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Geriatrics > Health Maintenance > Flashcards

Flashcards in Health Maintenance Deck (37):
1

Goals of Health Promotion/Prevention in the Elderly

Maximize quality & quantity of life
Contribute to preserving indepence & decreasing discomfort
Focus on elements of lifestyle, environment & health care management that delays onset of chronic disease

2

Define Aging

Characterized by the gradual decline of physical & physiologic capacity

3

Define Promotion

Prevention of avoidable decline, frailty & dependence

4

Goals of Screening

Reduce premature mortality caused by acute & chronic illness
Maintain function
Enhancing QOL
Extending active life expectancy

5

Role of PCP

Promote health at every opportunity
Individualize in terms of age, functional status, patient preference, culture, SES

6

Modifiable Risk Factors for CV Disease & Cerebrovascular Disease

HTN
Smoking
Inactivity
Cholesterol
Obesity
DM

7

Single Most Important Activity in Reducing Morbidity & Mortality in the Elderly

BP
Especially orthostatic BP

8

Screening for Cholesterol

Controversial
Less likely to increase after 65 years of age
Those on meds should be screened yearly

9

Screening for DM

High risk for DM2
Established DM patients need A1C & glucose monitoring

10

Screening for Smoking

Counseling
Education on smoking cessation

11

2nd Leading Cause of Death in the Elderly

Cancer

12

Things to Think About with Cancer Screening in the Elderly

Expected time-to-benefit
Risk of developing the cancer in the patient's lifetime
Individual's estimated life expectancy
Focus on colorectal, breast, cervical & lung cancer screening

13

Potential Harms with Screening for Cancer

False positive leading to interventions & anxiety
Over diagnosis
Cost, discomfort, & embarrassment associated available tests

14

Breast Cancer Screening

Yearly PE
SBE
Mammograms suggested every 1-2 years through age 75 & with a life expectancy of at least 10 years
75+ if woman is at high risk

15

Cervical Cancer Screening

May be discontinued for women 65+ with 3 normal Pap smears over preceding 10 years
Discontinue for hysterectomy for benign indication

16

Prostate Cancer Screening

50-69 most likely to benefit
Routine screening not recommended
Discuss risks vs. benefits
Stop after age 69 or life expectancy less than 10 years

17

Colorectal Cancer

50-75 who have 5+ years to live
76-85 depends on prior screening, risk factors, co-morbidities
Not over age 86
Colonoscopy

18

Other Screening Tests for Colorectal Cancer

CT colonography
Flexible sigmoidoscopy
Stool testing for blood or stool
DNA testing

19

Lung Cancer Screening

Education on smoking cessation
55-80: low dose spiral CT to HIGH RISK individuals until 15 years out from discontinuing or limited life expectancy

20

Define High Risk in Lung Cancer

At least 30 pack year history of smoking
Currently smoking or within 15 years of quitting

21

Skin Cancer Screening

Yearly skin exam
Recommend sunscreen

22

Oral Cancer Screening

Assess yearly
Education on risk: ETOH, smoking

23

Important Immunizations in the Elderly

Tetanus every 10 years
Influenza yearly
Pneumococcal
Herpes Zoster: immunocompetent >60 or immunocompromised persons

24

Osteoporosis Screening

DEXA scans
65+
Routine screening at 60 for increased risk of osteoporotic fractures

25

Vision Screening

Periodically
Senile chart
Amsler grid
Optometrist or ophthalmologist

26

Hearing Screening

Periodically
Screened with questionnaire
Whisper test
Audiogram

27

Social Support

Family & friends available for assistance & emotional support
Simple questionnaire
Emotional & cognitive problems

28

Fall Prevention Screening

Annual visit
Get up & go test (mobility)
MMSE
Medication assessment

29

Function Screening

ADLs
IADLs

30

Cognition Screening

MMSE

31

Depression Screening

Depression scale

32

Medication Screening

Brown bag test
Have patient bring in all their medications

33

Health Promotion that Correlate the Strongest with Healthy & Successful Aging

Physical activity
Nutrition

34

Exercise & the Elderly

Counseled on benefits of aerobic & resistance exercise & life-style modification

35

Long Term Effects of Sedentary Lifestyle

Functional limitations
Obesity
Diabetes
CV disease

36

Benefits of Exercise in the Elderly

Resilient with respect to CV endurance & strength
Improves functional limitations, overall sense of well-being & self esteem, longevity, blood lipids, osteoarthritis, & conditioning
Decreases progression to disability
Reduces BP & CV disease
Reduces abdominal fat & insulin resistance
Reduces falls
Minimizes or reverses physical frailty
Prevents hip fractures

37

Dynamic Aerobic Exercise for the Elderly

Swimming
Brisk walking
Running
Bicycling
Muscle strengthening