End of life care - lecture 10 Flashcards

1
Q

Number of seniors living in poverty

A

5%

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2
Q

What changed poverty among seniors?

A

introduction of canada pension plan and guaranteed income supplement

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3
Q

What happened in 2008?

A

25% increase in the number of seniors living in poverty

why? life expectancy: money not lasting as long , recession

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4
Q

To alleviate poverty?

A

CPP (60+), death benefits, benefits available from 60-64 but receive lesser amounts, old age security (450/month), GIS, OAS (GIS and OAS can be combined), spouse’s allowance, widowed spouse’s allowance

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5
Q

Main source of income for seniors?

A

OAS and CPP (2/3)

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6
Q

Number of full time retirees that can afford to pay their basic expenses?

A

55%

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7
Q

Earnings of seniors that can afford bills?

A

2/3 less than $20,000

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8
Q

Types of elder abuse?

A

physical, sexual, financial, neglect, mental

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9
Q

signs and symptoms?

A

depression, fear anxiety, passivity, unexplained physical injuries, dehydration or lack of food, poor hygiene, rashes, pressure ulcers, over sedation, money/ personal items missing without explanation

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10
Q

Principles of ethical decision making

A

fidelity, autonomy, beneficence, non maleficene, justice

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11
Q

Fidelity

A

faithful devotion to duty

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12
Q

Autonomy

A

the right of persons to choose for themselves what they think is best for them

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13
Q

Benedicence

A

treatment must have some potential to help

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14
Q

Non-maleficence

A

“do not harm” i.e. not performing painful tests to an elder patient that it will not survive

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15
Q

Justice

A

equitable distribution of burdens and benefits among many individuals

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16
Q

Geriatric care

A

information disclosure, informed consent, substitute decision making, withholding and withdrawing treatments, advance care planning, consent and capacity assessment

17
Q

assumption of capacity

A

assuming that a person is capable unless it is unreasonable to presume so

18
Q

what does it mean that capacity is decision specific not global?

A

may be capable of making a decision about one thing but not another

19
Q

Cognitive vs functional capacity

A

Cognitive: grasp, retain, rationally appraise information

Functional: physical ability to perform a task

20
Q

Indicators of capacity?

A

understand the information, appreciate the consequences of a decision. NO TO EITHER = INCAPABLE OF DECISION MAKING

21
Q

Consent

A

relate to treatment, be informed, given voluntarily, must not be misrepresentation or fraud

22
Q

SDM- substitute decision maker

A

must act in the best interest of the person, meet needs of person when they were capable

23
Q

Advance care directive

A

process of communication among patients, their HCPs and their families regarding the kind of care that will be considered appropriate when the patient cannot make decisions

24
Q

persistent vegetative state

A

exhibiting motor reflexes but without the ability to regain cognitive behaviour, communicate, or interact purposefully with the environment

25
Conflicts of interest as an RD
-educated to promote nourishment,
26
Ethical Decision Making
1. recognize ethical issue 2. acknowledge your feelings 3. determine the facts 4. examine values 5. evaluate alternative actions from various ethical perspectives 6. make a decision and implement it 7. evaluate/ reflect on the decision later
27
End of life care: judaism, islamic, hinduism
1. Do not assume anything ASK Judaism: treatment to provide comfort allowed, even if risk of shortening life Islamic: DNR, allah decides Hinduism pain and suffering are part of acceptance and detachment
28
Palliative care
diagnosed with end of life care, still being actively treated
29
end of life care
comfort, support and care to people who are living with or dying from any progressive life threatening disease, treatment not longer an option, not long to live