Tutorial 4: Ageing and Multi-Morbidity Flashcards

1
Q

What happens to homeostatic reserve in later life?

A

Decreases

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2
Q

What is ageism?

A

A process of systematic stereotyping and discrimination against people because of their age.

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3
Q

Demographics of old people

A

2000 - 11% of population over 60
2050 - 22% of population over 60
2000-2050: 4-fold increase in population over 80
By 2050 80% of over 60s will live in lower or middle income countries
From 2000-2050 number of people unable to care for themselves will increase 4-fold

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4
Q

What features make up a population demographics charts?

A
X-Axis: Percentage
Y-Axis: Age
2000 looks like a labia majora
2050 looks like a penis
Less young people
More old people
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5
Q

Why are we undergoing a change in population demographics?

A

Low levels of fertility

Low levels of mortality

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6
Q

By 2050 what significant event is to have happened?

A

Number of old people (>60) is to have surpassed the number of young people (<15)

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7
Q

What is the fastest growing age group?

A

Over 80s

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8
Q

A

Between 2004 and 2031:
Age groups between 0-49 are projected to decrease
Age groups 50+ are projected to increase

This is due to baby boomers born post WW-II will be reaching their 80s whilst mortality rates remain to fall and life expectancy increases

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9
Q

What effect does an ageing population have on health?

A
  • Increased number of geriatricians
  • Increased facilities for care of the elderly required
  • Care of long-term conditions moving from secondary to primary care
  • Prevalence of chronic disease will increase
  • Increase in specific health promotion campaigns aimed at the elderly
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10
Q

What are the social effects of an ageing population?

A
  • Increasing dependence of elderly relatives on families
  • The demand for home carers and nursing home places increasing
  • Increasing emphasis on provision of social activities for the elderly
  • Role between grandparents and grandchildren likely to change - grandchildren acting as carers
  • Housing demands are likely to change as an increased number of elderly people live alone
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11
Q

What are the economic effects of an ageing population?

A
  • Retirement/pension ages increasing
  • More difficulty in finding employment for younger people
  • Proportionately less people paying taxes and into pension funds
  • Elderly people who haven’t contributed to a private pension fund may find that the state pension is inadequate, resulting in poverty
  • Increasing cost of ‘free personal care for the elderly’ policy
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12
Q

What are the political effects of an ageing population?

A
  • Current decision-making and workforce planning has to take the ageing population into account
  • Increased proportion of elderly people could potentially have the power to influence political decision making in relation to their specific concerns
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13
Q

What is ‘multi-morbidity’?

A

The co-existence of two or more long-term conditions in an individual

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14
Q

What are the options for care in elderly patients who are unable to care for themselves at home?

A
Own home with support from family
Own home with support from social services 
Sheltered housing
Residential home
Nursing care home
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15
Q

What is an anticipatory care plan?

A

Advance and anticipatory care planning, as a philosophy, promotes discussion in which individuals, their care providers and often those close to them, make decisions with respect to their future health or personal and practical aspects of care.

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16
Q

When should an anticipatory care plan be organised?

A

Any time that it seems appropriate

Continuously

17
Q

Who should be involved in an anticipatory care plan?

A

Anyone with an appropriate relationship

18
Q

How should an anticipatory care plan be made?

A

Thinking ahead and making plans

It should be written

19
Q

How can it be shared amongst the relevant care providers?

A

Key information summary

20
Q

What aspects are there to an anticipatory care plan?

A

Legal:

  • Power of attourney
  • Guardianship

Personal:

  • Statement of values
  • Preferences and priorities
  • Advance decision to refuse treatment
  • Who else to consult

Medical

21
Q

List some of the stages of a reactive care journey

A
  • GPs, district nurses, ad hoc arrangements
  • No discussion with family on condition, outlook anticipated problems, place of care
  • Problems with pain, sickness, constipation, anxiety
  • Crisis call to Out of Hours Service
  • Admission to hospital
  • Death in hospital post CPR
  • Family given minimal support in grief
  • No reflection by professional care team
22
Q

List some of the stages of a proactive care journey

A
  • On GP register - discussed at team meeting
  • Social, financial support and information given to patient and carers
  • Usual GP and DN proactive support visits
  • Assessment of symptoms, partnership with specialists - customised care for patient needs
  • Care assessed including respite and psychosocial needs
  • Preferred place of care noted and organised
  • Care plan and medication issued for home
  • End of life pathway
  • Dies in preferred place, family bereavement support
  • Staff reflect SEA, audit gaps improve care