Care of the Older Adult WGU
Successful aging Ans: 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 Ans: Personal capacity to maintain activities of daily living.
Instrumental activities of daily living (IADLs): Ans: Functions involved in maintaining a
household; cleaning, cooking, shopping, paying bills, keeping appointments.
Independence Ans: Ability to care for oneself.
Basic activities of daily living (BADLs): Ans: Functions involved in maintaining personal
physical care; bathing, toileting, dressing, feeding.
Living Skills Ans: self-care, safety and health, money management, transportation and
telephone use, and work and leisure
Frailty Ans: 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) Ans: 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 Ans: 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 Ans: • 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 Ans: The nation's premier educational and advocacy
organization for promoting better nutritional habits.
Green House Ans: 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 Ans: Ten-year initiatives led by the U.S. Public Health Service in an
effort to reduce preventable death and disability for Americans.
Contracting Ans: 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 Ans: 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 Ans: 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) Ans: 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 Ans: Activities designed to completely prevent a disease from occurring,
such as immunization against pneumonia or influenza.
Secondary Prevention Ans: Efforts directed toward early detection and management of disease,
such as the use of colonoscopy to detect small, cancerous polyps.
Tertiary Prevention Ans: 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.
Successful aging Ans: 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 Ans: Personal capacity to maintain activities of daily living.
Instrumental activities of daily living (IADLs): Ans: Functions involved in maintaining a
household; cleaning, cooking, shopping, paying bills, keeping appointments.
Independence Ans: Ability to care for oneself.
Basic activities of daily living (BADLs): Ans: Functions involved in maintaining personal
physical care; bathing, toileting, dressing, feeding.
Living Skills Ans: self-care, safety and health, money management, transportation and
telephone use, and work and leisure
Frailty Ans: 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) Ans: 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 Ans: 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 Ans: • 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 Ans: The nation's premier educational and advocacy
organization for promoting better nutritional habits.
Green House Ans: 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 Ans: Ten-year initiatives led by the U.S. Public Health Service in an
effort to reduce preventable death and disability for Americans.
Contracting Ans: 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 Ans: 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 Ans: 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) Ans: 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 Ans: Activities designed to completely prevent a disease from occurring,
such as immunization against pneumonia or influenza.
Secondary Prevention Ans: Efforts directed toward early detection and management of disease,
such as the use of colonoscopy to detect small, cancerous polyps.
Tertiary Prevention Ans: 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.
