aware of.
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What is the purpose of the Comprehensive Geriatric Assessment (CGA)?
What is the purpose of the Comprehensive Geriatric Assessment (CGA)?
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Match the following health characteristics with their descriptions.
Match the following health characteristics with their descriptions.
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What are the four main causes of visual impairment in older adults?
What are the four main causes of visual impairment in older adults?
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What is the most common form of Age-related macular degeneration (ARMD)?
What is the most common form of Age-related macular degeneration (ARMD)?
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Cataracts develop quickly and painfully.
Cataracts develop quickly and painfully.
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By age 80, more than half of Americans will have had _______ or have had cataract surgery.
By age 80, more than half of Americans will have had _______ or have had cataract surgery.
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What is the preferred surgery technique for cataracts?
What is the preferred surgery technique for cataracts?
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Which of the following is NOT a symptom of cataracts?
Which of the following is NOT a symptom of cataracts?
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List one treatment option for Dry ARMD.
List one treatment option for Dry ARMD.
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Glaucoma is characterized by damage to the optic nerve due to increased intraocular pressure.
Glaucoma is characterized by damage to the optic nerve due to increased intraocular pressure.
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What is a common symptom of Angle-Closure Glaucoma?
What is a common symptom of Angle-Closure Glaucoma?
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What medication type is often used to decrease the rate of fluid production in glaucoma?
What medication type is often used to decrease the rate of fluid production in glaucoma?
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What is a primary prevention method for Diabetic Retinopathy?
What is a primary prevention method for Diabetic Retinopathy?
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Sleep disturbances are considered a normal part of aging.
Sleep disturbances are considered a normal part of aging.
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Older adults should aim for ______ hours of sleep each night to maintain health.
Older adults should aim for ______ hours of sleep each night to maintain health.
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Only about 4% of older adults live in a nursing home.
Only about 4% of older adults live in a nursing home.
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What are some reasons for nursing home admission? (Select all that apply)
What are some reasons for nursing home admission? (Select all that apply)
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What is OBRA?
What is OBRA?
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All residents must be assessed with standardized __________.
All residents must be assessed with standardized __________.
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What does the Quality Assurance and Performance Improvement (QAPI) involve?
What does the Quality Assurance and Performance Improvement (QAPI) involve?
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What is polypharmacy?
What is polypharmacy?
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Which of the following are risks of polypharmacy? (Select all that apply)
Which of the following are risks of polypharmacy? (Select all that apply)
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What is a common assessment tool used for older adults in nursing homes?
What is a common assessment tool used for older adults in nursing homes?
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Aging does not affect the pharmacokinetics of medications.
Aging does not affect the pharmacokinetics of medications.
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What are some common barriers to care transitions for older adults? (Select all that apply)
What are some common barriers to care transitions for older adults? (Select all that apply)
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What is BEER's criteria?
What is BEER's criteria?
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Match the following with their definitions:
Match the following with their definitions:
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What is a common consequence of hip fractures in older adults?
What is a common consequence of hip fractures in older adults?
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The average cost of nursing home care in Philadelphia is approximately ______ per year.
The average cost of nursing home care in Philadelphia is approximately ______ per year.
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Medicare covers most assisted living care expenses.
Medicare covers most assisted living care expenses.
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What is the preferred method of anesthesia for older patients undergoing surgery?
What is the preferred method of anesthesia for older patients undergoing surgery?
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What factors can increase the risk of falls in older adults? (Select all that apply)
What factors can increase the risk of falls in older adults? (Select all that apply)
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Study Notes
Healthy Aging
- Healthy aging emphasizes enhancing the second half of life for overall enjoyment and well-being.
- Aging encompasses biological, physiological, environmental, psychological, behavioral, and social changes, differing for each individual.
- Though aging can be slowed through health interventions, it cannot be halted.
Aging Theories
- Biological Theories: Include concepts like Wear and Tear, Free Radical effects, and Apoptosis.
- Sociological Theories: Focus on Disengagement and Activity levels in older adults.
- Psychological Theories: Erikson's theory on ego integrity versus despair, and Gerotranscendence which entails legacy building.
- Successful Aging Theories: Neugarten’s perspective links success in aging to personality, coping skills, and adaptability.
- No single theory adequately captures the complexities of aging.
Applying Theories
- Awareness of aging theories informs nursing practices and promotes healthy behavioral interventions.
- Important frameworks include:
- Register’s Middle Range Nursing Theory: Focuses on Quality of Life for the elderly.
- WHO Health Aging Framework: Guides comprehensive health strategies.
WHO Health Aging Framework
- Healthy aging is defined as functional capacity that supports well-being in older age, encompassing:
- Meeting basic needs and ensuring adequate living conditions.
- Opportunities for learning, growth, and decision-making.
- Mobility and social relationship maintenance.
- Community contribution and sociability.
Challenges to Healthy Aging and Quality of Life (QOL)
- Key challenges include life transitions, changing familial roles, loss of loved ones, functional changes, chronic illnesses, and mental health issues.
Reminiscence and Life Review
- Essential for self-reflection, understanding, and identity preservation in older adults.
- Involves validation of one’s life experiences and the process of letting go.
Aging Trends
- The population of adults aged 65 and over is projected to nearly double by 2060.
- Increasing ethnic diversity contributed by international migration is noted.
- Factors influencing demographic changes include the aging baby boomer population and improved healthcare leading to higher life expectancy.
Characteristics of the Older Population: Social
- Higher education attainment and remaining in the workforce longer due to financial pressures.
- Increased use of technology but declining tech-savviness in late 80s.
- About 27% of adults over 60 live alone; gender ratios are shifting towards equality due to increased life expectancy among men.
Characteristics of the Older Population: Health
- Approximately 80% of older adults have at least one chronic condition; chronic conditions are more prevalent than acute ones.
- Complications from chronic conditions often lead to prolonged recovery and poorer health outcomes.
Characteristics of the Older Population: Financial
- Fixed incomes lead to poverty, especially among older women and people of color.
- Social Security and Medicare are primary sources of income, often insufficient for needs.
Social Determinants of Health
- Health access and outcomes are affected by conditions present throughout life, compounded by ageism, racism, and other biases.
- Inequities in health lead to increased risks of geriatric syndromes.
Societal Implications & Solutions
- An aging population will drive increased care needs and highlight nursing shortages.
- Solutions include developing home-based care strategies and creating age-friendly communities.
Ageism
- Ageism negatively impacts health, leading to reduced lifespan and increased health issues.
- Myths of aging include assumptions about depression, dementia, learning abilities, and societal contributions of older adults.
Explicit vs. Implicit Bias
- Explicit bias: Consciously held beliefs about groups.
- Implicit bias: Unconscious attitudes affecting behavior and perceptions.
Addressing Implicit Bias
- Strategies include education, empathy, person-centered care, and varied engagement to combat implicit biases.
Ethical, Personal, & Emancipatory Knowing
- Emphasizes a perspective shift from a deficit model of aging to a strengths-based model that values older adults' capabilities.
Comprehensive Geriatric Assessment (CGA)
- CGA is an annual, person-centric evaluation addressing physical, functional, social, psychological, environmental, and spiritual dimensions of health.
Components of CGA
- Integrates multiple assessments including physical, functional, social, psychological, environmental, and spiritual evaluations, addressing holistic needs of the elderly.
Health Promotion and Prevention
- Vaccination recommendations for older adults include flu, pneumonia, tetanus, and shingles vaccines.
Screening Recommendations
- Regular screening guidelines for cancers and chronic diseases vary by age and risk factors.
Advance Care Planning
- Encourages older adults to articulate end-of-life care preferences through Advance Directives and Physician Orders for Life-Sustaining Treatment (POLST).
Atypical Presentations of Illness
- Atypical presentations in older adults may include vague or altered symptoms leading to potential missed diagnoses.
Gerontological Nursing
- A specialty addressing functional and health needs of older adults, focusing on advocacy, health promotion, and quality of life improvement.
Gerontological Nursing Principles
- Emphasizes strength-based approaches and advocacy for older adults’ rights and autonomy in healthcare planning and delivery.### Age Friendly Health Systems
- Focuses on improving care for older adults by implementing evidence-based practices.
- Utilizes the 4Ms framework:
- What Matters: Aligns care with older adults' health goals and preferences.
- Medication: Ensures use of age-friendly medications.
- Mentation: Identifies and manages dementia, depression, and delirium.
- Mobility: Promotes safe movement to maintain function.
Age Friendly Communities
- Supports aging in place to enhance quality of life for elders.
- Key community aspects for optimization:
- Outdoor spaces and transportation.
- Housing options and social participation.
- Respect, civic engagement, and access to health services.
Nursing in Community Settings
- Involves various forms of care:
- Home Health Care and Hospice services provide in-home support.
- Adult Day Services like senior centers and adult day care programs.
- Community Care Models include PACE and LIFE centers.
- Senior Living Communities offer a spectrum of support services.
Healthcare Financing
- The Older Americans Act was established in 1965 leading to Medicare and Medicaid.
-
Medicare provides coverage:
- Part A: Hospital and hospice care.
- Part B: Physician services and outpatient care.
- Part C: Medicare Advantage Plans.
- Part D: Prescription drug coverage.
- Medicaid offers varied support based on state regulations and aids dually eligible seniors.
Acute Care Setting Challenges
- Higher hospitalization rates for older adults with longer lengths of stay.
- Increased risk for complications such as infections and delirium, leading to diminished mobility.
Caregiver Involvement
- The CARE Act mandates identifying a caregiver to involve in healthcare decisions.
- This empowers caregivers in discharge planning and ongoing support.
Rehabilitative Care
- Available in sub-acute and long-term environments with therapy goals focused on functional capacity and independence.
- Duration and eligibility for Medicare coverage for rehabilitation depend on prior hospital stay length.
Skilled Nursing Facility (SNF)
- Only about 4% of older adults reside in nursing homes; admissions typically based on functional impairment or crisis.
- The OBRA of 1987 set regulations improving nursing home quality, including resident rights and assessed quality measures.
Assisted Living and Respite Care
- Assisted living facilities offer housing with minimal support and social activities.
- Respite care provides temporary relief for caregivers, varying in duration and typically not covered by insurance.
Care Transitions and Transitional Care
- Care transitions pose risks for older adults due to potential errors in care during transfers.
- Transitional care aims to enhance coordination, reduce hospital readmissions, and improve overall health outcomes.
Models of Care for Older Adults
- Interdisciplinary approaches like the Transitional Care Model (TCM) and PACE focus on comprehensive care across various settings.
Polypharmacy and Medication Safety
- Polypharmacy, defined as taking 5 or more medications, is prevalent among older adults, increasing ADE risks.
- Key considerations include:
- Changes in pharmacokinetics due to aging, affecting absorption, distribution, metabolism, and excretion.
- Increased sensitivity to medications resulting in potential adverse effects.
Adverse Drug Events (ADEs)
- ADEs significantly impact older adults, accounting for substantial emergency department visits.
- Common risk factors include multiple chronic diseases and high medication regimens.
Prevention Strategies for Polypharmacy
- Encourage proper medication management through reconciliation and deprescribing efforts.
- Promote patient education and awareness about potential harmful medications.
Osteoporosis and Fracture Prevention
- Strategies include dietary approaches (calcium and vitamin D supplementation), exercise, and lifestyle modifications.
- Pharmacological interventions utilize bisphosphonates and SERMs for managing osteoporosis.
Key Statistics
- Almost one-third of older adults take 5 or more medications; this group accounts for a disproportionate amount of prescriptions despite being a smaller demographic.
- Average costs for nursing homes and assisted living vary; nursing homes range from approximately $120,000 annually, while assisted living averages around $60,000.### Hip Fractures
- Affect 18% of women and 6% of men globally, primarily from osteoporosis-related falls.
- Two common types: Femoral Neck and Intertrochanteric Fractures, with femoral neck fractures posing higher complication risks due to potential blood supply interruption.
- Surgical intervention for stabilization is often necessary.
Risks Other Than Osteoporosis
- Excessive alcohol and tobacco use, sedentary lifestyle, low body weight, gender (female), tall stature, vision and cognitive impairments, and other fall-risk-increasing conditions or medications.
Prevention Strategies
- Address underlying risk factors through lifestyle modifications and increased physical activity.
- Manage osteoporosis and implement fall prevention strategies.
Hip Fracture Assessment
- Patients often found on the floor with a shortened, externally rotated leg.
- Coordinated hospital care enhances ED to OR transition, reducing postoperative complications.
- Important assessments upon hospital admission include cognitive baseline, pain, nutrition, skin integrity, and family engagement.
Surgical Intervention & Postoperative Care
- Surgery typically occurs within 24 hours of admission if stable, aimed at pain relief and improved mobility.
- Spinal anesthesia preferred over general anesthesia to reduce complications.
- Postoperative pain management includes scheduled low-dose opioids with non-opioids.
- Monitor neurovascular status using the 6Ps: Pain, Pallor, Paralysis, Paresthesia, Pulses, Poikilothermia.
Delirium Prevention & Support
- Constant orientation of patients to their environment to mitigate delirium risk.
- Continued nutritional support and skin integrity management crucial in recovery.
Hip Precautions Post-Op
- Avoid hip flexion beyond 90 degrees, adduction, internal rotation, crossing legs, or lying on the operative side.
Total Joint Arthroplasty
- Joint replacements may last over 25 years and are typically elective surgeries.
- Preoperative education, individualized care plans, and antibiotic prophylaxis are integral.
Age-Related Musculoskeletal Changes
- Age-related decrease of 30-40% in muscle mass leads to reduced strength and increased fall risk.
- Increased intramuscular fat, decreased bone density, and changes in joint flexibility noted with aging.
- Postural tremors and decreased hand/foot movement contribute to challenges in daily activities.
Sensory Changes with Aging
- Gradual sensory changes can lead to functional and social impairments.
- Common visual changes include graying of hair, skin wrinkling, and dry eye conditions.
Vision Assessment
- Regular eye exams and assessments for changes in vision and overall eye health recommended.
- Vision impacts safety, social interaction, and independence.
Hearing Changes with Age
- Hearing loss is prevalent, with 50% of those over 70 experiencing some degree of loss.
- Conductive and sensorineural hearing loss identified, with management including thorough assessments and potential use of hearing aids.
Taste and Smell Changes
- Age-related reductions in taste and smell ability can lead to malnutrition and impair food enjoyment.
- Good oral hygiene and social meals encouraged to enhance food experience.
Injury Prevention
- Focus on home safety, medication management, and driving safety to reduce fall-related injuries and enhance overall quality of life.
Common Causes of Visual Impairment
- Significant factors include cataracts, age-related macular degeneration, glaucoma, and diabetic retinopathy.
- By age 80, more than half of individuals may experience cataracts, emphasizing the importance of regular eye care and risk awareness.
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Description
Explore the various aspects of healthy aging in this quiz. Understand the biological, psychological, and social changes that accompany aging and learn about the theories that seek to explain these processes. Delve into the idea that while aging can be slowed, it is an inevitable part of life.
