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96 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Senior citizens are given discounts as long as they have their senior citizen card |
R.A 9994 Expanded Senior Citizens Act of 2010 |
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5% discount on _____ based on RA 9994 |
- discount on basic necessities and prime commodities - discount for the monthly utilization of water and electricity provided that the water and electricity meter bases are under the name of the senior citizen |
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12% ____ _________ on the purchase of goods andservices which are entitled to the 20% discount |
VAT exemption |
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Additional Incentives and Benefits of R.A 9994 |
- monthly social pension of P500 - mandatory PhilHealth coverage - Social Safety Assistance (food, medical, financial assistance) - Free vaccination for indigent seniors - Death benefit of P2,000 to next of kin |
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U.S. Federal and State Laws |
- Social Security Act 1965 - Omnibus Budget Reconciliation Act of 1987 - Old American Act of 1988 - Old American Act Amendments - Health Insurance Portability and Accountability Act of 1996 |
SOOOH |
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- provides medical services to aged and indigent - MediCARE Part A and B Part A: skilled care Part B: Nursing Home - MedicAID skilled care for indigent |
Social Security Act of 1965 |
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- set of survey requirements used for reimbursements for Medicaid programs > Medicaid was abused (ex. using dead people's insurance) > consequence: jail - skilled nursing facilities only in relation to Medicare facilities and has merged the distinction skilled intermediate into single term nursing facility for Medicaid purposes - can offer medical services to elderly with special needs because they have skilled nursing facility |
Omnibus Budget Reconciliation Act of 1987 |
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- requires states to maintain a minimum democratic system to perform various services to secure basic rights to older adults, particularly those starting at 60 y.o
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Old American Act of 1988 |
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- maintains an effective long-term care program for trained volunteers |
Old American Act Amendments |
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gives additional, although limited protection to individuals and their family when they need to buy, change or continue their health insurance much improved law passed by the U.S. Legislation |
Health Insurance Portability and Accountability Act of 1996 (HIPAA) |
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HIPAA may: |
➜ Increase a person’s ability to get healthcare coverage when the person begins a new job
➜ Lower the chance of losing existing health coverage, whether the coverage is through a jobor through individual health insurance
➜ Help maintain continuous health coverage whena change of job occurs
➜ Help purchase health insurance coverage individually if the coverage is lost under an employer’s group health plan and no other healthplan and no other health coverage is available. |
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Older Adult Abuse and Protected Services |
Family Violence Prevention and Services Act of 1992 |
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mandated a national study which reported 45,000 older persons were being abused/neglected in 1996 if an elder is abused, this law will be protected |
Family Violence Prevention and Services Act of 1992 |
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Category of Elder Abuse |
Domestic Institutional Self-Neglect/Self-Abuse |
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Domestic Abuse |
maltreatment by someone with a special relationship with the elder Ex. family member or caregiver (most common in the Third World Countries) |
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Institutional Abuse |
maltreatment by a paid caregiver or staff member in a nursing facility |
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Self-Neglect/Self-Abuse |
- entails the self-worth of the elder - doesn't want to receive help despite needing it |
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How to deal with Elder Self-Neglect/Abuse? |
call government social services and inform them that the elder is alone and that they are not seen going out for a long time and you want to make sure they are safe |
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Kinds of Elder Abuse |
-Physical -Sexual -Emotional -Financial and Material Exploitation -Neglect -Abandonment -Self-Neglect |
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Physical Abuse |
physical force that may result in bodily injury, physical pain, or impairment. |
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Sexual Abuse |
Non-consensual sexual contact of any kind. |
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Emotional Abuse |
Infliction of anguish, pain, or distress through verbal or nonverbal acts. |
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Financial & Material Exploitation Abuse |
Family members withdraw/spend the elder’s money through the power of the attorney |
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Neglect Abuse |
Refusal or failure of a person to fulfill any part of his/her duties of an older person. |
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Abandonment Abuse |
dissertation of an older adult by an individual who has physical custody of the elder. |
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Self-Neglect |
have lost their feeling of self-worth so they do not participate or be active anymore in terms of their role in the community |
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The more productive they are, the more they feel _______ |
needed |
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Signs/Symptoms of Elder Abuse |
-Bruise -Wound, Laceration -Fractures -Verbalized being hit -Sudden change of behavior -Unclean living conditions (neglect) -Malnourished -Unexplained disappearance of funds/valuable |
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- capacity to decide for oneself - can reject lifesaving treatment - speak for oneself - covers all decisions about one's care and treatment, including removal of life support, life-sustaining treatment, and life-prolonging measures |
Right to Self-Determination |
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Criteria to reject life saving treatment? |
- elder is competent - informed consent (pros/cons) - no coercion |
CIN |
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Can a person with Alzheimer's or Memory Loss speak for oneself? |
No, they do not have the right to self-determination. |
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What is the last resort when it comes to self-determination? |
Medical and Family Judgement - COURT DETERMINATION |
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a process by which competent individuals are provided with information that enables them to make a reasonable decision about the treatment/intervention to be performed |
Informed Consent |
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Basis of the decision |
Informed Consent |
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DO NOT RESUSCITATE (DNR) |
- specific order from a physician that instructs healthcare providers not to use/order methods of therapy referred to as CPR
- everything is withheld except, basic needs like air, water and food
- DOES NOT MEAN REMOVE Oxygen and not feed - WITHHOLD medication, labs, extra procedures - if pt goes into cardiorespiratory arrest -> no heroic measures |
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CARDIOPULMONARY RESUSCITATION (CPR) |
- generally includes measures and therapies, to restore cardiac function and to support ventilation - CPR and cardiac medications will not be done |
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Compared to CPR, medications, extraction of laboratories, and extra procedures are stillcontinued
T or F |
False.
should be compared to DNR |
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- living will of the patient and their family - documents that permit people to set forth in writing - indicated decisions - designating someone to convey their wishes - common in chronically disease with knowledge of prognosis |
Advanced Medical Directives |
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Legal Tools |
Living Wills/Designation of Healthcare Agent Durable Power of Attorney General Power of Attorney
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LDG |
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- written expressions of a client's wishes regarding the use of medical treatments in the event of aterminal illness or condition. - Particular in terminally ill patients or alreadyfacing end-of-life issues |
Living Wills/Designation of Healthcare Agent |
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- legal instrument by which a person can designate someone else to make healthcare decisions at a time in the future when he/she may be rendered incompetent. |
Durable Power of Attorney |
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Becomes invalid on the incompetence of the persondelegating the power of attorney |
General Power of Attorney |
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Determination of Competence |
❖ Medical and family judgment ❖ Court determination ❖ To determine if the patient is still of sound mind |
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What if there is no lawyer and there is a problem/fightbetween the family? |
The court of law will take over and decide basedon the patient's best interest. |
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The law upholds the expressed desires of the family over the client. T or F |
False. should be desires of client OVER the family |
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The role of the health professional is to maintain patient autonomy and maintain or improve health status. |
DO NO HARM and DO GOOD |
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The key ethical principles should serve as a frameworkand basis for nursing decision-making and the application ofprofessional judgment. T or F |
True |
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Key Ethical Principles |
Autonomy Beneficence Non-maleficence Justice Veracity |
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Truthfulness no matter how difficult or hurtful |
Veracity |
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doing good |
Beneficence |
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self-determination |
autonomy |
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fair allocation of resources |
justice |
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doing no harm and avoidinng evil |
Non-maleficence |
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Gerontologic nursing practice is guided by the nursing code of ethics T or F |
True |
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Nursing code of ethics? - - |
➜ Explain the values and ideals that serve as a framework for the nurse’s ethical decision-making and conduct ➜ Serves to regulate the professional practice and is followed by nurses, especially when handlingend-of-life patients |
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Ethical DIrectives? |
➜ Gives and directs the nurse who is caring for a dying patient. ➜ This is important because many nurses getcharged for assisted suicide/euthanasia in theU.S. |
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Ethical Dilemmas and Considerations? |
Euthanasia, Suicide, and assisted suicide Experimentation and Research Organ Donation |
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Nurses are allowed to participate in assisted suicide T or F |
False |
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Nursing facility residents may refuse to participate in experimental research.
T or F |
True |
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Organ donation when abused is called |
Human Trafficking |
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Organ Donation should be _______
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altruistic (voluntary and expect nothing in return) |
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❖Provides education and helps guide policy-making regarding ethical issues.
❖ Facilitate the resolution of ethical dilemmas.
❖ Takes an activist role in involving all interested parties inpromoting the best care for clients.
❖ Hospitals have professional and ethical regulations because of certain conflicts happening between patient-nurse, nurse-nurse, doctor-nurse, and doctor-doctor |
Ethics Committee |
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❖ Provides adequate social services and improved quality of life for all.
❖ Adopts an integrated and comprehensive approach towards health development, giving priority to elderly (>60)
❖ Senior citizen center – place with educational, health, andsocial programs, and facilities to house extracurricularactivities for senior citizens so that they can pass the timeproductively
❖ Has activities like Mahjong, Chess, Zumba, Exercise, andInteraction with other senior citizens for them not to getbored.
❖ Required for all barangays |
R.A 7876 Senior Citizen Act of the Philippines of 1995 |
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❖Maximize the contribution of senior citizens donation-building and to grant them benefits and special privileges ❖ Grants senior citizens a 20% discount for purchases ofessential goods and services |
R.A. 7432 Senior Citizen Act of 1992 |
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❖Maximizes the contribution of senior citizens not only donation-building but also to grant them benefits and special privileges for other purposes
❖ Amended RA 7432 |
R.A. 9257 Expanded Senior Citizen Act of 2003 |
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Generic Law of the Philippines Promotes, requires, and ensures production of anadequate supply, distribution, use, and acceptance ofdrugs and medicines identified by their generic names. Cheaper to address polypharmacy of older adults |
R.A. 6675 Generics Act of 1988 |
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❖ Implements universal health coverage ❖ All senior citizens shall be covered by the national healthinsurance program of PhilHealth. ❖ Tax-exempt, government-owned, controlled corporation ofthe Philippines attached to the DOH. ❖ All senior citizens shall be covered by the national health insurance program of PhilHealth; usually 20-30% off ❖ even without contrib. they can still avail |
Philhealth Act of 1995 |
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❖ All seniors automatically receive Philhealth coverage inaccredited healthcare facilities in the Philippines.
❖ Register through the Office for the Senior Citizen Affairs(OSCA) or through the Local Philhealth Insurance Office (LHIO)
❖ Availing beneficiaries through the OSCA must: Fill out 2 copies of the PhilHealth Member Registration Form (PMRF)
❖ Each case rate package has a fixed amount, which shall bededucted from the member’s total bill before discharge.
❖inclusive of hospital charges and professional fees of attending physicians |
R.A. 10645 Mandatory Philhealth Coverage for All Senior Citizen |
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Philhealth covered cases that affect the elderly |
➜ High-risk pneumonia (32,000) ➜ Osteoporosis (7,900) ➜ CHF (15,700) ➜ Myocardial infarction or heart attack (12,000) ➜ Stage II hypertension (9,000) |
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___ Benefits Package where illness is classified as Case Type (economically and medically catastrophic) |
Z |
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Philhealth's No ______ ______ Policy is under the Z Benfits Package |
No BIlling Balance |
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❖Ensure full implementation of laws, policies, andprograms of the government pertaining to senior citizens. ❖ Adopts measures whereby the senior citizens are assisted and appreciated by the community. ❖ Provide services and activities beneficial to senior citizens, their families, and the communities they serve. ❖ Establish community-based health and rehabilitation |
R.A. 11350 National Commission of Senior Citizens Act of 2019 |
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Senior Citizen Benefits in the Philippines |
Income tax exemption for minimum wage earners. ➜ For minimum wage earners ➜ 500 pesos a day
❖ Training fee exemption on socio-economic programs.
❖ Free medical and dental services in government facilities.
❖ Free flu and pneumococcal vaccine for indigent seniorcitizens. ❖ Scholarships and financial assistance for senior citizens’ education in public and private schools. ❖ Retirement benefits from SSS, GSIS, and Pag-ibig.
❖ Discounts in special programs for senior citizens.
❖ Express lanes for senior citizens in all government officesand commercial establishments ➜ For establishments with no express lane, they should be the priority |
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Rights of the Senior Citizens |
❖ inherent right to life, dignity, and integrity of theirpersons, which shall be protected by law. ❖ right to be free from abuse, neglect,and exploitation. ❖ right to be free from discrimination ❖ right to adequate healthcare ❖ right to maintenance ❖ right to material assistance ❖ right to property ❖ right to participation in society ❖ right to work |
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Healthcare Settings in the Care of the Older Adult
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Acute Care Hospital Long Term Care Facility (nursing homes) Home Inpatient Subacute Unit Inpatient Rehabilitation Unit |
ALHII |
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➜ Majority are in the ICU because of heart attacks and uncontrolled hypertension ➜ Majority may also be admitted due to sepsis ➜ Some may be admitted due to stroke |
Acute care hospital |
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need rehabilitation due to stroke |
Long Term Care Facility (Nursing Home) |
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don't have funds for long term care facilities, they continue at ____ |
Home |
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From ICU to ward |
Inpatient Subacute Unit |
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Rehab center |
Inpatient Rehabilitation Unit |
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Long Term Care Levels |
- Assisted Living - Intermediate Care - Skilled Care - Subacute/Transitional Care - Group Homes - Residential - Hospice |
AISSGRH |
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- condo or apartment type where elderly has own unit and nurse assigned per building - nurse goes round once a day |
Assisted Living |
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A part of a nursing home where the residents are sick yet go to a home setting but not that acute to stay at the hospital
Skilled Nursing Facility (SNFs) can handle these cases |
Skilled Care |
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Terminally ill Palliative Treatment |
Hospice |
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Home Setting Types |
Outpatient Therapies Home Health Care Adult Day Care Vocational Rehabilitation Hospice Care Senior Citizen Center |
OHAVHS |
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gives injection, wound care and VS monitoring, health teaching for meds |
Home Health Care |
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elderly is supervised during the day
activities are provided in this facility |
Adult Day Care |
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terminally ill elderly |
Hospice Care |
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in the community, there should be follow-ups for elderlies for their health |
Senior Citizen Center |
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Inpatient Rehabilitation |
Physical Therapy Occupational Therapy Speech Therapy Social Services Nursing Care |
POSSN |
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upper and lower strengthening |
Physical Therapy |
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for ADLs (basic and instrumental) retraining and vocational retraining |
Occupational Therapy |
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communication and safe swallowing |
Speech Therapy |
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Assures that the care of the older adult is paid for by his/her insurance or the government orcommunity resources |
Social Services |
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Inpatient Subacute Unit |
Long-term transitional care General Chronic Transitional |
LGCT |
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Level of nursing care for Long Term Transitional Care |
Toxic Slightly Toxic Non-Toxic |
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