Lecture 1 Flashcards
(81 cards)
1
Q
What is Gerontology / Geriatrics?
A
Scientific study of the process of aging and the problems of aged persons including physical, mental, and social problems. It is considered holistic.
The branch of medicine that deals with the disease and treatment of older people.
2
Q
What is Old?
A
WHO – 50 yrso
Western countries –65+ yrs
3
Q
Chronological
A
The number of years lived
4
Q
Biological
A
The age of the organ system. We are one organism.
5
Q
Psychological
A
How old one feels
6
Q
Social
A
Roles and relationships. They change and vary but are subjective
7
Q
SUBJECTIVE term
A
Varies by time, place, cohort, and perception
8
Q
Nonagenarian
A
90+ years old
9
Q
Centenarian
A
100+ years old (77% are female)
10
Q
Baby Boomer
A
People born between 1946-1964
A boom after World War II. Began turning 65 in 2011
11
Q
Who are these People
A
- 80% of adults over age 65
- Rely on health care services
- 34% of all older women
- Many older adults … Live alone
- Educational levels are increasing
- 8.9% were living below the poverty level
12
Q
What does poverty mean?
A
Women living in poverty is 10.3% and Men 7.2%. Men tended to be the breadwinners and more educated which is why they have lower poverty levels.
13
Q
Life expectancy- Cohort (Generation)
A
Generational (People in their 80’s have been expected to live to… how long from when you are born)
14
Q
Life expectancy- Current
A
Current (At this time going forward you are expected to live this long…)
15
Q
Caring for Our Aging Population: Setting
A
Nursing homes, hospitals, home care (hospice), long-term care facility
16
Q
Caring for Our Aging Population: Advanced Practice
A
Gerontological NP’s
17
Q
Caring for Our Aging Population: Mission
A
Preserve function, preventative (keep it from getting worse), enhance health, enhance the quality of life. Letting them have a say in their care. Enhance the dying experience.
18
Q
Caring for Our Aging Population: Research
A
Innovations in care, provision of services.
Hot topics: Dementia, delirium, reducing falls, use of restraints, pain management, end of life care
19
Q
Caring for Our Aging Population: Demand
A
Critical for gerontological nurses because of the growing amount of aging adults.
20
Q
Caring for Our Aging Population: Concern
A
Lack of adequate staffing. Lack of RN’s or LPN’s or Techs wanting to go into this type of nursing.
21
Q
What is Health?
A
Absence of disease
22
Q
What is Wellness?
A
The concept of wellness incorporates all aspects of one’s being
23
Q
What is Wellness? Physical
A
Able to walk, feed themselves, general ADL’s
24
Q
What is Wellness? Emotional
A
Living alone, social interactions, loved ones have passed on (spouses and children)
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What is Wellness? Intellectual
Think intellect and brain cognition
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What is Wellness? Social
Relation with others
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What is Wellness? Spiritual
Faith
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What is Wellness? Cultural
Religious or cultural practices
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What is Wellness? Environmental
Are they in a healthy living situation. What kind of environment are they in.
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What does the Wellness model suggest?
suggests that every person has an optimum level of functioning for each position on the wellness continuum to achieve a good and satisfactory existence
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Wellness Objectives?
- Dementia: How to prevent and deal with it
- Food-borne illness: It is easy for them to get sick
- Infectious disease
- Injury prevention
- Oral conditions
- Osteoporosis
- Respiratory disease
- Sensory or communication disorders
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Disease Prevention- Primary
Behavioral teaching, healthy lifestyles, ways to prevent disease, social engagement, cognitive simulation (crossword puzzles), immunizations
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Disease Prevention- Secondary
Evidence based screenings and guidelines (Mammograms, annual wellness visits, prevention plans, target diet, 81 mg aspirin)
34
Theories of Aging- Senescence
“to grow old” – condition/process of deterioration with age
35
Theories of Aging- Cellular Functioning
-Cells replicate but not exact replication. They become more complex, with increased replication there in an increase in damage.
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Theories of Aging- Error Theories
- Aging is the result of an accumulation of random errors in the synthesis of cellular DNA and RNA
37
Wear and Tear Theory:
Falls under an error theory. Cellular errors due to result of wearing out. Over time it breaks down. A progressive decline in cellular function or increased cellular death. Cells are aggravated by internal and external stressors. Cells are destroyed by mechanical or chemical injury.
38
Psychosocial Theories: Successful aging
Role
Adapting to changing roles. A sense of usefulness. Such as retirement (are they ready or not).
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Psychosocial Theories: Successful Aging
Activity
Maintain a productive life both physical and mental
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Psychosocial Theories: Successful Aging
Disengagement
Transfer control to the younger generation. Society distances itself from older adults and the older adult disengages from society.
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Psychosocial Theories: Successful Aging
Continuity
Maintain and continue previous behavior (current role) or find replacements.
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Psychosocial Theories: Successful Aging
Age Stratification
Individuals of a similar age or cohort have the most similar interests
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Psychosocial Theories: Successful Aging
Modernization
Older people lose power and status due to advances in technology (challenging).
44
Development Theories
Erikson: Widely accepted in nursing.
45
Theory-Based Intervention
Used as a bases to develop policy, standard of care, protocols, & orders. How we treat things. Theories used to develop interventions. Promote healthy aging.
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Health Disparity and Culture: Emerging Majority
Statistically, minorities become the majority by the numbers.
47
Health Disparity and Culture: Health Disparity
Differences in the state of health and health outcomes between groups of persons.
48
Health Disparity and Culture:
| Health Inequity
The excess burden of illness or the differences between the expected incidents and prevalence.
49
Health Disparity and Culture:
| Cultural Awareness
The development of cultural proficiency (how to relate to different groups of people) with increased awareness of our own beliefs and attitudes and those commonly seen along with the common beliefs in healthcare. (Such as a patient refusing a blood product necessary for their life) Think application
50
Health Disparity and Culture:
| Cultural Knowledge
What the nurse brings to the caring situation and what the nurse learns about older adults their families, their communities, their behaviors, and their expectations.
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Health Disparity and Culture:
| Culture
Shared and learned beliefs and expectations
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Health Disparity and Culture:
| Acculturation
A person from a minority or marginalized culture adopts that from a majority or dominant culture.
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Health Disparity and Culture:
| Ethnicity
Social differentiation is based on cultural criteria. Listen & Communication
54
Health Disparity and Culture:
Types
Barriers to quality care range from those related to:
Geographical location, gender, race, sexual orientation, age, ethnicity
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Health Disparity and Culture:
Types
African Americans
- 50% more likely to have a stroke
- Transient ischemic attack: 62% fewer get anticoagulation
- 50% more likely to die of stroke
- 20% more likely to die of heart disease
- 1.5 times more likely to have hypertension
- 2.5 times more likely to have diabetes
- 30% more likely to have diabetes-related amputations
56
Health Disparity and Culture:
Types
Mexican Americans
- 2 times more likely to have diabetes mellitus (DM)
| - Get 36% fewer prescriptions after myocardial infarction
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Health Disparity and Culture:
Types
Native Americans
- 5.7 times more likely to have DM than whites
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Reducing Health Disparities: Cultural Awareness
Self Level
Requiring self-understanding of one’s experience and values
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Reducing Health Disparities: Cultural Awareness
Ability to..
work and build a relationship with members of other cultural groups
60
Reducing Health Disparities: Cultural Awareness
Recognition of..
factors beyond culture such as health, safety, poverty; things that affect members of a population group (social determinants of health)
61
Reducing Health Disparities:
Cultural Knowledge
Both..
What the nurse brings to the caring situation and what the nurse learns about the older adults, their families, their expectations
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Reducing Health Disparities:
Cultural Knowledge
Essential Knowledge
Includes elders’ way of life. How they think, what they believe, and how they act
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Cultural Beliefs About Health, Illness, and Treatment
Biomedical
Focus on disease and abnormalities
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Cultural Beliefs About Health, Illness, and Treatment
Magico-Religious
God or supernatural forces call disease. Good health is a blessing or an award.
65
Cultural Beliefs About Health, Illness, and Treatment
Naturalistic or Holistic
Illness concerned with disbalance in harmony
66
Cultural Beliefs About Health, Illness, and Treatment (Obstacles)
Ethnocentrism
The belief that one's system is superior
67
Cultural Beliefs About Health, Illness, and Treatment (Obstacles)
Stereotyping
Simplified ideas about a group
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Cultural Beliefs About Health, Illness, and Treatment (Obstacles)
Ageism
Discriminating against someone because of their age
69
Cultural Beliefs About Health, Illness, and Treatment (Reducing Health Disparities)
Cultural Skills
Use of communication not always language, unspoken communication (Ask “may I” because they may find something disrespectful)
70
Cultural Beliefs About Health, Illness, and Treatment (Reducing Health Disparities)
Unspoken Communication
Handshakes, eye contact
71
Cultural Beliefs About Health, Illness, and Treatment (Reducing Health Disparities)
Spoken Communication
Interpreter to make sure you understand your patient
72
Cultural Beliefs About Health, Illness, and Treatment (Gender)
Older women
Fastest growing segment of the population
73
Cultural Beliefs About Health, Illness, and Treatment (Gender)
Older women
Social status
Most likely to live alone, women of color often have higher social status within families, often have extended social networks than men (more friends, family)
74
Cultural Beliefs About Health, Illness, and Treatment (Gender)
Older women
Economic Status
Overall lower than men and are considered poor
75
Cultural Beliefs About Health, Illness, and Treatment (Gender)
Older women
Health status
Tend to live longer but have more chronic disability or disease
76
Cultural Beliefs About Health, Illness, and Treatment (Gender)
Older women
Women's Health Issues
Often studied more than men
77
Cultural Beliefs About Health, Illness, and Treatment (Gender)
"Women's Health Initiative"
Promote enrolling women in research trials
78
Cultural Beliefs About Health, Illness, and Treatment (Gender)
Older women
Higher risk of being without insurance
Due to divorce/ death of a spouse; go back into women not working as much or making less money
79
Cultural Beliefs About Health, Illness, and Treatment (Gender)
Older Men
- Most literature on aging focuses on women
- More older women than men
- Black men with the shortest life span
- We often make assumptions about the social/economic status of older men
80
Culturally and Ethically Sensitive Assessment
Listening is key to assessment
81
Learn Model
L- Listen carefully to what the elder is talking about. Listen to the perspective of situations. Desired goals for treatment
E- Explain your perception
A- Acknowledge and discuss both the similarities and differences between your perceptions and goals
R-Recommend a plan of action that takes both perspectives into account
N- Negotiate a plan that is mutually acceptable
