Ageing

Question 1

What sort of medical factors may alter with age?

Answer 1

• Homeostatic reserve
• Disease presentation
• Normal ranges
• Drug handling

Question 2

What sort of factors may affect treatment of the elderly?

Answer 2

• Treatable disease being ascribed to normal aging
• Ageism
• Changes not being seen as worthwhile

Question 3

What is the general change in the population in terms of age?

Answer 3

Ageing population, decreasing proportions of young

Question 4

What factors are resulting in increasing the older population?

Answer 4

Lower levels of fertility

Lower levels of mortality

Question 5

Where is the pace of population faster - developed or developing countries?

Answer 5

Developing countries

Question 6

What are the two main reasons rapid ageing of the population is expected to take place?

Answer 6

• Baby boomers will become older

- Mortality rates improve due to preserving health and fitness.

Question 7

What are the healthcare implications of an ageing population?

Answer 7

• Need for more geriatricians/care of the elderly professionals
• Increased facilities for elderly healthcare needed
• More long-term, palliative conditions in primary care
• Specific health promotion campaigns aimed at the elderly

Question 8

What are the social implications of an ageing population?

Answer 8

• Dependency on family/carers
• Increasing demand for home carers/nursing home placements
• Increasing emphasis on social activities for the elderly
• Family role changes
• Housing demands changing

Question 9

What are the political implications of an ageing population?

Answer 9

• Must take into account ageing population

- Will have the power to influence political decision making in relation to their specific concerns

Question 10

What are the economic implications of an ageing population?

Answer 10

• Finding employment may become harder for younger people
• Proportionally less people will be paying into tax and pension funds
• Poverty due to inadequate state pension
• Increasing cost of ‘free personal care for the elderly’ policy

Question 11

What is the general trend with birth rate?

Answer 11

It is falling

Question 12

What is the general trend with life expectancy?

Answer 12

Increasing (faster in males)

Difference of 3.6yrs between males and females

Question 13

What is the leading cause of death for women in England?

Answer 13

Dementia and Alzheimer’s

Question 14

What is the leading cause of death for men in England?

Answer 14

Heart disease

Question 15

What is the life expectancy for males in england?

Answer 15

79.5

Question 16

What is the life expectancy for females in england?

Answer 16

83.1

Question 17

What is the healthy life expectancy for men?

Answer 17

63.4

Question 18

What is the healthy life expectancy for women?

Answer 18

64.1

Question 19

What does lower SES do to average life expectancy and average healthy life expectancy?

Answer 19

Decreases both

Question 20

How many people will be carers at some point in their lives?

Answer 20

3 in 5

Question 21

What sort of help may carers provide to those they support?

Answer 21

• Practical help such as preparing meals, shopping, laundry
• Keeping an eye on them
• Keeping them company
• Taking them out
• Help them with financial matters
• Help them deal with care services and benefits
• Help them with aspects of personal care

Question 22

What type of family member do most carers care for?

Answer 22

Parents/parents-in-law

Question 23

What are some impacts of caring?

Answer 23

• Unemployment
• Drops in household income, poverty
• Effects on health
• Missing out on financial support
• Impacts on relationships
• Feeling forgotten by society

Question 24

What defines multimorbidity?

Answer 24

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

Question 25

How does multimorbidity complicate treatment?

Answer 25

Adds complexity to treatment

-preferred treatment for one condition may worsen another

Question 26

What would be the adverse impacts of stopping calcium channel blocker?

Answer 26

Worsening hypertension, increased exertional chest pain

Question 27

What would be the adverse impacts of stopping beta blocker?

Answer 27

Worsening heart failure over long term,

increased exertional chest pain

Question 28

What options exist for care?

Answer 28

• Living in own home with support from family/social services
• Daycare centre support/respite care
• Sheltered housing/Very
• Residential Home
• Nursing Home Care
• Specialist units
• Hospital admissions

Question 29

What is the advantage of anticipatory care planning (ACP)?

Answer 29

Promotes discussion in which individuals, care providers etc can make decisions with respect to their future health/personal/practical aspects of care.

Question 30

How should an ACP be done?

Answer 30

• Thinking ahead and making plans

- Written down

Question 31

How can an ACP be shared?

Answer 31

• KIS (Key Information Summary)

- Other communication

Question 32

Give some examples of legal anticipatory care planning?

Answer 32

Welfare power of attorney
Financial power of attorney
Guardianship

Question 33

Give some examples of personal anticipatory care planning?

Answer 33

• Statement of wishes/Advanced directive
• Next of kin
• Consent to pass on info
• Preferences and priorities regarding treatment
• Who else to consult/inform
• Preferred place of death
• Religious and cultural beliefs
• Current level of support

Question 34

Give some examples of medical anticipatory care planning?

Answer 34

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