Chapter 7- Health Status and Health-Care Transitions in an Aging Context

Question 1

Describe the medical model. (4)

Answer 1

• Dominated most of 20th century
• Focuses on causes and treatments of disease with surgery, meds, rehab, and long-term nursing care
• Perpetuates idea that health is caused by physiological systems
• Criticized for making people too dependant on health care

Question 2

Describe the social model (3)

Answer 2

• Builds on medical
• Views health as having social, psychological, and biological/genetic basis
• Stresses role of the individual, prevention, continuum of health care

Question 3

What is the health promotion model? (1)

Answer 3

Promotes healthy behaviours by targeting individuals or groups in a community or across society.

Question 4

What is the population health model? (1)

Answer 4

Developed in 1990s in response to growing interest to identifying determinants of health.

Question 5

How has the older population healthier over time? (2)

Answer 5

• Morbidity compression hypothesis: onset of disease has compressed into shorter periods, health has improved
• However, there are patterns of increasing chronic conditions

Question 6

What are the factors associated with morbidity and reaction to illness in later life? (4)

Answer 6

• Personal (adaptation to stress and pain and coping strategies)
• Social (availability of a support system)
• Structural
• Cultural

Question 7

Define multimorbidity and its interlocking domains in the Lifecourse Model of Multimorbidity Resilience. (2)

Answer 7

• Mortimorbidity: facing more than one chronic condition

- Functional, social, psychological

Question 8

Describe the self-perceptions of health and self efficacy (2)

Answer 8

• Majority say that it is good to excellent, but tend to overestimate
• Self efficacy: perceived that one can accomplish a behavioural change or adopt a new behaviour (necessary to making a shift in behaviour)

Question 9

Describe gender, sexual orientation, identity, health, and aging. (3)

Answer 9

• Women live longer, but they experience more years with disability, non-fatal chronic diseases, stress/anxiety, and more frequent users of health care services and facilities
• Gender differences partly reflect women living longer and their cumulative SES disadvantages
• Discrimination and inequalities are key challenges to aging among LGBTQ+

Question 10

What is the relationship of ethnicity to health and aging? (3)

Answer 10

• Immigrants are healthier and live longer
• The longer immigrants live in Canada, the more their health resembles the population
• Immigrants fare worse in accessing health-care (language, health-literacy barriers

Question 11

Describe rural and remote living (2)

Answer 11

• Farther from urban centre, poorer the health
• Insufficient and inefficient health from fragmentation of services, closing of small hospitals, difficulty attracting and keeping health workers, and restructuring and regionalization of health services

Question 12

Explain self-care. (2)

Answer 12

• Seeking health information, examining oneself for disease symptoms, treating oneself for minor ailments with rest, and over-the-counter medication
• Demonstrates independence, empowerment, lower cost of health care, and improved quality of life

Question 13

Explain nutrition weight, and obesity. (2)

Answer 13

• Current level of public pensions are not high enough for a nutritional diet
• Obesity is a result of lifelong of overeating and physical inactivity, associated with chronic illnesses (diabetes, heart disease, arthritis)

Question 14

Explain physical activity. (2)

Answer 14

• Reduces risk of diseases, disability. Increases quality of life and longevity.
• Inactivity more pronounced with women, less, educated, lower incomes, rural areas, and manual occupations

Question 15

Explain smoking.

Answer 15

• Tend to have lower income and education levels
• Higher in Quebec
• Major risk factor for cardiovascular and respiratory disease, and lung cancer

Question 16

List the causes of poor oral health. (4)

Answer 16

• Expense of treatment
• Lack of knowledge
• Inadequate lifelong dental care
• Cognitive impairment

Question 17

Explain mental health.

Answer 17

• 20% of adults have a mental-health issue and 8-% are in institutions
• Women tend to have higher rates
• Results from disease processes or inability to cope with change-related stress
• Often not diagnosed or misdiagnosed (not referred to professionals or don’t seek help)

Question 18

Explain delirium (1) and dementia (3)

Answer 18

• Delirium: fluctuation in consciousness, inability to focus, hallucinations, and bizarre behaviour at random moments
• Dementia: impairs memory, thinking and behaviour; prevalent with women and increases with age; most common is Alzheimer’s (starts with short-term memory loss and slowly destroys cognitive functioning, no simple test to diagnose)

Question 19

Describe suicide in later life. (3)

Answer 19

• Males 85 and older are most at risk
• Increasing rate as longevity increases
• Prevention: monitoring those who live alone or suffered losses, social support, regular contact, encourage professional health

Question 20

Explain Canada’s health care system. (4)

Answer 20

• Universal medicare system was established in 1972, based on Medical Care Act of 1968
• Highly medicalized, bureaucratic, and fragmented, making it difficult to meet changing and complex health-care needs
• Older people account for 50%+ of patients in acute-care hospitals and 45% of health spending
• Older people do not misuse system, Canada just spends 15% of public fund for long-term care

Question 21

What is the anti-aging movement? (2)

Answer 21

• Products, treatments, and procedures aimed to reduce/reverse aging process
• Promotes ageism, is class-based, and requires careful monitoring by gov’t to protect from scammers and side effects of unproven meds and therapies

Question 22

List the barriers to accessing health care. (5)

Answer 22

• Lack of transportation
• Far from needed services
• Language and cognitive deficits
• Part of a vulnerable group
• Cultural differences