Adult Final Review PDF

Adult Final Review Age related changes Cardiovascular changes a. Structural changes to the lung tissue i. Diaphragm flattens ii. Thorax becomes less flexible iii. Decreased efficiency in gas exchange b. Structural changes to the...

Adult Final Review Age related changes Cardiovascular changes a. Structural changes to the lung tissue i. Diaphragm flattens ii. Thorax becomes less flexible iii. Decreased efficiency in gas exchange b. Structural changes to the heart i. Irregularities in conduction ii. Less efficient pumping iii. Decreased elasticity in blood vessels iv. Decreased contractile ability of the venous system Functional performance threshold a. Definition i. The ability to perform ADLS to meet the minimum criterion compatible with personal care and independent living can be thought of as a functional performance threshold (the one in slides) ii. indicates the level of activity someone can consistently sustain over a period of time, marking the point where further exertion becomes unsustainable; essentially, it's the upper limit of their sustained performance in a specific activity. (the one karp gave with outline) 1. Older adults lose capacity reserves b. Functional capacity i. Refers to an individual's maximum ability to perform daily activities, essential representing their full potential in a given task c. If physical decline results in a functional capacity below the functional performance threshold, the minimum criteria for self care and independent living cannot be met i. Falling below this threshold can be a result of progressive age-related changes, restricted mobility, or health conditions sufficient to lower an individuals already minimal reserves 1. Ex: functional capacity: a persons maximum ability to lift heavy objects in a single lift, determined by strength test 2. Functional performance threshold: the weight someone can consistently lift for a sustained period during a work shift Sensory function a. Low vision i. Definition 1. A serious visual loss that is uncorrectable by medical or surgical intervention or with eyeglasses ii. Vision problems affect 18% of the older population 1. 30% of people above age 85 have age related vision problems iii. Normal age related changes in the eyes and visual pathways  1. Support structure changes a. Loss of subcutaneous fat decreased tone and elasticity 2. Decreased tear productions a. Dry eyes 3. Decreased convergence a. Poor eye coordination b. Difficulty focusing 4. Cornea a. Flattens and becomes thicker 5. Lens a. Increased density and rigidity (affects rear and far vision, loss of color sensitivity) Sclera, pupil iris: degenerative changes resulting in gradual loss of visual acuity & difficulty seeing in low light conditions. iv. Nervous system changes 1. Slower processing of visual stimuli 2. Need to see stimuli longer for accurate identification v. Pathological changes in the eyes and visual pathways 1. Cataracts a. Degeneration on the lens b. Results in i. Decreased visual acuity ii. Blurred vision iii. Altered color perception iv. sensitivity to glare v. Image distortion 2. Age related macular degeneration (AMD) a. Affects people >50 b. LOSS OF CENTRAL VISION c. Commonly seen in industrialized countries d. Risk factors i. Caucasian ii. Smoking iii. Family history 3. Glaucoma a. Group of diseases i. Progressive optic nerve damage- in stages ii. Treated medically or surgically depending on stage iii. Peripheral vision is lost 4. Diabetic retinopathy a. Resulting from damage to the blood vessels of the retina b. Scotoma: are blind spots in one's visual field, which often occur as a result of Diabetic Retinopathy. 5. Presbyopia: present with what deficit that will affect competing occupations that are “up close”?  b. Hearing loss i. Begins in the 30s ii. Types of hearing loss 1. Conductive hearing loss- not primary cause of hearing loss in older adults 2. Sensorineural hearing loss 3. Tinnitus 4. Presbycusis- age related hearing loss iii. Behavior in adults with hearing loss 1. Repeated request to speak louder or repeat what was said 2. Non-responsive to verbal question s or conversation 3. Inappropriate or out of context responses 4. Questions directed to spouse, family, or caregiver 5. Leaning outward or tilting head to one-side 6. Distress or irritation 7. Disoriented or confused during conversation 8. Withdrawing from social situations c. Taste and smell loss i. Declines as we age- becoming noticeable at 65-70 1. Less saliva 2. Fewer tast buds 3. Decreased number of odor receptors d. Neuromusculoskeletal movement and function i. Decreased muscle strength and power ii. Marked loss of skeletal muscle mass iii. Decreased number of functional motor units iv. Changes in postural alignment v. Bone and cartilage changes along with balance and gait vi. Decreased maximal speed of movement and initiation of responses to stimuli vii. Increased Threshold for vibration sensation and decreased proprioception e. Bone i. Calcium loss is the major change in primary aging of the bones ii. Bone mass peaks around the age of 30 followed by gradual decline iii. Osteoporosis 1. Severe loss of bone mass iv. Osteoarthritis 1. Most common form of joint disease Active Aging a. Self care i. Definition 1. Duties and chores ranging from personal care to personal business 2. Can include the individual, the family, the community 3. Basic or personal self care activities and IADL may be viewed as forming a foundation or survival and for participation in the community ii. Models for understanding performance for self care 1. EHP  2. ICF 3. PEOP & PEO iii. Competencies, values, and meaning 1. Everyday competence: person’s ability to perform a broad array of activities considered essential for independent living 2. Personal value and meaning within a context affect occupational performance 3. Ability to competently carry out daily activities is also affected by client factors, context, and task requirements 4. Unique to the individual and the specific contexts 5. Integral to human function and to status in the community iv. Factors affecting everyday competence 1. Personal values and meaning s 2. Client factors 3. Context 4. Task requirements v. Significance of self care 1. Healthy aging, longevity, quality of life, independence 2. Perception of self, psychological well-being 3. Dependence on health care system and need for in-home supports 4. Need for hospitalization 5. Recovery from illness vi. Identity and socialization 1. Western cultural norms place value on self care and it is important for some to follow expectations 2. Functional capacity and personal care have been shown to relate to a. Healthy self- esteem b. Life satisfaction c. Healthy aging d. Personal identity e. Perception of life situation f. Social acceptance g. Social well-being 3. Inability to perform self care a. Can increase loneliness and social isolation b. Affects perception of competence and agency c. Potential to increase need for help/support b. Leisure i. Definition 1. Discretionary time- time not obligated to work, self-care, or instrumental activity 2. culturally sanctioned activity- an activity readily recognized as leisure (fishing & crochet) 3. A state of being relaxed, contented 4. Must be understood as experience- based ii. Value of leisure  1. Well being and quality of life are associated with engagement in activities with great personal significance 2. Contributes to a sense of purpose and meaning in everyday life 3. Doing , belonging, being, becoming, leisure as a statement of identity iii. Types of leisure 1. Active- walking, running, dancing 2. Passive- reading, watching movies 3. Social- spending time with friends, book club 4. Hobbies.interests- art, woodworking, gardening 5. Travel & educational pursuits iv. Elements of leisure 1. Flow 2. Involvement 3. Serious leisure 4. Committed leisure 5. Reciprocity 6. Leisure as means of taking control of one's life a. Motivation: complexity of motivation b. Freedom from unnecessary constraints of reality c. Work and retirement i. Supers developmental concept theory 1. Formation of stages and developmental tasks ii. James Marcia- Career identity 1. Career selection is part of identity achievement that takes palace in adolescence and emerging adulthood 2. Four stages that lead to career identity a. Foreclosure: i've made a choice without thinking b. Identity achievement: i thought about it and i now know what i should do with my life c. Identity diffusion: i don't know and i don't care what i'm supposed to do with my life d. Moratorium: i'm thinking about what i should do 3. What effects career selections a. Gender b. Family influence i. Working mother ii. Educational attainment iii. Marital status of parents 4. Phased retirement: gradually reduce hours in current position (job sharing) 5. Bridged retirement: work fewer houses, starting new business, can help with financial issues Articles a. Resilience in aging The journal article "Resilience in Aging" by Erica S. McFadden, John Hall, and Alex Zautra focuses on understanding resilience in the context of aging. The authors explore how older adults adapt to the challenges associated with aging, such as physical health declines, social losses, and changing roles, and how they maintain well-being despite these adversities. The article highlights key factors that contribute to resilience among older populations and offers insights for promoting healthy aging. Key Themes and Findings: 1. Definition of Resilience in Aging: Resilience is conceptualized as the capacity to maintain or regain well-being in the face of adversity. For older adults, this often involves adapting to physical, emotional, and social changes while preserving a sense of purpose and engagement in life. 2. Factors Contributing to Resilience: ○ Individual Resources: Personal traits such as optimism, self-efficacy, and a sense of control play a critical role in fostering resilience. ○ Social Support: Strong social networks, including family, friends, and community connections, provide emotional and practical support that buffers stress. ○ Physical and Mental Health: Maintaining physical activity, managing chronic conditions, and addressing mental health issues are essential for resilience. ○ Meaningful Engagement: Involvement in activities that provide a sense of purpose and belonging contributes significantly to resilience. 3. Psychological and Social Adaptation: The authors discuss how older adults often reframe challenges, focusing on what they can do rather than on what they have lost. This adaptive coping enhances emotional regulation and fosters a sense of hope. 4. Resilience Pathways: The study identifies two primary pathways for resilience: ○ Recovery: Returning to baseline functioning after a setback. ○ Sustainability: Maintaining well-being by adapting to ongoing challenges. 5. Promoting Resilience in Aging: Interventions that focus on enhancing personal resources, building supportive relationships, and creating opportunities for meaningful engagement are emphasized as crucial strategies for promoting resilience. Implications: The article underscores the importance of designing policies and programs that support the resilience of older adults, particularly by addressing their physical, emotional, and social needs. Healthcare professionals, caregivers, and policymakers are encouraged to create environments that empower older individuals, helping them to navigate the challenges of aging while maintaining a high quality of life. By highlighting the strengths and adaptive capacities of older adults, the study contributes to a positive perspective on aging and resilience. b. Community Mobility CE article The journal article "The Importance of Public Transportation to Community Mobility and Participation" by Jeffrey L. Crabtree emphasizes the critical role public transportation plays in enabling community engagement, especially for individuals with disabilities, older adults, and those without personal vehicles. The article explores the relationship between access to transportation and participation in daily activities, employment, healthcare, and social interactions, highlighting the broader societal and individual benefits. Key Themes and Findings: 1. Public Transportation and Community Participation: Public transit systems are essential for facilitating community mobility, allowing individuals to access essential services, maintain employment, and engage in social and recreational activities. Reliable transportation is directly linked to increased independence and improved quality of life. 2. Impact on Vulnerable Populations: The study focuses on how public transportation serves populations that face mobility challenges, including: ○ Older Adults: Enabling access to healthcare, grocery shopping, and social events, helping them age in place. ○ Individuals with Disabilities: Offering opportunities for greater independence and reducing reliance on caregivers. ○ Low-Income Groups: Providing affordable mobility options to reach jobs, schools, and services. 3. Barriers to Access: The article identifies common barriers to effective use of public transportation, including: ○ Limited routes or schedules. ○ Physical inaccessibility for individuals with disabilities. ○ Safety concerns or poor maintenance. ○ Inadequate funding for public transit systems. 4. Benefits of Accessible Transportation: Improved public transit enhances social inclusion, reduces social isolation, and contributes to economic growth by increasing workforce participation. Additionally, accessible transportation supports sustainable urban development by reducing dependence on private vehicles. 5. Recommendations for Improvement: ○ Increasing funding and policy support for public transportation systems. ○ Ensuring compliance with accessibility standards to accommodate all users. ○ Enhancing transit design to meet the needs of diverse populations. ○ Raising public awareness about the importance of public transit to societal well-being. Implications: Crabtree’s work underscores that public transportation is not just a means of travel but a critical component of community infrastructure that supports health, equity, and participation. Policymakers, urban planners, and community leaders are encouraged to prioritize investment in public transit systems to foster inclusive communities and improve societal outcomes. This article serves as a call to action to address gaps in transportation access and ensure that all individuals have the opportunity to participate fully in their communities. c. Transportation transitions The journal article "Transportation Transitions: Addressing Current and Future Transportation Needs of Older Clients"by Sabrina Salvant and Debra Gibbs explores the transportation challenges faced by older adults and offers strategies for addressing their evolving mobility needs. The authors focus on how occupational therapists and related professionals can support older adults in maintaining independence and community engagement as their transportation options change. Key Themes and Findings: 1. Transportation as a Key to Independence: The ability to travel safely and efficiently is vital for older adults to maintain independence, access healthcare, participate in social activities, and fulfill daily needs. Transitioning away from driving can significantly impact their quality of life and sense of autonomy. 2. Challenges in Transportation Transitions: ○ Physical and Cognitive Declines: Health changes may limit an older adult's ability to drive or use public transportation. ○ Limited Alternative Options: Many older adults live in areas with inadequate public transportation or ride services. ○ Emotional Impact: Losing the ability to drive can lead to feelings of isolation, frustration, and diminished self-worth. 3. Role of Occupational Therapy: The article emphasizes the critical role of occupational therapists in assessing and supporting older adults during transportation transitions. ○ Driving Assessments: Identifying when it is no longer safe for an individual to drive. ○ Education and Counseling: Guiding clients and families through the transition, including discussions on alternative transportation options. ○ Skill Training: Teaching older adults how to use public transit, ride-sharing apps, or other community resources. 4. Future-Proofing Transportation Needs: The authors encourage proactive planning to address future transportation needs, including: ○ Early discussions about alternatives to driving. ○ Advocating for accessible and age-friendly transportation systems. ○ Encouraging community-level investments in transit infrastructure that meets the needs of aging populations. 5. Community and Policy Recommendations: ○ Development of senior-friendly transportation programs. ○ Collaboration with community organizations to expand access to affordable and reliable mobility options. ○ Policy advocacy to ensure transportation systems are inclusive and sustainable. Implications: The study highlights the importance of a person-centered approach to transportation transitions, where the needs and preferences of older adults are prioritized. By addressing these needs proactively, professionals can help older clients maintain their independence, reduce social isolation, and enhance their overall well-being. Salvant and Gibbs provide a framework for occupational therapists and other stakeholders to collaborate in creating more inclusive mobility solutions, emphasizing that effective transportation transitions are critical to healthy and engaged aging. d. 100 days of confinement The journal article, "A Hundred Days in Confinement: Doing, Being, Becoming, and Belonging Among Older People in Sweden During the COVID-19 Pandemic" by Gunilla Carlsson et al., explores the experiences of older adults in Sweden during the first 100 days of COVID-19 restrictions. The study employs a qualitative approach, using the lens of the occupational science framework of "doing, being, becoming, and belonging" to understand the impact of confinement on their daily lives, identities, and social connections. Key Themes and Findings: 1. Doing: The study examines how older adults adapted their daily activities to confinement, including changes to routines and hobbies. Many participants experienced disruptions in their usual practices, leading to feelings of boredom and frustration but also finding new ways to stay active and engaged. 2. Being: The confinement period encouraged introspection and a reevaluation of personal identity. Participants often reflected on their values, priorities, and roles, experiencing both challenges and opportunities for personal growth. 3. Becoming: Adjustments during the pandemic fostered resilience and adaptability. Some individuals developed new skills or interests, while others struggled to cope with the uncertainty and limitations of the pandemic. 4. Belonging: Social isolation was a significant issue, with restrictions limiting physical interactions with family, friends, and community. However, some participants found innovative ways to maintain connections, such as using digital technologies or participating in socially distanced activities. Implications: The research highlights the importance of addressing the multifaceted needs of older adults during crises, emphasizing the value of supporting their engagement in meaningful activities, promoting social inclusion, and facilitating access to digital tools. Policymakers and healthcare professionals are encouraged to consider these dimensions to enhance the well-being of older populations in similar situations. This study contributes to the broader understanding of how pandemics affect vulnerable groups, providing valuable insights into fostering resilience and well-being among older adults