Care of the older Adult.

#1 Competency 742.1.1: Compassionate and Respectful Care of Older

Adults

1. How do you define Baby Boomers?

Born between 1946-1964

2. What are the five racial groups listed in text?

European Americans, African Americans, Hispanic Americans, Asian Americans,

and Native Americans.

3. How would you perform discharge teaching to an Hispanic patient?

Involve family

response to disagreement may be silence and non-compliance

4. How would you perform discharge teaching to a European American

patient?

possibly not as many close family ties

trust in science/medicine

5. How would you perform discharge teaching to an Asian American patient?

more closer to western, with emphasis on science

health philosophy balance between individual and world

traditional medicine focuses on regaining balance

6. How would you perform discharge teaching to an African American patient?

include religion and spirituality, include family, account for distrust of medical

community d/t hx of discrimination

7. How would you perform discharge teaching to a Native American patient

Natualistic/magic approach

Issues of trust with providers

8. What is the concept of individualized care?

the standard of practice with older adults, considering the right care, at the right

time, in the right place and by the right provider of care.

9. What are some visual changes related to aging?

lens changes in color (more yellow), more opaque, denser, thinner and less flexible

• pupil/iris- does not dilate as fully (more difficult to see in lower light) or contract

as quickly (prob. sudden illumination

10.What are some communication accommodations that can be made for visual

deficits?

Position objects within visual field

• verbal indications of actions about to impart

• Large print type

• avoiding dim-illumination or glare

11.What are some hearing changes related to aging?

decreased sensitivity to pitch, with high-pitched consonants lost first (t, p, k, f, s,

and ch)

• Conductive problems - reduction of sound transmission - wave blocked from

outer to inner.

• Sesorinueral - sound wave transmission interrupted from inner ear to auditory

cortex (possible damage to choclea and/or auditory nerve).

12.What is presbycusis?

Old man's hearing - Presbycusis occurs following loss of hair and supporting cells

and nerve fibers in the cochlea.

13.What are some communication accommodations that can be made for

hearing deficits?

Don't shout

• Make use of unimpaired senses

• Stand in front of pt in well-lit room

• Limit background noise

• short sentences, speak clearly

• writing, pictograms, other modes

14.What are some speech/language changes associated with aging?

↓respirations strength, deeper voice and shaky/breathy

• ↓saliva, teeth, elasticity and muscle tone may change articulation

• cognitive changes may result in fewer words and making more semantic errors

15.What are some communication accommodations that can be made for

speech/language deficits?

environment low in distractions

• close proximity (maintaining eye-contact)

• rephrasing to check for comprehension

16.What are some somatosensory changes associated with aging?

there is a reduction in tactile and vibration sensations as well as decreased

sensitivity to warm or cold stimuli as we age , more prevalent in fingertips than

other areas

17.What are some communication accommodations that can be made for

somatosensory deficits?

When engaging in physical activity with older adults, it is important to use verbal

explanations to describe the physical activities as they take place.

18.What is an AAC?

Augmentative and alternative communication (AAC):

An integrated group of components or assistive devices and strategies that help

individuals improve communication.

19.What are some communication tips for someone with dysarthria?

Encourage the person to speak slowly and use simple sentences or single words.

Allow time for the patient to respond. Don't try to complete their words or

sentences. If there is no speech (aphasia, presence of an artificial airway,

postoperatively after oral surgery):

• Assess the individual's yes/no reliability.

• Establish a system for yes/no communication (picture board or eye blink—1 =

yes, 2 = no). Post rules for use at the bedside and in the medical record.

• Ask yes/no questions and allow the person time to respond. Confirm response

before acting.

20.Describe a BTE

Behind the Ear

BTEs are about 1 inch long and worn behind the outer ear. A small tube connects

with the amplification device behind the ear and delivers amplified sound into the

ear canal. The device has an adjustable volume control and is battery powered. It is

the most common style of hearing aid. These devices are suitable for the entire

range of hearing loss.

21.Describe an OTE

Over the ear

This is a new style that is very small and sits on top of the outer ear.

22.Describe an ITE

In the ear

ITEs are custom-fitted devices molded to the contour of the outer ear. The device

has an adjustable volume control and a battery; however, both are much smaller

than ones used in a BTE device. Some users have difficulty seeing or manipulating

the control and battery. These devices are used for mild to moderate hearing loss.

23.Describe an ITC

In the Canal

ITCs are tiny devices that fit into the ear canal and are barely visible. They are

customized to fit the size and shape of the ear canal. Although cosmetically

appealing, their small size is a drawback for some individuals.

24.Describe a CIC

Completely in the Canal

CICs are the smallest type of device in the in the ear class. The entire device fits

within the canal. Although cosmetically flattering, the small size is a true

disadvantage because of difficulty handling and positioning the device. This device

is the most expensive model of hearing aid.

25.What patients could benefit from an AAC?

individuals with speech impairments

26.What are Satir's five principles of contact and communication?

•invite

• arrange environment

• maximize communication

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