Exam 3 - Lecture 2 (Retirement, Legal & Ethical Issues)

Question 1

what are the types of economic assistance that older adults are entitled to?

Answer 1

• SS
• Medicare

Question 2

what is retirement?

Answer 2

the expectation that older adults will cease full-time work

Question 3

which group of older adults plan to work past 65 yrs old or have no intentions to retire?

Answer 3

Baby Boomers

Question 4

retirement planning is largely aimed at these group of people

Answer 4

• highly educated
• those with high occupational status
• government employees
• employees in companies with pensions

Question 5

why do women retire earlier than men?

Answer 5

• gender bias
• family responsibilities
• more variability in work due to interrupted careers
• sporadic work history

Question 6

what are the nursing responsibilities regarding retirement?

Answer 6

• discuss it with clients in primary care
• discuss transition to retired status
• address health issues affecting retirement
• provide resources for planning & support

Question 7

what is the full retirement age for SS?

Answer 7

65-67 years old

Question 8

what was the purpose of the “Age-entitlement Program” (SS) under FDR?

Answer 8

provide monetary support at a certain age regardless of personal financial resources

Question 9

how is the “benefit amount” calculated for SS?

Answer 9

get the avg salary during 35 working years

Question 10

what are the different insurance plans provided by the US government?

Answer 10

• Medicare
• Railroad Medicare
• Medicaid
• TRICARE
• VA

Question 11

which insurance plan is designed for adults age 65, people who are blind or totally disabled and those with ESRD?

Answer 11

Medicare

Question 12

what do supplemental insurance plans (Medigap) help with?

Answer 12

• Medicare co-pays
• deductibles
• a portion of coinsurance amounts

Question 13

what does Supplemental Security Income provide?

Answer 13

minimum level of economic support to people older than 65 regardless of earning power in early working life

Question 14

what is Medicaid?

Answer 14

a health insurance program funded by the federal and state with tax dollars

Question 15

Medicaid provides health services to which group of people?

Answer 15

• low-income children
• pregnant women
• permanently disabled
• adults 65 and older

Question 16

this type of insurance is designed to cover expenses for LTC that are not included in health insurance or Medicare

Answer 16

LTC insurance

Question 17

what are some things that LTC insurance offer?

Answer 17

• wide range of benefits
• wide range of costs
• some offer a maximum time for coverage (5 years)

Question 18

how are costs for LTC paid for?

Answer 18

• Medicaid
• Medicare
• private LTC insurance
• out-of-pocket

Question 19

most older adults prefer to stay at home

Answer 19

true

Question 20

what are the 3 residence options for older adults?

Answer 20

• shared housing with family members
• community care
• skilled-nursing facilities

Question 21

what are the 4 types of community care?

Answer 21

• PACE (care for older adults living in communities)
• adult day services
• assisted living facilities
• continuing care retirement communities

Question 22

what are the 2 types of skilled nursing facilities?

Answer 22

• sub-acute
• chronic care (LTC)

Question 23

who are typical residents of an LTC facility?

Answer 23

• women older than 80
• widowed

Question 24

what is fictive kin?

Answer 24

people unrelated to an individual who are close to them

Question 25

who is considered *fictive kin*?

Answer 25

- CNA - RN - caregivers - case managers

Question 26

who is most likely to inflict abuse on an older adult?

Answer 26

their own children

Question 27

nurses are ***mandated*** to report elder abuse

Answer 27

true

Question 28

documented elder abuse occurs with which population?

Answer 28

Caucasians

Question 29

most elderly abuse occurs in the home by spouses and children

Answer 29

true

Question 30

types of abuse

Answer 30

- physical - sexual - emotional - medical - financial - discrmination - abandonment / neglect

Question 31

what is the most common type of elder abuse?

Answer 31

neglect

Question 32

what are 2 common bruising patterns in abused older adults

Answer 32

- wrap-around - linear

Question 33

where are *linear* bruising patterns most commonly seen?

Answer 33

- back - thighs - arms - buttocks

Question 34

what causes *linear* bruising?

Answer 34

striking with an object

Question 35

what are the nursing interventions for elder abuse?

Answer 35

- observe for obvious bruises - ask about medications *(medical abuse)* - photograph injuries - note body odor, dirty clothing - other signs of neglect - look for signs of restraints

Question 36

which agency are nurses required to report elderly abuse to?

Answer 36

Adult Protective Services

Question 37

according to SS, what does one "credit" equal to?

Answer 37

$1,300

Question 38

how many credits can a working adult earn in one year?

Answer 38

4

Question 39

how can one receive the minimal monthly income from SS?

Answer 39

earn 40 credits

Question 40

how much does does the *Supplemental Security Income (SSI)* provide?

Answer 40

maximum benefit of $750 per month

Question 41

how are beneficiaries determined for *SSI*?

Answer 41

consideration of total income plus the value of "gifts" such as housing

Question 42

this type of Medicare is designed to partially cover costs of acute hospitalization *(semiprivate rooms)*, short-term rehabilitation, hospice care, and any necessary medical services and supplies

Answer 42

Medicare part A

Question 43

this type of Medicare is designed to cover costs associated with outpatient or ambulatory services | outpt: clinics, outpt surgery, imaging, dialysis, chemotherapy, etc

Answer 43

Medicare part B

Question 44

under *Medicare part B*, diabetic supplies require deductibles & copays

Answer 44

true

Question 45

what other name is *Medicare part C* referred to as?

Answer 45

Medicare Advantage Plans

Question 46

what does *Medicare part C* entail?

Answer 46

- use of prospective payment system *(reimbursement based on fixed amount)* - inclusion of health maintenance organizations (HMOs)

Question 47

*Medicare part C* requires what special rule in order to provide full coverage?

Answer 47

providing proof of referral to the assigned PCP

Question 48

what does *Medicare part D* help cover?

Answer 48

cost of prescription drugs

Question 49

# assisted living facilities annual cost

Answer 49

$45,000

Question 50

# nursing home care national median daily rate (semiprivate room)

Answer 50

$235

Question 51

# nursing home care national median monthly rate

Answer 51

$7,148

Question 52

# nursing home care annual cost

Answer 52

$85,783

Question 53

# assisted living facility national median monthly rate

Answer 53

$3,750

Question 54

what are the factors to consider when selecting a nursing home? | Box 32.13

Answer 54

- central focus are the residents & families - positive interactions between staff - calm & friendly milieu - clean & well-maintained environment - individualized care - well-trained staff - involved RNs - safety

Question 55

nursing home culture change competencies for nurses

Answer 55

- effective communication skills - accommodation of resident preferences - views self as part of the team - addresses barriers to person-directed care - views the environment as the resident's home - consistency - shared problem solving