Intro To Gero Flashcards by Abigail Interrante

Why is polymedicine common in older adults?

Older adults have more health issues
May require more OTC and prescription medications
-> account for 1/3 of all prescription drug costs

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What is polypharmacy?

The inappropriate use of unnecessary medications, often involving:

Many OTC drugs
Not consulting a healthcare provider

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Give examples of OTC drugs often used in polypharmacy

Analgesics and antacids
Cold medications
Laxatives
Herbal supplements

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Why are older adults at increased risk for adverse drug events (ADEs)?

Older adults usually take multiple drugs to treat their illness, and the number of drugs taken and how frequently they are used increases the risk of ADEs

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List common ADEs in older adults

Edema
Severe NVD (nausea, vomitting, diarrhea)
Constipation
Anorexia
Dehydration
Dysrhythmia
Fatigue
Weakness
Acute confusion
Syncope
HTN
Urinary retention

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Why are older adults often intolerant (sensitive) of standard drug doses?

Age-related physiological changes

Affect absorption, distribution, metabolism, excretion
-> stronger/longer lasting effects -> increase risk of toxicity

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How can chronic diseases impact medication tolerance?

Chronic conditions may worsen side effects or alter drug effectiveness/metabolism

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What is a common effect of opioid use in older adults?

Constipation

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Why does self-administration increase the risk of toxicity in older adults?

Because they may be taking multiple drugs without proper oversight, increasing the chance of dosing errors and interactions

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What are 4 common issues that are related to self-administration of drugs?

Forgetting to take medications

Leads to incorrect dosing

Avoid taking drugs

Delay/Pvt healing process

Poor communication with providers

May be misinformed about their medications

Taking complementary or integrative therapies

Drug interactions

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How can complementary or integrative therapies be risky for older adults?

They can cause drug interactions that:

↓ Effectiveness of prescriptions
↑ Risk of adverse effects
Speed up or slow down drug metabolism

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What happens when older adults avoid taking medications?

Can delay or prevent healing
Leads to ineffective treatment

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How do relationships impact older adult adaptation?

Those with friends and social connections do better than isolated individuals
Maintaining relationships helps cope with life and stress

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______ support is especially important as people age

Social

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What are trends in work and retirement among older adults?

Many continue to work into their 70s–80s
Some continue working after retirement
-> Often because retirement savings may run out

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What does Medicare cover for older adults?

Covers some healthcare expenses
May not cover all health expenses

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What are the 3 programs that help support older adults?

National Aging in Place Council
Village to Village Network (Administration for Community Living)
AARP Livable Communities (Administration for Community Living)

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What is the National Aging in Place Council?

A program that helps older adults stay in their homes as they age

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What is the Village to Village Network?

Created by the Administration for Community Living
supports older adults staying in their own homes or communities

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What is the AARP Livable Communities initiative?

Run by the Administration for Community Living
Make neighborhoods, towns, and cities more livable and age-friendly

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Relocation Stress Syndrome

Physical and emotional stress when one person moves from one setting to another

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What are physical manifestations of relocation stress syndrome?

sleep disturbances
GI stress
Emotional/withdrawl activity
-> Anxiety, anger, depression

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What are the interventions that can be used for a patient with relocation stress syndrome?

Provide as many opportunities to assist in decision making (more likely to adhere to it)
Explain all of the routines before they occur
Reorient them
Ask their expectations
Trusting relationships
Don’t move them around too much (keep in one room)
Have friends/family visit

What communication strategies should be used with older adults who have hearing loss?

Speak slowly and clearly
Face the person to allow lip reading
Minimize background noise
Use lower tones

How can nurses collaborate when caring for older adults with hearing loss?

Involve family or significant others (with consent)

For those suffering from prebycusis, what is one thing you want to ensure within these patients?

Ensure proper use of hearing aids

What communication adaptations support older adults with vision impairment?

- Use large print - Provide adequate lighting - Use visual aids - Orient the person to their surroundings

What is a helpful reminder for patients with vision impairment?

Remind them to wear eyeglasses

How can nurses helps older adults with reduced touch sensation (in regards to prevention of falls) ?

Assist with mobility to prevent falls

How should nurses communicate with cognitively impaired older adults?

- Use simple, direct communication - Repeat as needed

How should nurses approach patients with delirium?

- Reorient using a calm voice

How should nurses approach patients with dementia?

- Validate feelings rather than reorienting them

What communication strategies help patients with decreased mobility?

- Allow enough time for responses and movement - Break down activity instructions into small steps

What teamwork strategies support patients with decreased mobility?

Collaborate to allow safe and supported movement

What strategies help older adults with low health literacy understand care instructions?

- Avoid medical jargon - Provide written information at an appropriate reading level - Use teach-back method to confirm understanding

What are the risks of poor care coordination during transitions of care?

- ↑ Hospital readmission rates - ↑ Emergency department (ED) and primary health care provider (PHCP) visits

What causes poor care coordination during discharge?

- Breakdown in communication when transitioning from hospital to home or long-term care - Nurses may not communicate discharge plans effectively → causes confusion

How should discharge instructions be presented to older adults to address patients communication needs?

- In large print - Easy to read and understand

When should discharge planning begin?

At the time of admission

What should nurses do during discharge teaching?

- Over-explain - Assess for understanding -> Use teach-back method: have the patient read it back or teach it back

T/F: Home health should follow up with patients when they are discharged home

true

What role does home health play after discharge?

- Follow up at home - Ensure patients are continuing care appropriately

What is the purpose of using a health coach for older adults?

- Ensure understanding of discharge instructions - Help maintain consistent follow-up appointments - are designated emergency contact for the pt family

What is sensory deprivation in older adults?

self-imposed isolation that can decrease stimulation and lead to loneliness or depression

What is sensory overload in older adults?

Stress caused by being moved to unfamiliar environments (like hospitals) that are overstimulating

What events can negatively affect self-concept in older adults?

- Decreased mobility - Death of a spouse or caregiver

What are effects of self-concept loss in older adults?

- Loss of autonomy and independence - Feelings of emptiness, boredom, and worthlessness - Impacted appearance/body image - Loss of identity and control in life

What is presbyopia?

Worsening farsightedness due to aging

How does visual loss affect older adults?

- Leads to social isolation - Difficulty performing activities they once enjoyed → increase lonliness -> ↓ self-worth

What is presbycusis?

Hearing loss associated with aging

How does auditory loss affect self-concept?

- Harder to engage in conversations → isolation - Loneliness → ↓ self-worth

How does reduced touch sensation impact older adults?

- ↑ Risk for falls - Fear of movement → avoidance of activities - ↓ Social engagement → ↑ feelings of being frail/incapable

What are the effects of reduced proprioception/kinesthetic awareness?

- ↑ Falls - Fear and avoidance of movement - ↓ Activity and engagement → reinforces feeling of being incapable

What happens when older adults lose their sense of smell?

- ↓ Desire for food - Can lead to inadequate nutrition - ↓ Participation in social mealtimes

What are effects of diminished taste in older adults?

- ↓ Ability to taste sweet and salty - ↑ Ability to taste bitter and sour - ↓ Satisfaction with meals → may avoid mealtimes with others