Podcast
Questions and Answers
What percentage of drivers in the United States are over the age of 65?
What percentage of drivers in the United States are over the age of 65?
- 40%
- 30%
- 10%
- 20% (correct)
Driving is classified as which type of activity of daily living?
Driving is classified as which type of activity of daily living?
- Basic Activity of Daily Living (BADL)
- Essential Activity of Daily Living (EADL)
- Secondary Activity of Daily Living (SADL)
- Instrumental Activity of Daily Living (IADL) (correct)
Which of the following is NOT a functional demand of driving?
Which of the following is NOT a functional demand of driving?
- Complex mathematical calculations (correct)
- Ability to operate a vehicle
- Higher-order reasoning and decision making
- Knowledge of road rules
Which screening test is used to assess visuospatial skills relevant to geriatric driving?
Which screening test is used to assess visuospatial skills relevant to geriatric driving?
Reporting an unsafe older driver typically flags them for which of the following?
Reporting an unsafe older driver typically flags them for which of the following?
Unhealthy alcohol use in older adults is best described as:
Unhealthy alcohol use in older adults is best described as:
For older adults (65 years and older), what is considered 'standard' or 'normal' alcohol use per week?
For older adults (65 years and older), what is considered 'standard' or 'normal' alcohol use per week?
According to DSM-5 criteria, a 'mild' alcohol use disorder is characterized by how many symptoms?
According to DSM-5 criteria, a 'mild' alcohol use disorder is characterized by how many symptoms?
Which of the following is NOT identified as a factor influencing unhealthy alcohol use in older adults?
Which of the following is NOT identified as a factor influencing unhealthy alcohol use in older adults?
What does AUDIT stand for, in the context of screening for unhealthy alcohol use?
What does AUDIT stand for, in the context of screening for unhealthy alcohol use?
If an older patient screens positive on the AUDIT, which of the following is the MOST appropriate next step for a clinician?
If an older patient screens positive on the AUDIT, which of the following is the MOST appropriate next step for a clinician?
Which of the following is NOT a recommended component in the treatment of Alcohol Use Disorder in older adults?
Which of the following is NOT a recommended component in the treatment of Alcohol Use Disorder in older adults?
In the context of cannabis use, when is cannabis considered an 'alternative' therapy?
In the context of cannabis use, when is cannabis considered an 'alternative' therapy?
Which of the following is a therapeutic benefit of cannabis with sufficient evidence to support its use?
Which of the following is a therapeutic benefit of cannabis with sufficient evidence to support its use?
What is the primary focus of 'integrative medicine' regarding patient care?
What is the primary focus of 'integrative medicine' regarding patient care?
Which of the following is a profound positive impact of appropriate exercise for older adults?
Which of the following is a profound positive impact of appropriate exercise for older adults?
Physical activity is defined as:
Physical activity is defined as:
Before starting an exercise program, older adults should be screened for:
Before starting an exercise program, older adults should be screened for:
Which type of exercise is specifically recommended for all major muscle groups in older adults?
Which type of exercise is specifically recommended for all major muscle groups in older adults?
What is a major risk associated with strength training in older adults, if not performed correctly?
What is a major risk associated with strength training in older adults, if not performed correctly?
Historical context and social stigma have significantly impacted the health outcomes of which special population of older adults?
Historical context and social stigma have significantly impacted the health outcomes of which special population of older adults?
Which of the following office practices is recommended to create a welcoming environment for LGBT older adults?
Which of the following office practices is recommended to create a welcoming environment for LGBT older adults?
Older gay and bisexual men are at increased risk for which type of cancer compared to heterosexual men?
Older gay and bisexual men are at increased risk for which type of cancer compared to heterosexual men?
Older lesbian and bisexual women may have a higher risk for which of the following health issues?
Older lesbian and bisexual women may have a higher risk for which of the following health issues?
What is a significant health concern for older transgender individuals related to sexual health?
What is a significant health concern for older transgender individuals related to sexual health?
In what year was gay marriage recognized nationally in the United States?
In what year was gay marriage recognized nationally in the United States?
Limited health literacy is best defined as:
Limited health literacy is best defined as:
What percentage of caregivers may have limited health literacy?
What percentage of caregivers may have limited health literacy?
Which of the following is NOT a consideration related to health literacy in older adults?
Which of the following is NOT a consideration related to health literacy in older adults?
REALM and TOFHLA are examples of:
REALM and TOFHLA are examples of:
Homelessness and housing instability in older adults is:
Homelessness and housing instability in older adults is:
Homelessness is defined as lacking:
Homelessness is defined as lacking:
Clinicians play an important role in addressing homelessness by:
Clinicians play an important role in addressing homelessness by:
Which of the following is a significant risk factor for becoming homeless for older patients?
Which of the following is a significant risk factor for becoming homeless for older patients?
Rapid rehousing is a resource for homeless older patients that focuses on:
Rapid rehousing is a resource for homeless older patients that focuses on:
Older adults are the fastest-growing segment of which population?
Older adults are the fastest-growing segment of which population?
The increase in older adults in the criminal justice system is partly a result of:
The increase in older adults in the criminal justice system is partly a result of:
Compared to their chronological age, incarcerated older adults often appear:
Compared to their chronological age, incarcerated older adults often appear:
Which of the following health conditions is NOT commonly seen at higher rates in older adults within the criminal justice system?
Which of the following health conditions is NOT commonly seen at higher rates in older adults within the criminal justice system?
Older travelers face barriers to safe travel primarily due to:
Older travelers face barriers to safe travel primarily due to:
What is an essential aspect of preparing older patients for travel?
What is an essential aspect of preparing older patients for travel?
What is a significant social determinant of health for older immigrants?
What is a significant social determinant of health for older immigrants?
Which of the following legal statuses is NOT mentioned in the context of older immigrants in the US?
Which of the following legal statuses is NOT mentioned in the context of older immigrants in the US?
What percentage of the US population is comprised of immigrants?
What percentage of the US population is comprised of immigrants?
What is cited as the major barrier to healthcare for older immigrants?
What is cited as the major barrier to healthcare for older immigrants?
Beyond knowledge of road rules and ability to operate a vehicle, what cognitive function is MOST critical for driving?
Beyond knowledge of road rules and ability to operate a vehicle, what cognitive function is MOST critical for driving?
What specific visuospatial skill is assessed using the clock drawing test in the context of geriatric driving?
What specific visuospatial skill is assessed using the clock drawing test in the context of geriatric driving?
What information is MOST crucial to obtain if an older patient screens positive on the Alcohol Use Disorders Identification Test (AUDIT)?
What information is MOST crucial to obtain if an older patient screens positive on the Alcohol Use Disorders Identification Test (AUDIT)?
What is a key consideration when using cannabis as a 'complementary' therapy in older adults?
What is a key consideration when using cannabis as a 'complementary' therapy in older adults?
What is the MOST emphasized aspect of integrative medicine regarding patient care?
What is the MOST emphasized aspect of integrative medicine regarding patient care?
Besides soreness and injury, what is another major risk associated with strength training in older adults?
Besides soreness and injury, what is another major risk associated with strength training in older adults?
What is the MOST important initial step a clinician can take to create a welcoming environment for LGBT older adults?
What is the MOST important initial step a clinician can take to create a welcoming environment for LGBT older adults?
What is a potential sexual health concern that should be addressed when providing care for older transgender individuals?
What is a potential sexual health concern that should be addressed when providing care for older transgender individuals?
An older LGBT individual presents with concerns about accessing social security benefits and Medicare. What policy issue is MOST likely affecting this patient?
An older LGBT individual presents with concerns about accessing social security benefits and Medicare. What policy issue is MOST likely affecting this patient?
An 80-year-old immigrant patient, otherwise eligible for Medicare, is denied coverage. What legal circumstance MOST likely explains this?
An 80-year-old immigrant patient, otherwise eligible for Medicare, is denied coverage. What legal circumstance MOST likely explains this?
A 78-year-old man presents with his daughter, who is concerned about his driving. She reports multiple near-misses and confusion at intersections. Which of the following tests is most appropriate to assess his visuospatial abilities?
A 78-year-old man presents with his daughter, who is concerned about his driving. She reports multiple near-misses and confusion at intersections. Which of the following tests is most appropriate to assess his visuospatial abilities?
A 72-year-old woman reports having 2-3 glasses of wine every evening. She lives alone and reports feeling "a little down lately." What is the most appropriate next step in evaluating her alcohol use?
A 72-year-old woman reports having 2-3 glasses of wine every evening. She lives alone and reports feeling "a little down lately." What is the most appropriate next step in evaluating her alcohol use?
A 70-year-old man with chronic neuropathic pain is interested in alternative treatments. He is asking about cannabis. Which of the following is an evidence-supported indication for medical cannabis?
A 70-year-old man with chronic neuropathic pain is interested in alternative treatments. He is asking about cannabis. Which of the following is an evidence-supported indication for medical cannabis?
A 69-year-old lesbian woman presents for a wellness visit. Which of the following is true regarding her preventive care?
A 69-year-old lesbian woman presents for a wellness visit. Which of the following is true regarding her preventive care?
A 75-year-old man is brought in by his case manager from a transitional shelter. He recently lost his housing after the death of his spouse. Which of the following is a major risk factor for homelessness in this population?
A 75-year-old man is brought in by his case manager from a transitional shelter. He recently lost his housing after the death of his spouse. Which of the following is a major risk factor for homelessness in this population?
An 80-year-old man who was recently released from prison appears frail and has poor dentition, chronic pain, and urinary incontinence. What concept best explains his presentation?
An 80-year-old man who was recently released from prison appears frail and has poor dentition, chronic pain, and urinary incontinence. What concept best explains his presentation?
A 68-year-old woman is preparing for a trip to Southeast Asia. She takes medications for hypertension and diabetes. Which of the following should be discussed in anticipatory guidance?
A 68-year-old woman is preparing for a trip to Southeast Asia. She takes medications for hypertension and diabetes. Which of the following should be discussed in anticipatory guidance?
A 70-year-old immigrant woman with limited English proficiency presents to your clinic. She has difficulty understanding instructions and completing forms. Which of the following is the best screening tool for her health literacy?
A 70-year-old immigrant woman with limited English proficiency presents to your clinic. She has difficulty understanding instructions and completing forms. Which of the following is the best screening tool for her health literacy?
A 74-year-old immigrant with limited English proficiency and no insurance presents to the clinic with uncontrolled diabetes. Which of the following is the greatest barrier to care in this population?
A 74-year-old immigrant with limited English proficiency and no insurance presents to the clinic with uncontrolled diabetes. Which of the following is the greatest barrier to care in this population?
A 66-year-old lawful permanent resident recently arrived in the U.S. He is unsure if he qualifies for Medicare. Which of the following best describes his eligibility?
A 66-year-old lawful permanent resident recently arrived in the U.S. He is unsure if he qualifies for Medicare. Which of the following best describes his eligibility?
A 70-year-old woman with multiple comorbidities wants to begin an exercise program. What is the most appropriate first step?
A 70-year-old woman with multiple comorbidities wants to begin an exercise program. What is the most appropriate first step?
A 73-year-old man asks about the best types of exercise to prevent falls and maintain mobility. Which of the following is most appropriate?
A 73-year-old man asks about the best types of exercise to prevent falls and maintain mobility. Which of the following is most appropriate?
A 75-year-old woman has difficulty understanding medication instructions, completing forms, and asks, "Can I take these with food?" Which of the following tools would most appropriately screen her health literacy?
A 75-year-old woman has difficulty understanding medication instructions, completing forms, and asks, "Can I take these with food?" Which of the following tools would most appropriately screen her health literacy?
A 76-year-old man presents with frequent ER visits and confusion about his medication regimen. Which of the following findings would most strongly suggest limited health literacy?
A 76-year-old man presents with frequent ER visits and confusion about his medication regimen. Which of the following findings would most strongly suggest limited health literacy?
A 79-year-old woman who recently lost her husband reports falling behind on rent. She's worried about losing her apartment. What is the most appropriate resource to recommend?
A 79-year-old woman who recently lost her husband reports falling behind on rent. She's worried about losing her apartment. What is the most appropriate resource to recommend?
A 77-year-old transgender woman on long-term estrogen therapy presents for routine care. Which of the following health concerns is most appropriate to monitor?
A 77-year-old transgender woman on long-term estrogen therapy presents for routine care. Which of the following health concerns is most appropriate to monitor?
A 71-year-old gay man is concerned about anal cancer risk. Which of the following conditions increases his risk the most?
A 71-year-old gay man is concerned about anal cancer risk. Which of the following conditions increases his risk the most?
A 68-year-old woman asks about the difference between complementary and alternative medicine. Which of the following correctly defines complementary therapy?
A 68-year-old woman asks about the difference between complementary and alternative medicine. Which of the following correctly defines complementary therapy?
Flashcards
Instrumental Activities of Daily Living (IADLs)
Instrumental Activities of Daily Living (IADLs)
Difficulty or inability to perform activities related to independent community living.
Screening Tests for Geriatric Driving
Screening Tests for Geriatric Driving
Visual acuity, visual fields, contrast sensitivity, visuospatial skill, maze test, trail making, rapid pace walk, joint ROM, muscle strength.
Unhealthy Alcohol Use
Unhealthy Alcohol Use
Defined as a spectrum from risky use (co-morbidities) or Alcohol Use Disorder
Classifying Alcohol Use Disorder (DSM-5)
Classifying Alcohol Use Disorder (DSM-5)
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Cannabis Use in Older Adults
Cannabis Use in Older Adults
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Integrative Medicine
Integrative Medicine
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Nonmainstream therapies in Integrated medicine
Nonmainstream therapies in Integrated medicine
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Physical Activity for Older Adults
Physical Activity for Older Adults
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Types of Exercise for Older Adults
Types of Exercise for Older Adults
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LGBT- Friendly Environment
LGBT- Friendly Environment
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Transgender Medicine
Transgender Medicine
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Limited Health Literacy
Limited Health Literacy
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Health Literacy Considerations for Geriatrics
Health Literacy Considerations for Geriatrics
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Homelessness
Homelessness
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Risk Factors: Homelessness
Risk Factors: Homelessness
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Resources for Homeless Patients
Resources for Homeless Patients
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Fastest growing segment of criminal justice population
Fastest growing segment of criminal justice population
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Older traveler-Preparing patients
Older traveler-Preparing patients
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New Immigrants
New Immigrants
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Immigrants Barriers
Immigrants Barriers
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Clock Drawing Test
Clock Drawing Test
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AUDIT Questionnaire
AUDIT Questionnaire
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Medical cannabis use
Medical cannabis use
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Cancer Screening in Older Lesbian Women
Cancer Screening in Older Lesbian Women
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Accelerated aging in incarcerated adults
Accelerated aging in incarcerated adults
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Travel Considerations for Older Adults
Travel Considerations for Older Adults
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Rapid Estimate of Adult Literacy in Medicine (REALM)
Rapid Estimate of Adult Literacy in Medicine (REALM)
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Health insurance and older immigrants
Health insurance and older immigrants
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Medicare eligibility
Medicare eligibility
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Exercise program and older adults
Exercise program and older adults
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Test of Functional Health Literacy in Adults (TOFHLA)
Test of Functional Health Literacy in Adults (TOFHLA)
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Medication management
Medication management
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Balance exercises and mobility
Balance exercises and mobility
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Rapid Rehousing
Rapid Rehousing
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Prostate Cancer
Prostate Cancer
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HPV and Anal Cancer
HPV and Anal Cancer
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Complementary medicine defined
Complementary medicine defined
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Study Notes
Special Populations and Health Policies for an Aging Society
- Common physical examination requirements for geriatric populations should be identified.
- Specific geriatric findings/abnormalities during physical examinations
Driving and Older Adults
- 20% of US drivers are older than 65.
- Caregivers are important when determining a patient's medical fitness to drive.
- Knowledge of road rules and operating the vehicle, hidden coordination between the eyes, brain, and body, higher-order reasoning, decision-making, visual acuity, visual fields, contrast sensitivity, and visuospatial skill are all needed for driving.
- The clock drawing test assesses visuospatial abilities, which are crucial for driving safety and evaluates higher-order coordination between vision, motor planning, and cognition.
- Driving performance tests can be done.
- The state decides if it's unsafe to drive.
Unhealthy Alcohol Use
- Covers a whole spectrum, from risky use with co-morbidities to Alcohol Use Disorder (AUD).
- Moderate AUD involves 4-5 symptoms from the DSM-5.
- Factors include genetics, environment, demographics.
- The Alcohol Use Disorders Identification Test (AUDIT) is a validated screening tool to assess risky or unhealthy alcohol use and helps stratify severity and determine the need for further intervention.
- Willing patients should be treated with medication and counseling while giving attention to social circumstances.
Cannabis Use
- Symptoms can be managed using cannabis.
- It can aid in disease prevention and wellness.
- It can forestall aging and treat chronic conditions.
- Integrative medicine attends to social, psychological, spiritual, behavioral, and environmental factors.
- Nonmainstream therapies are "Alternative" when conventional medicine is not used.
- Complementary therapies are used alongside conventional medicine (e.g., acupuncture with physical therapy).
Therapeutic Benefits Of Cannabis Use
- Chemotherapy-induced nausea and vomiting can be treated.
- HIV-induced wasting can be treated.
- Neuropathic pain and pain and spasticity of multiple sclerosis can be treated.
Appropriate Exercise for Older Adults
- Helps health, chronic disease prevention, function, and fall prevention.
- Defined as any bodily movement produced by skeletal muscles.
- Exercise results in energy expenditure.
- Exercise is planned, structured, and repetitive bodily movement.
- Before initiating exercise, older adults should be screened for safety with a focused history and physical to guide appropriate modifications and identify contraindications.
- Aerobic exercise like running, jogging, walking, biking, and swimming are appropriate.
- Flexibility and balance training are good exercises for older adults, and strength training helps prevent falls and maintain function in older adults.
Meeting the Unique Needs of LGBT Older Adults
- Impact of social stigma on medical, psychological, and social outcomes.
- LGBT-friendly symbols, signs, and fliers should be present in offices.
- Providers should use inclusive language to accommodate.
Health Issues For Older Gay And Bisexual Men and Lesbian And Bisexual Women
- Important to understand Sexual health.
- Understand Cardiovascular Health and encourage no smoking.
- Older lesbian and bisexual women may have reduced rates of cancer screening due to stigma, healthcare avoidance, or provider assumptions.
- Screen for potential Cancers
- HPV is the leading risk factor for anal cancer, particularly in older gay and bisexual men, where vaccination and screening are essential preventive strategies.
Older Transgender Health
- Four steps.
- Diagnosis
- Lifestyle assumption
- Hormonal and drug therapy
- Surgical treatment
- Screen for Cardiovascular disease Screen for cancer
- Transgender women retain their prostate and remain at risk for prostate cancer, so screen appropriately because hormone therapy can alter its presentation. Discuss Hormone Use
Policy Issues Affecting LGBT Older Adults
- Gay marriage has been legal since 2015. LGBT health disparities.
Limited Health Literacy
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The degree to which people can obtain, process, and understand basic health information.
-
Vision and hearing impairment are important.
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Cognitive impairment can limit health literacy.
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Polypharmacy and emotional stress may also be involved.
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Caregivers may have limited health literacy.
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Consider social history.
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Consider highest level of education and non-compliance with medical instructions.
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The Rapid Estimate of Adult Literacy in Medicine (REALM) is a quick, validated tool that screens for functional health literacy, especially in patients with communication barriers and difficulty following medical instructions.
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The Test of Functional Health Literacy in Adults (TOFHLA) is a validated tool that assesses reading comprehension and numerical skills in a health context
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Difficulty understanding and managing medications is common with limited health literacy
Homelessness and Housing Instability
- Lacking a fixed, regular, and adequate nighttime residence can make someone homeless.
- Risk factors: Death of a relative or friend and Disputes with a landlord, cotenant, neighbor, or coworker.
- Social disruptions, such as the death of a spouse, a breakdown of relationships, and a lack of support systems, are major risk factors for homelessness among older adults.
- Rapid rehousing offers rental assistance and support services to prevent first-time homelessness or help older adults recover from recent housing loss.
- Help can be given with medical respite with services delivered by highly trained professionals.
Older Adults and The Criminal Justice System
- The population grew 300% between 1993 and 2016.
- Premature or "accelerated" aging results from incarceration.
- Older incarcerated adults often exhibit accelerated aging, appearing 10-15 years older than their biological age due to poor healthcare access, inadequate nutrition, and stressful environments.
- Health issues include high rates of multimorbidity, geriatric syndromes, and functional impairments.
The Older Traveler
- Face barriers to safe travel due to multimorbidity, functional issues, cognitive impairment, or medication management difficulties.
- Travel in older adults may worsen chronic conditions due to time zone changes, medication disruptions, or physical strain.
- Preparing patients for travel is essential.
Unique Needs of Older Immigrants
- Many lawful permanent residents over 65 y/o are eligible for Medicare in the US.
- Lawful permanent residents (green card holders) can qualify for Medicare after meeting residency and work requirements
- Extrinsic barriers include Immigration policies and Insurance access.
- Lack of health insurance is the single greatest barrier to care among older immigrants, and many remain uninsured.
- Intrinsic barriers include language proficiency.
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