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END OF PAGE what are the five types of intimacy?
- commitment
- affective
- cognitive
- physical
- interdependence intimacy close, family like connection and a warm, meaningful feeling of joy. involves the need for close friendships along with relationships with family, friends sexuality central aspect of being human throughout life; basic human need
- social dimension
- psychlogical dimension
- biological dimension 3 factors that influence sexual health
- expectations (old person doesn't feel sexual)
- activity levels (arent active enough to have intercourse)
- cohort or cultural differences (era in which person was born influences their attitudes about sexuality) sexual dysfunction causes can be both physical and psychological
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- sexual arousal disorder
- medication
- sexual pain male dysfunction impotence inability to achieve and sustain erection sufficient for satisfactory sexual intercourse in at least 50% attempts STIs prevalence of STIs increasing in older adults what does it mean to have capacity? ability to make decision, understand the situation elder abuse any action by someone in a relationship of trust that results in harm or distress to older person neglect lack of action by that person in relationship of trust with the same result true or false: elder abuse usually done by someone older person already knows (family) true physical elder abuse use of physical force that either injures or risks injuring
END OF PAGE provides shelter, place for security
- should provide highest level of independence, function, comfort
- age in place aging in place choosing to stay at home and age rather than move essential elements of an age-friendly community include
- transportation
- housing
- social participation
- civic participation
- community support and health services barriers to aging in place
- safety
- socialization
- grocery shopping/meal prep wear-and-tear theory cell errors are the result of "wearing out" over time owing to trauma and continued use. internal and external stressors increase the number of errors and the speed with which they occur. these errors cause a progressive decline in cellular function
END OF PAGE cross-link theory explains aging in terms of accumulation of errors by cross-linking, or the stiffening of proteins in the cell. most easily with collagens free radical theory free radicals are natural by-products of cellular activity and are always present to some extent. it is believed that cellular errors are the result of random damage from molecules (free radicals) in the cells. exposure to environment pollutants increase production of free radicals how does the skin change with age?
- dryness
- pallor
- fragility
- wrinkling and sagging
- decreased perspiration
- age spots
- thinning and greying of body hair how does the neuromuscular system change with age?
- decreased speed and power of muscles
- slowed reaction time
- loss of height
- loss of bone mass
- joint stiffness
- impaired balance kyphosis
END OF PAGE residual capacity air still left over in lungs after max exhalation dyspnea shortness of breath cardiovascular changes with age?
- reduced cardiac output
- reduced elasticity
- increased rigidity of arteries
- increased bp age-related gastrointestinal changes?
- delayed swallowing time
- increased indigestion
- constipation
- xerostomia xerostomia dry mouth age-related urinary changes?
- less effective concentration of urine
- urgency and frequency
- nocturia
- retention nocturia
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- changes in sexual function
- prostate enlargement (can cause not completely emptying) female reproductive age-related changes?
- atrophy of reproductive organs
- reduction in vaginal secretions and changes in vaginal flora age-related immunological changes?
- decreased immune system function
- lowered resistance to infection, poor response to immunizations endocrine age-related changes?
- as body ages, most glands atrophy and decrease rate of secretin
- tissues of body often develop a decreased sensitivity to insulin; when combined with the increased need fr insulin in the presence of obesity, result is often type 2 diabetes
- change in structure and function oof thyroid gland golden rule of thirds 1/3 = normal aging changes 1/3 = deconditioning 1/3 = pathological disease deconditioning
END OF PAGE identify baseline and changes of abilities in performing ADLs and IADLs
- assist in determining needs for specific services
- provide useful info for determining safety of living situation activities of daily living (ADLs) self-care activities such as eating, toileting, ambulation, bathing, dressing, and grooming instrumental activities of daily living (IADLs) tasks needed for independent living; call for higher cognitive and physical functioning (grocery shopping, banking) katz index
- basic framework for most ADL measures
- one version based on 3 - point scale that scores people as independent, assistive, dependent, or unable to perform
- another version assigns one point to each ADL person caan perform independently barthal index
- used in rehab settings
- commonly used to measure the amount of physical assistance person needs when they can no longer perform ADLs functional independence measure (FIM)
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- most comprehensive functional assessment tool
- includes measures of mobility, cognition, social functioning, ability to perform ADLs mini mental state examination (MMSE)
- first tool developed to screen for cognitive deficiencies such as those that occur with dementia or delirium
- tests orientation, short-term memory, attention, calculation ability, language, construction
- score of 30 suggests no cognitive impairment; 24 or less suggests potential dementia clock-drawing test identifies severity of cognitive impairment mini-cog determines person's cognitive status; combines short-term memory recall with executive functioning tested in clock-drawing test montreal cognitive assessment (MoCA) designed to detect mild cognitive impairment; includes orientation, short-term memory, executive function, language ability, visuospatial ability
- scores range from 0 - 30; 26 or higher considered normal confusion assessment method (CAM) detects:
- acute onset and fluctuating course of symptoms
END OF PAGE ability to give health care in ways that are acceptable and useful to older persons because it is congruent with their cultural background spirituality intangible and immaterial and may be considered a more general term, not associated with a particular group/organization; can refer to feelings, thoughts, experiences, and behaviours related too the soul or to search for the sacred geotranscendence ultimate psychological goal of aging; shift from material world to cosmic world; increased satisfaction with life 3 common geriatric syndromes include
- bladder control issues
- sleep disorders
- delirium insomnia subjective perception of insufficient or non-responsive sleep sleep-onset insomnia difficulty falling asleep sleep-maintenance insomnia can fall asleep easily, wake up in the middle of the night, easy to fall back asleep
END OF PAGE early waking insomnia wake up early and cannot go back to sleep what are 3 factors that contribute to sleep problems in older adults?
- comorbidities (cardiovascular disease, diabetes)
- depression, anxiety
- medication sleep hygiene
- limit daytime naps to 30mins
- avoid stimulants before sleep
- engage in daily activity
- bedroom for sleep only sleep apnea condition in which people stop breathing while asleep; episodes are usually terminated by an arousal (brief awakening) which results in fragmented sleep obstructive sleep apnea (OSA) caused by obstruction of upper airway risk factors of sleep apnea
- increasing age
- increased neck circumference
- male
- large tonsils
END OF PAGE what are 3 things to look for during a home environment assessment?
- lack of grab bars in tub/shower area
- unsafe rugs/carpets
- toilet too high restraint physical, chemical, or environmental measures used to control the physical or behavioural activity of a person or portion of the body frailty chronic condition in which the body has few reserves left, any disturbance can cause multiple health conditions and costs
- independent geriatric syndrome that may be seen in older people with multiple comorbidities
- both physical and mental decline diagnosis of frailty requires 3/5 of the following...
- unintentional weight loss (greater than 10lbs or 5% body weight from year prior)
- muscle weakness, measured by grip strength
- physical slowness, based on measured time to walk 15ft
- poor endurance, self-reported
- low physical activity, using standardized questionnaire pain
END OF PAGE sensation of distress; unpleasant sensory and emotional experience associated with actual or potential tissue damage acute pain temporary, includes postoperative, procedural, and traumatic pain chronic pain not time-limited, persistent at varying levels of intensity true or false: pain is a normal part of aging false OPQRST onset of event, palliative/precipitating factors, quality/quantity, region/radiation of pain, severity scale, timing BEERS criteria tool used to identify high risk medications that cross the blood-brain barrier to minimize the risk of causing adverse medication events STOPP START used in primary care; screening tool of older person's prescriptions (STOPP); screening tool to alert to right treatment (START) adverse drug reactions (ADRs) harmful response to a medication health
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- stress
- urge
- functional stress UI happens when coughing, sneezing, laughing (involuntary) urge UI urgent need to use washroom but cannot get there in time functional UI having the acknowledgement to go but not able to do so (long car rides) what are 3 behavioural interventions for UI?
- scheduled voiding
- bladder training
- pelvic floor exercises late life transitions process during which people redefine their sense of self and develop self-agency in response to disruptive life events retirement effects
- self worth, identity, social position what are the 7 phases of retirement?
- remote (future anticipation with little real planning)
- near (prep and fantasizing)
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- honeymoon (euphoria)
- disenchantment (boredom)
- reorientation (developing realistic lifestyle)
- stability (meaningful activities)
- termination what are the 3 core features of grief?
- depression
- anxiety
- loneliness shrinking social world loss of social connection, risk of loneliness, potential failure to thrive, awareness of one's own mortality grief individual's response to loss mourning behaviours used to incorporate loss into one's life actual loss response to a situation (death, loss of job) perceived loss loss experienced by one person but cannot be verified by others, psychological loss
