Healthy Aging
Terms
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- Geriatrics
- refers to diseases associated with aging
- By 2019, what percentage of the provincial population will be 65+?
- 20%
- What percentage of undergraduate student nurses indentify working with older adults as their first choice?
- 1.9%
- Older adults are becoming healthier & less likely to die from infection and disease. True or False
- True
- Chronic diseases are increasing. True or False
- True
- What percentage of seniors volunteer through group organizations?
- 30%
- What is a nurse specialist?
-
-education must be at the masters or doctoral level
- All people can have good health and wellbeing even as they cope with impairments and health issues. True or False
- True
- 6 Principles of Healthy Aging
-
1. Dignity (respect)
2. Self-fulfillment (opportunities)
3. Social Inclusion (accepted)
4. Independence
5. Safety & Security
6. Fairness (considered equal) - What are the 12 determinants of health?
-
1. Social Support Networks
2. Education
3. Biology & Genetic Endowment
4. Health Services
5. Employment & Working Conditions
6. Income & Social Status
7. Personal Health Practices & Coping Skills
8. Physical Environment
9. Social Envirnoment
10. Healthy Child development
11. Gender
12. Culture - What is Stochastic and what are the 3 theories associated with it?
-
Stochastic - suggest that aging events occur RANDOMLY and ACCUMULATE with time
1. Error Theory
2. Free Radical
3. Wear & Tear - What is the error theory?
- aging as a result of accumulation of errors in DNA & RNA that eventually lead to cell failure
- What is Free Radical Theory?
- unpaired ions that exist momentarily and are highly reactive to molecules that can damage protein membranes, enzymes, and DNA which can attach to other molecules and damage them
- What is the 'wear and tear' theory?
- accumulation of repeated and random injury and overuse of cells, tissues, organs, or systems
- What is Nonstochastic and what are the 3 theories associated with it?
-
Nonstochastic - consider aging to be predetermined
1. Programmed
2. Immunological
3. Neuroendocrine - What is the Programmed Theory?
-
aging as a result of inner biological clock
- each cell is "born" with a limited number of replications - What is the Immunological Theory?
- over time there is an alteration of B & T cells that lead to the loss of cellular regulation. These "foreign" cells are attacked by antibodies causing them to die
- What is the Neuroendocrine Control Theory?
-
aging as part of the life span program regulated by neuro-hormonal signals that begin at the time of fertilization until death
- common neurons in high brain centers act as pacemakers that regulate the biological clock during development and aging - What are 3 things that often get neglected with nursing care?
-
1. Mouth Care
2. Foot Care
3. Hair Care - What percentage of people 70+ have degenerative joint disease?
- 85%
- What are analgesics?
- remedies that relieve pain
- Smoking causes bladder cancer, especially in older men. True or False
- True
- Most problems with children are not age related issues from parents. True or False
- True. (However, Down's Syndrome is an age-related problem)
- What are psychosocial theories of aging and what are the associated 3 subtheories?
-
Psychosocial Theories - behaviouristic theroies of aging and determine how older adults most successfully experience later life
1. Disengagement Theory
2. Activity Theory
3. Continuity Theory - What is the Disengagement Theory?
-
-person "naturally" withdraws from society
- decreased interaction with others
- amount of disengagement is measured in terms of work - What is the Activity Theory?
-
- Old Age is an extension of middle age
- remaining as active as possible in middle age will lead to a more satisfactory old age - What is the Continuity Theory?
-
- focuses on the relationship between life satisfaction and role activity
- personality influences role activity
- personality influences life satisfaction - What are the major stress hormones?
- Epinephrine & Norepinephrine
- What are 3 major factors in sociological aging?
-
1. Environmental influences
2. Life Transitions
3. Social Support - What percentage of the older population are sedentary?
- Almost 75%
- What is a chronic illness?
- the irresversible presence, accumulation, or latency of disease states or impairments
- What are some examples of chronic illnesses?
-
Arthritis
COPD
Emphysema
Diabetes
Hypertension - Aphasia
-
affects persons ability to communicate
- usually occurs after a stroke - Alzheimer's disease is a type of dementia. True or False.
- True
- Effective listening:
-
DO NOT:
- be still and quiet
- passively wait for the message to come to you
- listen with only the ears
- listen for only the words - Ethnogeriatrics
- the medical science dealing with disease, disabilities, and care of ethnic older adults
- Cultural Sensitivity
-
be aware of your own values, beliefs, attitudes and predjudices
- keep an open mind
- do not judge
- listen
- respect differences - What are the 3 cultural belief systems?
-
1. Western or Biomedical
2. Personalistic or Magicoreligious
3. Naturalistic or Holistic - What is the Western/Biomedical System?
-
disease is believed to be the result of abnormalities in the structure and function of the body & systems often caused by germs
- assessment & diagnosis are directed at identifying the pathogen or problem causing the disease
- treatment is based on removing or destroying the invading organism or repairing or removing the afflicted body part - What is the Personalisitic/Magicoreligious System?
-
- illness is caused by the actions of the supernatural
- illness might be a punishment for wrongdoing
- treatment may consist of or include religious practices such as praying, meditating, fasting, wearing amulets, burning candles, or establishing alters - What is the Naturalistic/Holistic Health System?
-
- based on the concept of balance and stems from ancient civilizations of China, India, and Greece
- disturbance of this balance results in disharmony and subsequent illness
- diagnosis requires a determination of the type of imbalance
- herbs are often used in treatment - Falls are the leading cause of mobidity and mortality in people over the age of 65. True or False
- True
- Nearly half of all injuries among seniors take place at home. True or False
- True
- Instrumental Activities of Daily Living (IADL's)
- - more complex and higher level functions include activites such as using the phone, transportation, paying bills, planning meals, and managing meds
- Normal core body temperature
- 36-37 degrees C
- First signs of hypothermia
- Confusion & Disorientation
- Risk factors of hyperthermia in the older adult
-
dehydration
extremes in temp
inactivity
immobility
alcohol
infection - What foods contain fiber?
-
fruits
veggies
whole grains
cereals
beans
nuts
***helps decrease Coronary Artery Disease (CAD) - Which vitamins are especially important?
-
Vitamins A, B6, C, E
(intake is often inadequate) - Which mineral may be linked to dementia?
- Folic Acid
- What factors affect nutritional intake?
-
- lifelong eating habits
- socialization
- income
- housing
- transportation
- decrease in senses
- dental/oral health - What interventions can be implemented to enhance nutritional intake?
-
- eat with family/friends
- join group meal programs
- ask doctor if meds are causing appetite changes. If so, ask about changing meds
- add spices and herbs
- soft foods
- delivery of food from stores
- use coupons
- buy foods on sale or store brands
- get food stamps - The combination of lack of physical exercise and poor diet is the 2nd highest underlying cause of death in Canada. True or False
- True
- What is Keratosis?
- Dry skin
- What are the 6 subscales of the Braden Scale for assessing risks for pressure ulcers?
-
1. sensory perception
2. skin moisture
3. activity
4. mobility
5. friction & shearing
6. Nutritional status - Should foot care be done on dry or wet feet?
- dry
- Pharmacodynamics
- interaction between the drug and the body
- Polypharmacy
-
the prescription, use, or administration of more medications than is clinically indicated
- mainly associated with lack of knowledge, forgetfulness, & multiple care providers - What is the "brown bag approach"?
-
- ask client to bring in ALL meds
- do not write down what is on the container. Ask the client how they take their meds
- ask about side effects
- where the meds are stored
- who manages the meds
- individuals knowledge about the meds - Nonpharmacological Interventions for promoting sleep
-
- regular bedtime and wake time
- avoid naps or keep them under 30 mins
- exercise at least 3 hours before bedtime
- limit caffiene, nicotine, and diuretics late in the day
- do not use alcohol to sleep
- wind down and relax
- do not watch the clock
- use the bed only for sleep and sexual activity - Pain is not a normal part of aging. True or False
- True
- What are Nonopioid Analgesics?
-
-Acetaminophen (Tylenol)-mild to moderate
-NSAIDS (Ibuprofen, Motrin)-pain for arthritis - What are Opioid Analgesics?
-
used for acute pain or cancer
- generally the 1st dose should be half the usual dose given to younger person and increase increments by 25%
- side effects: constipation, nausea, dizziness, sedation, falls, rash
- stool softeners are almost always used with opioids (start them early) - Impotence is not a normal part of aging. True or False
- True
- What are some approaches to inappropriate sexual behaviour?
-
- place resident in a setting away from male/female resident
- tell resident ahead of time what is expected
- involve family members
- council resident regarding natural sexual feelings and privacy
-avoid situations or activites that promote sexual activity
- communicate with staff interventions that have worked in the past - What are the phases of retirement?
-
1.Preretirement
- Remote phase
- What are the 3 phases of retirement?
-
1. Pre-Retirement
- Remote Phase
- Near Phase
2. Retirement
- Honeymoon Phase
- Disenchantment Phase
3. Post-retirement
- Re-Orientation Phase
- Stability Phase
- Termination Phase - What is the remote phase of retirement?
-
rarely thinks about retiring but is aware that it is in the future
(pre-retirement phase) - What is the near phase of retirement?
-
individual plans and prepares for life after work
- may have fantasies of doing all the things they have never been able to do
(pre-retirement phase) - What is the honeymoon phase of retirement?
-
- feeling of euphoria & freedom
- generally high energy level
(retirement phase) - What is the disenchantment phase of retirement?
-
- experienced by most retirees
- cannot do all the things they previously planned
- may not adjust to freedom from work or lower income
- realization of losses associated with job - What is the re-orientation phase of retirement?
-
- a more realistic routine
- generally satisfactory and comfortable lifestyle
(post-retirement phase) - What is the stability phase of retirement?
-
- most of one's retirement is spent in this phase
- investment is made into meaningful, satisfying decision making and activities
(post-retirement phase) - What is the termination phase?
- - sometimes the retiree returns to work
- What are 5 key factors that affect the impact of loss?
-
1. Significance of the loss
2. Person's Coping Response
3. Impact of the Loss
4. Availability of Supports
5. Personal Values - What are common losses experienced by older adults?
-
1. Physical losses
- What are some common losses experienced by older adults?
-
1. Physical Losses
- self-image
- lowered resistance to disease
- diminished control of bodily functions
2. Psychological Losses
- self-esteem
- victim of ageism
- relocation
- loss of feeling of contribution
3. Personal Network Losses
- spouse
- siblings or children
- friends
- pets
- work associates
4. Financial or Economic Losses
- diminished purchasing power such as:
- food
- meds
- clothing
- rent
- car/gas
- telephone - What is the suicide rate for people 65+?
- 12.4/100,000 people
- What are the 5 Stages of Kubler-Ross Grief and Death Reactions?
-
1. Denial and Isolation
2. Anger
3. Bargaining
4. Depression
5. Acceptance
DABDA - What are some strategies to help individuals who are grieving?
-
- allow time to grieve
- help the person express their feelings
- encourage reminiscence
- secure religious support if desired
- give direction and support
- be alert for suicide ideation
- encourage family involvement - Nursing interventions for individuals who are lonely.
-
- explore the nature of the lonliness
- guide the client in reviewing life experiences related to loneliness to gain insight
- spend time with the person (frequent breif periods)
- let them know you are available
- suggest the person get a pet
- assist the person in keeping in contact with people important to him/her - Iatrogenic
-
illness caused by medical examination or treatment
(35%)
- falls
- dehydration
- medication reactions
- incontinence
- pressure ulcers
- What is an informal caregiver?
-
- an unpaid, unprofessional caregiver
- most informal care comes from family members
- usually women, ~57 years old, married - What are 4 types of elder abuse?
-
1. Physical Abuse
2. Emotional Abuse
3. Material Abuse
4. Sexual Abuse - What are 4 theories relative to abuse and neglect?
-
1. Social Learning Theory
2. Personality Disorders of Caregiver
3. Stressed Caregiver
4. Isolation of the Older Adult - What does palliative care focus on?
- Comfort
- What are the 6 C's approach to maximizing quality of life for an individual who is dying?
-
1. Care
2. Control
3. Composure
4. Communication
5. Continuity
6. Closure - How to care for family members of a loved one who is dying.
-
- keep them informed
- ask how they are doing
- put an arm around them
- bring them food
- know their name
- cry with them
- tell them to hold the client's hand while they are dying
- get the chaplain
- let them take care of their loved one - When is a person considered incompetent?
- when the courts have declared them incompetent AND the person is unable to understand the consequences of his or her actions
- What is legal competence based upon?
- a physician's or other health care professional's assessment
- Powers of Attorney
- legal document where the older adult appoints another individual to act on their own behalf
- Guardianship
-
- appointed by the court
- individual, agency, or corporation that has control of an incompetent person - Do-Not-Resuscitate (DNR)
-
- specific order of a person's wishes to not receive CPR
- written by physician which gives direction not to perform CPR