Ageing Well or Not So Well Flashcards
What is homeostatic reverse?
The ability of an organism to stabilise its normal internal environment
How does homeostatic reverse change with age?
Gets worse
Do diseases always present the same in the elderly as they would in younger people?
They can present differently
Are normal ranges, such as peak flow rate, affected by age?
Yes they are
Is drug handling affected by age?
Yes it is altered
What are treatable diseases in the elderly often ascribed to?
‘Normal ageing’
What is ageism?
Process of systemic stereotyping and discrimination against people just because they are old
Is the number of elderly people in the world expected to rise or decline?
Rise massively
What are the biggest killers in the worlds poorest countries?
Heart disease
Stroke
Chronic lung disease
Compare and contrast the population distribution of developed and developing regions?
In more developed regions:
- Proportions of older persons (60 and older) increasing and proportions of young people (younger than 15) if falling
- Lower levels of fertility
- Mortality increasing in older population
In less developed regions:
- Smaller proportion of population is elderly compared to more developed regions
- But pace of population ageing is much faster in developing countries than developed countries so they will have less time to adjust to the consequences of population ageing
- Population ageing also taking place at much lower levels of socio-economic development than it would in developed countries
In more developed regions, are the proportions of older people and younger people increasing or decreasing?
Older people - increasing
Younger people - decreasing
Are more developed regions getting higher or lower leveils of fertility?
Lower
By 2050, how is the population expected to change in more developed regions?
By 2050 number of older people in the world expected to exceed younger people, this is due to:
- Decreasing fertility
- Decreasing premature morality
- Due to migration, health education programmes such as those relating to AIDs, malaria prevention, improvements in public health in relation to house, clean water, nutrition
Why is the number of older people in the world expected to exceed younger people by 2050?
- Decreasing fertility
- Decreasing premature morality
- Due to migration, health education programmes such as those relating to AIDs, malaria prevention, improvements in public health in relation to house, clean water, nutrition
What is causing decreasing premature mortaility?
- Due to migration, health education programmes such as those relating to AIDs, malaria prevention, improvements in public health in relation to house, clean water, nutrition
How does the proportion of the population being elderly in less developed countries compared to more developed ones?
- Smaller proportion of population is elderly compared to more developed regions
Is the pace of the population ageing faster in developed or less developed countries?
Less developed countries so have less time to adjust to the consequences of population ageing
How is the population changing in Scotland?
- People are living longer
- More over 50s are living alone, woman being more likely too but the number of men living alone is increasing faster as mens life expectancy increases
What is the large projected rise in older people in Scotland due to?
- ‘Baby boomers’ after WW2 entering their 80s by 2031
- Overall mortality rates are expected to continue to improve
- Older people are increasingly healthy
What impacts will the ageing population have?
- Health
- Increased numbers of geriaticians and health professionals invovled in care of the eldery required
- Increased facilities for elderly health care required
- Care of many long term conditions (such as diabetes, CVD, neurological conditions, renal disease) is moving from secondary care to primary/community care. End stage of these diseases requires as much palliative care as cancer, and prevalence of such diseases will increase as the population ages
- Specific health promotion campaigns aimed at the eldery
- Social
- As population ages they will be increasingly dependent on families and/or carers who are also ageing
- Demand for home carers and nursing home places is likely to increase
- Within local communities will be increasing emphasis on providing social activites for the eldery
- Role of elderly as grandparents and carers of grandchildren is likely to change
- Housing demands are likely to change as more elderly people live alone
- Economic
- Retirement/pension age is already increasing
- Finding employment may become harder for younh people as older people being required to work for longer
- Proportionately less people will be paying into tax and pension funds, making it increasingly difficult to obtain an adequate return from pension funds
- Those elderly who have not contributed to a private pension fund may find that state pension is inadequate, resulting in poverty
- Increasing cost of ‘free personal care for the elderly’ policy in Scotland
- Political
- Current decision making and workforce planning must take into account of the ageing population
Increasing elderly population will potentially have the power to influence political decision making in relation to their specific concerns
What are the different categories of things an ageing population will impact?
Health
Social
Economic
Political
What are impacts of an ageing population on health?
- Increased numbers of geriaticians and health professionals invovled in care of the eldery required
- Increased facilities for elderly health care required
- Care of many long term conditions (such as diabetes, CVD, neurological conditions, renal disease) is moving from secondary care to primary/community care. End stage of these diseases requires as much palliative care as cancer, and prevalence of such diseases will increase as the population ages
- Specific health promotion campaigns aimed at the eldery
What are social impacts of an ageing population?
- As population ages they will be increasingly dependent on families and/or carers who are also ageing
- Demand for home carers and nursing home places is likely to increase
- Within local communities will be increasing emphasis on providing social activites for the eldery
- Role of elderly as grandparents and carers of grandchildren is likely to change
- Housing demands are likely to change as more elderly people live alone
What are economic impacts of an ageing population?
- Retirement/pension age is already increasing
- Finding employment may become harder for younh people as older people being required to work for longer
- Proportionately less people will be paying into tax and pension funds, making it increasingly difficult to obtain an adequate return from pension funds
- Those elderly who have not contributed to a private pension fund may find that state pension is inadequate, resulting in poverty
- Increasing cost of ‘free personal care for the elderly’ policy in Scotland
What are political impacts of an ageing population?
- Current decision making and workforce planning must take into account of the ageing population
- Increasing elderly population will potentially have the power to influence political decision making in relation to their specific concerns
How does the average age very within countries?
Can differ from region to region, such as the Highlands have a greater ageing population than Edinburgh
Are births and deaths increasing or decreasing in Scotland?
Births - decreasing
Deaths - increasing
How does female life expectancy compare to males?
Female’s are 3.6 years greater, but male life expectancy is increasing faster than female
Are rises in life expectancy increasing or starting to slow?
Some studies suggest they are starting to slow
Maybe due to austerity changes
What does austerity changes mean?
Difficut economic conditions created by government measures to reduce public expenditure
What is the leading causes of death for men and woman in England?
Men - heart disease
Woman - dementia and Alzheimer’s disease
(vice versa for 2nd)
What is life expectancy for men and woman in the UK?
Males - 79.5 years
Females - 83.1 years
What is healthy life expectancy for males and females in the UK?
Males - 63.4
Females - 64.1
What has increased by more, life expectancy or healthy life expectancy?
Life expectancy, therefore people are spending more years in poor health
How does sicoeconomic class impact both life expectancy and healthy life expectancy?
Both increase with an increased socioeconomic class
What things have recently put pressure on health and social care systems in the UK?
Combined effects of higher prevalence of long term conditions and older population and spending more years in poor health
What aspects of care are currently trying to be merged together?
Health and social care
Is spending on social care increasing or decreasing?
Increasing, after slowing due to 2008 financial crises
How does a lack of social care impact hospitals?
Lots of patients are stranded in hospitals
Are the number of carers expected to rise or fall?
Rise
x in 5 will be carers at one point in there life?
3 in 5
What are some examples of things carers do?
- Practical help such as preparing meals, doing laundry or shopping
- Keep an eye on the person they care for
- Keep them company
- Take the person out
- Help with financial matters
- Help the person deal with care services and benefits
- Help with aspects of personal care
Most carers care for who?
Parents or parents in law (40%)
Then spouse or partner (26%)
What are some of the impacts of caring?
- Half of carers live in household where no one is in paid work
- 1 in 3 carers had seen a drop of £20000 or more a year in their household due to caring
- 1 in 3 need to cut back on essentials like food and heating
- 1 in 2 carers health is impacted by their financial situations
- Miss out on financial support due to not getting the correct information
- Carers who provide around the clock care are 2x as likely to be in bad health as those who are not carers
- Carers feel society does not think about them at all
What is multimorbidity?
Co-occurence of two or or more chronic conditions
How does multimorbidity change with age?
Number of conditions increases with age
What does multimorbidity lead to?
Polypharmacy
What can be complications of polypharmacy?
Drug interactions and unwanted side effects
Why does multimorbidity add complexity to management?
The preferred treatment for one condition might worsen another
What are some support options that allow for older people to go home after treatment?
- Home with care package?
- Nursing home?
- What about their wishes
- What about family wishes?
What are some options for care following discharge?
- Living in own home with family support
- Living in own home with support from social services
- Sheltered housing
- Residential home
- Nursing home care
What should be done to help decide what care is appropriate?
- Interview with patient and carer
- Issues for carer
- Impact on personal health
- Financial
- What is it like being a carer
- Gaps in service
- How patient feels about being dependent on others
- Issues for carer
- Interview with care manager
- How they ensure that patients are receiving the appropriate level of care
- How they deal with rationing decisions
- What service can they realistically provide
- How do they co-ordinate care
What does ACP stand for?
Anticipatory care plans
What are anticipatory care plans (ACP)?
These are advanced and anticipatory care planning as a philosophy promoting discussion in which individuals, their care providers and those close to them make decisions with respect to their future health or personal and practical aspects of care
When should ACPs be done?
Should be done at any time in life that seems appropriate and continuously
Who can ACPs be done by?
Can be done by anyone with an appropriate relationship
What can ACPs be shared by?
It can be shared by KIS (key information summary)
What does KIS stand for?
Key information summary
What kinds of things do ACPs address?
- Legal
- Welfare power of attorney
- Financial power of attorney
- Guardianship
- Personal
- Statement of wishes regarding treatment/advance directive
- Next of kin
- Consent to pass on information to relevant others
- Preferences and priorities regarding treatment
- Who else to consult/inform
- Preferred place of death
- Religious and cultural beliefs regarding death
- Medical
- Potential problems
- Home care package
- Wishes regarding CPR
- Communication which has occurred with other professionals
- Details of ‘just in case’ medicines
- Electronic care summary
- Assessment of capacity/competence
What legal things do ACPs address?
- Welfare power of attorney
- Financial power of attorney
- Guardianship
What personal things do ACPs address?
- Statement of wishes regarding treatment/advance directive
- Next of kin
- Consent to pass on information to relevant others
- Preferences and priorities regarding treatment
- Who else to consult/inform
- Preferred place of death
- Religious and cultural beliefs regarding death
What medical things do ACPs address?
- Potential problems
- Home care package
- Wishes regarding CPR
- Communication which has occurred with other professionals
- Details of ‘just in case’ medicines
- Electronic care summary
- Assessment of capacity/competence
What is Scottish Index of Multiple Deprivation (SIMD)?
SIMD = 7 factors>
- Income
- Employment
- Education
- Health
- Access to Services
- Crime
- Housing
