2 - Aging in Place Flashcards
What is Home care?
Home care: care that is provided in home-based settings rather than in a hospital or a LTC home; allows individuals to remain independent in the community
- recognized as an extended health services and is not publicly insured under the CHA
- designed to complement, not replace, efforts of individuals to care for themselves
- can be grouped into two types:
1) home care services
- focuses on the provision of health
care services by trained
professionals
2) home support services
- focus on facilitating ADLs and
include non-medical services (e.g.
personal care) - consists of: nursing care, personal care, physiotherapy, occupational therapy, social work , dietetics, speech language therapy, medical equipment and supplies
- 70% is funded by the government through the public health system and the rest is funded by private sources (ie. Supplemental insurance and out-of pocket spending)
- includes acute, chronic, rehabilitative, palliative
Competencies of home health nursing?
- emphasize the independent and autonomous, flexible, and adaptive nature of the HHN, characterized as being “a guest in the home”
The competencies of HHN has 3 categories
1) Elements of HHN
- Focuses on nursing activities, functions, goals, and outcomes central to nursing practice
2) Foundations of HHN
- Focuses on knowledge and the primary care philosophy
3) Quality and professional responsibility
- Focuses on activities and strategies’ by which the HHN promote quality of care and demonstrates professional responsibility
Public Health Nurse VS. Home Health Nurse VS. Community Health Nurse
Public Health Nurse - schools, churches, community health centres, homes
Home Health Nurse - homeschool clinic, shelters, street
Community Health - health centres
Canada spends a significantly larger portion of its care expenditures on…
- institutional LTC rather than home and community care (despite home being overwhelming preferred by Canadians)
How has illness shifted overtime?
- Previously, illness was more acute, for example:
○ Infection
○ Trauma
○ Injury - As of today, illness is more chronic for example:
○ Diabetes and hypertension
- Leads to heart attack/ heart
failure and stroke
○ COPD
○ Osteoarthritis and dementia
Home Care VS. LTC
- Don’t want to live in LTC
- Didn’t plan for it
- Waiting lists
- Costs
- Ageing at home – does not include LTC
What is the National Institute on Aging?
- a public policy and research centre (based at TMU)
- dedicated to enhancing successful ageing across the life course
- considers ageing issues from range of perspectives, including: financial, psychological, and social well-being
Aging: at home, in place, in the right place
Aging at home
- enabling healthy aging in one’s home and community
- refers to the ability to live safely, independently, and comfortably in one’s own home and community, regardless of age, income, or capacity
Aging in place
- term often used by practitioners, policymakers, and researchers
Aging in the right place
- used by organizations/researchers
- the ability to live in a dwelling with the closest fit to the person’s culture, identity, needs and preferences, which may or may not be one’s home
Risks of Aging in Place
- Literally ageing in place…in a chair
- Risk of very limited mobility, extreme isolation
- Barrier of cost for care…cheaper health care
What are the values guiding aging in place?
1) Ensures low-income people can access equitable services
2) Upholds human rights of older persons and based on the engagement of them, their loved ones, caregivers, and care providers
3) Ensures programs and benefits are designed and delivered with empathy in to enhances older person’s dignity and honors their contributions to society
4) Promotes self-expression and empowerment so older persons can make decisions and have choices, including the choice to live at risk
- Live at risk: acknowledges that certain decisions may carry risks— (ie. living independently, managing health conditions) —but empowering individuals to make these choices respects their independence and personal agency.
5) Enhances older persons’ intrinsic capabilities and capacities using a strength-based lens and an asset-based perspective
6) Is person-centred and oriented around the needs of the older person with a team-based (ie. working with PSW’s) and multi-disciplinary approach
7) Ensures the health and social care workforce (care providers) are respected, valued, and appreciated
- Building capacity and competency, having access to training and professional development opportunities
8) Ensures that family, friends, neighbours, and caregivers are respected, acknowledged, valued, supported, and recognized for their contribution to society
9) Ensure that governments at the federal, provincial, territorial, and municipal levels work collaboratively and in partnership and takes overall responsibility for the stewardship of support systems. Sets standards on the quality of care and support and implements evidence-based decision-making
10) Ensures a balance between technology-based (high-tech) approaches and in-person care and support (high-touch)
- It should be conditional to technology acceptance by older persons
- 70 % of people 65+ use the internet
11) Ensures older persons achieve quality of life as they age and receive equitable services, no matter their geographical location
4 Barriers to Aging at Home
1) Availability
2) Accessibility
3) Affordability
4) Accountability
- 4 As have become pillars for policy development
Quality of Life (QOL) framework for Aging in Canada
Recognizes that:
- aging at home requires a holistic effort and a broad range of services/ support
* aging at home should not only aim to help people stay at home, but help people live fulfilling lives
- successful aging at home policy will lead to improved qol indicators for older persons living in the community
Policy Domains of QOL Framework
1) Prosperity
- Income insecurity (particularly women)
- utilize government benefits to facilitate income security
- ex. benefits during COVID
2) Health
- enhance palliative care
- health promotion (e.g. list of ‘9’)
3) Society
- Affordable housing
- Grants/programs that provide longer-term funding for housing
- Support caregivers e.g. funding, caregiver associations
4) Environment
- Technology access
- Digital literacy
- Age-friendly communities
- Local public transportation
5) Good governance
- enacting legislation on home care (ie. implemented national quality standards as done for LTC)
- create national standards for LTC
- prevention of mistreatment/abuse
- Convention on the rights of older persons
How Nurses can enable healthy aging:
- Focus on disease prevention and health promotion
- Invest in a national public awareness campaign and broad disease prevention, health promotion strategy and action plan
- Include disease prevention and health promotion activities: physical, mental and brain health community and work force engagement anti-ageism
safety awareness, etc.
Activities can include: exercise, balance, stress reduction, nutrition and cognitive stimulation
Which of the following is a normal age-related change in older adults?
F. Decreased ability to understand language
T. Reduced lung capacity
F. Increased bone density
F. Enhanced immune response
