Ageing

Question 1

Define Ageism [2]

Answer 1

A process of systematic stereotyping and discrimination [1] against people just because they are old [1]

Question 2

In 2000, the proportion of the world’s population over 60years was 11%. By 2050, it is expected to be:

Answer 2

22%

Question 3

In the period 2000 to 2050, the number of people aged 80 and older will increase:

Answer 3

4-fold

Question 4

By 2050, what percentage of older people will live in low-income and middle-income countries?

Answer 4

80%

Question 5

By 2050, the number of older people who are no longer able to look after themselves is forecast to increase:

Answer 5

4-fold

Question 6

What are some factors which could account for the ageing population (7)

Answer 6

1. Migration
2. Decrease in birth / fertility rates
3. Improvements in housing
4. Improvements in water supplies
5. Improvements in sanitation / sewerage systems
6. Improved safety and reduction of injury
7. War / genocide

Question 7

Discuss the health implications of the ageing population (4)

Answer 7

1. Increased numbers of geriatricians and health professionals involved in care of the elderly will be required.
2. Increased facilities for elderly health care will be required.
3. The prevalence of chronic diseases will increase as the population ages. The end stage of these diseases requires as much palliative care as cancer. So increased funding is needed.
4. Specific health promotion campaigns aimed at the elderly.

Question 8

Discuss the social implications of the ageing population (5)

Answer 8

1. As the population ages, they will be increasingly dependent on families and/or carers who are also ageing.
2. The demand for home carers and nursing home places is likely to increase.
3. Within local communities, there will be increasing emphasis on providing social activities for the elderly.
4. The role of the elderly as grandparents and carers of grandchildren is likely to change.
5. Housing demands are likely to change as more elderly people live alone.

Question 9

Discuss the economic implications of the ageing population (4)

Answer 9

1. Finding employment may become harder for young people, as older people being required to work for longer blocks the “top end” of the employment sector.
2. Proportionately less people will be paying into tax and pension funds, making it increasingly difficult to obtain an adequate return from pension funds.
3. Those elderly who have not contributed to a private pension fund may find that the state pension is inadequate, resulting in poverty.
4. As there are more elderly people there is an increased cost for healthcare for the elderly

Question 10

Discuss the political implications of the ageing population (2)

Answer 10

1. Current decision making and workforce planning must take account of the ageing population.
2. The increasing elderly population will potentially have the power to influence political decision making in relation to their specific concerns.

Question 11

What are the different roles of a carer (from most to least common) (7)

Answer 11

1. Provide practical help: meal prep, laundry or shopping
2. Keep an eye on the person they care for
3. Company
4. Take person out
5. Financial matters
6. Help deal with care services and benefits
7. Help with aspects of personal care

Question 12

What are the different types of carers (5)

Answer 12

1. Children / In-Laws
2. Spouse / Partner
3. Parents looking after disabled children
4. Grandchildren / other relative
5. Neighbour / friend

Question 13

What are the impacts of caring for another on care-givers (6)

Answer 13

1. Drop in household income
2. so having to cut back on essentials like food and heating
3. Financial circumstances affecting health.
4. Missed out on financial support as a result of not getting the right information and advice.
5. Worried about the impact of caring on their relationships with friends and family.
6. Feel society does not think about them at all

Question 14

Definition of multi-morbidity

Answer 14

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

Question 15

Options for care (5)

Answer 15

1. Living in own home with support from family
2. Living in own home with support from social services
3. Sheltered Housing
4. Residential Home
5. Nursing Home Care

Question 16

What legal aspects need to be considered with anticipatory care planning (3)

Answer 16

1. Welfare power of attorney
2. Financial power of attorney
3. Guardianship

Question 17

What personal aspects need to be considered with anticipatory care planning (8)

Answer 17

1. Statement of wishes regarding treatment/advance directive
2. Next of kin
3. Consent to pass on information to relevant others
4. Preferences and priorities regarding treatment
5. Who else to consult/inform
6. Preferred place of death
7. Religious and cultural beliefs re death
8. Current level of support e.g. family/carers

Question 18

What medical aspects need to be considered with anticipatory care planning (9)

Answer 18

1. Potential problems
2. Home care package
3. Wishes re DNA CPR
4. Scottish Palliative Care Guidelines
5. Communication which has occurred with other professionals
6. Details of “just-in-case” medicines
7. Electronic care summary
8. Assessment of capacity/competence
9. Current aids and appliances (helps assess current functional level)

Question 19

What is anticipatory care plans [2]

Answer 19

Promotes discussion in which individuals, their care providers and often those close to them, [1] make decisions with respect to their future health or personal and practical aspects of care [1]

Question 20

List five points relating to the proactive care resulting from anticipatory care planning.

Answer 20

Patient on GP palliative care register and discussed at team meetings.
Information on social and financial support given to patients and their carers and referral to relevant team members to facilitate provision of this.
Usual GP and District Nurse support visits and phone calls.
Assessment of symptoms and partnership with specialists to customise care to patient and carer needs.
Overall 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/LCP used.
Dies in preferred place, family bereavement support.
Staff reflect - SEA, audit, gaps in care identified, learn, improve care.