4 - Healthy Aging and Centred Care

Question 1

The importance of culture in aging is due to 3 issues:

Answer 1

1) realization of a “gerontological explosion”
- Gerontological explosion is the rapid increase in the total # of older adults, and to the high proportion of older adults in most countries

2) impact of Cdn policies of multiculturalism

3) recognition of health disparities for minorities

Question 2

How do health disparities affect health?

Answer 2

• Health disparities refers to the differences in disease burden between groups of people
• factors related to health disparities are: Indigenous identity, low SES, sexual & gender minority identity, racism, immigrant status, & living with a functional limitation

Question 3

Health disparities for ethnic minorities

Answer 3

• language barriers
• cultural values and beliefs that can influence the seeking of health care
• lack of interpretation services
• absence of culturally specific programs
• lack of health care providers who understand the culture

Question 4

What is the healthy migrant effect?

Answer 4

• recent immigrants have better health than long-term immigrants because of Canadian immigration policies

Question 5

How can we reduce health inequities?

Answer 5

• using an intersectional approach that considers the intersection of sources of inequity and older adults’ multiple identities

i.e. age, race, ethnicity, Indigeneity, gender identity, sexual orientation, language, disability, and religion - and the power imbalances that perpetuate these inequities

Question 6

Relationship bw Loneliness and Health

Answer 6

• bi-directional relationship
• means that poor health can also lead to increased social isolation and loneliness, while social isolation and loneliness can lead to poor health outcomes
• the impact of social isolation and loneliness on mortality rates is comparable to other risk factors: smoking, lack of physical activity, obesity, substance abuse, injury and violence, and lack of access to health care

Question 7

Social Isolation vs. Loneliness

Answer 7

Social isolation
- an objective lack of contacts, family or friends

Loneliness
- an internal subjective experience; it is an unpleasant sensation felt when a person’s social relationships are lacking in quality and/or quantity compared to what they desire
- reactions to the absence of intimate and social needs
- Those reporting loneliness appear to lack meaningful connections with others

Question 8

Risk Factors of Loneliness

Answer 8

• Age
• Ageing in Place vs. independent/isolation
• Relationships
• Immigration (social disruption, access services, language)
• Education
• Gender

Question 9

Impact of Loneliness/ Social Isolation on Older Adults

Answer 9

• Mood disorders
• dementia
• cardiovascular disease
• malnutrition
• falls
• premature mortality

Question 10

Behavioural Impacts of Loneliness

Answer 10

Physical activity

Nutrition
- Increases risk of comorbidities

Sleep
- Sleep problems increase as you age

Alcohol (or substances)
- How we process medication and alcohol changes with age

Question 11

Physical Impacts of Loneliness

Answer 11

• Risk of motor decline (this is both a risk factor and outcome r/t loneliness)
• Potential to increase risk of hypertension, possible immune response

Question 12

Mental Health Impacts of Loneliness

Answer 12

• Risk for depression and anxiety
• Social networks and risk r/t cognition/cognitive decline

To delay cognitive decline, build and have strong social connections

Question 13

Sexuality and the Older Adult

Answer 13

• Stereotypes of older adults being asexual or less sexual beings may cause personal embarrassment and stigma
• Where and with whom one lives impacts sexual intimacy of older adults
  E.g. living in one’s own home; moving in with family, renting a room or home; group housing such as residential care facilities

Question 14

Sympathy VS. Empathy VS. Compassion

Answer 14

Sympathy
- pity-based response to a distressing situation
- characterized by a lack of relational understanding and the self-preservation of the observer
- does nothing for the person suffering

Empathy
- acknowledge suffering but to feel with the person and attempt to understand them in the process

Compassion
- not ‘doing unto others as you would have them do unto you’ but ‘doing unto others as they would want done unto themselves’
- unlike sympathy or empathy, compassion requires action, and involves not simply observing and feeling for the person in suffering but taking action to alleviate a persons suffering
- Actively listen, kind, loving, genuinely seek to understand needs, put ego aside to actively engage