Chapter 12: Where we live Flashcards
What is the 2011 Census
- included those 65+
- 92% of older adults lived in private dwellings
- 8% in collective dwellings
- relatively unchanged since 2001
- majority 56.4% lived as part of a couple
How does living as a couple change with age?
- the likelihood of living as a couple declines with age
- 85 and over, 46.2% and 10.4% of women
What is Long Term Care and how has it changed
- more options than in the past
- primarily for older adults
- need assistance with ADLs and/or IADLs
- home care or institutionalized care
Is Canada long term care covered by the Canada Health Act?
- no
- there is also no fully insured health service
- costs vary within and across provinces and territories
- in Alberta: long term care= continuing care
What is aging in place
- remaining in own home or community
Ways to make aging in place easier and more pleasant
- more items to easy reach
- put grab bars on shower
- improve lighting
- lower water heater temperature
- open space between rooms
- remoce tripping hazards
- stay connected
- reduce fire hazards
How can home care help and what services do they do
services: meals, cleaning, assessment, case management, physiotherapy, occupational therapy, nursing care
- the goal is to delay or eliminate moving to long term care
- demand is growing
What are Alternative level of care patients (ALC)
- waiting for placement
- home care shortages
- costly
- medically stable
Gender differences in home caregivers?
- slightly over half 54% of caregivers were female and 44% between ages of 45 and 64
Who provides home care support
- health care professionals
- paid caregivers
- volunteers (family members)
- personal support workers (PSWs) (underpaid, female, foreign-born, demanding conditions)
What are older adult villages
- community-based service for older adults
What are Adult Day Programs
- older adults who need assistance or supervision during the day receive a range of services in a setting that is either attached to another facility such as nursing home or stand alone agency
What is Respite Care
- can include medication programs, therapy, meals, medical care, counselling etc
- provides families and caregivers with a break while allowing the older adult to receive needed support
- temporary care
What are Assisted Living Facilities
- for people who need some assistance with activities of daily living but do not need 24 hour care
- provides things such as meals, laundry, maybe nursing care
- smaller and lower cost than nursing homes
- alternative to nursing home
What services do nursing homes provide
- moderate to high care
- rooming, meals, nursing, rehabilitative care, medical services (comprehensive care)
How have nursing homes changed
- people are moving to person centred or family centred care
- more holistic
- theres an overall shortage of beds (especially in indigenous communities)
Who provides nursing homes
- there are public, private and nonprofit providers
- for-profit (Private?) care increasing
- becoming more common
What are the behavioural and mental health issues associated with nursing homes
- often related to confusion
- may lead to overmedication which can lead to increased number of falls
- lack of personnel for psychological treatment
How to make a choice to stay at home or move to an alternative community
- ideal situation is someone choosing to move to one
- any level of control helps, feelings involved in the decision, do not want it to be forced
- sometimes there really isnt a choice (stroke , fall, frailty)
- can be very hard on the family ( feelings of guilt and regret)
Admission to Long Term Care in Canada
- Is executed through a co-ordinated placement process (single point entry model)
- screening, referring and case managing
- there is not a one size fits all nursing home
What is Adjustment to Relocation based on?
- preparation and education
- communication between settings
- preferences and goals considered
- interprofessional collaboration
- evidence- based model of care (relocation)
What is the right environment (Models of Adaptation)
- important to adapt as we age
- traditionally nursing homes have catered to the ‘average’, which doesnt work for everyone
- people have different cognitive, physical and psychosocial needs, think about how people might differ on these
- usually ‘control’ over environment is good
What is the Competence-Press Model
- Competence: upper limit of a persons capacity to function (ability to handle situation)
- Press: demands placed on the person (physical, interpersonal, social)
- higher competence = handle more demands
- lower competence = environment has greater impact
- you cant just cater to those with the lowest competence because that is bad for people with higher competence
Monitoring in long term care facilities
- monitoring: continuing care reporting system
- resident assessment instrument, indices of physical, cognitive and psychosocial health
What is the quality of long term care in Canada
- 81% of covid 19 deaths in long-term care
- 42% across other countries
What are the problems of long term care facilities
- not enough staff
- stressful
- too much work
- lack of autonomy
- lack of social support with other workers
- low status
(must make residents feel competent and in control)
What are the things that may lead to negative outcomes in long term care
- resident has little to say on decision to enter nursing homes
- patient instead of resident
- being overly helpful makes residents more dependent (perform under their ability)
- there is a strict routine tjat leads to mindless behaviour
How can we impact the environment and make things better
- more focus in community/ neighbourhood
Human factors and ergonomic factors in making care facilities better
- behavioural methods to increase independence (staff-resident relationships)
- sense of neighbourhood to community
- allocate staff to specific residents NOT specific tasks
- make more home-like
What is the Culture Change Movement
- person centred care
- sense of community
- increase independence
- allocate staff to residents not needs
- make more home like
What is the green house model
- individual homes within a small community of 6-10 residents and skilled nursing staff
