NURS 5462 Geriatric Issues
"Timed Up and Go" take a look at - ANS-Consists of rising from the chair, taking walks 10
feet (3 meters), turning round and returning to the chair, turning, after which sitting backpedal
within the chair
if > 15s, inc hazard falls and req. In addition eval
• Accountable Care Organization (ACO) - ANS-Aims to manipulate the whole continuum of
care➢ Provider-led corporation ❖Large integrated delivery systems ❖Physician - health
center agencies ❖Independent practice associations
Receive charge-for-service payments, if sure great performance measures are carried out,
the ACO will percentage inside the price savings
• Acute rehabilitation medical institution - ANS-➢ For older adults with good sized
rehabilitation desires and significant rehabilitation potential ➢ Many older adults are
ineligible because they can't take part in three hours/day of intense remedy
• Acute tubular necrosis: - ANS-Hold all probably nephrotoxic medicinal drugs and
meticulously preserve a euvolemic kingdom
• CareMore - ANS-➢Developed to provide extensive management for frail, chronically ill
Medicare Advantage application contributors who accounted for 70% of clinical fees
➢Patients enrolled are: ❖Assessed for continual illnesses and geriatric conditions
❖Managed via an outpatient Interprofessional team (NP, nurse care supervisor, medical
assistant care extenders) ➢Employs Hospitalists termed "Extensivists" ❖Provide care
within the inpatient, publish-discharge comply with-up, SNF and domestic settings
• Comprehensive Geriatric Assessment (CGA) - ANS-Aimed at determining a affected
person's clinical, functional, and psychosocial competencies and obstacles, and growing a
plan for remedy and long-time period follow-up ➢ Typically calls for a pretty trained
interprofessional group, so is highly-priced and time eating
• Custodial care - ANS-(eg, assisted living or "nursing home")
• Folstein's Mini-Mental State Examination (MMSE) - ANS-➢ Widely used but now
proprietary, and with boundaries
• Gait velocity - ANS-Strongest predictor of destiny incapacity and demise
zero.8m/s=indep comminuty ambulation, 0.6m/s=network activity s wheelchail
50ft in 20s or much less
• Guided Care - ANS-➢ Aims to decorate number one care via: ❖ Disease control ❖
Self-management ❖ Case control ❖ Lifestyle modification ❖ Transitional care ❖ Caregiver
education and aid ❖ Geriatric evaluation and control ➢ Specialized RN works with assigned
number one care physicians and office group of workers to take care of older person
patients. Advanced exceptional of care, outcomes
• Instrumental sports of day by day dwelling (IADLs) - ANS-Using telephone, preparing
meals, handling price range, taking medicines, doing laundry, doing home tasks, buying,
coping with transportation
• Life area - ANS-In Kurt Lewin's idea, all the inner and outside forces that act on an man or
woman
concentric circles starting with in which pt sleeps
, • Long-term acute care - ANS-➢ For the uncommon patient who calls for prolonged health
facility-stage care consisting of lengthy-time period mechanical air flow, multiple IV
medicines, parenteral nutrients, or complicated wound care
• Medicolegal worries - ANS-➢ Hospital physicians have a duty to the affected person to
guarantee care till the transition is whole, such as observe-up of pending tests, incidental
findings, and scientific remedies started within the medical institution ➢ The primary care
provider has a obligation to the patient to attain health center records, if now not received,
and ensure proper comply with-up once the care transition is whole
• Mini-Cog - ANS-➢ Combines 3-word bear in mind and clock draw take a look at
• Patient-Centered Medical Home (PCMH) - ANS-➢ Each affected person has an ongoing
courting with a non-public doctor and participates in decision making ➢ Physician directed
scientific practice, whereby, the practice adopts a "entire-individual orientation" and
gives/arranges for all of the affected person's health care needs
• Skilled-nursing facility (SNF) - ANS-➢ Under Medicare, older adults in SNFs need to need
a professional service including IV therapy, synthetic nutrition and hydration, complex wound
care, ostomy care, or rehabilitation ➢ Medicare covers all or a part of SNF take care of up to
100 days after a qualifying health facility live ➢ Coverage stops earlier if treatment dreams
are met or the older adult now not demonstrates improvement
ACCOUNTABLE CARE ORGANIZATIONS ( - ANS-• Goal of coordinated care: Ensure that
Medicare beneficiaries, specifically the chronically unwell, get the proper care on the proper
time, whilst fending off useless duplication of services and preventing clinical mistakes •
ACOs are able to proportion inside the value-financial savings it achieves for the Medicare
application (get a few savings again)
ACUTE FUNCTIONAL DECLINE - ANS-Usually brought about through an contamination or
harm (hip fracture, stroke, coronary heart failure, pneumonia), Most get better impartial
feature within 6 months, however are at excessive danger of next incapacity
ADULT DAY CARE - ANS-Used normally for: • Patients with dementia who want supervision
and help with their ADLs at the same time as the primary caregiver is at paintings or tending
to other obligations • As a form of respite for the primary caregiver. In trendy, adult day care
isn't protected by way of Medicare, even though some charges may be protected by means
of Medicaid or other insurers
ADULT FOSTER CARE - ANS-• Generally offer room, board, and some help with ADLs by
means of the sponsoring family or paid caregivers, who customarily stay at the premises •
Advantage: keeping frail older people in a homelike environment • Regulations range with
the aid of kingdom; no longer all states require licensing • Covered through Medicaid in a few
states
Adverse drug activities (ADEs) - ANS-substantial source of health center threat for older
patient, ➢ The Beers Criteria ➢ The screening device of older folks' probably beside the
point prescriptions (STOPP), Consultation with a medical pharmacist optimizes
pharmacotherapy (SOE=A)
Appropriate symptoms for a bladder catheter encompass: - ANS-➢ Acute urinary retention
or bladder outlet obstruction ➢ Perioperatively for decided on strategies ➢ Open sacral or
perineal wounds in incontinent patients ➢ Prolonged immobility due to unstable thoracic,
lumbar, pelvic fractures ➢ For consolation at stop-of- lifestyles as wanted
ASSISTED-LIVING FACILITIES - ANS-personal-care offerings, social sports, healthrelated
offerings, and supervision in a domestic-like environment • Services vary significantly •
Caring for an increasing number of frail human beings with substantial clinical needs • Care
is commonly transitional: Average length of residency is ~2 years
"Timed Up and Go" take a look at - ANS-Consists of rising from the chair, taking walks 10
feet (3 meters), turning round and returning to the chair, turning, after which sitting backpedal
within the chair
if > 15s, inc hazard falls and req. In addition eval
• Accountable Care Organization (ACO) - ANS-Aims to manipulate the whole continuum of
care➢ Provider-led corporation ❖Large integrated delivery systems ❖Physician - health
center agencies ❖Independent practice associations
Receive charge-for-service payments, if sure great performance measures are carried out,
the ACO will percentage inside the price savings
• Acute rehabilitation medical institution - ANS-➢ For older adults with good sized
rehabilitation desires and significant rehabilitation potential ➢ Many older adults are
ineligible because they can't take part in three hours/day of intense remedy
• Acute tubular necrosis: - ANS-Hold all probably nephrotoxic medicinal drugs and
meticulously preserve a euvolemic kingdom
• CareMore - ANS-➢Developed to provide extensive management for frail, chronically ill
Medicare Advantage application contributors who accounted for 70% of clinical fees
➢Patients enrolled are: ❖Assessed for continual illnesses and geriatric conditions
❖Managed via an outpatient Interprofessional team (NP, nurse care supervisor, medical
assistant care extenders) ➢Employs Hospitalists termed "Extensivists" ❖Provide care
within the inpatient, publish-discharge comply with-up, SNF and domestic settings
• Comprehensive Geriatric Assessment (CGA) - ANS-Aimed at determining a affected
person's clinical, functional, and psychosocial competencies and obstacles, and growing a
plan for remedy and long-time period follow-up ➢ Typically calls for a pretty trained
interprofessional group, so is highly-priced and time eating
• Custodial care - ANS-(eg, assisted living or "nursing home")
• Folstein's Mini-Mental State Examination (MMSE) - ANS-➢ Widely used but now
proprietary, and with boundaries
• Gait velocity - ANS-Strongest predictor of destiny incapacity and demise
zero.8m/s=indep comminuty ambulation, 0.6m/s=network activity s wheelchail
50ft in 20s or much less
• Guided Care - ANS-➢ Aims to decorate number one care via: ❖ Disease control ❖
Self-management ❖ Case control ❖ Lifestyle modification ❖ Transitional care ❖ Caregiver
education and aid ❖ Geriatric evaluation and control ➢ Specialized RN works with assigned
number one care physicians and office group of workers to take care of older person
patients. Advanced exceptional of care, outcomes
• Instrumental sports of day by day dwelling (IADLs) - ANS-Using telephone, preparing
meals, handling price range, taking medicines, doing laundry, doing home tasks, buying,
coping with transportation
• Life area - ANS-In Kurt Lewin's idea, all the inner and outside forces that act on an man or
woman
concentric circles starting with in which pt sleeps
, • Long-term acute care - ANS-➢ For the uncommon patient who calls for prolonged health
facility-stage care consisting of lengthy-time period mechanical air flow, multiple IV
medicines, parenteral nutrients, or complicated wound care
• Medicolegal worries - ANS-➢ Hospital physicians have a duty to the affected person to
guarantee care till the transition is whole, such as observe-up of pending tests, incidental
findings, and scientific remedies started within the medical institution ➢ The primary care
provider has a obligation to the patient to attain health center records, if now not received,
and ensure proper comply with-up once the care transition is whole
• Mini-Cog - ANS-➢ Combines 3-word bear in mind and clock draw take a look at
• Patient-Centered Medical Home (PCMH) - ANS-➢ Each affected person has an ongoing
courting with a non-public doctor and participates in decision making ➢ Physician directed
scientific practice, whereby, the practice adopts a "entire-individual orientation" and
gives/arranges for all of the affected person's health care needs
• Skilled-nursing facility (SNF) - ANS-➢ Under Medicare, older adults in SNFs need to need
a professional service including IV therapy, synthetic nutrition and hydration, complex wound
care, ostomy care, or rehabilitation ➢ Medicare covers all or a part of SNF take care of up to
100 days after a qualifying health facility live ➢ Coverage stops earlier if treatment dreams
are met or the older adult now not demonstrates improvement
ACCOUNTABLE CARE ORGANIZATIONS ( - ANS-• Goal of coordinated care: Ensure that
Medicare beneficiaries, specifically the chronically unwell, get the proper care on the proper
time, whilst fending off useless duplication of services and preventing clinical mistakes •
ACOs are able to proportion inside the value-financial savings it achieves for the Medicare
application (get a few savings again)
ACUTE FUNCTIONAL DECLINE - ANS-Usually brought about through an contamination or
harm (hip fracture, stroke, coronary heart failure, pneumonia), Most get better impartial
feature within 6 months, however are at excessive danger of next incapacity
ADULT DAY CARE - ANS-Used normally for: • Patients with dementia who want supervision
and help with their ADLs at the same time as the primary caregiver is at paintings or tending
to other obligations • As a form of respite for the primary caregiver. In trendy, adult day care
isn't protected by way of Medicare, even though some charges may be protected by means
of Medicaid or other insurers
ADULT FOSTER CARE - ANS-• Generally offer room, board, and some help with ADLs by
means of the sponsoring family or paid caregivers, who customarily stay at the premises •
Advantage: keeping frail older people in a homelike environment • Regulations range with
the aid of kingdom; no longer all states require licensing • Covered through Medicaid in a few
states
Adverse drug activities (ADEs) - ANS-substantial source of health center threat for older
patient, ➢ The Beers Criteria ➢ The screening device of older folks' probably beside the
point prescriptions (STOPP), Consultation with a medical pharmacist optimizes
pharmacotherapy (SOE=A)
Appropriate symptoms for a bladder catheter encompass: - ANS-➢ Acute urinary retention
or bladder outlet obstruction ➢ Perioperatively for decided on strategies ➢ Open sacral or
perineal wounds in incontinent patients ➢ Prolonged immobility due to unstable thoracic,
lumbar, pelvic fractures ➢ For consolation at stop-of- lifestyles as wanted
ASSISTED-LIVING FACILITIES - ANS-personal-care offerings, social sports, healthrelated
offerings, and supervision in a domestic-like environment • Services vary significantly •
Caring for an increasing number of frail human beings with substantial clinical needs • Care
is commonly transitional: Average length of residency is ~2 years
