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Terms in this set (49)
Chronic illnesses account for about ______% of all deaths in the US.
What is the most common reason for older adults to be hospitalized?
Osteoarthritis affects 1 in _____ people.
Obesity affects > ______% of people.
Hypertension affects ______% of people.
What is a nurse's role in helping people manage chronic illnesses (7)?
1. managing and preventing crises
2. carry out prescribed treatment regimen
3. control symptoms
4. reordering time (change schedule and limiting activities)
5. adjusting to disease changes
6. preventing social isolation
7. attempting to normalize interactions with others
What are 4 reasons people are living longer?
1. flu and diarrhea are less common causes of death now
2. new drug therapies, immunizations, and surgical interventions (advanced technology)
3. greater emphasis on health promotion
4. earlier detection and treatment of diseases
When did the first of the baby boomers begin to turn 65?
What percentage of the population is 65+? What is this projected to increase to by 2030?
13% --> 20%
What percentage of older adults have one chronic illness? 2? 3?
1 - 84%
2 - 62%
3 - 23%
What is considered to be young old? What percentage of this population lives in a nursing home/can't do their ADLs?
ages 65-74; 6%
What is considered to be old old? What percentage of this population lives in a nursing home/can't do their ADLs?
anyone 85 or older; 25%
What theory about the 'recipe for long life' is not proven by any evidence?
large doses of vitamin E, C, and A slow aging
What is a theory of the 'recipe for long life' that is not feasible, but if it were, would be very beneficial?
extreme calorie restriction by decreasing intake by 25-50%
What 7 things contribute to a long, healthy life?
good genes, healthy BMI, exercise, good nutrition, not smoking, social support, ability to handle stress well
How much money was spent by US consumers on food supplements?
Which demographic is more likely to live alone on a lower income, with a higher incidence of chronic conditions?
What are 6 risk factors that make the older adult more vulnerable to chronic disease?
1. living alone
2. lower income
3. living in a rural area with less access to transportation to health care
4. being homeless due to lack of affordable housing
5. cognitive impairment
What is the criteria for having frailty (the geriatric syndrome)?
must have 3 or more of the following:
1. advanced age (over 75 years old)
2. unplanned weight loss (over 10 lbs in the last year)
3. poor endurance and energy
5. low activity levels
What percentage of community-dwelling older adults in the US are abused, neglected, or exploited by trusted people? Who are the ones responsible for most of this? When this happens, what risk does this put the older adult at?
2-10%; family; mortality rate is 3x higher for them
What are factors that increase risk for abuse of older adults (3)?
inability to do ADLs, cognitive impairment, decreased social support
What are the different forms of mistreatment in elderly abuse (5)?
physical abuse, neglect of basic needs, psychological abuse, sexual abuse, financial abuse
What is self-neglect?
failure to meet own needs due to lack of or refusal of resources
Who is usually considered primary support for the older adult? Semiformal levels of support (2)? Formal (3)?
primary - family caregivers
semiformal - church/neighborhood organizations, senior centers
formal - government welfare agencies, clinics, hospitals
What are the 4 most common formal systems of support for the older adult?
home health care, assisted living, skilled nursing facility, intermediate care
What is home health care? Does Medicare pay for this?
short term skilled nursing care in the patient's home that Medicare will reimburse
What is assisted living?
a living arrangement in which meals and supervision with medications are provided, but the patient must be a able to do their own ADLs
What is a skilled nursing facility? Does Medicare pay for this?
a short term need for rehabilitation or skilled nursing care in which Medicare will pay for a maximum of 100 days per spell of illness
What is intermediate care?
provides assistance for ADLs to those who can't live on their own
What are the 8 most common conditions that require hospitalizations?
heart failure, falls, dysrhythmia, stroke, hip fracture, dehydration, pneumonia, urosepsis
What is urosepsis?
UTI that spreads to the blood
What is Medicare? How many options for coverage are there?
A federally funded health insurance for people older than 65; 4 options
What is Part A of Medicare? How is it funded?
fully covers inpatient hospital care, and partially covers SNIF, hospice, and home health care; funded by payroll taxes so it is available to everyone for free
What is Part B of Medicare? How is it funded?
partially covers outpatient care, physicians services, home health care, and some preventative service such as mammograms; has a monthly premium and annual deductible (is optional)
What is Part C of Medicare? What is another name for it?
offered by private companies and approved by Medicare; Medicare Advantage Plans
What is Part D of Medicare? How is it funded?
provides a prescription drug benefit; has a yearly deductible and monthly premium, and a copayment in which lower-income patients may qualify for extra help
What does Medicare cover? What doesn't it cover (3)?
covers - those over 65 who have certain disabilities
NOT - long-term care, ADL and IADL care, dentures, hearing aids, glasses
What is Medicaid?
health insurance program to assist low-income people with medical expenses
What are advanced directives? What 3 things might it include?
legal documents that designate medical care you want to receive
living will, durable power of attorney, DNR
What is a living will?
a patient's wishes regarding decisions about care provided or withheld when terminally ill
What is a durable/medical power of attorney?
a designation of person to make a health care decision in the event that the patient is incapacitated
What is a DNR order?
a very specific type of advance directive that compels HCPs to refrain from CPR if no sign of breathing or heart beat
What are 3 reasons gerontologic nursing might be complex?
1. older adults often have multiple chronic conditions in addition to the acute condition that causes them to seek care
2. disease symptoms are often atypical (ex. MI symptom might be fatigue or UTI symptom might be confusion)
3. underreported symptoms and attributing it to 'old age'
What is SPICES? What does it stand for?
a risk screening tool that assesses for common nonspecific indicators of disease
Problems with eating/feeding
Evidence of falls
What are 9 common assistive devices that decrease disability?
dentures, glasses, hearing aids, walkers, wheelchairs, adult briefs/protectors, adaptive eating utensils, elevated toilet seats, skin protective devices
What is a common fear of those trying to participate in rehabilitation?
What 5 preexisting conditions can affect quality of recovery in rehabilitation?
1. visual acuity
2. fine motor skills
3. physical strength
4. cognitive function
In terms of rehab, what does inactivity/immobility lead to (2)?
deconditioning and functional decline
What are 6 important acute care considerations when taking care of the older adult?
1. plan for discharge needs earlier in the hospital stay
2. engage in the interdisciplinary team
3. be vigilant when screening for hospitalization complications
4. implement an early mobility program
5. advocate for the most appropriate community-based transfer upon discharge
6. frail older adults are particularly vulnerable to complications when transferred from one setting to another
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