Community Health seminars 5&6 Flashcards
what percentage of sight loss is acquired
97%
how can you identify visual impairment (x5)
white stick white symbol cane guiding cane dark/tinted glasses peering closely at something (with magnifier) guide dog being guided reading braile
RF for visual impairment (x3)
female
BME communities
learning diabilities
main causes of sight loss (x4)
cataracts
glaucoma
AMD
diabetic retinopathy
retinitis pigmentosa
hemianopia
what are cataracts
cloudy lens over time - gets worse over time
what is AMD
age-related macular degeneration
- blurry pot in vision
- 2 forms - dry and wet
macular disease = damage to macular cells, central part of retina and affects CENTRAL vision
(not peripheral vision)
what type of sight are macular cells for
fine detail (reading, writing, cooking watching TV)
treatments for AMD
no cure but treatments can halt the process
how can you reduced RF of AMD
protect eyes from sun
eat fresh fruit and veg
quit smoking
what is glaucoma
group of eye conditions which cause optic nerve damage and effect vision
what causes glaucoma
raised eye pressure or weakness in optic nerve
types of glaucoma (x3) - which is most common
- chronic open-angle glaucoma - MOST COMMON, develops slowly
- primary angle- closure glaucoma - rare, rapid or chronic
- secondary glaucoma - eye injury or condition e.g. uveitis
- developmental glaucoma/ congenital - rare
- normal tension glaucoma
what is retinitis pigmentosa
- tunnel vision
- inherited condition of retina
- difficulties with NIGHT vision and PERIPHERAL vision (later reading, colour and central)
- can be AD, AR, or x-linked
what causes hemianopia
stroke/ brain injury
homonomous hemianopia = loss of part of the field of view on the same side in both eyes
what is the leading cause of vision loss in adults over 65
diabetic retinopathy
what happens in diabetic retinopathy
damage to blood vessels to retina (part of the eye that responds to light)
tx diabetic retinopathy
early stages - laser
will halt progress but not restore vision
tools for effective communication with blind people
large print audio email voice activated mobile phone braille and moon speech packages - Jaws and Hal
how to assess AMD
amsler grid
what is charles bonnie syndrome
hallucinations following vision loss
what should you look out for in blind people
depression, employment isolation
what are Human Givens
emotional needs
name 5 human givens
security attention autonomy and control intimacy part of wider community privacy status competence achievement meaning and purpose
name 4 challenges of old age
- staying engaged
- coping with loss
- living ever closer to the end (gerotranscendence)
- coming to terms with the life you have led (integrity vs despair)
risks of old age (x2)
depression/ despair
isolation/ loneliness
–> self neglect/ harm
signs of loneliness
body language/ appearance
denial/ boredom
highly talkative/ clingy
RF for loneliness (x5)
live alone bereavement illness mobility sensory impairment quality not quantity of social contact no close family nearby no regular time away from house
what can depression cause
vascular dementia/ Alzheimers
physical consequences of isolation (x3)
earlier death
hard to regulate behaviour
less likely to engage in safe behaviours
brain changes –> ill health
define social theory of disengagement
ageing is an inevitable, mutual withdrawal or disengagement, resulting in decreased interaction between the ageing person and other in the social system he belongs to… natural and acceptable for older adults to withdraw from society… innate, universal ad unidirectional
social exclusion theory
the dynamic process of being shut out, fully or partially, from any of the social, economic, political or cultural systems which determine the social integration of a person in society
what are the 5 domains of social exclusion in older adults
material resources basic services civic activities neighbourhood social relationships
give 3 national initiatives for older people
Silver Line (confidential, free helpline for older people)
Dementia Friends
Men in Sheds
give 3 housing initiatives for older people
intergenorational housing
co-housing
flexible care
an example of initiative for older people in Sheffield
dementia cafe
social challenges of older people
number of older people increasing
number of childless old people increasing
why are old men more at risk than women
less social
RF for homelessness (x4)
BME
local authority care leavers
ex army
ex prisoner
risk to person from homelessness (x4)
die from unnatural causes
mental health problems
suicide
low life expectancy
health problems related to homelessness (5)
infectious diseases (TB, hep) poor conditions teeth and feet respiratory problems injuries following violence/rape sexual health, smears, contraction (blood borne infection) serious mental health problems (depression, personality disorder) poor nutrition addiction/ substance misuse
barriers to health care for homeless
- difficulties with access (opening times)
- lack of integration between mainstream primary care and other agencies (justice)
- other things on their mind (Maslows)
- may not know where to find help
what health conditions are more likely in travellers (x5)
miscarriage chronic bronchitis asthma smoking suspected angina
barriers to care for travellers
reluctance of GPs to register gypsies/ travellers or to visit sites poor reading and writing skills communication difficulties too few permanent and transient sites mistrust professionals lack of choice
what comprises a travellers team
specialist health visitor
mobile clinic
liaison with GP, hosp, ante-natal clinic
gradual acceptance of mainstream health care
asylum seeker definition
a person who has made an application for refugee status
awaiting court, legal terms, anyone has right to apply, mostly young men
refugee definition
a person granted asylum and refugee status. usually means leave to remain for 5yrs then re-apply
(Geneva convention description)
humanitarian protection
failed to demonstrate claim for asylum but face serious threat to life if returner (usually 3yrs then re-apply)
what right does a refugee have
all the right of a UK citizen
eligible for family reunion (one spouse and any children of that marriage under the age of 18)
what is indefinite leave to remain
granted full refugee status and given permanent residence in UK
what are asylum seekers entitled too (x4)
- £35/week
- housing
- NHS care (primary health care and maternity care?)
<18yrs - social service key worker and can go to school
what are asylum seekers NOT entitled too
work
any other form of benefit
secondary health care?
(failed asylum seekers are not entitled to money, housing, NHS)
barrier to health services for asylum seekers (x3)
lack of knowledge on where to get help lack of understanding on how NHS works language/ culture/ communication hyper-mobility not homogeneous group health not priority
refugee experience in UK
separation from family hostility racism poverty poor housing unemployment detention
physical health of asylum seekers (x5)
common illnesses illness specific to country of origin injuries from war and travelling no prev health surveillance/ neonatal screening/ immunisations malnutrition torture/ sexual abuse infestation and debilitation communicable disease/ blood bourne untreated chronic disease/ congenital problems
mental health conditions among asylum seekers
PTSD depression sleep disturbance psychosis self harm
NB: psychological expression is culture bound
health care for asylum seekers
rapid access screening catch up programmes/ imms/ child health appropriate assessment and referrals education for asylum seekers and health professionals mental health expertise supporting evidence for asylum hearings
define unaccompanied children
- crossed international border in search of safety/ refugee status
- applying for asylum
- under 18
- without adult family members
what are the differences in asylum treatment pre and post 1999
pre 1999
- council housing
- baisc benefits
- employment rights
- freedom of movement
- access to NHS
post 1999 - FASTER, FAIRER, FIRMER
- no choice dispersal
- vouchers (70% income support)
- NASS support package
- full access to NHS
- not allowed to work
previous experience in home country (x5)
massacre torture sexual assault/ rape witness torture disappearance of family forced eviction forced conscription political oppression deprivation of human rights detention being held under siege being taken hostage
children and torture
Direct Experience of Torture Witnessing Torture Child Soldiers Different Reactions Secrets Developing Trust / Confidence / Belonging Importance of School Support for Parents
most common cause of homelessness
eviction by private landlords
3 contributory factors associated with homelessness
relationship breakdown economic hardship bereavement mental health ex prisoner domestic abuse (mother and children, not father) substance abuse
inverse care law
the principle that the availability of good medical or social care tends to vary inversely with the need of the population served
3 barrier to access of care by vulnerable groups
education language transport stigma money
3 factors which most influence traveller health
level of education
no antenatal care
no screening
what is the biggest barrier asylum seekers have to over come?
stigma?
