Quiz 3
Gero 301
T and F
1) Private transportation has come to dominate travel in this country to such an extent that the United States is less connected via public transportation now than it was in the late 1980s.
2) Older Americans do not rely on private vehicles for their transportation needs; almost 90% of trips taken by older adults over age 65 are in public transportation.
3) Up to age 70 the majority of older adults have good driving records and appear to perform as well as middle-aged drivers.
4) Medicare beneficiaries estimate that 14.1 million older adults have some degree of difficulty walking or climbing stairs.
5) Walking long distances to the nearest bus stop and bus stops that have inadequate shelters, no benches, and poor lighting are barriers to public transit by older adults.
6) Public transportation is defined as service that is available for specific trip purpose to working individuals of any age and is operated by public agencies or supported by public funds to some extent.
7) Competence refers to the upper limits of an individual’s abilities and extends across several areas of functioning, including sensory-cognitive abilities, capacity for self-care but not the ability to perform instrumental activities, mastery, and social skills.
8) A moderately challenging environment is not beneficial because it encourages growth and therefore stretches the person’s abilities.
9) To be eligible for a Reversible Mortgage, a homeowner must be 67 years of age or older, have a very low outstanding mortgage balance or own the home free and clear, occupy the property as the principal resident, but could be delinquent on any federal debt.
10) Once borrowers receive an HECM, (Reversible Mortgage) they are obligated to occupy the home as a principal residence, make timely payments of the property taxes, maintain a homeowner’s hazard insurance policy, and maintain the property in a condition equal to when they secured the loan.
11) Many public housing communities employ on-site service coordinators who help elderly residents obtain supportive services that allow them to continue to live in place independently, without having to move to more expensive assisted care environments
12) Cohousing, a form of residential development designed to promote the practice of caring for neighbors as they age while retaining individual privacy, is not an appealing living arrangement for older adults.
13) When the care manager determines that a client is eligible for care management services, he or she conducts a multidimensional assessment that profiles details of the client’s needs and support systems.
14) Episodic care management occurs only when called for by providers in any of the other models of care management. The key feature of this model is that it can only be reactionary. It occurs in reaction to admission, consultation, or a phone call.
15) Hospice is a philosophy of caring for individuals who are terminally ill, but not their family members.
16) Respite care is temporary, short-term supervisory, personal, and nursing care provided to older adults with physical or mental impairments to allow caregivers to take a break from their caregiver’s role.
17) Personal care is a reimbursable service under Medicare.
18) An alternative type of in-home respite is called Video Respite. This series of 20 to 50 minute videotapes was designed to capture and maintain the attention of persons with dementia.
19) System barriers related to the use of respite care services include lack of service availability when wanted or needed most and lack of control over who provides services
20) But the real impetus to the creation of the nursing home industry came with the enactment of Medicare and Medicaid. Both Medicare and Medicaid provide payments to nursing homes—Medicare for acute care, and Medicaid for long-term care for those with low income.
21) Staff retention has been a problem in many nursing homes across the country, in part because of the stressful nature of the work and the low wages
1 point each x 21 = 21 points
Multiple Choices
1) Older adults reported that the ideal transportation system would:
a) Have drivers who were courteous and patient and have bilingual staff
b) Require traveling shorter distances to destinations located within their neighborhoods
c) Have smaller buses that were for seniors and persons with disabilities only and not require transferring.
d) Have more flexible bus schedules to meet the needs of community people, not just workers.
e) B and C
f) All the above
2) The ADS industry promotes three models of care:
a) The social model, the medical/health model, and specialized care model.
b) The social model, the health maintenance model and the recreational model
c) The Adult Day Health care, the specialized care and the individual an family care model
d) The ADS industry does not promote any of the above models
3) The following applies to Institutional Respite Except
a) Institutional settings such as nursing homes, Veterans Administration hospital-based nursing homes, and hospitals provide temporary institutional respite (TIR) services.
b) In most situations, caregivers pay out of pocket for institutional respite care.
c) This type of respite care similar to in-home or day programs
d) Beds may be available for both emergency respite care (e.g., illness of a caregiver) and planned respite stays
4) Caregivers often have negative views or misconceptions about Institutional Respite They often believe that:
(a) Temporary residential respite is not appropriate when care responsibilities become overwhelming or they encounter an emergency situation
(b) Institutional Respite may exacerbate positive behaviors of the care recipient;
(c) Use of institutional respite is equivalent to betrayal of family responsibility for care.
(d) Care received in an institution is always superior to the care provided in a familiar home environment
5) Persons with dementia are more likely than those without dementia to:
a) Be able to perform ADLs without assistance.
b) Be continent,
c) Have psychiatric symptoms (delusions and hallucinations),
d) Have no behavioral problems just memory problems.
6) Long-term care ombudsman programs were created to
a) To deal with a wide range of issues, including resolving problems that residents might have with their public benefits or guardianship procedures.
b) Act as advocates for older adults living in nursing homes but not living in board-and-care homes.
c) Was created as the result of concerns from the nursing homes industry.
d) Establish as a mechanism for receiving and resolving complaints regarding the use of volunteers.
e) Test the effectiveness of using paid nursing home employees as ombudsmen.
7) Adult foster care (AFC)
a) Serves people who, because of physical, mental, or emotional limitations, are unable to continue independent functioning in the community
b) Serves who need and desire the support and security of family living
c) Serve people that are indigent regardless of age
d) A and B
e) All the above
8) The following is correct about Congregate Housing except:
a) Public housing is the same as congregate housing and medical personnel are not usually onsite in a congregate facility.
b) Many congregate facilities are privately owned. The typical onsite staff includes a building manager, janitorial services, and social/activity organizer
c) Most congregate housing facilities have separate apartments for each resident plus common, shared areas for meals and recreation.
d) These facilities provide services in a residential setting for persons who can no longer independently manage the tasks of everyday living.
9) Several barriers can impede the use of shared housing in later life. The following are those barriers except
a) The most frequently cited barrier is a lack of financial support for programs that help match older individuals with prospective housemates and older adults may be hesitant to share their homes with a stranger
b) Federal, state, or local support is available for these programs, and the clients served are often unable to pay the actual cost of providing the service.
c) Restrictive zoning regulations and building and fire codes prohibit shared housing in many residential neighborhoods.
d) Fear that their income from SSI, food stamps, or fuel subsidies will be reduced if regulatory agencies base decisions on the income of the household.
10) Public and private care management services have proliferated during the past decade in response to:
a) Demographic changes
b) Increased concern about the cost of services.
c) Complexity of the health care and service systems.
d) A and C
e) All the above
2 points each x 10 = 20
Essay Questions
1) Please discuss in detail at least three different independent living options for elders.
2) Could you discuss the top 10 essential or most important services rated by caregivers of persons with dementia?
3) Please identify programs and services that allow elders to Age in Place.
3 points each x 3 questions = 9 points