Ageing Well, or Not so Well Flashcards
Homeostatic reserve (the ability of an organism to stabilise its normal internal environment) is the same in the elderly as in early and middle adult life: True or False
False
Disease always presents in the same way in the elderly as it does in younger adults: True or False
False
Normal ranges e.g. peak flow rate, are affected by age: True or False
True
Drug handling alters with age: True or False
True
Treatable disease in the elderly is frequently ascribed to “normal ageing”: True or False
True
Define ageism.
A process of systematic stereotyping and discrimination against people just because they are old.
Lifestyle changes in old age are not worthwhile as they produce no significant health benefits: True or False
False
In 2000, the proportion of the world’s population over 60years was 11%. By 2050, it is expected to be: A 8% B 15% C 22% D 40%
C 22%
In the period 2000 to 2050, the number of people aged 80 and older will increase: A 2-fold B 3-fold C 4-fold D 5-fold
C 4-fold
By 2050, what percentage of older people will live in low-income and middle-income countries? A 80% B 65% C 50% D 35%
A 80%
In the world’s poorest countries, the “biggest killers” are:
A) Cholera and dysentery
B) Heart disease, stroke and chronic lung disease
C) Malaria
D) Sleeping sickness
B) Heart disease, stroke and chronic lung disease
Older people in low-income and middle-income countries carry a greater disease burden than those in the rich world: True or false?
True
By 2050, the number of older people who are no longer able to look after themselves is forecast to increase: A Not at all B 2-fold C 3-fold D 4-fold
D 4-fold
Worldwide, most training for health professionals includes instruction about specific care for older people:
True or False
False
Creating “age-friendly” physical and social environments does not improve the active participation and independence of older people:
True or False
False
A 63 year old patient who gives up smoking will decrease their risk of premature death by: A 50% B 40% C 30% D 20%
A 50%
How has age distribution changed from 1950 to 2000 to 2050 (predicted) in more developed regions (UK,USA, Canada, Australia, Japan)?
1950 = Young population, traditional pyramid shape
2000 = Ageing population (Highest between 40-60), shape = Thin, thick, thin.
2050 = Ageing population
(Highest between +60)
shape = Square, slight increase +60, thin.
In more developed regions what has happened to growth rate in populations, total?
Small increase but by 2050
Decrease overall
In more developed regions what has happened to growth rate in populations, +60?
Increase
In more developed regions what has happened to growth rate in populations, +70?
Increase
In more developed regions what has happened to growth rate in populations, +80?
Increase
In more developed regions what has happened to total fertility rate?
Gradual decrease in fertility
In more developed regions what has happened to life expectancy?
Increase
How has age distribution changed from 1950 to 2000 to 2050 (predicted) in Less developed regions (Iraq, Thailand, Jamaica, Ukraine)?
1950 = Young population, traditional pyramid shape
2000 = Slight change with a more ageing population, traditional pyramid still
2050 = Ageing population
(Highest between +60)
shape = Square, +60, thinning.
How would you describe population in less developed regions?
Population ageing is enduring.
What is the fastest growing age group in the world?
The +80 age band
Where is population ageing the quickest?
What consequence does this have?
The developing countries than developed countries
Developing countries will have less time to adjust to the consequences of population ageing. Moreover, population ageing in the developing countries is taking place at much lower levels of socio-economic development than was the case in developed countries.
In less developed regions what has happened to growth rate in populations, total?
Gradual decrease in growth rate overall but increase in the elderly
In more developed regions what has happened to total fertility rate?
Fertility is decreasing
In least developed regions what has happened to total fertility rate?
Increasing
In least developed regions what has happened to total fertility rate?
Higher than developed world but slowly decreasing
In least developed regions what has happened to life expectancy?
Lower than the less developed (64, 2000; 75, 2050) well but is slowing increasing (51, 2000; 70, 2050)
In less developed regions what has happened to life expectancy?
Lower than developed world (75, 2000; 82, 2050) but increasing (64, 2000; 75, 2050)
In less developed regions what has happened to life expectancy?
Lower than developed world (75, 2000; 82, 2050) but increasing (64, 2000; 75, 2050)
What is the life expectancy for those born 2004 versus 2031 in Scotland?
2004:
74. 3 years for males
79. 4 years for females
2031:
- 2 years for males
- 7 years for females
Within Scotland what has happened to net migrations?
> Prior to 1960s = Net-out
1960s = Decrease net-out
Post 1980s = Net-gain
Between 2004 and 2031:
The number of children aged under 16 is projected to?
decrease by 15%
Between 2004 and 2031:
The number of people aged 16-29 is projected to?
fall by 12%
Between 2004 and 2031:
The number of people aged 30-49 is projected to?
decrease by 17%
Between 2004 and 2031:
The number of people aged 50 and over is projected to?
increase by 28%
Between 2004 and 2031:
The number of people aged 65 and over is projected to ?
rise by 58%
Between 2004 and 2031:
The number of people aged 75 and over is projected to ?
rise by 75%
What is the main reason for the rise in elderly population in Scotland?
1) The baby boomers born after the Second World War will be entering their early 80s by 2031 and overall mortality rates are expected to continue to improve.
2) Older people are increasingly healthy, and there is an increasing emphasis on preserving health and fitness into old age.
Health implications of an ageing population?
> Increased numbers of geriatricians and health professionals involved in care of the elderly will be required.
> Increased facilities for elderly health care will be required.
> The care of many long term conditions e.g. diabetes, CVD, neurological conditions, renal disease is moving from secondary care to primary/community care. The end stage of these diseases requires as much palliative care as cancer. The prevalence of such diseases will increase as the population ages.
> Specific health promotion campaigns aimed at the elderly.
Social implications of an ageing population?
> As the population ages, they will be increasingly dependent on families and/or carers who are also ageing.
> The demand for home carers and nursing home places is likely to increase.
> Within local communities, there will be increasing emphasis on providing social activities for the elderly.
> The role of the elderly as grandparents and carers of grandchildren is likely to change.
> Housing demands are likely to change as more elderly people live alone.
Economic implications of an ageing population?
> Retirement/Pension age is already increasing.
> 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.
> 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 the state pension is inadequate, resulting in poverty.
> Increasing cost of “free personal care for the elderly” policy (Scotland)
Political implications of an ageing population?
Current decision making and workforce planning must take account of the ageing population.
The increasing elderly population will potentially have the power to influence political decision making in relation to their specific concerns.
What are the leading causes of death in Woman - Mortality data?
1) Dementia and Alzheimer’s
2) Heart Disease
3) Stroke
4) Chronic Lower Respiratory
5) Lung cancer
What are the leading causes of death in men - Mortality data?
1) Heart Disease
2) Dementia and Alzheimer’s
3) Lung cancer
4) Chronic lower Respiratory
5) Stroke
Healthy life expectancy?
The number of years lived in self-assessed good health
Men = 64.3 yrs Women = 64.1 yrs
What is the main issue around life expectancy versus healthy life expectancy?
As life expectancy increases healthy life expectancy has made little change.
Therefore there is an increased time period of ill health which can have physical, social and psychological impact on the patient and their families.
What inequality is there with healthy life expectancy?
Those from most deprived areas are more likely to live in poor health for longer periods, having a poorer healthy life expectancy than those from least deprived areas
What ratio of individuals become carers within their lifetime?
3 in 5
Who makes up the majority of carers?
1) Children 40%
2) Spouse 26%
Do most carers care for more than one person?
No most carers take care of one person 83%
What is the impact of being a carer?
1) Financial -
> 1 in 3 saw a loss of £20K in their household income
> 32% have had to cut back on food and heating
> 45% said financial worry was impacting their health
> 42% have missed out of financial support as a result of not receiving the correct information
2) Social/psychological:
> Loss of time
> 61% say impacting their own relationships
> 49% feel society does not think of them at all
What is comorbidity?
“the co-existence of two or more long-term conditions in an individual “
What is the issue with older patients?
Usually much more complex care needs due comorbidity
Options for care?
> Living in own home with support from family
Living in own home with support from social services
Sheltered Housing
Residential Home
Nursing Home Care
What are anticipatory care plans?
“Advance and anticipatory care planning, as a philosophy, promotes discussion in which individuals, their care providers and often those close to them, make decisions with respect to their future health or personal and practical aspects of care”
What is included in an anticipatory care plan?
1) Legal needs
2) Personal needs
3) Medical needs
What is included in an anticipatory care plan - Legal?
> Welfare power of attorney
Financial power of attorney
Guardianship
What is included in an anticipatory care plan - 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 re death
Current level of support e.g. family/carers
What is included in an anticipatory care plan - Medical?
> 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)
