AAC (Augmentative and Alternative Communications ✔✔refers to all forms of communication that enhances or supplements speech and writing. AAC can enhance (augment) and replace (alternate) conventional forms of expression for people who can not communicate through speech, writing or gestures. active aging ✔✔based on the human rights of older people - principles of independence, participation, dignity, care and self fulfillment adherence in low literacy patients ✔✔color code medication bottles or use organizer that separates daily doses into morning, noon, evening and night ADL's vs IADL's ✔✔ADL - Activities of daily living such as bathing, dressing, transferring, walking, eating, and continence. IADL - Activities R/T independent living such as meal preparation, money mgmt., shopping, housework, telephone use. African Americans - top five health disparities ✔✔new cases of gonorrhea, congenital syphilis, new cases of AIDS, and deaths due to HIV infection. The impact of racism has long been considered one of the factors that contribute to decreased longevity and increases of chronic illnesses African Americans ✔✔second larges minority populations. Role of religion and spirituality plays important role in health and wellness. Equate good luck, good fortune, and good health with being right with God. Disease and illness can be thought of as being in disfavor with God. Believe they have less control over their health and well being than God. Illness/disease is part of God's plan. Closer ties with extended families and rely on their close family ties for support. Distrustful of health care personnel because of discrimination in medical care and because most authority figures in health care are not African Americans. Age related changes which may affect therapeutic communication ✔✔Visual acuity Hearing loss Speech and language difficulties Ageism ✔✔prejudice towards elderly Among older adults living in the community, when and where do most falls occur? ✔✔most falls occur during usual activities such as walking. Indoor falls occur most often in the bathroom, bedroom, and kitchen. Analyze a given policy or legislative act that promotes or hinders the independence and autonomy of older adults. ✔✔Patient Protection and Affordable Care Act - eliminates lifetime limits for health insurance coverage for essential services, eliminates the ability of insurance companies to rescind coverage, free preventative care, development of a prevention and public health fund, increases access to affordable care, and quality improvement and risk reduction. Asian Americans - top 5 disparities ✔✔new cases of TB, congenital syphilis, no pap test among females > 18, exposure to particulate matter, and carbon monoxide exposure Asian Americans ✔✔most still practice holistic (naturalistic) medicine and may incorporate this as an adjunct to Western medicine. Use herbal supplements Majority of influence comes from Confucianism (stresses accommodation and avoids confrontation). Follows a naturalistic perspective, defining health and illness as a balance between the individual and the world around the individual. (Strives to be in harmony with the universe in which he or she lives) Basic concept of Chinese medicine is that all things, including the body, are composed of opposing forces called yin and yang. (Health is said to depend on balance of these forces). Chinese medicine focuses on maintaining the yin-yang balance to maintain health and prevent illness. If the balance of yin and yang is broken, it is essential to restore the balance. To regain balance, the belief is that the balance between the internal body organs and the external elements of earth, fire, water, wood, and metal must be adjusted. Treatments may involve - acupuncture, moxibustion (burning of herbal leaves on or near the body), cupping (the use of warmed glass jars to create suction on certain parts of the body), massage, herbal remedies, movement and concentration exercises (tai chi) Some elders may forgo life sustaining treatment because of the principles of ren. Ren is the golden rule of Chines decision making "Do not do to others what you do not want done to yourself".