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21 Cards in this Set
- Front
- Back
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Functional health
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ability to take care of personal needs such as bathing, toileting, dressing, everyday life tasks
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Quality of life
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optimal health, maintenance of independence, affective and cognitive components
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Assessing functional health
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1. ADL's - Activities of daily life
2. IADL's - Instrumental activities of daily life 3. gait and balance using the Tinetti scale 4. Cognitive function |
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Activities of Daily Life
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Bathing, dressing, toileting, transferring from a bed to a chair, etc
Level of assistance a person needs to remain independent in a home 3 Levels: - ability to perform a task independently - ability to perform a task with some assistance - inability to complete a task, even with assistance |
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Instrumental Activities of Daily Living
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To complete, the person must have physical and mental abilities to perform a task.
Using the telephone, shopping, food prep, housekeeping, laundry, independent travel, taking schedule meds, handling finances. Dependent on physical ability and mental and social functioning IADL limitations increases with aging Older people more likely to having limitations in IADL's than ADL's because they are more complex |
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Scale used to observe person's ability to complete a function
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Direct Assessment of Functional Status (DAFS) - developed by Lowenstein
- used on those with dementia ex: verbal grocery list and taken to mock grocery store, memory tasks |
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How do functional limitations impact lifestyle?
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Can cause great fear of falling, lose muscle functioning, loss of independence, signals the beginning of a downward trend, can affect mental health, precursor of nursing home placement
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Negative behaviors
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smoking, alcohol abuse, obesity, can accelerate a disease and cause functional loss, includes mental health: depression, low self esteem, poor eating habits, social isolation, physical inactivity
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Positive behaviors
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diet, exercise, good support system, good nutrition, personal attitude towards health can manage chronic diseases
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According to David Reuben, who are the elderly individuals?
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Elderly Americans in perfectly health community dwelling
Elderly Americans with at least one disease in a community dwelling People with ADL & IADL limitations People residing in a nursing home |
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Most chronic conditions affecting older persons
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Hypertension - 51%
Athritis - 48% Heart disease - 31% Coronary heart disease - 21% Cancer - 20% Diabetes - 16% Sinusitis - 13% |
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Assisted living
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Nursing home population stays stable/ decreases rather than increase. It's the "new nursing home" and it will grow in the next 20-30 years. People come to assist the elderly in their own homes.
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Who provides medical care to these elderly americans?
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Family/ general - 35-40%
Internal medicine Cardiology Geriatricians - only 3% There is a current need for geriatricians but a lack of them. People don't go into it because lifestyle is difficult and pay is low. |
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Tinetti scale
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assesses gait and balance
Observing a person rising form a chair to standing position, walking, turning, standing, leaning forward & backing, assesses strength, flexibility, balance |
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Assessment of elderly patient includes
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Medical - balance,hearing, vision, etc
Cognitive - screening test Affective Functional Physical Social Economic Social support/Caregiver Environmental Quality of life Advance directives Spirituality |
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Advanced Activities of Daily Living (AADLs)
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patient specific functional activities (e.g., recreational, occupational, community service)
raises the question: do people stop AADL's because they are sick or loss of interest? |
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Prognosis
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Comorbidities can worsen prognosis
Comorbidities - having more than 2 chronic diseases at once which makes diagnosis and treatment difficult |
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Insufficient evidence
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base guiding management of many conditions are insufficient because those with comorbidities are often excluded from clinical trials, so treatment goes beyond evidence.
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Patient goals and preferences
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May relate to functional and health state,symptom control, living situation, or survival. Patient goals and preferences are not always best evidence base.
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Meta-analysis
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process and technique of combing research results by using various statistical methods
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Time issues
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short term issues: present to 1 year
mid-range issues: preventative care for the next 5 years long term issues: 5+ years, planning for eventual care |
