Nursing- Gerontology Flashcards

Terms Definitions
Challenge of global aging
Society, families, health care systems
American population is generally
Aging population is a challenge to
Japan Korea and continental Europe
Three factors affect the age structure of any population
Falling birth rates, increasing life expectancy, immigration and migration rates
Forces behind global aging
Falling fertility and increased longevity
Global aging occurs when
People have fewer babies
Lower fertility does what
Shrinks the number of younger people
Age pyramid
Will become a rectangle- even
Fertility rate is
Below 2.1
US fertility rate
Higher than most industrial countries
US fertility rate is what it is why
Immigration of Latino and Hispanic- higher birth rate
Lowest fertility rate
Longer life spans
Enlarge the relative number of older people in the population
Life spans in developed countries
Risen dramatically
Young old people are.
50-70 , relatively healthy and vigorous, may or may not be retired, seeking meaningful uses of tie
Older old are
70-80, some active or vigorous, most require supportive health and social services and may require economic support
Very old
85 and older, fastest growing population, increased from 100.000 in 1900 to 5.5 million in 2010
Those over 90, trouble with ADLs
US diversity is
More diverse racially, ethnically, educationally, and in health status
Sex that lives longer
Gradual structural changes that occur over time, not due to disease or accident, different from pathological processes, rate varies
Biological aging is influenced by
Non biological processes
Aging results in
Loss of functional capacity and increased vulnerability to disease and death
Characteristics of aging
Loss of functional capacity, increased vulnerability to disease, changes in composition of body
Chemical composition changes of old people
More fat and less water
Variation among individuals in rate of aging
Wide variations, different organs at different rates even within same individual
Longer life means
More exposure to toxins and the impact of life style choices are more apparent
Sun alcohol fat smoke and chemicals
Life style choices that affect
Diet, exercise
Today's focus of health care
On chronic disease which is often the result of lifestyle decisions
Biological theories of aging
Genetic, wear and tear, environment, immunity, and neuroendocrine
Psychological theories of aging
Personality, developmental tasks, disengagement, activity, continuity, no equilibrium system
Free radical and waste product as compared to age
Both increase together
Life span
Varies , average age
Life expectancy
How long you can expect to live
Life expectancy of us
Just over 78 and variations its m
Variations of life expectancy
For men and women and race
Key indicators of health status
Life expectancy, morality, chronic health conditions, depressive symptoms, memory impairment, self rated health status, functional ability
USA older population is becoming
Somewhat healthier and engage in health promotion activities
Death rates of elderly
Heart disease, cancer, stroke, flu and pneumonia, chronic lower respiratory disease, Alzheimer's, and diabetes
Major health problems and causes of disability
Chronic- arthritis, hypertension and strokes, hearing problems, and heart disease
Bathing, dressing, eating, and getting around the hous
Preparing meals, shopping, managing money, phone, housework, mess
Percent of elderly with at least 1 problem
85 or more
Percent with 3 or more chronic problems
Americans do or don't adhere to mess
40 years and over with chronic conditions
Depart from doctors orders, skip forget r miss doses, don't refill or fill rx, under or overuse, take different med for different condition or person
Areas of concern for elderly
Vision, hearing
Older with vision problems
Vision problems associated with
Increased dependency and fall risk
Hearing problems elderly %
10-30 % 65 and older and 25-52 those 85 and older
Psychological consequences elderly
Isolation and poor cognitive testing
Digestion and nutrition problems
Can't get prepare consume and enjoy food, can't absorb, malnutrition, dehydration, constipation
Decreased absorption of
Iron, calcium, folate, and vb12
Under nutrition. %
23 , 46 at risk
Over nutrition
Social risks influencing nutritional risk
Isolation, poverty, dependency
Psychological factors influencing nutritional risk
Depression, dementia
Biological factors affecting nutritional risk
Dentition, taste, gastrointestinal disorders, muscle weakness, dry mouth, olfaction, renal disease
Study of berries in women
Proven to ward off myocardial infarction with high levels of anthocyanins and antioxidants
Cardio protective effects of berries
Red and blue fruits - anti inflammatory effects, plaque stabilization, inhibition of expression of growth factors
Urinary elimination problem
Incontinence, problems for caregivers, and psychosocial effects
Urinary incontinence among institutionalized
Incontinence among noninstitutionalized 60 years and older
15% men , 30 % women
Osteoporosis and arthritis problems
Pain, risk for fractures, decreased mobility, fallaphobia, post fall syndrome, what if
% of hospital admissions and nursing home admissions related to fallin
20, 40
Skin problems elderly
Decreased sweat and sebaceous gland production therefore prone to dryness
Elderly thermal regulation
Prone to hypothermia and hyperthermia
Pain common in elderly
Chronic- need to watch out out for OTC and herbal meds
Manage pain
Keep a pain diary
Three D's
Dementia, delirium, depression
Progressive impairment in cognitive function
Causes of dementia
Alzheimer's (2/3), multiple strokes or vascular dementia, Parkinson's and aids
Types of dementia
Alzheimer's, vascular, mixed, Lewy body, fronto temporal, Parkinson's
Mild stage of Alzheimer's
Conspicuous behavior at work, forgetfulness, mood swings, attention disturbances
Moderate stage Alzheimer's
Conspicuous cognitive defects, restricted everyday activities, orientation disturbance, apraxia, agnostic, aphasia, behavioral abnormalities
Severe stage Alzheimer's
Loss of independence, decay of memory and speech, incontinence, complete dependence on nursing care
Vascular or multi infarct dementia
Step wise progression
Testing for dementia
MMS and mini cog or clock drawing test
Mini mental status exam, 10 to 20 as,
MMS questions
Day, season, month, year, president, basic math
Mini cog test
Memory test for 3 words, correctly draw a clock
May ward off dementia
Exercise and coffee
Health promotion timing
As early as possible but it can never be too late to start
Pseudo dementia, acute confusional state due to changes in consciousness, cognition, sleep wake cycle, is reversible
Remove underlying causes of delirium
Drugs, illness (infections, UTIs), fluid and electrolyte imbalance
Affective mood disorder, often undetected and under reported, considered high among the elderly, ESP those ill or institutionalized, highly responsive to treatment
Those at greatest risk of depression
Elderly white men- also high suicide rate over 85 especially
Dementia key points
Gradual onset, impaired memory, Kabila effect, evasive, angry, sarcastic, tries to cover up deficits, inappropriate dress and actions
Depression key points
Abrupt onset, memory deficits related to lack of motivation, consistent feelings of sadness, slow, apathetic, don't know don't care, little or no concern about appearance because of lack of motivation
Geriatric syndromes
Falls, incontinence, delirium, atypical presentation
Falls in elderly
1:3 older people fall every year, can be an indicator of increasing frailty
Have to treat what is
Behind the symptom
Medications but what else
Anemia, malnutrition, infection, hypoxia, deconditioning, pain, sensory deficits, why and or where is it occurring
Assessment of elderly
Comprehensive, interdisciplinary, emphasis on functional abilities
Comprehensive assessment
Physical, psychological, and socioeconomic
Emphasis on functional abilities
ADLs and IADLs
Assessment key things
Take your time, sit down, make eye contact, listen, watch for clues
Continuum of care
Independence to skilled care
Home care
>90 % of older adults want to stay in their own homes for as long as possible, therefore increasing arrays residential options
Family structure today
Fewer kids and siblings, children live farther, delaying childbirth, older with young kids
Financial issues
3 leg stool- social security, savings/ assets, pension plan
Most of the elderly rely on what for income
Social security
Without social security
44% of the elderly would be poor , but only 9 % are now
Who pays for elder care
Medicare, secondary and long term care insurance, self pay, spending down to poverty- Medicaid
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