Test 1 from SG

Question 1

What are the 4 types of age definitions?

Answer 1

1. chronologic age
2. percieved age
3. subjective age
4. functional age

Question 2

define

chronologic age

in relation to aging

Answer 2

length of time since birth

most popular way of measuring age but doesn’t reflect a person’s cognitive and physical age

Question 3

define

percieved age

in relation to aging

Answer 3

others’ estimation of age

external observation

Question 4

define

subjective age

in relation to aging

Answer 4

person’s perception of their own age

internal observation

Question 5

define

functional age

in relation to aging

Answer 5

cumulative effect of medical and psychosocial stressors on the aging process

MOST clinically important when providing care

Question 6

define

ageism

Answer 6

stereotypes or generalizations (usually negative) based on age

applied to older adults

Question 7

explain

aging anxiety

Answer 7

fears about detrimental effects of aging

Question 8

explain

age attribution

with an example

Answer 8

automatically attribute problems to aging instead of treatable conditions

ex: problems with memory discounted as “a senior moment” or complaints of pain as “part of getting older”

Question 9

What can we do to debunk myths and stereotypes of aging and older adults?

2 general points

Answer 9

• promote wellness in older adults
• listen to them regarding beliefs/value/hopes/experiences that are integral to self-identity

Question 10

What is the overall life expectancy in the US? How does it differ by sex and race?

Answer 10

Overall ≈ 76 years (dropped from 79 in 2020)

Women ≈ 82
* hispanic 85
* white 80
* black 76

Men ≈ 78
* hispanic 79
* white 75
* black 71

Question 11

define

successful aging

and what it encompasses

Answer 11

maintaing physical, cognitive, and psychosocial wellness

encompasses healthy aging, active aging, productive aging, and effective aging

Question 12

define

healthy aging

Answer 12

no illness and perserved function

Question 13

define

active aging

Answer 13

high physical and cognitive function

Question 14

define

productive aging

Answer 14

social participation and engagement

Question 15

define

effective aging

Answer 15

the capacity to manage age related life challenges

Question 16

What is compression of morbidity?

Answer 16

postponing illness/disability onset as long as possible by increasing our QoL with primary interventions

primary interventions: doing things to prevent issues before they even begin to occur

Question 17

What are the 3 broad theories of aging?

Answer 17

• biologic theories
• sociocultural theories
• psychological theories

Question 18

List

the 5 biologic theories of aging

provides important data on how cells age and triggers for aging process, and risk factors that aggravate age-related changes

Answer 18

1. wear and tear theory
2. free radical theory
3. immunosenecence theory
4. program theory
5. caloric restriction theory

Question 19

define

wear and tear theory

biologic theory

Answer 19

the body declines over time

longevity is determined by genetics and the care provided

biologic theory

Question 20

define

free radical theory

biologic theory

Answer 20

organisms age b/c they accumulate oxidative damage

fix with antioxidants

biologic theory

Question 21

define

immunosenescence theory

biologic theory

Answer 21

immune decline increases susceptibilty

may to lead to conditions such as RA

biologic theory

Question 22

define

program theory

biologic theory

Answer 22

lifespan is predetermined genetically

biologic theory

Question 23

define

caloric restriction theory

biologic theory

Answer 23

reducing caloric intake by 30-40% without malnutrition increases lifespan

biologic theory

Question 24

List

the 4 sociocultural theories of aging

helps nurses view older adults in relation to society and cultural environment

Answer 24

1. activity theory
2. subculture theory
3. age stratification theory
4. person-environment fit theory (aka Ecological)

Question 25

# define **activity theory** | sociocultural theory

Answer 25

**staying engaged socially and psychologically maintains fitness** volunteering improves QoL | sociocultural theory

Question 26

# define **subculture theory** | sociocultural theory

Answer 26

**old people interact more among themselves** status is based on health and morbidity | sociocultural theory

Question 27

# define **age stratification theory** | sociocultural theory

Answer 27

interdependencies between age and cohorts as social process/structure | sociocultural theory

Question 28

# define **person-environment fit/ecological theory** | sociocultural theory

Answer 28

individuals with functional limitations need to adapt to their environment for independence | sociocultural theory

Question 29

# list the **4 psychological theories** of aging ## Footnote addresses psychological factors pertinent to aging such as coping with loss

Answer 29

1. life course theories 2. selective optimization with compensation 3. socio-emotional selectivity theory 4. gero-transcendence theory

Question 30

# define the **2 life course theories** and what they theorize | psychological theory

Answer 30

1. **Maslow Human Needs theory** hierarchical order of human needs/motivations 2. **Erikson's life-course theory** 8 stages of life (trust v. mistrust, autonomy v. shame and doubt, etc.) | psychological theory

Question 31

# define **selective optimization with compensation** | psychological theory

Answer 31

**adapting to declining resources by selecting prioritized goals** optimizing performance through practice and compensating for losses with alternative methods | psychological theory

Question 32

# define **socio-emotional selectivity theory** | psychological theory

Answer 32

shift from knowledge-related goals to emotionally meaningful ones | psychological theory

Question 33

# define **Gero-transcendence theory** | psychological theory

Answer 33

shift from materialistic to a transcendent vision | psychological theory

Question 34

# explain **discipline specific nursing theories**

Answer 34

**focuses on the core concepts of person, nursing, health and environment that informs nursing care of adults** essential to promote wellness of older adults

Question 35

What are ADLs v. IADLs? | define each and give examples

Answer 35

**Activities of daily living**: bathing, toileting, moving, feeding, dressing, continence **Instrumental activities of daily living**: phone use, laundry, shopping, food prep, housekeeping, medications, transportation, handle finance

Question 36

# Explain Functional Consequences Theory (FCT)

Answer 36

a framework to promote wellness, function, and QoL | for older adults

Question 37

# list and explain **key concepts of FCT** | 3 concepts + risk factors

Answer 37

**age related changes**: inevitable, irreversible, and progressive change (NOT caused by extrinisic or pathologic conditions) **functional consequences**: observable effects on QoL (positive vs negative) **wellness outcome**: improved function and reduced dependency ## Footnote key concepts of FCT

Question 38

# explain **risk factors** and the **sources** of **FCT**

Answer 38

**risk factors**: conditions causing detrimental effect on health/function that CAN be modified/eliminated **sources**: environment, acute/chronic conditions, psychosocial conditions, or adverse med effects

Question 39

differentiate positive vs. negative functional consequences

Answer 39

**positive**: facilitates highest performance level, least dependency **negative**: interferes with function/Qol, increased dependency | positive = good outcomes

Question 40

difference between age-related changes and pathological conditions

Answer 40

age-related **varies from person-to-person** influenced by genetics/lifestyle/environment

Question 41

# define **cultural competence**

Answer 41

the ability to deliver healthcare with knowledge and sensitivity to cultural factors that influence health behavior and the curing/healing/dying/grieving process

Question 42

# describe strategies to help nurses achieve cultural competence | 7 bullet points

Answer 42

* develop awareness of own culture * don't assume everyone's beliefs are the same * demonstrate knowledge of client's culture/needs * use nonjudgement attitude * accept and respect differences * adapt care to client's culture * leverage resources to learn more about cultural groups

Question 43

# explain key cultural beliefs: **african americans** | and factors to beliefs

Answer 43

* heterogenous, wide range of socioeconomic conditions * less likely to live alone (multi-generation) * trusted community/religious leaders are pathway to care * health disparities linked to racism consequences **factors**: discrimination, cultural barriers, lack of access ## Footnote key cultural beliefs: african americans

Question 44

# explain key cultural beliefs: asian americans | 4 bullet points

Answer 44

* strong value on care of older family members * less likely to use nursing homes * more accepting of mental decline * health is physical and spiritual harmony ## Footnote key cultural beliefs: asian americans

Question 45

# explain key cultural beliefs: hispanic/latino americans | 4 bullet points

Answer 45

* strong respect for family and older people * older adults frequently live with family * health is a gift/reward, God's blessing * English and Spanish spoken ## Footnote key cultural beliefs: hispanic/latino americans

Question 46

# explain key cultural beliefs: native american/alaska native | 5 bullet points

Answer 46

* value elders as grandparents/storytellers * unique spiritual/religious tradtions per tribe * believes body, mind, spirit are connected * poorer health due to: low economic conditions, barriers, mistrust * high rates of: diabetes, TB, heart disease, substance use, certain cancers ## Footnote key cultural beliefs: native american/alaska native

Question 47

# define **ethno-geriatrics**

Answer 47

**integrates the influence of race, ethnicity, and culture on health and well-being** of older adults (1987)

Question 48

# explain Capacity vs Competence

Answer 48

**capacity**: clinical ability to make decisions * understand situation, weigh pros/cons, apply values, arrive at consistent decsion, communicate it **competence**: one's legal ability * older adults assumed legally competent unless determined otherwise

Question 49

What **tool** assesses **decison-making capacity**? | and what should you be sure to document?

Answer 49

**MacArthur Competency Assessment Tool for Treatment (MacCAT-T)** always document specifically and descriptively what patient/surrogate understands and wishes

Question 50

# List 8 types of elder abuse

Answer 50

* **physical** * **sexual** * **financial** * **emotional** * **neglect** (dehydration, malnutrition, poor hygiene) * **abandonment** (isolation) * **scams** * **self-neglect**

Question 51

# list **risk factors of elder abuse** for the **victim** AND **perpetrator**

Answer 51

**victim**: functional dependence, disability, poor health, cognitive impairment, low income, female, financial dependence **perpetrator**: mental health issues, substance use, dependency on older adult, ineffective coping/high stress ## Footnote Hispanic elders have LOWEST rates of elder abuse

Question 52

# explain nurse's **first and second obligation** when **elder abuse** is **suspected** | in order and who to work with

Answer 52

**FIRST**: assure safety of the older adult **THEN**: report to Adult Protective Services (mandated reporting!!!!) ## Footnote collaborate with case managers and community workers

Question 53

**how to properly screen for elder abuse** | enforced by United States Preventative Services Task Force (USPSTF) ## Footnote **where to do it, what to ask, what to look for**

Answer 53

**Elder Mistreatment Assessment** * interview alone (avoids intimidation) * *ask* about family situation, living arrangments, directly about abuse/neglect/exploitation * *look for*: indicators, poorly explained injuries, neglect evidence, isolation, fear of caretaker, fund transfers

Question 54

How do renal changes affect medications in older adults? | what is decreased, the result, and which specific drugs affect renal?

Answer 54

**decreased:** renal blood flow, GFR, tubular function, creatinine clearance **results:** increased half-life of meds causes drug accumulation and toxicity risk **especially affects:** renally excreted drugs (digoxin, insulin)