Academic Geriatric Resource Center
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AT A GLANCE

Glossary

0. Introduction
1. Demography And Epidemiology
1.1 The Changing Face of Aging: Objectives
1.2 Local and Regional Variations Among Older Adults in the United States
1.3 Implications of an Aging Society for Health Care Needs and Resources
1.4 Common Chronic Conditions Associated with Advanced Age
1.5 Post Test
2. Biology and Physiology of Aging
2.1 Introduction and Background
2.2 Theories of Aging
2.3 Physiological Changes with Aging
2.3.1 Loss of Homeostatic Reserve--Hyperthermia
2.3.2 Loss of Homeostatic Reserve--Hypothermia
2.3.3 Vulnerability of Older Adults to Hypothermia
2.3.4 Clinical Importance of Vulnerability to Hypothermia
2.3.5 Loss of Homeostatic Reserve--Other Examples and Clinical Implications
2.3.6 Clinically Important Age-Related Changes in Organ Systems
2.3.7 Clinically Important Age-Related Changes in the Renal System
2.3.8 Clinical Significance of Age-Related Changes in Renal System
2.3.9 Clinically Important Age-Related Changes in the Cardiovascular System
2.3.10 Clinical Significance of Age-Related Changes in the Cardiovascular System
2.3.11 Clinically Important Age-Related Changes in the Pulmonary System
2.3.12 Clinical Significance of Age-Related Changes in the Pulmonary System
2.3.13 Age-Related Changes in the Neurologic System
2.3.14 Clinical Significance of Age-Related Changes in the Neurologic System (I)
2.3.15 Clinical Significance of Age-Related Changes in the Neurologic System (II)
2.3.16 Clinically Important Age-Related Changes in the Gastrointestinal System
2.3.17 Clinical Significance of Age-Related Changes in the Gastrointestinal System (I)
2.3.18 Clinical Significance of Age-Related Changes in the Gastrointestinal System (II)
2.3.19 Clinically Important Age-Related Changes in the Immune System
2.3.20 Clinical Significance of Age-Related Changes in the Immune System
2.3.21 Clinically Important Age-Related Changes in the Endocrine System (I)
2.3.22 Clinically Important Age-Related Changes in the Endocrine System (II)
2.3.23 Clinical Significance of Age-Related Changes in the Endocrine System
2.3.24 Clinically Important Age-Related Changes in the Musculoskeletal System
2.3.25 Clinical Significance of Age-Related Changes in the Musculoskeletal System (I)
2.3.26 Clinical Significance of Age-Related Changes in the Musculoskeletal System (II)
2.3.27 Clinically Important Age-Related Changes in the Genitourinary System (I)
2.3.28 Clinically Important Age-Related Changes in the Genitourinary System (II)
2.3.29 Clinical Significance of Age-Related Changes in the Genitourinary System
2.3.30 Clinically Important Age-Related Changes in the Sensory Systems
2.3.31 Clinical Significance of Age-Related Changes in the Sensory Systems (I)
2.3.32 Clinical Significance of Age-Related Changes in the Sensory Systems (II)
2.3.33 Clinically Important Age-Related Changes in the Integument
2.3.34 Clinical Significance of Age-Related Changes in the Integument
2.4 Pharmacologic Considerations
2.5 Post Test
3. Socio-cultural And Psychologicial…
3.1 Module Objectives
3.2 Social Theories of Aging
3.3 Psychological Development In Late Life
3.4 Ethno-Cultural Issues And Age-Stratified Societies
3.5 Late-Life Transitions
3.6 Dependent Elders: Special Concerns
3.7 Cultural Views of Death
3.8 References
3.9 Post Test
4. Assessment Of The Geriatric…
4.1 Module Objectives
4.2 Domains of Assessment: Functional Assessment
4.2.1 How to Use Information from a Functional Assessment
4.2.2 Vision Impairment
4.2.3 Hearing Impairment (I)
4.2.4 Hearing Impairment (II)
4.2.5 Oral and Dental Health
4.2.6 Introduction to Oral Health Assessment
4.2.7 Oral Health Assessment
4.2.8 Common Oral Conditions in Older Adults: Tooth Loss (I)
4.2.9 Common Oral Conditions in Older Adults: Tooth Loss (II)
4.2.10 Common Oral Conditions in Older Adults: Care of Dentures
4.2.11 Common Oral Conditions in Older Adults: Dental Decay
4.2.12 Common Oral Conditions in Older Adults: Periodontal Disease
4.2.13 Common Oral Conditions in Older Adults: Candidiasis Infection
4.2.14 Common Oral Conditions in Older Adults: Leukoplakia and the Risk for Oral Cancer
4.2.15 Guidelines for a Dental Referral
4.2.16 Falls and Gait Assessment
4.2.17 Assessing for Falls
4.2.18 Techniques for Gait Assessment
4.2.19 Gait Assessments and Falls Interventions
4.2.20 Risk Factors for Falls and Targeted Interventions
4.2.21 Modification of Risk Factors: Ability to Get Up After a Fall
4.2.22 Modification of Risk Factors: Fracture Risk
4.2.23 Modification of Risk Factors: Anticoagulation
4.2.24 Incontinence
4.2.25 Skin Breakdown: Pressure Ulcers
4.2.26 Cognition/Dementia
4.2.27 Benefits of Early Detection of Dementia
4.2.28 Screening Techniques for Dementia
4.2.29 Decision-Making about Dementia Screening
4.2.30 Nutrition
4.2.31 Alcohol Use and Alcoholism
4.2.32 Medication and Complementary Therapies
4.2.33 Case Example: Mr. Singh
4.2.34 Mr. Singh--Use of Herbal Medicines
4.2.35 Mr. Singh--Possible Interventions
4.2.36 Mr. Singh--Concerns about Marathon Running at 92?
4.2.37 Mr. Singh--Considerations for Patient/Family Well-Being
4.2.38 Assessing for Polypharmacy (I)
4.2.39 Assessing for Polypharmacy (II)
4.3 Domains Of Assessment: Psychosocial Health And Functioning
4.4 Special Considerations In Assessment
4.5 Post Test
5. Health Care Policies
5.1 Module Objectives
5.2 The Policy-Making Process
5.3 Financing Health & Long Term Care
5.4 Quality Of Care Issues In Long Term Care
5.5 Need And Access Across The Spectrum Of Care
5.6 References
5.7 Post Test
6. Exploring Age-Related Body…
6.1 Cardiovascular System
6.2 Endocrine System
6.3 Immune System
6.4 Musculo-Skeletal System
6.5 Neurological System
6.6 Renal System
6.7 Post Test

Module 5: Health Care Policies

5.4: Quality Of Care Issues In Long Term Care


Nursing Facilities and Quality of Care

About 18,000 nursing facilities in the U.S. provide care to 1.63 million adults with disabilities that require nursing care (NCHS, 2002). Approximately 90% of these individuals are aged 65 years or and older, with younger persons with severe disabilities comprising the remaining 10% (NCHS, 2002). Most need assistance with bathing, dressing, and toileting and have many chronic and/or acute illnesses that require 24-hour nursing care services. Nursing homes must comply with state licensing laws in order to provide services and comply with federal regulatory standards if they want to provide care to individuals qualified for Medicare and Medicaid services. The federal rules require periodic surveys of nursing facilities for compliance with these requirements. Since the early 1970s, there have been studies by the US Senate about poor quality of nursing home care (US Senate Special Committee on Aging, 1963-1974). In 1983, when President Reagan planned to deregulate nursing facilities, Congress asked the Institute of Medicine (IOM) to conduct a study about nursing home regulation. The Institute published its report entitled Improving the Quality of Care in Nursing Homes in 1986 (IOM, 1986).

Module 5: Health Care Policies
5.3.22 Issue 2: Expanding…
5.4.1 Residents of Nursing…