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PSYC 322 > Chapter 12 & 13: Long-term care & Death and dying > Flashcards

Chapter 12 & 13: Long-term care & Death and dying Flashcards

1
Q

institutional facility

A

group residential setting that provides individuals with medical or psychological care; short-term (e.g. hospitals) or long-term

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2
Q

aging in place

A

with appropriate principles, older adults can remain in their own homes or communities

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3
Q

alternate level of care (ALC) patients

A

reside in hospitals but no longer need high level of care and are just waiting for a long-term care bed

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4
Q

home care

A

personal support workers providing assistance to older adults within their own private residences; heavily reliant on unpaid caregivers

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5
Q

adult day programs

A

older adults who need assistance or supervision during the day receive a range of services in a facility (e.g. nursing home) or a stand-alone agency

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6
Q

respite care

A

gives family caregivers a break while allowing older adults to receive needed support services

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7
Q

supportive or assisted living facility

A

provides supportive care services and supervision to individuals who do not require skilled nursing care; not the same as retirement homes

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8
Q

nursing home

A

type of medical institution that provides a room, meals, skilled nursing and rehabilitative care, medical services, and protective supervision

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9
Q

competence-press model

A

predicts an optimal level of adjustment that institutionalized people will experience when their competence levels match the demands of the institutional environment

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10
Q

green house model

A

an alternative to traditional nursing homes that is an individual home with a small community of 6 to 10 residents and skilled nursing staff

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11
Q

culture change movement

A

promotes person-centered care by adopting care to the needs of the individual in innovative ways

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12
Q

death

A

irreversible cessation of brain function that can be determined by prolonged absence of respiratory and cardiac functions

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13
Q

dying

A

period during which the organism loses its vitality

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14
Q

dying trajectory

A

temporal pattern of the disease process leading to a patient’s death

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15
Q

four types of dying trajectories

A

sudden death, terminal illness, progressive organ failure, frailty

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16
Q

sudden death trajectory

A

individual is at a high level of functioning until death suddenly occurs

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17
Q

terminal illness trajectory

A

people have an advance warning of a terminal illness and were functioning at a high level until the disease progressed

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18
Q

organ failure trajectory

A

death occurs over a prolonged period with dips and recoveries until the organ failure completely compromises life

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19
Q

frailty trajectory

A

immediate cause of death may be an acute illness developing against a backdrop of general loss of function; e.g. later stages of Alzheimer’s

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20
Q

anorexia-cachexia syndrome

A

individual loses their appetite (anorexia) and muscle mass (cachexia)

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21
Q

death ethos

A

a culture’s prevailing philosophy of death e.g. belief in ghosts and afterlife, treatment of those dying, funeral ritual, representation in arts

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22
Q

tamed death

A

viewing death as familiar and simple, and a transition to eternal life that tamed the unknown

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23
Q

invisible death

A

preference that the dying retreat from the family and spend their final days confined in a hospital

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24
Q

social death

A

process in which the dying become treated as non-persons by family or health care workers as they are left to spend their final months or years in the hospital or nursing home

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25
Q

5 stages of dying for terminally ill patients

A

denial, anger, bargaining, depression, acceptance; shows as a progression instead of discrete steps

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26
Q

death with dignity

A

the period of dying should not subject the individual to extreme physical dependency or loss of control of bodily functions

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27
Q

good death

A

patients have the autonomy in making decisions about the type, site, and duration of care they receive at the end of life

28
Q

legitimization of biography

A

attempting to see what one has done as having meaning and preparing to leave a legacy

29
Q

awareness of finitude

A

point in time when one first thinks about their own mortality and passes the age when other people close to them have died

30
Q

terror management theory

A

when thoughts of death are activated, consciously or unconsciously, they can experience beneficial effects, particularly those who can cope with stressful situations

31
Q

advance directive

A

document that describes one’s preferences for future care if they are unable to speak for themself

32
Q

overtreatment

A

occurs when patients with DNRs receive active life support that includes resuscitation and do not have their DNR orders respected

33
Q

2 ways of medical assistance in dying (MAiD)

A

Clinician-administered MAID (used to be voluntary euthanasia) and self-administered MAID (used to be assisted suicide)

34
Q

hospice palliative care

A

provision of holistic, person-centered end of life care that begins when the patient no longer wishes to receive active treatment

35
Q

bereavement

A

process wherein people cope with the death of another person

36
Q

attachment view of bereavement

A

the bereaved can continue to benefit from maintaining emotional bonds to the deceased individual

37
Q

dual-process model of coping with bereavement

A

the restoration dimension are the practical adaptations or life changes that accompany death; the loss dimension is coping with the direct emotional consequences

38
Q

long-term care

A

entire continuum of care, from receiving in-home help with daily tasks to institutionalized care

39
Q

Benefits of home care

A

maintained sense of identity, control, and autonomy, familiarity of surroundings and community, prevention or delay of institutionalization, cost-effective

40
Q

Who most likely uses government-funded home care?

A

those who are single, have lower income, more physical limitations, and had a recent hospitalization

41
Q

Types of long-term care

A

home care, assisted living, nursing home, retirement home

42
Q

assisted living

A

provides government-regulated housing with a supportive environment e.g. hospitality and personal care services

43
Q

Who likely uses assisted living?

A

those who have physical and functional health challenges, can live independently but not unaided, can make their own decisions

44
Q

3 ideal attributes of assisted living facilities

A

physical space has a residential appearance and feel, promotes normal lifestyle, meets residents’ routine services and special needs

45
Q

traits of those with greater well-being after transitioning to assisted living

A

had greater control over transition, optimized person/environment fit, live in smaller facilities, have positive co-resident relationships usually of similar levels of functioning, frequent family contact, moved from a hospital or other AL facility (not home)

46
Q

nursing home

A

government-regulated type of medical institution that provides a room, meals, skilled nursing, and rehabilitative care, medical services, and protective supervision; usually the last resort

47
Q

Who typically lives in nursing homes?

A

those with multiple health conditions and/or moderate/severe cognitive impairment (dementia); those recovering from major injuries, illness, or surgery (temporary residents)

48
Q

elder abuse

A

physical, sexual, and psychological abuse; financial exploitation; neglect; and violation of rights

49
Q

features of the traditional medical model

A

hierarchical, focused on physical needs, routines for residents and frontline workers, efficient, standardized, cost-driven, rule-compliant, residents often isolated

50
Q

features of the culture change movement

A

voices of residents and carers respected, focused on emotional needs, enables continued growth, treats everyone as individuals, restructured staff roles and responsibility, encourages connections and contributions to family and community

51
Q

eden alternative

A

close and continued contact with plants, animals, and children; daily life includes variety and spontaneity; maximized decision making; focused on the well-being of elders and workers

52
Q

Benefits of non-profit facilities

A

more and better quality staffing, fewer regulatory deficiencies, patients have less pressure sores, less use of physical restraints

53
Q

How do costs of nursing homes vary?

A

by province, type of ownership, and model of care; residents are required to pay out-of-pocket

54
Q

factors that influence the experience of death

A

cultural factors, trajectories and nature of death, individual differences, social support, medical system

55
Q

focus of palliative/hospice care

A

unique end-of-life goals, how symptoms, treatment, and issues are hindering goals, interventions to assist in reaching them, quality of life and closure

56
Q

barriers to access palliative care

A

lack of patient understanding, limited resources, funding, and specialized doctors, reluctance to discuss dying

57
Q

decisions to be made in advanced care planning

A

preference for what kind of and where care is received, personal wishes and goals, who makes decisions if the patient is unable to do so (e.g. living wills and advanced directives)

58
Q

options for advanced care planning

A

refusal or withdrawal of treatment (e.g. DNR), palliative sedation

59
Q

palliative sedation

A

admission of sedative medication to reduce patient’s consciousness and alleviate suffering, not to cause or hasten death; used as a last resort, MAID

60
Q

barriers to ACP on the patient and family caregiver level

A

cultural beliefs, lack of emotional preparedness, preference to defer to doctors, cognitive impairment (+/-), diagnosis of less serious illnesses

61
Q

barriers to ACP on health care provider level

A

prognosis uncertainty, lack of communication skills and preparedness of MD

62
Q

Clinician-administered MAID

A

a physician or nurse practitioner directly administers a drug that intentionally causes death

63
Q

Self-administered MAID

A

a physician or nurse practitioner prescribes a drug that the eligible person takes themselves

64
Q

What is considered a “grievous and irremediable medical condition” for MAID eligibility?

A

serious, incurable illness or disability; advanced state of irreversible decline in capability; unbearable physical or mental suffering; reasonably foreseeable natural death and capable of providing informed consent (no longer the case)

65
Q

6 themes that people tend to value at the end of life

A

clear decision making, pain and symptom management, affirmation of the whole person, preparation for death, contributing to others, completion

66
Q

Completion at the end of life

A

deep importance of spirituality and meaningfulness of life (e.g. reviewing one’s life, spending time with loved ones, resolving conflicts, saying goodbye, prayer)

PSYC 322 (13 decks)

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