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Flashcards in Ageing Well or Not So Well Deck (62)
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1

What is homeostatic reverse?

The ability of an organism to stabilise its normal internal environment

2

How does homeostatic reverse change with age?

Gets worse

3

Do diseases always present the same in the elderly as they would in younger people?

They can present differently

4

Are normal ranges, such as peak flow rate, affected by age?

Yes they are

5

Is drug handling affected by age?

Yes it is altered

6

What are treatable diseases in the elderly often ascribed to?

'Normal ageing'

7

What is ageism?

Process of systemic stereotyping and discrimination against people just because they are old

8

Is the number of elderly people in the world expected to rise or decline?

Rise massively

9

What are the biggest killers in the worlds poorest countries?

Heart disease

Stroke

Chronic lung disease

10

Compare and contrast the population distribution of developed and developing regions?

In more developed regions:

  • Proportions of older persons (60 and older) increasing and proportions of young people (younger than 15) if falling
  • Lower levels of fertility
  • Mortality increasing in older population

In less developed regions:

  • Smaller proportion of population is elderly compared to more developed regions
  • But pace of population ageing is much faster in developing countries than developed countries so they will have less time to adjust to the consequences of population ageing
  • Population ageing also taking place at much lower levels of socio-economic development than it would in developed countries

 

11

In more developed regions, are the proportions of older people and younger people increasing or decreasing?

Older people - increasing

Younger people - decreasing

12

Are more developed regions getting higher or lower leveils of fertility?

Lower

13

By 2050, how is the population expected to change in more developed regions?

By 2050 number of older people in the world expected to exceed younger people, this is due to:

  • Decreasing fertility
  • Decreasing premature morality
    • Due to migration, health education programmes such as those relating to AIDs, malaria prevention, improvements in public health in relation to house, clean water, nutrition

14

Why is the number of older people in the world expected to exceed younger people by 2050?

  • Decreasing fertility
  • Decreasing premature morality
    • Due to migration, health education programmes such as those relating to AIDs, malaria prevention, improvements in public health in relation to house, clean water, nutrition

15

What is causing decreasing premature mortaility?

  • Due to migration, health education programmes such as those relating to AIDs, malaria prevention, improvements in public health in relation to house, clean water, nutrition

16

How does the proportion of the population being elderly in less developed countries compared to more developed ones?

  • Smaller proportion of population is elderly compared to more developed regions

17

Is the pace of the population ageing faster in developed or less developed countries?

Less developed countries so have less time to adjust to the consequences of population ageing

18

How is the population changing in Scotland?

  • People are living longer
  • More over 50s are living alone, woman being more likely too but the number of men living alone is increasing faster as mens life expectancy increases

19

What is the large projected rise in older people in Scotland due to?

  • ‘Baby boomers’ after WW2 entering their 80s by 2031
  • Overall mortality rates are expected to continue to improve
  • Older people are increasingly healthy

20

What impacts will the ageing population have?

  • Health
    • Increased numbers of geriaticians and health professionals invovled in care of the eldery required
    • Increased facilities for elderly health care required
    • Care of many long term conditions (such as diabetes, CVD, neurological conditions, renal disease) is moving from secondary care to primary/community care. End stage of these diseases requires as much palliative care as cancer, and prevalence of such diseases will increase as the population ages
    • Specific health promotion campaigns aimed at the eldery
  • Social
    • As population ages they will be increasingly dependent on families and/or carers who are also ageing
    • Demand for home carers and nursing home places is likely to increase
    • Within local communities will be increasing emphasis on providing social activites for the eldery
    • Role of elderly as grandparents and carers of grandchildren is likely to change
    • Housing demands are likely to change as more elderly people live alone
  • Economic
    • Retirement/pension age is already increasing
    • Finding employment may become harder for younh people as older people being required to work for longer
    • Proportionately less people will be paying into tax and pension funds, making it increasingly difficult to obtain an adequate return from pension funds
    • Those elderly who have not contributed to a private pension fund may find that state pension is inadequate, resulting in poverty
    • Increasing cost of ‘free personal care for the elderly’ policy in Scotland
  • Political
    • Current decision making and workforce planning must take into account of the ageing population

Increasing elderly population will potentially have the power to influence political decision making in relation to their specific concerns

21

What are the different categories of things an ageing population will impact?

Health

Social

Economic

Political

22

What are impacts of an ageing population on health?

  • Increased numbers of geriaticians and health professionals invovled in care of the eldery required
  • Increased facilities for elderly health care required
  • Care of many long term conditions (such as diabetes, CVD, neurological conditions, renal disease) is moving from secondary care to primary/community care. End stage of these diseases requires as much palliative care as cancer, and prevalence of such diseases will increase as the population ages
  • Specific health promotion campaigns aimed at the eldery

23

What are social impacts of an ageing population?

  • As population ages they will be increasingly dependent on families and/or carers who are also ageing
  • Demand for home carers and nursing home places is likely to increase
  • Within local communities will be increasing emphasis on providing social activites for the eldery
  • Role of elderly as grandparents and carers of grandchildren is likely to change
  • Housing demands are likely to change as more elderly people live alone

24

What are economic impacts of an ageing population?

  • Retirement/pension age is already increasing
  • Finding employment may become harder for younh people as older people being required to work for longer
  • Proportionately less people will be paying into tax and pension funds, making it increasingly difficult to obtain an adequate return from pension funds
  • Those elderly who have not contributed to a private pension fund may find that state pension is inadequate, resulting in poverty
  • Increasing cost of ‘free personal care for the elderly’ policy in Scotland

25

What are political impacts of an ageing population?

  • Current decision making and workforce planning must take into account of the ageing population
  • Increasing elderly population will potentially have the power to influence political decision making in relation to their specific concerns

26

How does the average age very within countries?

Can differ from region to region, such as the Highlands have a greater ageing population than Edinburgh

27

Are births and deaths increasing or decreasing in Scotland?

Births - decreasing

Deaths - increasing

28

How does female life expectancy compare to males?

Female's are 3.6 years greater, but male life expectancy is increasing faster than female

29

Are rises in life expectancy increasing or starting to slow?

Some studies suggest they are starting to slow

Maybe due to austerity changes

30

What does austerity changes mean?

Difficut economic conditions created by government measures to reduce public expenditure

31

What is the leading causes of death for men and woman in England?

Men - heart disease

Woman - dementia and Alzheimer's disease

(vice versa for 2nd)

32

What is life expectancy for men and woman in the UK?

Males - 79.5 years

Females - 83.1 years

33

What is healthy life expectancy for males and females in the UK?

Males - 63.4

Females - 64.1

34

What has increased by more, life expectancy or healthy life expectancy?

Life expectancy, therefore people are spending more years in poor health

35

How does sicoeconomic class impact both life expectancy and healthy life expectancy?

Both increase with an increased socioeconomic class

36

What things have recently put pressure on health and social care systems in the UK?

Combined effects of higher prevalence of long term conditions and older population and spending more years in poor health

37

What aspects of care are currently trying to be merged together?

Health and social care

38

Is spending on social care increasing or decreasing?

Increasing, after slowing due to 2008 financial crises

39

How does a lack of social care impact hospitals?

Lots of patients are stranded in hospitals

40

Are the number of carers expected to rise or fall?

Rise

41

x in 5 will be carers at one point in there life?

3 in 5

42

What are some examples of things carers do?

  • Practical help such as preparing meals, doing laundry or shopping
  • Keep an eye on the person they care for
  • Keep them company
  • Take the person out
  • Help with financial matters
  • Help the person deal with care services and benefits
  • Help with aspects of personal care

43

Most carers care for who?

Parents or parents in law (40%)

Then spouse or partner (26%)

44

What are some of the impacts of caring?

  • Half of carers live in household where no one is in paid work
  • 1 in 3 carers had seen a drop of £20000 or more a year in their household due to caring
  • 1 in 3 need to cut back on essentials like food and heating
  • 1 in 2 carers health is impacted by their financial situations
  • Miss out on financial support due to not getting the correct information
  • Carers who provide around the clock care are 2x as likely to be in bad health as those who are not carers
  • Carers feel society does not think about them at all

45

What is multimorbidity?

Co-occurence of two or or more chronic conditions

46

How does multimorbidity change with age?

Number of conditions increases with age

47

What does multimorbidity lead to?

Polypharmacy

48

What can be complications of polypharmacy?

Drug interactions and unwanted side effects

49

Why does multimorbidity add complexity to management?

The preferred treatment for one condition might worsen another

50

What are some support options that allow for older people to go home after treatment?

  • Home with care package?
  • Nursing home?
  • What about their wishes
  • What about family wishes?

51

What are some options for care following discharge?

  • Living in own home with family support
  • Living in own home with support from social services
  • Sheltered housing
  • Residential home
  • Nursing home care

52

What should be done to help decide what care is appropriate?

  • Interview with patient and carer
    • Issues for carer
      • Impact on personal health
      • Financial
      • What is it like being a carer
      • Gaps in service
    • How patient feels about being dependent on others
  • Interview with care manager
    • How they ensure that patients are receiving the appropriate level of care
    • How they deal with rationing decisions
    • What service can they realistically provide
    • How do they co-ordinate care

53

What does ACP stand for?

Anticipatory care plans

54

What are anticipatory care plans (ACP)?

These are advanced and anticipatory care planning as a philosophy promoting discussion in which individuals, their care providers and those close to them make decisions with respect to their future health or personal and practical aspects of care

55

When should ACPs be done?

Should be done at any time in life that seems appropriate and continuously

56

Who can ACPs be done by?

Can be done by anyone with an appropriate relationship

57

What can ACPs be shared by?

It can be shared by KIS (key information summary)

58

What does KIS stand for?

Key information summary

59

What kinds of things do ACPs address?

  • Legal
    • Welfare power of attorney
    • Financial power of attorney
    • Guardianship
  • Personal
    • Statement of wishes regarding treatment/advance directive
    • Next of kin
    • Consent to pass on information to relevant others
    • Preferences and priorities regarding treatment
    • Who else to consult/inform
    • Preferred place of death
    • Religious and cultural beliefs regarding death
  • Medical
    • Potential problems
    • Home care package
    • Wishes regarding CPR
    • Communication which has occurred with other professionals
    • Details of ‘just in case’ medicines
    • Electronic care summary
    • Assessment of capacity/competence

60

What legal things do ACPs address?

  • Welfare power of attorney
  • Financial power of attorney
  • Guardianship

61

What personal things do ACPs address?

  • Statement of wishes regarding treatment/advance directive
  • Next of kin
  • Consent to pass on information to relevant others
  • Preferences and priorities regarding treatment
  • Who else to consult/inform
  • Preferred place of death
  • Religious and cultural beliefs regarding death

62

What medical things do ACPs address?

  • Potential problems
  • Home care package
  • Wishes regarding CPR
  • Communication which has occurred with other professionals
  • Details of ‘just in case’ medicines
  • Electronic care summary
  • Assessment of capacity/competence