Care of the Older Adult WGU
Successful aging - Answer the ability to maintain three key behaviors: low risk of
disease and disease-related disability, high mental and physical function, and active
engagement of life" (Rowe & Kahn, 1998, p. 3).
Functional Ability - Answer Personal capacity to maintain activities of daily living.
Instrumental activities of daily living (IADLs): - Answer Functions involved in maintaining
a household; cleaning, cooking, shopping, paying bills, keeping appointments.
Independence - Answer Ability to care for oneself.
Basic activities of daily living (BADLs): - Answer Functions involved in maintaining
personal physical care; bathing, toileting, dressing, feeding.
Living Skills - Answer self-care, safety and health, money management, transportation
and telephone use, and work and leisure
Frailty - Answer either age nor disability alone makes a person frail, but changes that
often occur with age may contribute significantly to its presence. At nearly every age
past 65, women commonly experience frailty at a greater percentage than men
Harvard Women's Health Watch (Forestalling Frailty, 2003) - Answer suggests several
steps that can be taken to prevent or interrupt the course of frailty:• Maintain a healthy
weight and diet.
• Stay active.
• Practice fall prevention.
• Make connections—maintain relationships with others.
• See medical personnel regularly—physician, eye doctor, dentist.
Restraints - Answer Devices (e.g., belts, vests, pelvic ties, mitts, specialized chairs, bed
side rails) are usually considered in order to promote the safety of the recipient—
especially those who are forgetful and unsteady. A restraint is defined as "any manual
method or physical or mechanical device, material or equipment attached or adjacent to
[the resident's] body that the individual cannot remove easily which restricts freedom of
movement or normal access to one's body" Wandering, agitation, lashing out at others,
unsteadiness and potential to fall, and pulling at tubing or needles have been common
reasons for use of restraints. Because restraints also have the potential for causing
falls, injury, or even death and because quality-of-life issues may be affected, there are
protocols and stringent rules governing their use. The Omnibus Budget Reconciliation
Act (OBRA) mandates that restraints may be used only to treat someone's medical
condition, and not for convenience or discipline.
Alternatives to Restraints - Answer • Placement of the patient near the nurse's station or
oversight personnel
• Use of a call button or alerting device to call a caregiver when needed
• Handy accessibility of necessary items (e.g., tissues, phone, TV remote)
• Physical company of another person (e.g., a "sitter" to monitor and distract as needed)
• Relaxing/calming surroundings (e.g., music, holding a favorite item, home-like features
to room)
• Appropriate use of eyeglasses or hearing aids
• Positioning devices (e.g., body pillows, cushions, wedge cushions, tilt-back chair)
• Adequate pain management
Center for Science in the Public Interest - Answer The nation's premier educational and
advocacy organization for promoting better nutritional habits.
, Care of the Older Adult WGU
Green House - Answer An innovative and home-like alternative to nursing homes
developed by the physician William Thomas and supported by the Robert Wood
Johnson Foundation for the purpose of national replication.
Healthy People initiative - Answer Ten-year initiatives led by the U.S. Public Health
Service in an effort to reduce preventable death and disability for Americans.
Contracting - Answer A specific agreement between the nurse and client in which a
behavior change is described and a plan for the change is committed to paper.
Functional Decline - Answer Decreased ability to independently perform activities of
independent living or instrumental activities of daily living, such as dressing, bathing,
shopping, and bill paying.
Healthy People 2010 - Answer An initiative of the U.S. Department of Health and
Human Services that set forth health care objectives designed to increase the quality
and quantity of years of healthy life of Americans and to eliminate health disparities
(Healthy People 2010, 2005).
U.S. Preventive Services Task Force (USPSTF) - Answer A task force convened by the
U.S. Public Health Service to systematically review the evidence of effectiveness of
clinical preventive services. Its mission is to evaluate the benefits of individual services
and to create age-, gender-, and risk-based recommendations about services that
should routinely be incorporated into primary medical care (USPSTF, 2004).
Primary Prevention - Answer Activities designed to completely prevent a disease from
occurring, such as immunization against pneumonia or influenza.
Secondary Prevention - Answer Efforts directed toward early detection and
management of disease, such as the use of colonoscopy to detect small, cancerous
polyps.
Tertiary Prevention - Answer Efforts used to manage clinical diseases in order to
prevent them from progressing or to avoid complications of the disease, as is done
when beta blockers are used to help remodel the heart in congestive heart failure.
Mini Mental State Examination (MMSE) - Answer A brief series of questions to help
determine the presence of cognitive impairment.
Advanced Directives - Answer Legal document that records decisions regarding life-
saving or life-sustaining care and actions to be taken in a situation where the patient is
no longer able to provide informed consent. These include a living will, durable power of
attorney for health care, and life-prolonging procedures documents; they are only in
effect if the individual is unable to make his or her wishes known.
Advocacy - Answer The act or process of pleading the case of another.
Autonomy - Answer Referring to self-governance or self-directing freedom; being in
charge of one's own being; having moral independence.
Competence - Answer Having the capacity to function or respond; having requisite or
adequate abilities or qualities to perform a task or respond to a situation. Mental
competence is evaluated to determine whether a person has adequate capacity to
make informed decisions.
Failure to rescue - Answer Neglecting to take action or to recognize a preventable
complication.
Fidelity - Answer The state of being faithful and loyal, referring to allegiance to another.
Informed consent - Answer Consent that has been granted, not assumed, following an
educational process that facilitates the weighing of benefits, risks, and available options.
Successful aging - Answer the ability to maintain three key behaviors: low risk of
disease and disease-related disability, high mental and physical function, and active
engagement of life" (Rowe & Kahn, 1998, p. 3).
Functional Ability - Answer Personal capacity to maintain activities of daily living.
Instrumental activities of daily living (IADLs): - Answer Functions involved in maintaining
a household; cleaning, cooking, shopping, paying bills, keeping appointments.
Independence - Answer Ability to care for oneself.
Basic activities of daily living (BADLs): - Answer Functions involved in maintaining
personal physical care; bathing, toileting, dressing, feeding.
Living Skills - Answer self-care, safety and health, money management, transportation
and telephone use, and work and leisure
Frailty - Answer either age nor disability alone makes a person frail, but changes that
often occur with age may contribute significantly to its presence. At nearly every age
past 65, women commonly experience frailty at a greater percentage than men
Harvard Women's Health Watch (Forestalling Frailty, 2003) - Answer suggests several
steps that can be taken to prevent or interrupt the course of frailty:• Maintain a healthy
weight and diet.
• Stay active.
• Practice fall prevention.
• Make connections—maintain relationships with others.
• See medical personnel regularly—physician, eye doctor, dentist.
Restraints - Answer Devices (e.g., belts, vests, pelvic ties, mitts, specialized chairs, bed
side rails) are usually considered in order to promote the safety of the recipient—
especially those who are forgetful and unsteady. A restraint is defined as "any manual
method or physical or mechanical device, material or equipment attached or adjacent to
[the resident's] body that the individual cannot remove easily which restricts freedom of
movement or normal access to one's body" Wandering, agitation, lashing out at others,
unsteadiness and potential to fall, and pulling at tubing or needles have been common
reasons for use of restraints. Because restraints also have the potential for causing
falls, injury, or even death and because quality-of-life issues may be affected, there are
protocols and stringent rules governing their use. The Omnibus Budget Reconciliation
Act (OBRA) mandates that restraints may be used only to treat someone's medical
condition, and not for convenience or discipline.
Alternatives to Restraints - Answer • Placement of the patient near the nurse's station or
oversight personnel
• Use of a call button or alerting device to call a caregiver when needed
• Handy accessibility of necessary items (e.g., tissues, phone, TV remote)
• Physical company of another person (e.g., a "sitter" to monitor and distract as needed)
• Relaxing/calming surroundings (e.g., music, holding a favorite item, home-like features
to room)
• Appropriate use of eyeglasses or hearing aids
• Positioning devices (e.g., body pillows, cushions, wedge cushions, tilt-back chair)
• Adequate pain management
Center for Science in the Public Interest - Answer The nation's premier educational and
advocacy organization for promoting better nutritional habits.
, Care of the Older Adult WGU
Green House - Answer An innovative and home-like alternative to nursing homes
developed by the physician William Thomas and supported by the Robert Wood
Johnson Foundation for the purpose of national replication.
Healthy People initiative - Answer Ten-year initiatives led by the U.S. Public Health
Service in an effort to reduce preventable death and disability for Americans.
Contracting - Answer A specific agreement between the nurse and client in which a
behavior change is described and a plan for the change is committed to paper.
Functional Decline - Answer Decreased ability to independently perform activities of
independent living or instrumental activities of daily living, such as dressing, bathing,
shopping, and bill paying.
Healthy People 2010 - Answer An initiative of the U.S. Department of Health and
Human Services that set forth health care objectives designed to increase the quality
and quantity of years of healthy life of Americans and to eliminate health disparities
(Healthy People 2010, 2005).
U.S. Preventive Services Task Force (USPSTF) - Answer A task force convened by the
U.S. Public Health Service to systematically review the evidence of effectiveness of
clinical preventive services. Its mission is to evaluate the benefits of individual services
and to create age-, gender-, and risk-based recommendations about services that
should routinely be incorporated into primary medical care (USPSTF, 2004).
Primary Prevention - Answer Activities designed to completely prevent a disease from
occurring, such as immunization against pneumonia or influenza.
Secondary Prevention - Answer Efforts directed toward early detection and
management of disease, such as the use of colonoscopy to detect small, cancerous
polyps.
Tertiary Prevention - Answer Efforts used to manage clinical diseases in order to
prevent them from progressing or to avoid complications of the disease, as is done
when beta blockers are used to help remodel the heart in congestive heart failure.
Mini Mental State Examination (MMSE) - Answer A brief series of questions to help
determine the presence of cognitive impairment.
Advanced Directives - Answer Legal document that records decisions regarding life-
saving or life-sustaining care and actions to be taken in a situation where the patient is
no longer able to provide informed consent. These include a living will, durable power of
attorney for health care, and life-prolonging procedures documents; they are only in
effect if the individual is unable to make his or her wishes known.
Advocacy - Answer The act or process of pleading the case of another.
Autonomy - Answer Referring to self-governance or self-directing freedom; being in
charge of one's own being; having moral independence.
Competence - Answer Having the capacity to function or respond; having requisite or
adequate abilities or qualities to perform a task or respond to a situation. Mental
competence is evaluated to determine whether a person has adequate capacity to
make informed decisions.
Failure to rescue - Answer Neglecting to take action or to recognize a preventable
complication.
Fidelity - Answer The state of being faithful and loyal, referring to allegiance to another.
Informed consent - Answer Consent that has been granted, not assumed, following an
educational process that facilitates the weighing of benefits, risks, and available options.
