Life Span - Late Adulthood

A, B

Health screenings currently recommended by the United States Preventative Services Task Force (USPSTF) for this age group with a grade of _____ or ______

True

True or False: Higher heart rates will elicit stronger training responses

disengagement

process whereby people withdraw from social relationships, as they age; may be true for the depressed older adult but is likely not a natural or healthy aging process

factors that affect health and wellbeing (of older adults)

-Access to healthcare -Reduced income -Changes in living arrangements -Caregiver assistance -Altered nutritional needs -Assistive devices -Preventing falls -Polypharmacy -Elder or dependent abuse

changes in living arrangements

-Adjusting to this factor of health and wellbeing can also influence the physical and mental wellbeing of the older adult -Living with extended family or near family members is optimal -Assisted living communities help the older adult maintain independence, social interaction, and a positive self-concept -Some older adults may live in inadequate housing, whereas others may be institutionalized in nursing homes and may lose independence and control over their lives

elder or dependent abuse

-Affects more than 2 million older adults each year -Abuse can be physical, emotional, or financial and include neglect or obstruction of personal rights -Observed by the healthcare worker through interactions between older adults and the caregivers

preventing falls

-Becomes more important as the older adult develops vision or hearing problems and slower response times -More than 25% of people aged 65+ fall each year and medical costs of fall-related injuries total more than $50 billion annually -The use of certain medications can cause dizziness or imbalance that can also increase the vulnerability of the older adult to falling -The healthcare worker can assess the older adult's environment and can help with securing loose rings, improving tracking on slippery floors, clearing general clutter, and improving lighting, especially near stairways

altered nutritional needs

-Dental problems, inability to cook, dislike of eating alone, pain or malaise because of a medical condition, or lack of accommodation for special needs related to cultural or religious food traditions may be causes for altered eating habits -Attention to diet and nutrition improves and maintains good health in the older adult -Caloric needs may decrease with age, but a balanced nutritional intake remains essential -Assessment of the nutritional needs of the older adult is vital, and community resources such as "Meals on Wheels" can be used

health concerns (for late adulthood)

-Development of osteoporosis -Risk for falls and fractures -Insufficient awareness of healthy behavior options -Increased risk of influenza and pneumonia -Development of cataracts -Reduced hearing acuity

health concerns (of the older adult)

-Development of osteoporosis -Risks for falls and fractures -Poor awareness of healthy behavior options -Increased risk of influenza and pneumonia -Development of cataracts -Increased loss of hearing

causes of memory decline

-Drug toxicity -Depression -Metabolic problems (kidney or liver dysfunction, hypoglycemia) -Sensory problems (difficulty hearing, seeing, or sensing information) -Nutritional deficiencies (dehydration, vitamin B12 deficiency, iron deficiency) -Illness (pneumonia and other infections)

discomforts of menopause

-Genital atrophy -Vasomotor instability -Heart disease -Breast cancer -Osteoporosis

goals of healthy people 2030

-Increase lifespan and quality of life -Focus on wellness and healthy behaviors -Illness prevention -Treatment of disease -Reduce occurrence of hip fractures -Early diagnosis and management of dementia -Promoting mobility and independence

assistive devices

-May be needed to help the older adult maintain independent living -Include items such as walkers, canes, respiratory equipment, hearing aids, and electronic emergency-response devices

warning signs of memory decline

-Memory loss affecting job functioning -Difficulty remembering steps in familiar tasks -Disorientation -Lack of awareness of time, place, or date -Decrease in abstract thinking (increased need for concreteness) -Associated problems with mood, language, or personality changes

adjustments (within the older adult)

-Menopause -Retirement and redirection of goals and energy -Decreased income -Grandparenting -Reentry into the job market

reduced income

-Problem for many older adults -Social security and pension incomes may not cover daily living and healthcare expenses -Working past retirement age is a potential solution for some older adults -Age-based mandatory retirement is now abolished, but age discrimination still persists

health screenings (USPTF)

-Screening for depression, elder abuse, and/or intimate partner violence -Screening for high blood pressure -Screening for fall risk and need for exercise interventions to prevent falls -Asking questions about unhealthy drug or alcohol use or smoking in adults age 18 or older -Screening for hepatitis C in adults aged 18-79 -Screen for the need for interventions for weight loss if body mass index is 30 or higher -Abnormal blood glucose up to age 70 for those who are overweight or obese -Screen for the need for cholesterol reducing medications if age 40-75 and have a risk factor for cardiovascular disease -Screening for osteoporosis with bone measurement testing in women 65 and older -Screening for colorectal cancer until age 75 -Biennial screening mammography for women until age 74 -One-time screening for abdominal aortic aneurysm with ultrasound in men aged 65-75 years who have ever smoked -Screening for lung cancer in adults aged 55-80 with a 30 pack-year smoking history and have smoked within the past 15 years -Screening for prostate cancer in men up to age 69 years is based on individual preference

caregiver assistance

-The most common activities of daily living that require assistance by home healthcare aides include body hygiene, bed-to-chair transfer, toileting, shopping, meal preparation, and light housework -Ambulatory care clinics and home-care organizations can be helpful

access to health care

-The older adult should maintain optimum physical and mental health -May be blocked by lack of transportation or knowledge of community resources -When this is blocked, preventative care is neglected, and healthcare is only obtained after an illness or disease develops

polypharmacy

-This problem arises with the use of medications by older adults -Medications may be prescribed for various medical conditions or may be purchased over the counter -Drug-drug interactions, drug-food interactions, and drug-environment interactions can occur -In older adults, the decreased ability of the liver and kidneys to excrete drugs from the body can result in an accumulation of the drugs to toxic levels -The older adult may forget to take a dose of medication or may accidentally take an extra dose

late adulthood

65 years and older; does not take into consideration the biological, employment and retirement, and sociological dimensions of older age

young old

65-74 years old

middle old

75-84 years

old old

85+

normal, pathological

A challenge of older adulthood is differentiating ________ age-related changes from __________ changes

Medicare

A federal program of health insurance for persons 65 years of age and older

learn

A person's ability and readiness to _________ depends on his or her stage of development, physical, psychological, and social health, support systems and environmental stress, and personal motivation

Mini-Mental State Examination (MMSE)

A test that is used to measure cognitive ability, especially in late adulthood; screens for dementia

2.5, 5

A total of ______ hours of moderate to vigorous physical aerobic activity spread throughout the course of a week is a baseline goal for adults of all ages; when that baseline is achieved, the guidelines shift to encourage _____ hours per week, with vigorous exercise counting as double

pessimistic

A young person who looks at life's events in a ___________ way may be vulnerable to developing depression as an older adult

integrity

Ability to look back on their life with a sense of accomplishment and fulfillment

medical

Approximately 4.6 million people above the age of 65 were below poverty level, with this increase being attributed to out-of-pocket _________ expenses, and the 3% of this group requiring caregiver assistance

autonomy, competence, relatedness

Basic needs for __________ (self-direction), ___________ (effective interactions), and __________ (a sense of belonging) motivate social activities that enhance general wellbeing; an environment that helps meet these basic needs enables the older adult to maintain positive social interactions

50

Chronic diseases limit daily activities for ____% of people over age 65; this impairs the ability and motivation to learn health behaviors

health

Chronic poor ________ can lead to stress, decreased activity, and fewer social interactions, which can trigger depression; depression can also be caused by prescribed treatment of the medical conditions present in the older adult

preventative care

Developing a healthy lifestyle and healthy behaviors with access to ____________ _______ is a primary goal in the education and care of the older adult

integrity vs despair

Erikson's final stage in which those near the end of life look back and evaluate their lives

limitations, abilities

Family education concerning the older adult's ___________ and ___________ can increase compassion and motivation to assist and improve verbal communication and the quality of the relationship

respect

For the older adult, learning is enhanced if mutual _________ exists between the teacher and the learner; the teacher should recognize and appreciate the lifelong accomplishments of the older adult and should be nonjudgmental

health

Good _________ in older people is described as the absence of disease or disability; however, normal body changes resulting from aging, such as ovarian failure or menopause, place a risk on the cardiovascular, skeletal, and metabolic systems

33

In 2017, 70% of men and 46% of women over 65 years of age were married, but widows accounted for _______% of all older women and there were three times as many widows as widowers

liver, kidneys

In older adults, the decreased ability of the ________ and _________ to excrete drugs from the body can result in an accumulation of the drugs to toxic levels

Medicare

In the year 2017, 93% of people over 65 years were covered by ___________ with 53% having private health insurance; a total of 1% of people over 65 had no health coverage

occupational, physical

Many adults over age 65 may have early undetected impairments that can affect their safety on the roads, but ___________ and __________ therapy can help maintain driving safety and delay loss of their driver's licenses

electronic health record

Many older adults receive referrals to specialists resulting in multiple physicians managing their care; the use of the _____________ ________ __________ is one measure to ensure that all physicians caring for a patient are aware of what medications have been prescribed

sedentary

Many people entering late adulthood have spent years or even decades at varying levels of a __________ lifestyle, and as a result have a very low level of fitness; as the aging process begins to threaten their independence, physical activity becomes an essential component for an elderly person to maintain cardiac and muscle function, balance, and a range of motion

exercise

Metabolic function, cardiac function, muscular strength, and bone structure all change as we age regardless of physical activity levels, but __________ can significantly slow the aging process, increase life expectancy, and reduce mortality

complementary therapies

Method of treatment used in conjunction with biomedical therapies

decrease

Norming aging brings about a decrease/increase in gastrointestinal functioning, leading to changes in nutrient absorption and elimination issues

old age, change

Older adults may show a readiness for learning if they recognize _______ ______ is near and they realize that physical health and life circumstances may _________

7

Older adults use the most health care dollars in the last ____ years of life

less, longer

On average, Americans are having less/more children and living for shorter/longer amounts of time

teaching moment

Point at which the learner is most receptive to change or growth within a situation; the learner must be motivated to learn and the teaching must be relevant to the learner and appropriate for them

extended family

Remaining an integral part of an __________ _________ provides valuable social activities and relationships, but family relationships are different than peer relationships

short

Scheduling _________ teaching sessions enables the older adult to concentrate and absorb all the information throughout the session without losing concentration due to fatigue or other interference, such as having to use the restroom

gels, lubricants

Simple lifestyle changes for women experiencing menopausal and postmenopausal symptoms include the use of water-based ________ or ____________

muscles, joints

Stronger _________ and ________ reduce the risk of falling and decrease the likelihood and severity of injury if there is a fall, which is a significant danger for the elderly population

65, 67

The US government has traditionally defined old age as over age _____ or _____, when full Social Security benefits become available, retirement usually occurs, and a leisurely lifestyle is adopted

grade B

The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.

income

The _________ sources for older persons in the US include Social Security, pensions, income from assets, and earnings

grandparent

The __________ role can be satisfying for the older adult, because it enhances self-image, increases activity level, creates feelings of self-worth and usefulness, and contributes to the meaning and quality of life

memory

The older adult experiences _________ changes, particularly in remembering names and faces of people

increases

The percentage of persons who live alone decreases/increases with advancing age, with almost half of women over 75 living alone

ill, disabled

The role of the grandparent in the home can be a positive experience for grandchildren when healthy relationships between all generations are maintained; it is when grandparents become ______ or __________ that the roles can reverse and the older adult needs more assistance, causing family stress and financial strain

narrows

The social network of friends usually narrows/widens for the older adult due to the death of peers; this may result in fewer social experiences unless older adults live in retirement communities or are connected with organized social activities specific for their age group

herbal supplements

The use of CAM therapy such as ________ ___________ to prevent the development of depression requires close evaluation for possible interaction with prescribed medicines or other treatments

polypharmacy

The use of many different drugs concurrently in treating a patient, who often has several health problems.

cognitive

There is evidence that physical activity has a protective effect on _________ function in the older population; habits of physical activity may be used in the future to aid in the battle of causes of decline such as Alzheimer disease and other types of dementia

50

This increase in population of this age group will also lead to a greater than _____% increase in the number of Americans over 65 requiring assisted living or nursing home care

False (decreases)

True or False: Increases in estrogen during menopause often cause vaginal wall thinning and urine leakage when sneezing or laughing

True

True or False: More older Americans above age 65 are working than at any time since the turn of the century

True

True or False: Most older persons have at least one chronic condition and many have multiple conditions

True

True or False: Older adults with healthy attitudes and coping skills typically do not mourn their lose youth but are able to find fulfillment and meaning in their lives despite health limitations

False (34%)

True or False: The large majority of people over age 65 in 2015 were college graduates

False

True or False: The older adult is sexually inactive due to specific changes in sexual responses

True

True or False: Today many people in the late adulthood phase of the life cycle postpone retirement and remain active in the workforce as senior employees or part-time consultants

grade A

USPSTF recommends the service; high certainty that the net benefit is substantial

lack of a partner

What is the most common cause of sexual dissatisfaction among older adults?

50%

What percentage of noninstitutionalized persons over age 65 live with their spouse?

transportation

When an older adult loses their driver's license, counseling concerning other methods of _____________ available within their community is essential; isolation, loneliness, stagnation, inadequate nutrition, or depression may occur if this is not offered

f

Which of the following is a top reported chronic condition in late adulthood? A.) Hypertension B.) Hyperlipidemia C.) Arthritis D.) Heart disease E.) Diabetes F.) These are all top reported chronic conditions in late adulthood

safety, comfort

With the growing population of elderly adults, there is a need for living arrangements that promote _________ and __________, such as hallways and doorjambs wide enough to accommodate wheelchairs, handrails or grab bars and bath seats in bathrooms, elevated toilets, and single-story homes without staircases

health screenings

_______ _________, including dental and eye checkups and a general physical evaluation, can identify developing health issues in early stages and can lead to early interventions and prevention of greater difficulties

late-onset

_______-_________ depression, or change in personality, may be attributed to changes in the brain itself; the DSM-V lists criteria for diagnosis of major depression and is more inclusive of the characteristics of the older adult

muscle strengthening

________ __________ exercises can increase the amount of metabolically active muscle tissue, or at least slow the decreases in muscle mass that often come with age and a sedentary lifestyle; decreases in muscle mass impact daily functioning and eventually impede independence and reduce quality of life

visual aids

_________ ______ in learning should include large print in a bright color; visual decline in the older adult often causes color distortions so important objects, like medications, should not be referred to by color

resting metabolic rate

_________ __________ _______, or the energy required to maintain essential body processes at rest, decreases with age so fewer calories are burned during a resting state; without adjustments in food intake and energy output, this metabolic shift is likely to result in weight gain

hearing

_________ loss in the older adult usually affects perception of high-pitched sounds or rapid speech; shouting or raising the volume is not helpful

normal, temporary

_________ memory loss can be associated with aging, and ___________ memory loss can be caused by depression or anxiety

depression

__________ should not be automatically expected to appear in the older adult; in some, it occurs as a continuation of a negative attitude from young adulthood

complementary and alternative medicine (CAM)

a diverse set of approaches and therapies for treating illness and promoting well-being that generally falls outside standard medical practices

menopause

cessation of menstruation for a period of at least 1 year; natural occurrence in the life cycle

Mobility devices

helps the older adult to resume activities of daily living, travel, visiting family and friends, and independence; examples include cane, walker, crutches, gait belt, wheelchair, trapeze bar

despair

looking back on life with a feeling of regret, shame, or disappointment

alternative therapies

method of treatment used in place of biomedical therapies

centenarian

one who is 100 or older

dyspareunia

painful intercourse; may be the result of atrophy of the vaginal wall and a decrease in natural lubrication

elder abuse

the physical or psychological mistreatment or neglect of elderly individuals through infliction of harm or neglect through actions or acts of omission

hormone replacement therapy

the use of the female hormones estrogen and progestin to replace those the body no longer produces during and after perimenopause