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Adulthood and Aging Final > Week 15 > Flashcards

Week 15 Flashcards

1
Q

According to Hung article, how did the definition of “healthy aging” vary in lay terms compared to academically?

A
  • More domains/factors contributing to healthy aging in laypersons: independency, family, adaptation, financial security, personal growth, and spirituality
  • In lay definition, more diversity in the healthy aging concept than academic views (which tend to focus more on physical and mental health and social functioning in later life
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2
Q

In Hung article, how was healthy aging shown to be perceived across cultures?

A

-findings affirm that healthy aging is a multi-dimensional and complex concept and that there are substantial differences in different cultures

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3
Q

What suggestion did Hung et al. make for researchers looking at healthy aging?

A

-Suggest that academic researchers should integrate the more holistic perspectives of older lay people and cultural diversity into the classical ‘physical–mental–social’ healthy aging concept.

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4
Q

What did the USC Well Elderly Clinical Trials look at (Clark)?

A

Used Lifestyle Redesign approach to test effects of OT on older adults’ health and well-being

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5
Q

Clark: How was the Lifestyle Redesign Program at USC therapeutic?

A

-Provided OA who were living independently with tools to analyze the health benefits of their own occupations

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6
Q

What did the well elderly study find?

A

Preventive OT represents a cost-effective strategy for increasing health-related quality of life in OA

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7
Q

What did the journey of the well elderly study begin with?

A

A small pilot study testing how individuals created meaningful lives in OA

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8
Q

What did results of the first well elderly study indicate?

A

OT could be effective with an OA population in health and well-being

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9
Q

What did the second Well Elderly Study document?

A

Effectiveness of a Lifestyle Redesign intervention applied to OA at high risk for experiencing health disparities, implemented in diverse community settings, delivered in shorter time interval. Once again, successful

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10
Q

The Well elderly study demonstrates the applicability of OT to what new area?

A

Prevention. What we do every day and how we do it over time has cumulative effect on our health.

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11
Q

Dynamic Equilibrium which involves capacity in multiple domains to fxn well as the circumstances in one’s life change

A

Successful Aging

–Can pertain to social, emotional, physical health

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12
Q

What does dynamic equilibrium mean in the definition for successful aging?

A
  • Constantly changing/moving, but with equilibrium, always working to balance our lives
  • -Can pertain to social, emotional, physical health
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13
Q

In the U.S., what do we normally base success (e.g., successful aging) off of?

A

Relate to finances

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14
Q

Healthy aging, active aging, and robust aging are alternative forms of what term?

A

Successful aging

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15
Q

Why may the alternative forms of “successful aging” (Healthy aging, active aging, robust aging) be more appropriate for us than the original term?

A

May not have cultural expectations (In U.S., we often relate success to finances)

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16
Q

Growing older in ideal health with the ability to adapt or compensate in the face of age-related changes, so as to function optimally in all life domains

A

Healthy aging. May be more appropriate for us than “successful aging”

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17
Q

When talking about successful aging, what is often left out?

A

Idea of longevity

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18
Q

T/F: When thinking of successful aging, we should think in terms of a medical view e.g., cognition, memory, ADLs, IADLs, avoiding pathology

A

False! When thinking of successful aging, we should think in terms of a layperson’s view: health, activity, personal growth, happiness, independence, relationships, appreciation of life. More about QOL and psychosocial

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19
Q

Ability to bounce back in face of challenge and become better than before

A

Resilience

-Rebound after some sort of loss e.g., car accident, loss job, death of loved on

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20
Q

In resilience, when are resources the most important?

A
  • Resources drawn upon after challenges occur e.g., car accident, loss of loved on
  • E.g., when lost job, pull from economic and social support, and self-efficacy
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21
Q

“I’m glad I was in a car accident because I met my wife in the hospital afterwards”. This is an example of what?

A

A resilient response

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22
Q

How can OTs help pts develop resilient responses?

A

We can target resources e.g., economic, social support, self-efficacy to help them develop resilient response

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23
Q

The following are general strategies for what?

  • Focus on QOL as opposed to cure
  • Focus on health behavior, improving lifestyle
  • Engage OA in decision making process to help them decide what is right in their life
  • Caregiver training
A

Promoting resilience and successful aging

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24
Q

How can we help to promote resiliency and successful aging in patient centered medical homes?

A
  • Help people age in place b/c offers opportunity for coordinating care
  • Talk with each other to decide what’s best for OA in successful aging
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25
Q

How can we help promote resiliency and successful aging in community based settings? What should we focus on?

A
  • Focus on balance of program

- Help OA gain physical, spiritual, mental etc. help

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26
Q

How might a balance and strength program help contribute to resiliency?

A
  • Interacting socially at program
  • Challenging event may have been a fall-program could then help prevent fall or bounce back after fall
  • In social program, may help bounce back after death of spouse b/c have social network
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27
Q

This program establishes benchmarks for what people are supposed to work with in terms of health for OA

A

Healthy people 2020

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28
Q

What is the overarching goal for OA in the Healthy People 2020 national agenda?

A

To improve the health, function, and QOL of older adults. Specific objects developed to meet this goal

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29
Q

How does the healthy people 2020 program empower OA?

A

Empowers OA to make their own health decisions

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30
Q

Emerging issues related to healthy people 2020 program

A
  • Disease self-management: help people manage own chronic issues rather than relying on providers
  • Measure quality of care, not just quantitiy
  • Training healthcare professionals in OA–do we have enough providers in geriatrics and do we give providers our tools to be able to interact successfully with OA
  • Coordinated care! All communicating and working towards same goal
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31
Q

What kind of care, according to the healthy people 2020 agenda, should we be giving OA?

A

Coordinated care! All communicating and working towards same goal

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32
Q

T/F: Research on LGBT OA is limited

A

True

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33
Q

T/F: if we want to reduce people with functional limitations, we want to be above the target line

A

False. If we want to reduce people with functional limitations, we want to be BELOW the target line

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34
Q

What are trends in 2007-2011 showing regarding OA with moderate to severe functional limitations?

A

Trends from 2007-2011 show that we are not meeting the target line for OA with moderate to severe functional limitations (Objective of healthy people 2020)

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35
Q

According to research, what race of people is farthest away from the target of reducing OA with moderate to severe functional limitations (healthy people 2020 objective)

A

Black non-hispanic

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36
Q

According to research in 2007-2011, are female or male OAs struggling more with moderate to severe functional limitations? Why may this be?

A

Females are struggling more. Males hit the target–may have to do with longevity b/c they live longer, so may have more opportunities to meet target

37
Q

According to research in 2012, what population is doing the best at engaging in leisure time physical activities?

A

Asian population

38
Q

In attempting to increase the amount of time OA engage in physical activity, who should we focus on according to the healthy people 2020 objective?

A

-We should focus on those with reduced physical or cognitive abilities

39
Q

According to research, are OA males or females doing better at meeting the target for increasing leisure time physical activities?

A

Males are doing better

40
Q

What population is the most challenged in meeting the target of increased leisure time physical activity ?

A

Black non-hispanic is the most challenged in meeting the target

41
Q

In general, how are we doing in hitting the target for OAs engaging in leisure-time physical activities?

A

In general, not doing too bad at hitting target

42
Q

Who is missing from helping to reach the target proportion of health care workforce with geriatric certificates?

A

OT!

43
Q

Why aren’t there as many OTs working with a geriatrics certification?

A
  • In many OT courses, Adulthood and Aging is not a required course (but peds is)
  • Need more courses like this
  • Certificates require increased training in geriatrics–require hours in clinical practice
44
Q

What population is doing worst at meeting target (falling below target line) of reduced emergency department visits due to falls (OA)

A

Black non-hispanics are doing the worst

45
Q

Are males or females at a higher risk for emergency department visits following falls?

A

Females are at a higher risk for falls

46
Q

What age group is the most impacted in emergency department visits due to falls?

A

85+

–Identifying programs, especially for this age group, is important

47
Q

What kind of changes may help delay or even prevent disease?

A

Lifestyle changes!

48
Q 
Which of the following diseases doesn't have the potential to be delayed or prevented through lifestyle changes?
A. Osteoporosis
B. Coronary Heart Disease
C. Tunnel vision
D. Dementia
A

C. Tunnel vision

49
Q

What is Vivir Mi Vida?

A

Lifestyle program following the first and second Well Elderly studies. By Niemiec/Schepens (Clark in I and II)

50
Q

What was the main goal of the Well Elderly I study?

A

To assess whether a type of preventive OT, lifestyle redesign, leads to improved health and well-being in older people

51
Q

What did the Well Elderly I Study address that was a relatively new idea at the time?

A

Prevention

52
Q

What did the Well Elderly I Study plan to measure?

A

Planned to measure the efficacy of the program as it pertained to different health outcomes, both mental and physical

53
Q

Since the Well Elderly I study, what do we know about the term “effectiveness” that was used in the article ?

A

-We now know that there’s a difference between prevention and effectiveness

54
Q

How did the Well Elderly I study look at efficacy?

A
  • Started with efficacy, wanting to know if intervention improved psychosocial or physical health
  • Were measurements after 6 months sustained?Were there improvement?
55
Q

In the 9 month interventions in the Well Elderly I study, what did the intervention sessions look like? What did they address?

A
  • Group meetings: peer exchange, direct experience, personal exploration
  • Individual sessions: personal goals, build new habits, traditional OT, individualize and reinforce group session materials
56
Q

What kind of comparison groups were used in the Well elderly I study?

A
  • Traditional lifestyle group
  • Social control group: led by nonprofessionals, group meetings where pts did whatever they wanted e.g., games, movies
  • Regular control
57
Q

What did the use of a social control group with group meetings led by a nonprofessional in the Well Elderly I study show?

A

-Keeping people busy with nonprofessional is not the same as professional interventions

58
Q

Difference between efficacy and effectiveness as it relates to Elderly I and II study?

A
  • Efficacy study has very controlled environment
  • Effectiveness study loosens restrictions, opens up patient population, maybe get different community programs involved
  • When open up to different community settings, variety of people involved in study very different
  • Study began with efficacy, wanting to know if improved psychosocial or physical health
59
Q

What did the WE I study find was the biggest difference between the OT and control groups?

A

Vitality

60
Q

How effective was the control group in the WE I study?

A

-Significantly declined over time

61
Q

In the WE I Study, what happened with the social control group?

A
  • Social control group had equivalent results as regular control
  • Social group busy activities with nonprofessional similarly not effective
62
Q

How cost effective was the OT intervention shown to be in the WE I study?

A

Very cost effective!

-Substantially more cost effective than was already seen

63
Q

How does the WE II study differ from the WE I Study?

A
  • Replicates previous results on positive effects of Lifestyle Redesign intervention
  • Answering how it works–what’s responsible for WE I’s positive effects
  • Extends focus from efficacy to effectiveness
64
Q

What questions did the WE II study aim to answer?

A
  • How does the Lifestyle Redesign Intervention work?
  • What mediating mechanisms are responsible for the WE I’s positive effects
  • Again, is this cost effective?
65
Q

In the Well Elderly II Study, why was it important to look at the mediating mechanisms? AKA Why is it important to know how something works?

A
  • Can replicate if you know what ingredients make the intervention effective
  • Can incorporate mechanisms into other interventions
66
Q

The Well Elderly II study moved away from efficacy to effectiveness. What does this mean?

A
  • Closer to implementation scale (Efficacy –> effectiveness –> Implementation)
  • Less lab like
  • Less controlled setting
67
Q

How did the length of intervention change from Well Elderly I to II study?

A

Changed from 9 months to 6 months

68
Q

How did the participants change from WE 1 to WE 2?

A

-Participants more diverse
-One recruitment selections was CCRC:
start healthy, as you decline in health, can transition to next level (have assisted living, skilled nursing, LTC). But expensive, so more financially well off participants

69
Q

What cultural and language adaptations did the WE II study do?

A
  • Adapted to Spanish language and culture, as population more diverse
  • Made a group designed for Spanish speaking populations
70
Q

T/F: In WE 1 study, Individual sessions were not required and OTs were paid the same whether they did individual sessions or not

A

F: In the WE 2 study, Individual sessions were no longer required and OTs were paid the same whether or not they did them. Unfortunately, many did not–showed up in the results

71
Q 
All of the following except which module was added to the WE 2 study:
A. Community Mobility 
B. Thriving
C. Longevity 
D. Time and Occuaption
E. Nutrition
F. Navigating Healthcare
G. Hormones, Aging, and Sexuality
H. Finalizing Personal Engagement Plans 
I. Stress and Inflammation Management
A 
D. Time and Occupation was a module used in WE 1 study as well. 
(Stress and Inflammation management involves self-management for chronic disease )
72
Q

What made the WE II intervention more effective ?

A

-Minimum of 5 individualized sessions in addition to group sessions
-Interviewer matched ethnicity of participant
(in real setting probably can’t control this)

73
Q

T/F: The WE II study had the same positive outcomes as the WE I study

A

True:

-Mental health, social functioning, vitality, bodily pain, life satisfaction, depression

74
Q

T/F: The WE II study was found to be much more cost-effective than WE I

A

False. Both very cost effective

75
Q

What did the WE II find out was important for improving severity of depressive symptoms?

A
  1. Increasing activity frequency–more activity person engaged in, more improvements
  2. Improving person’s perception of activity significance contributed (more meaningful they found activities, more improvements in depressive symptoms they noted)
76
Q

What was found to improve one’s perception of their control over activities (one of mechanisms to improve depressive symptoms) in WE II study?

A

Social connections–social network

77
Q

What did Vivir La Vida Study look at?

A

How to implement the OT Lifestyle Redesign into a community-based setting?

78
Q

What population did the Vivir La Vida study target?

A

At-risk late-midlife (50-64yo) Latino pts

79
Q

What setting did the Vivir Mi Vida study take place in?

A

Primary Care

80
Q

In the Vivir Mi Vida study, how did they decide which outcomes to target?

A

Asked participants which outcomes would be helpful for them

81
Q

T/F: Priorities that elders listed in Well Elder III study (Vivir Mi Vida) were very similar to priorities of the past Well Elder studies?

A

False. Priorities were very different.

82
Q 
Which of the following modules present in the Well Elder III (Vivir Mi Vida) were not addressed by OA previously?
A. Weight Management
B. Disease Management
C. Mental Health and Well-Being
D. Personal Finances
E. Family, Friends, and Community
F. Stress Management
A

F. Stress Management

A. Weight Management

83
Q

T/F: In All of the Well Elderly Studies (including Vivir mi Vida), OTs delivered the interventions.

A

False. In Vivir Mi Vida, Latino community health workers trained by senior health workers delivered intervention. They worked with the OT, but institution couldn’t pay for OTs.

84
Q

Why were the following modules important for the Vivir Mi Vida study?

  • Healthcare System Navigation and Resources
  • Chronic Condition Management
  • Mental Well-being
A
  • Almost all of the participants had biabetes

- Mental well-being often on their mind

85
Q

After 4 months of intervention in the Vivir Mi Viva study, what did results show?

A

-In 4 months intervention with pts in their home, perceived severity of symptoms declined, impact of symptoms on life declined, and well being substantially improved

86
Q

What did the Vivir Mi Viva study find 12 months later after the intervention?

A

They saw further improvements

87
Q

What location was Viva Mi Viva study done in?

A

In rural area, so people weren’t getting any services before.

88
Q

The following outcomes of the Vivir Mi Vida were important to who?
-Improvements in BP, decreased stress, improved dietary intake, particularly in salt and sat. fat

A

Healthcare professionals

89
Q

Future goals for the Well Elderly…

A
  • Implement program in primary care and community settings

- Worldwide adaptation and dissemination

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