Ageing + Caring Flashcards
What is the average life expectancy in the UK? (M/F)
What % UK population is over 65
What % inpatients are over 65
What % of over 65s are in care home
M: 80; F: 83
18% UK pop >65
65% inpatients (2/3rd) >65
5% of over 65s in care home
What chronic conditions can be helped/prevented by physical activity (7)
HTN
Dyslipidaemia
DM
Obesity
Osteoporosis
Osteoarthritis
Sarcopenia
What is the global prevalence of physical inactivity in adults?
How does this compare to the prevalences of smoking/HTN
17%
UK prevalence of physical inactivity (higher)
= Twice as much as prevalence of HTN/Smoking
List some benefits of physical activity in elderly people (8)
Reduce mortality of all CV/DM causes
Slowed cognitive decline
Social opportunities
Delay need for nursing home
Improve strength/balance/coordination:
Reduce falls
Reduce immobility complications
Maintain ADL independance
What % >75s do recommended physical activity levels
What % >80s are sedentary
What % >65s cannot walk independently / manage stairs
What % >65s have insuff quads to stand from chair
9% men + 4% women >75 do recomm. physical activity
40% men + 65% women >80 are sedentary
12% >65s cannot walk independently
9% can’t manage stairs
30% men + 50% women >65 insuff quads
What aspects of functional capacity change/worsen with age (8)
Muscle strength (1-3% loss/yr) Muscle power (3-4% loss/yr) Proprioception Kinesthetic awareness Thermoregulation Aerobic capacity (10% loss/10yrs) Loss of flexibility (+ balance) Loss of bone density (1%/yr men + 2-3%/yr women)
What are the 3 Categories of people in the Heidlberg WHO Framework (of physical function)
Physically unfit-unhealthy dependant:
Could enhance QoL/restore indépendance w. physical
Physically unfit-unhealthy dependant:
Still living indep but doesn’t do adequate physical
Physically fit-healthy
Adequate physical + ADL independent
Describe the Hierachy of Physical Function groups (5)
Elite Fit Independent Frail Dependant
What types of activity can be recommended for the elderly? (5)
Strength + Balance exercises (e.g. aqua aerobic, tai-chi)
Muscle power + strength exercises
Flexibility exercises
Cardio
Bone exercises (anti-gravity, in fracture sites)
What % adults are unpaid carers? (+ M/F)
What is the peak age of being a carer?
12.5% (1/8) adults unpaid carers - 58% women/42% men
Peak age - 50-59
What are the adverse health impacts of being a carer? + give some stats behind this
85% -ve physical effects (e.g. man handling injuries)
and -ve mental effects (stress/depression)
40% put off own GP/Tx
What are the adverse social impacts of being a carer?
What % care ± family / ± social services?
Social isolation
40% no day off in 18m/ holiday in 5yrs
37% no fam + no social services
29% fam but no social services
What is the average life expectancy in a nursing home VS in a residential home
Nursing home = 1yr
Residential = 2yrs
What % residents in care homes...: Cognitive impairment Urinary incontinence Bed bound Behavioural Sx Risk of malnutrition Malnourished
50-75% cog impaired
50-75% incontinent
25-50% bedbound
66% (2/3) behavioural Sx
56% malnutrition risk
30% malnourished
List the domains of a CGA (6)
Medical (co-morbs/ meds/ nutrition/ problem list)
Psychological (cognition / mood / fears)
Functional (core funcs e.g. balance, ADLs, pts life roles)
Social (networks / statutory care)
Environmental (home/ transport facilities/ technology)
When is a CGA used? (IIII)
Instability (falls)
Immobility
Incontinence
Intellectual impairment (delirium/dementia)
What is defined as ‘approached end of life’?
= likely to die within 12m (inc. where death imminent)
And those with:
- Advanced/progressive/incurable conditions
- General frailty w. co-existing conditions
- Existing conditions w. risk of sudden acute crisis
- Life threatening acute condition (from catastrophic event)
List some indicators of decline (regarding terminal care) (10)
Co-morbidities** Physical decline Advanced disease Reduced activity Reduced Tx response
Sentinel event e.g. fall, bereavement Repeated admissions (unplanned) Choice of no further Tx Wt loss >10% in 6m Serum albumin <25
List the domains of the ICF (International Classification of Functioning + Health Framework) (5)
List the advantages over previously used classifications of Disability
Health Condition:
Body Functions+Structures / Activity / Participation
Contextual Factors:
Environmental factors / Personal factors
ICF recognises disability as a universal experience, not just based on medical but taking account of social/environment aspects of disability
What are the indicators of severe frailty (7)
Deteriorating functional score (Barthel's) Combo of ≥3: Depression Weakness Slow walking Signif wt loss Exhaustion Low physical activity
List some drugs used for Sx control in palliative care (5)
Morphine (pain + breathlessness)
Midazolam (agitation + breathlessness)
Levopromazine (agitation + N+V)
Hyoscine/Butylbromide (resp tract secretions)
What is the prevalence of elder abuse in the community + residential care
Which groups of people is the abuse from
4% prevalence
(5% verbal; 2% physical; 2% financial)
US study suggests 5-10% in residential care
Partners (35%) / Family (35%) / Neighbours etc (35%)
+ more
Who should be contacted if suspect Elder Abuse
Safeguarding! Police!
Medic/ nurse/ social worker / psychiatrist
