Upgrade to remove ads
Only $2.99/month

Gerontology Exam 2

Terms in this set (68)

Care-giving and Culture (Whites, Hispanics, African Americans, Asians)
Spouse
Adult Children
Non Family Member
Daughter in law or daughter; will always be female
Long Distance Care-Giving
Will usually help with finances
Arrange for in home care
Provide emotional support
Information coordinator
Create an emergency plan

Works until serious decisions need to be made
Caregiver Assessment
Identify specific problems, strengths, and resources of the family caregiver
Caregiver's ability to provide care
Need and preferences of caregiver and care recipient
How the health team can help
Caregiver Role Strain
Expressed frustration
Apprehension about providing future care
Anger over responsibilities
Not enough support
Not able to meet personal needs
Trouble coping
Negative feels about patient/relationship
Ignores/abuses patient
Change in caregiver health status
Caregiver Interventions
Education about care giving/stress
Needed care skills
Caregiver health and home safety
Support groups
Linkages to ongoing support and resources
Counseling
Relief and respite from daily care demands
Stress management
Physical Abuse
Any form of aggressive behavior

-cuts and bruises
Abuse; intentional or unintentional?
INTENTIONAL

Must report any suspicion
Neglect
A form of mistreatment resulting from the failure of action by a caregiver or through one's own behavior or choices
Active Neglect
INTENTIONAL failure to fulfill care obligations, abandonment
Passive Neglect
UNINTENTIONAL failure to fulfill care obligation due to inexperience, ignorance, and or inability
Self Neglect
Behaviors that threaten personal safety, refusal or failure to provide self with basic necessities

"not giving a shit; can be mental health related"
Care-giving
Most are unpaid
Females
Lasts average of 4 years
Grief - Kubler-Ross
Denial
Anger
Bargaining
Depression
Acceptance
Anticipatory Grief
Response to a real or perceived loss before it actually occurs
Acute Grief
Crisis, physical and emotional symptoms, disbelief
Shadow Grief
Intense sadness that overcomes us when least expected

Memory triggers (smell, etc.)
Complicated/Chronic Grief
Heightened state of mourning that does not lessen over time
Disenfranchised Grief
Loss cannot be openly acknowledged or publicly mourned

Ex: grief w/ retiring
Good Copers
Maintain composure
Use good judgement
Are optimistic w/o denying the loss (are glad for the years spent w/ them)
Ineffective Coping
More rigid and pessimistic
Demanding
Have emotional extremes
Live alone, socialize little, few close friends
May have mental illness
Have guilt
Palliative Care
Making person comfortable
Symptom management

a cure is being hoped for
Hospice
Person is usually dying; 6 months or less
Comfort measures are taken
Care occurs at home usually
6 C's
Care
Control
Composure
Communication
Continuity
Closure
Care
Physical and emotional
Comfort is best
Symptom/pain control (use as much as possible)
Control
Feeling of loss
Give person as much control as possible
Learn the dying persons preferences
Composure
Not avoid sadness but to have moments of relief
Counter-coping
Communication
Closed awareness (pt unaware of their impending death/diagnosis)do not lie

Suspicion awareness (attempt to confirm their suspicions; questions are indirect)
Continuity
Need to be engaged with life
Establish a legacy, treasured memories
All life needs meaning; teaching, donations, giving personal items away
Closure
An opportunity for reconciliation and transcendence

"I forgive you, please forgive me, I'm sorry, I love you, good-bye"
Euthanasia and Assisted Suicide
Assisted Suicide: done by pt themselves

Euthanasia: dose is administered by physician or nurse; illegal and unethical in US
LGBT Stonewall Riots
Birth of the gay liberation movement
1969 in Greenwich Village
HIV/AIDS LGBT
Increased in older adult population
No preventative programs for older adults
Long term side effects of medications
Complex treatment regimen (chronic disease/polypharmacy)
Accelerated Aging
Usually with gay men
Perceiving self as being old at an early age
Suicide Risk
LGB seniors: 39% considered suicide
Transgender seniors: 71% considered suicide

Social isolation
Loneliness
Lack of companionship
Crisis Competence
Good at coping

A sense of resilience and perceived hardiness as a result of life stressors
Family of Choice
Replacement family networks that are made up of individuals who are significant to them
Sexual Orientation/Discrimination in Kansas
Kansas does not have a statewide law that prohibits discrimination based on sexual orientation or gender identity in employment
Healthcare Disparities
Differences in health outcomes or groups
One group having an illness greater burden than another
Western Biological Model
Health care providers within this model consider it to be superior with an ethnocentric viewpoint
Familism
Orientation to independent culture is in contrast to many parts of the world, where family influences many decisions
Naturopathic Medicine
Distinct, integrated system of primary health care offered by licensed naturopaths/providers

Consists of diagnosis, treatment, and prevention of human disorders by the therapeutic use of natural methods and materials
Personalistic Model
Separates patients into different groups with medical decisions, practices, interventions, and or products being tailored to the individual patient based on their predicted response or risk of disease
Medicare A
Hospital Insurance
Inpatient hospital care;short term rehab; hospice; home health

Provides insurance regardless of financial status and you are automatically enrolled on the first of the month of your 65th birthday
Medicare B
Medical Insurance
Healthcare provider; outpatient services; PT, OT
Medicare C
Private Insurance Option
Replaces A and B w a health maintenance organization (HMO) or preferred provider organization (PPO)
Co-pays; deductibles
Medicare D
Prescription Insurance

Medications
Long Term Care Insurance
Medicare does not cover LTC

Arguments for: people are living longer; future of medicare and medicaid are uncertain

Arguments against: cost; less than 5% of older adults reside in nursing homes
Capacity (competence)
Term used to indicate the levels of a persons ability to make decisions
Ability to understand: financial issues; health care decisions; consent to treatments
Powers of Attorney
Legal document that gives a designated person the power to act on the behalf of a person
Conservatorship
Appointed to control the finances of the person
Guardianship
Appointed to be responsible for another person's health, safety, and welfare
General POA
Usually has the right to make financial decisions, pay bills, and so on in defined circumstances but not necessarily to make decisions related to health care
Durable POA
Can make health-related decisions for persons when they are unable to do so themselves
Greatest Risk Factor for a Fall
The elderly are at a higher risk for falls during episodes of acute illness, infection, or exacerbations of chronic illness
Intrinsic Causes of Falls
Reduced vision and hearing
Unsteady gait
Cognitive impairment
Acute and chronic illnesses
Effects of medication
Extrinsic Causes of Falls
Lack of support equipment in the bathtub and at the toilet
Height of the bed
Floor conditions
Poor lighting
Inappropriate footwear
Improper or inadequate assistive devices
Post Fall Assessment
Determining the reason for a fall and ensure that appropriate plans can be put into place to prevent future falls
-Fall-focused history
-Medical problems
-Medication review
-Mobility, vision and hearing, neurologic, and cardiovascular assessments
Physical Restraint
Manual method that uses either a physical or mechanical device
Chemical Restraint
Drug or medication is used as a restriction to manage behavior or movement
Side Rails
No evidence that suggests side rails decrease risk of falls

If pt does not use side rails to assist getting in and out of bed then it is considered to be restraints
Hip Fracture
More than 95% of hip fractures among older adults are caused by falls

2nd leading cause of hospitalization

Associated with considerable morbidity and mortality
Get Up and Go
Fall Risk Assessment

Hendrich II Fall Risk Model

Validated with skilled nursing and rehabilitation centers
Environmental Temperatures
Older individuals are vulnerable to environmental temperatures
Thermoregulation
The ability to maintain internal body temperature within a narrow range

Diminished in older adults
R/T: Neurosensory changes; Medications and alcohol; Economic, behavioral, and environmental factors
Emerging Safety Technology
Improve the quality of life, encourage independence & provide the ability to live safely at home.

Adaptive switches

Communication equipment

Home modifications

Mobility aids

Gerotechnology describes assistive technologies for older people
Hypothermia
Core temperature of less than 35°C (95°F)

Hypothyroidism
Cardiac, respiratory, and musculoskeletal impairments
Impair either the response to or the function of thermoregulation
Decrease mobility
Excessive alcohol use
Causes vasodilation
Poor nutrition
Inadequate housing
Medications
Barbiturates, tranquilizers, tricyclic antidepressants
Surgery
Hyperthermia
Body temperature increases above normal ranges because of environmental or metabolic heat loads

Due to: Low fluid intake
Obesity, cardiovascular disease, respiratory disease, diabetes, or peripheral vascular disease
Driving Safety
Shorter trips

During the daylight

Avoid inclement weather and traffic
THIS SET IS OFTEN IN FOLDERS WITH...