Lecture 6-8-Communication

Front 1

# of abused elders in USA in 1996?

Back 1

-.8-1.9 million abused
-33,000 olders adults at a given time
-50% of cases lead to physically apparent trauma

Front 2

What are the types of abuse?

Back 2

-Neglect (55%): Self, Active, Passive
-Physical (14.6%)
-Financial (12.3%)
-Abandonment (11%)

Front 3

Population at Risk?

Back 3

-Women>Men
-Advanced age
-Drug abuse in elder/caregiver
-HX of conflict
-Elders who internalize blame
-XS loyalty to caregiver

Front 4

Caregiver Risks?

Back 4

-EtOH/Drug abuse
-Dementia
-Inexperience
-Economic stress
-HX of abuse as a child
-Economic Dependenace on Elderly

Front 5

Family Unit Characteristics Engendering Abuse?

Back 5

-Lack of family support
-Caregiver reluctance
-Overcrowding
-Isolation
-Martial conflict
-Violence

Front 6

Orofacial sign of Physical Abuse

Back 6

-Facial bruising
-Lip trauma
-Fractured teeth/jaw
-Red, swollen eyes
-Unkempt

Front 7

B/c of the prevalence of dental/periodontal disease in elderly-DDS comes into contact often more frequently than MD (T/F0

Back 7

True

Front 8

All 50 states with legislation to protect elderly victims of abuse (T/F)

Back 8

True: 42 states with mandatory reporting

Front 9

Elder abuse is a medical DX and a crime (T/F)

Back 9

True

Front 10

Describe Suspected Abuse?

Back 10

-Can be reported by anyone suspecting abuse
-Self abuse/neglect
-Reported most frequently by Home Health Agenecies or health care professional
-One ONLY needs to suspect abuse
-64.2 of reported abuse

Front 11

Required information of report?

Back 11

-Name/age of adult and caregiver
-Age of adult
-Information that indicated disability
-What was done to harm, mistreat, exploit the adult in questions

Front 12

What is the Screening criteria?

Back 12

-Disabled (> 18 yrs of age, Live in NC, physical or mental handicapped)
-Have they been abused, neglected or exploited
-Need APS?

Front 13

Def Abuse?

Back 13

-Willful infliction of pain, injury, or mental anguish
-Willful deprivation of needed services
-Unreasonable confinement

Front 14

What is exploitation?

Back 14

-Illegal or improper use of disabled adult or his resources for another person's advantages

Front 15

Who is in need of APS?

Back 15

-Any adult unable to perform or obtain essential services and is w/p an able, responsible and willing person to obtain these services

Front 16

How quickly are reports followed up?

Back 16

-Emergency: 24 hrs
-Routine: w/in 72 hrs

Front 17

What does APS evaluate?

Back 17

-Physical/mental health
-Social supports
-Functional status
-Financial status
-Physical environs of residence

Front 18

What determines if services are rendered or not?

Back 18

-Must fulfill 3 screening criteria and:
-Has capacity and consents to services
-Has capacity and refuses services
-Legal guardianship proceedings if suspected incompetence

Front 19

What happens if APS suspects abuse?

Back 19

-Report is filled w/ District attorney
-Detective is hired to investigate
-Case is take to court
-APS attempts to fultill unmet needs of abused person

Front 20

END OF LECTURE 6

Back 20

END OF LECTURE 6

Front 21

What is Presbyopia?

Back 21

-Reduced accommodation (losing focus): Due to loss of elasticity of the lens

Front 22

What is Reduced retinal illuminance results from?

Back 22

-Senile miosis (reduce pupil size) and more absorptive lens

Front 23

Reduced and contrast and color saturation?

Back 23

-Decreased clarity of the lens --> increased light scattering--> Reduced contrast and color saturation

Front 24

Reduced ability to discriminate blue colors result from?

Back 24

-Progressive yellowing of the crystalline lens

Front 25

Common causes of age-related vision loss?

Back 25

-Macular Degeneration: central vision loss
-Glaucoma: loss of peripheral vision
-Cataracts: Blurry distance vision
-Diabetic Retinopathy: Blurred vision to due to hemorrhage

Front 26

Age-related hearing loss?

Back 26

-Presbycusis: Progressive bilateral symmetrical age-related sensorineural hearing loss (Loss at high frequency)
-Noise-induced hearing loss: ass. w/ long-term exposure to high volume and high frequency noise
-Tinnitus: high-pitched ringing, hissing, or roaring sound in ears

Front 27

Communication w/ older adults w/ hearing impariment?

Back 27

-use communication aids: dry erase board
-Personal pocket talker system
-Sign language interpreter

Front 28

What is the differences b/t Fluid and Crystallized intelligence?

Back 28

-Fluid Intelligence: Ability to think and reason, declines with age
-Crystallized intelligence: Accumulated information and vocabulary acquired from educaiton and life

Front 29

Decreased processing speed = decreased cognitive functioning (T/F)

Back 29

False

Front 30

Decreased processing speed is ass. w/ motor fx decline (T/F)

Back 30

True

Front 31

Working memory is most affected by age (T/F)

Back 31

True
-Age related cognitive changes does not = cognitive impairment

Front 32

Common cause of cognitive deficits w/o dementia?

Back 32

-Alchohol abuse, depression, diabetes, heart disease and stroke.

Front 33

What is Aphasia?

Back 33

-Inability to generate coherent speech or understand spoken or written language

Front 34

What is Apraxia?

Back 34

-Inability to excuate motor activities

Front 35

What is Agnosia?

Back 35

-Inability to recognize or ID objects

Front 36

Disturbance in executive fxing:

Back 36

Inability to think abstractly, make sound judgements and plan and carry out complex tasks

Front 37

What are warning signs of Cogntive Impairment in Dental office?

Back 37

-Changes in personal hygiene and grooming
-Confusion w/ time and place
-Trouble following a conversation
-Changes in mood and personality
-Difficulty making and following decisions

Front 38

What are Cognitive Screening tools?

Back 38

-Mini-Mental Status Exam (MMSE)
-Instrumental Activities of Daily Living (IADL)
-Mini-Cog test (0-3) 3 = No problem

Front 39

How do you test with MSSE

Back 39

Draw the clock with the long and short hands.

Front 40

What are commonly seen behavior problems in dental office?

Back 40

-Refuse to open, Don't follow instructions, Active hands, aggression, Erupted emotional changes, Wandering, Biting, Screaming.

Front 41

Verbal and Non-verbal communication strategies?

Back 41

-Verbal: short words, simple sentences, try to avoid open-ended questions, speak slowly, ask one question at a time
-Non-verbal: take off your mask, maintain eye contact, maintain a smile and use gentle touch, reduce background noise
-Other: presence of caregiver, break down tasks, positive feedback, Tell-Show-Do, Continue talking to pt while working, Hand-over-hand technique

Front 42

Behavior management strategies?

Back 42

-Least restrictive and least invasive technique first
-Oral anxiolytic medicaiton
-Conscious sedation or GA
-Physical restraint (Extra-oral mouth props, Intra-oral mouth props, Gentle hand-holding, Stabilize head,

Front 43

END OF LECTURE 7

Back 43

END OF LECTURE 7

Front 44

Form 2010-2030, the 65+ population is expected to increase by __% to over 69 million.

Back 44

-75%

Front 45

Causes for changes in the Proportion of Elderly?

Back 45

-Declining and low fertility
-Declines in mortality at the adult and older ages
-Matureof baby boom cohorts

Front 46

Compared to the curren 65+ population, baby boomers?

Back 46

-Have fewer children
-Are more likely to be raising their grandchildren
-Have higher rates of divorce and remarriage

Front 47

__% of caregivers provide 8 hrs or less of care per week, __% provide more than 40 hrs.

Back 47

-48%: 8 hrs or less weekly
-17%: 40 hrs or more.