43 terms

Health and Older Persons: Final Exam

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Part A: Through social security. Covers hospital stays.
Part B: Paid for by individual. But, heavily subsidized by tax payers (70%).
Compare and contrast Part A and B Medicare.
Welfare program to ensure the poor
What is Medicaid?
Insurance to cover drugs and gaps up to ceiling established by medicare.
What is Medigap?
15%
____% of elderly population need help of another person to manage daily lives.
$205 per day. ($6235 per month).

Probably don't need to know. But she had some obscure numbers on the last test.
How much does it cost for a semi-private room in a nursing home per day?
$229 per day ($6965)

Probably don't need to know. But she had some obscure numbers on the last test.
How much does it cost for a private room in a nursing home per day?
$3293.

Probably don't need to know. But she had some obscure numbers on the last test.
How much does it cost per month for care in an assisted living facility?
For 2-3 Home Care Visits per week: $20,000
For Assisted Living Facility: $40,000
Nursing Home: $62,000
In Minnesota, the average cost of care for a year is....

For 2-3 Home Care Visits per week:
For Assisted Living Facility:
Nursing Home:
Provide a safe and supportive environment for chronically ill and dependent people
Restore and maintain the highest possible level of functional independence
Preserve individual autonomy
Maximize quality of life perceived well-being, and life satisfaction
Provide comfort and dignity for terminally ill patients and their loved ones
Stabilize and delay progression, whenever possible, of chronic medical conditions
Prevent acute medical and iatrogenic illnesses, and identify and treat them rapidly when they do occur
List as many goals of care as you can for nursing homes.
New emerging form of chronic care. Provides services in a setting which closely resembles a person's home.

Don't lose personhood or autonomy. Resident is seen as a tenant and has control of a living unit.
What is Assisted living?
Home health services and homemaking/chore service.
What are the two forms of homecare?
False. We focus on sending them off to nursing homes.
T/F: In the US, we focus on keeping people at home instead of sending people to nursing homes.
At least 3 days. It was waived because nobody stays at the hospital for three days anymore.
Formerly, in order for medicaid to cover homecare, you had to have to have a prior hospital stay of....
Homebound and that the intermittent skilled care is likely to produce a benefit in a reasonable time.
To get home health services, a physician must certify that the patient is....
No. Its goal is to help you die with dignity. It neither hastens nor postpones death.
Does hospice hasten death?
6 months or less.
Hospice care is provided to patients who have a limited life expectancy of....
Cancer. Though any condition qualifies.
Most hospice patients have what condition?
Physician
Nurse
Home health aide
Social Worker
Chaplain
Volunteer
Who makes up the Hospice team?
yes. Medicare and medicaid in 47 states.
Is hospice covered? by what?
Autonomy is a person's right to make their own decisions. Beneficence is whats best for the patient.

We have to ask if the person is capable of understanding the dilemma, if the patient is able to express a preference, if the patient has received accurate info, etc.
What is the balancing act of autonomy and beneficence?
True
T/F: It is federal law that all persons entering a hospital or nursing home has the opportunity to indicate advanced directives
denying an older adult medication, medical care, shelter, food, a therapeutic device, or other physical assistance, and exposing that person to the risk of physical, mental, or emotional harm—except when the older, competent adult has expressed a desire to go without such care.
Willful deprivation means....
1 out of 10 have experienced some form of it.

1 in 14 are reported.
How many Americans aged 60+ have experienced elder abuse? How many cases are reported?
60% of the time
How often is the perpetrator of elder abuse a family member?
two thirds
How often is the perpetrator of elder abuse adult children or spouses?
Physical abuse, neglect, or mistreatment: Bruises, pressure marks, broken bones, abrasions, burns
Emotional abuse: Unexplained withdrawal from normal activities, a sudden change in alertness, or unusual depression; strained or tense relationships; frequent arguments between the caregiver and older adult
Financial abuse: Sudden changes in financial situations
Neglect: Bedsores, unattended medical needs, poor hygiene, unusual weight loss
Verbal or emotional abuse: Belittling, threats, or other uses of power and control by individuals
List some warning signs for elder abuse
300%
Elders who have been abused have a ___% higher risk of death when compared to those who have not been mistreated.
1. Visual
2. Vestibular system (equilibrium)
3. Somatosensory (proprioceptions)
What three senses help a person to balance?
28-45%
How many elderly fall each year?
95%
How many hip fractures are caused by falling?
2.9 billion
How much did medicare spend on hip fractures in 1991?
20%
What percentage of hip fracture patients die within one year of a fall?
1 in 3
How many adults lose a level of their independence after a fall?
$39,299
What is the average cost of a hip replacement?
33.6%
How many Americans get osteoarthritis above the age of 65?
20% of individuals above 70 yoa and older experience neck pain once per month.
____% of individuals above 70 yoa and older experience neck pain _____ per ________.
1. UTIs
2. Prostate gland
3. Constipation
4. Side effects of medications
5. Other bowel issues
6. Most common in patients with dementia with overactive bladder
Give some causes of incontinence.
False. That is dementia. Refer it.
T/F: Serious mental decline is eventually a normal part of aging.
Most common: Alzheimer's disease
2nd Most common: vascular dementia due to stroke
What is the most common and 2nd most common cause of dementia?
The symptoms can vary greatly. But, it needs at least two of the following core mental functions to be significantly impaired.

1. Memory
2. Communication and language
3. Ability to focus and pay attention
4. Reasoning and judgment
5. Visual perception
What is the diagnostic criteria for dementia?
1 in 3. It is the 6th leading cause of death in the US.
How many people die in the US due to Alzheimer's or dementia?
patients lose 5-6% of muscle mass and strength with each day lost. Can ultimately cause death.
What is the danger of complete bed rest?
Slow gait, difficulty performing tandem walk, reduced visual acuity, and small calf circumference.
What are the 4 fall-related predictors