Fast Facts for the Gerontology Nurse by Eliopoulos Charlotte;

Author:Eliopoulos, Charlotte;
Language: eng
Format: epub
Publisher: Springer Publishing Company, Incorporated
Published: 2018-05-07T00:00:00+00:00

FAST FACTS in a NUTSHELL

There are several tools available to assist in assessing IADLs. The Instrumental Activities of Daily Living Scale (Lawton and Brody, 1969) has long been used to score IADL independence. The Cleveland Scale for Activities of Daily Living (CSADL) is an informant-based instrument that expands existing ADL and IADL instruments and is particularly useful in assessing ADL and IADL capacity in persons with dementia (Patterson & Mack, 2001).

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DECONDITIONING AND SARCOPENIA

Deconditioning refers to the multiple changes in the body systems that occur as a result of inactivity. Impaired physical mobility, immobility, and disuse syndrome are terms that are sometimes used to describe deconditioning. Deconditioning can take the form of:

•Acute deconditioning: This happens rapidly as a result of a sudden cessation of usual activity. This can occur when a person fractures a hip, is hospitalized, and inactive for a period of time.

•Chronic deconditioning: This is a slower process in which there is a gradual reduction in activity over time. This can develop when a person reduces ambulation due to increased arthritis pain or when grief causes a person to withdraw and reduce activity.

As psychosocial factors can contribute to deconditioning, the importance of identifying all factors that could impact health status cannot be overstated.

Sarcopenia, a decrease in muscle mass and/or function resulting from a reduction of protein synthesis and an increase in muscle protein degradation, can contribute to impaired function. Immobility and lack of exercise, increased levels of proinflammatory cytokines, increased production of oxygen free radicals or impaired detoxification, low anabolic hormone output, malnutrition, and reduced neurological drive have been advocated as being responsible for sarcopenia (Di Iorio et al., 2006). When added to the impaired capacity for muscle regeneration that occurs in late life, this can lead to disability, particularly when compounded by diseases or organ impairment. The deconditioning effects of inactivity are significant in older adults and exaggerate the effects of sarcopenia, so every effort must be made to maximize their activity level.

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