NR 442 Factors Leading to Health of a
Community
Immunizations for Older Adults
• Tetanus, diphtheria, pertussis: Every 10 years
• Influenza (flu) vaccine: Annually
• Pneumonia vaccine: Once after age 65
• Ask physician about booster every 5 years
• Hepatitis A and B: For those at risk
• Herpes zoster (shingles): One-time dose
• Varicella: If evidence of lack of immunity and significant risk for exposure
RECOMMENDED
SCREENINGS/EXAMS
For All Older Adults
• Complete physical: Annually
• Blood pressure: Annually
• More often if hypertensive or at risk
• Blood glucose: Annually
• More often if diabetic or at risk
• Serum cholesterol: Every 5 years
• More often if at risk
• Fecal occult blood test: Annually
•
For All Older Women
• Breast self-exam: Monthly
• Clinical breast exam: Annually
• Mammogram: Every 1 to 2 years if age 40 or older
• Check with HCP if 74 years+
• Pelvic exam and Pap smear: Annually
• Check with HCP about discontinuation at 65 or older with three consecutive
negatives.
• exams and no abnormal in previous 10 years and not otherwise at ris
• Digital rectal exam: Annually with pelvic exam
• Bone density: Once after menopause
• More often if at risk
For All Older Men
• Digital rectal exam and prostate exam: Annually
• Prostate-specific antigen (PSA) blood test: Annually
For all Adults
NR 442 Factors Leading to Health of a Community 1/11
, NR 442 Factors Leading to Health of a
Community
• Sigmoidoscopy: Every 3 to 5 years OR Colonoscopy: Every 10 years
More often if high risk
• Visual acuity and glaucoma screening: Annually
• Dental exam: Annually for those with teeth; cleaning every 6 months
(every 2 years for denture wearers)
• Hearing test: Every 2 to 5 years
• Complete physical: Annually
• Blood pressure: Annually
• More often if hypertensive or at risk
• Blood glucose: Annually
• More often if diabetic or at risk
• Serum cholesterol: Every 5 years
• More often if at risk
• Fecal occult blood test: Annually
END-OF-LIFE ISSUES
• Patient Self-Determination Act (PSDA)
• Federal law enacted in 1990
• Requires health care facilities that receive Medicare and
Medicaid funds to ask patients on admission if they
possess advance directives.
Living will- step by step document on what treatment wanted when one can’t make
decisions about emergency treatment.
Advance directive- someone is making all medical decisions on your behalf
Disability- impairments, activity limitations. individual level
Impairment-problem in body function or structure. micro level
Handicap-disability that prevents fulfillment of an
expected role (macro level). Macro level
Americans with Disabilities Act (ADA)- defined disability according to limitations
in a person’s ability to
carry out a major life activity, ability to breathe,
walk, see, hear, speak, work, care for
oneself, perform manual tasks, and learn.
NR 442 Factors Leading to Health of a Community 2/11
Community
Immunizations for Older Adults
• Tetanus, diphtheria, pertussis: Every 10 years
• Influenza (flu) vaccine: Annually
• Pneumonia vaccine: Once after age 65
• Ask physician about booster every 5 years
• Hepatitis A and B: For those at risk
• Herpes zoster (shingles): One-time dose
• Varicella: If evidence of lack of immunity and significant risk for exposure
RECOMMENDED
SCREENINGS/EXAMS
For All Older Adults
• Complete physical: Annually
• Blood pressure: Annually
• More often if hypertensive or at risk
• Blood glucose: Annually
• More often if diabetic or at risk
• Serum cholesterol: Every 5 years
• More often if at risk
• Fecal occult blood test: Annually
•
For All Older Women
• Breast self-exam: Monthly
• Clinical breast exam: Annually
• Mammogram: Every 1 to 2 years if age 40 or older
• Check with HCP if 74 years+
• Pelvic exam and Pap smear: Annually
• Check with HCP about discontinuation at 65 or older with three consecutive
negatives.
• exams and no abnormal in previous 10 years and not otherwise at ris
• Digital rectal exam: Annually with pelvic exam
• Bone density: Once after menopause
• More often if at risk
For All Older Men
• Digital rectal exam and prostate exam: Annually
• Prostate-specific antigen (PSA) blood test: Annually
For all Adults
NR 442 Factors Leading to Health of a Community 1/11
, NR 442 Factors Leading to Health of a
Community
• Sigmoidoscopy: Every 3 to 5 years OR Colonoscopy: Every 10 years
More often if high risk
• Visual acuity and glaucoma screening: Annually
• Dental exam: Annually for those with teeth; cleaning every 6 months
(every 2 years for denture wearers)
• Hearing test: Every 2 to 5 years
• Complete physical: Annually
• Blood pressure: Annually
• More often if hypertensive or at risk
• Blood glucose: Annually
• More often if diabetic or at risk
• Serum cholesterol: Every 5 years
• More often if at risk
• Fecal occult blood test: Annually
END-OF-LIFE ISSUES
• Patient Self-Determination Act (PSDA)
• Federal law enacted in 1990
• Requires health care facilities that receive Medicare and
Medicaid funds to ask patients on admission if they
possess advance directives.
Living will- step by step document on what treatment wanted when one can’t make
decisions about emergency treatment.
Advance directive- someone is making all medical decisions on your behalf
Disability- impairments, activity limitations. individual level
Impairment-problem in body function or structure. micro level
Handicap-disability that prevents fulfillment of an
expected role (macro level). Macro level
Americans with Disabilities Act (ADA)- defined disability according to limitations
in a person’s ability to
carry out a major life activity, ability to breathe,
walk, see, hear, speak, work, care for
oneself, perform manual tasks, and learn.
NR 442 Factors Leading to Health of a Community 2/11
