FPC2 Tutorial 3 Ageing Well or Not so Well Flashcards

1
Q

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

A

false

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2
Q

Disease always presents in the same way in the elderly as it does in younger adults: True or False

A

false

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3
Q

Normal ranges e.g. peak flow rate, are affected by age: True or False

A

true

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4
Q

Drug handling alters with age: True or False

A

true

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5
Q

Treatable disease in the elderly is frequently ascribed to “normal ageing”: True or False

A

true

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6
Q

Define “Ageism”

A

A process of systematic stereotyping and discrimination against people just because they are old.

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7
Q

Lifestyle changes in old age are not worthwhile as they produce no significant health benefits: True or False

A

false

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8
Q

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%

A

C

22%

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9
Q

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

A

C

4-fold

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10
Q

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

A 80%

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11
Q

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

A

B Heart disease, stroke and chronic lung disease

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12
Q

Older people in low-income and middle-income countries carry a greater disease burden than those in the rich world: True or false?

A

true

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13
Q

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 Two-fold C Three-fold D Four-fold

A

D

4-fold

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14
Q

Worldwide, most training for health professionals includes instruction about specific care for older people: True or False

A

false

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15
Q

Creating “age-friendly” physical and social environments does not improve the active participation and independence of older people: True or False

A

false

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16
Q

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

A

50%

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17
Q

what are happening to the shape of population pyramids?

A

beocming more top heavy as the numbers of the eldery population is increasing

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18
Q

what is the fastest growing age group in the world?

A

80+ age group

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19
Q

Scotland 2004-2031:

The number of children aged under 16 is projected to decrease by 15%

The number of people aged 16-29 is projected to fall by 12%

The number of people aged 30-49 is projected to decrease by 17%

The number of people aged 50 and over is projected to increase by 28%

The number of people aged 65 and over is projected to rise by 58% and the number aged 75 and over is projected to rise by 75%.

what are some health implications of this demographic change?

A

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

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20
Q

Scotland 2004-2031:

The number of children aged under 16 is projected to decrease by 15%

The number of people aged 16-29 is projected to fall by 12%

The number of people aged 30-49 is projected to decrease by 17%

The number of people aged 50 and over is projected to increase by 28%

The number of people aged 65 and over is projected to rise by 58% and the number aged 75 and over is projected to rise by 75%.

What are some social implications of this demographic change?

A

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

21
Q

Scotland 2004-2031:

The number of children aged under 16 is projected to decrease by 15%

The number of people aged 16-29 is projected to fall by 12%

The number of people aged 30-49 is projected to decrease by 17%

The number of people aged 50 and over is projected to increase by 28%

The number of people aged 65 and over is projected to rise by 58% and the number aged 75 and over is projected to rise by 75%.

What are the political implications of this demographic change?

A

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

22
Q

Scotland 2004-2031:

The number of children aged under 16 is projected to decrease by 15%

The number of people aged 16-29 is projected to fall by 12%

The number of people aged 30-49 is projected to decrease by 17%

The number of people aged 50 and over is projected to increase by 28%

The number of people aged 65 and over is projected to rise by 58% and the number aged 75 and over is projected to rise by 75%.

What are the economic implications of this demographic change?

A

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)

23
Q

From 1951 to 2001, how have the births and deaths changed in scotland?

A

births decreased

deaths stayed around the same

24
Q

how have life expentancies for males and females changed over recent decades?

A
25
Q

what is the leading cause of death for women in england?

2015

A

dementia and alzheimers disease

26
Q

what is the leading cause of death of men in england?

2015

A

heart disease

27
Q

what is the life expectancy in england?

A

Provisional data for 2016 indicate that life expectancy at birth has now reached 79.5 years for males and 83.1 years for females

Since 2000 to 2002, both life expectancy and healthy life expectancy have increased; the population is now living longer and spending more years in good health.

Since 2000 to 2002, life expectancy has increased by more years than healthy life expectancy and therefore the number of years lived in poor health has also increased slightly; in 2013 to 2015 it was 16.1 years for males and 19.0 years for females. However, the proportion of life spent in poor health has remained stable and these data do not take into account trends in the types and severity of diseases over time

28
Q

for both sexes, have years in poor health increased?

A
29
Q

what is inequity?

A

The following graphs give an indication that not only life expectancy, but also healthy life expectancy can vary depending on the socioeconomic status of the person affected

30
Q

how is poor health related to ageing and what is its effect?

A

The combined effect of the higher prevalence of Long Term Conditions (Tutorial 1, Year 2) and a population which is proprotionately older and spending more years in poor health is placing considerable pressure on Health Care and Social Care systems in the UK

31
Q

It is important to work with _______________ such as Age Concern to help patients live healthier and better quality lives

A

Third Sector Organisations

32
Q

are the number of family/friend carers increasing or decreasing?

A

6.5 million people in the UK are carers and this number continues to rise

There will be 9 million carers in the UK by 2037

Every year over 2.1 million adults become carers and almost as many people find that their caring responsibilities come to an end

This ‘turnover’ means that caring will touch the lives of most of the population, as we all need or provide care or support family members caring for loved ones at some point in our lives

3 in 5 people will be carers at some point in their lives

1.4 million people provide over 50 hours of unpaid care per week

The care provided unpaid, by the nations’ carers is worth an estimated £119bn per year – considerably more than total spending on the NHS in England

27% of carers were in receipt of Disability Living Allowance as a result of their own disability or ill health

33
Q

who do family/friend carers care for?

A

Most carers (40%) care for their parents or parents-in-law

Over a quarter (26%) care for their spouse or partner

People caring for disabled children under 18 account for 8% of carers and 5% of carers are looking after adult children

A further 4% care for their grandparents and 7% care for another relative

Whilst the majority care for relatives, one in ten carers (9%) care for a friend or neighbour

Most carers care for just one person (83%), but 14% care for two people and 3% are caring for at least three people

34
Q

what is the impact of caring?

A

Half of working age carers live in a household where no-one is in paid work

Almost 1 in 3 (30%) carers had seen a drop of £20,000 or more a year in their household income as a result of caring

A third of carers had cut back on essentials like food and heating (32%)

45% of carers said their financial circumstances were affecting their health

42% of carers have missed out on financial support as a result of not getting the right information and advice

Carers providing round the clock care are more than twice as likely to be in bad health than non-carers

61% of carers said that they were worried about the impact of caring on their relationships with friends and family

In 2014, half of carers (49%) said they feel society does not think about them at all

35
Q

what is multimorbidity?

A

“the co-existence of two or more long-term conditions in an individual“

It is the norm, rather than the exception, in primary care patients

36
Q

what are some examples of drug classes for different conditions?

A
37
Q

what makes the management of older patients more complex?

A

Older patients may have more than one chronic health condition

This adds complexity to management

For example the preferred treatment for one condition may worsen another

38
Q

what are different options for care?

A

Living in own home with support from family - Different families have different levels of support they are willing or able to provide

Living in own home with support from social services - Social work often can only provide care for a short spell up to three times a day, leaving her alone for long periods of time

Sheltered Housing - Sheltered housing is often a useful option for people who wish to live independently, but to know there are others nearby to help when needed.

Residential Home - have greater 24 hr support but no medical cover on site

Nursing Home Care - have resident nurses on site. They can be extremely expensive, perhaps up to £1500 per week if funding the stay privately

39
Q

What are Anticipatory Care Plans?

A

“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”

40
Q

When should ACP be done?

A

At any time in life that seems appropriate

Continuously

41
Q

Who should do the ACP?

A

by anyone with an appropriate relationship

42
Q

how should the ACP be done?

A

Thinking Ahead & Making Plans

Carefully! Write it down

43
Q

How can the ACP be shared?

A

KIS (Key Information Summary)

Other communication

44
Q

what is some legal information that can be in a ACP?

A

Welfare power of attorney

Financial power of attorney

Guardianship

45
Q

what is some personal information that can be in a ACP?

A

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

46
Q

what is some medical information that can be in a ACP?

A

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)

47
Q

what are some wuestions to consider in regards to home care?

A

What are the true costs of home care?

Is care always available?

What Care options are available?

Rapid response; respite e.g. Rosewell.

What is care planning?

Discuss how the service has had to be redesigned

48
Q

when interviewing a patient and a carer, what is important information to gather?

A

Find out what the issues are for the carer:

What is it like to be a carer? What help is available? What gaps are there in the service? What is the impact of being a carer on the carer’s own physical and mental health?

Find out from the patient how they feel about being dependent on others for care needs? What would they like from the service that is not available?

Find out from the patient how they feel about being dependent on others for care needs?

Work through a scenario of patient who lives at home but is in progressive decline and requires increasing amounts of care

Demonstrate what is meant by anticipatory care. How can this improve outcomes?

49
Q

what questions owuld be asked in an interview with a care manager?

A

What is the role of a care manager? (Will be discussed in Tutorial 4 also)

How can they ensure that patients are receiving the appropriate level of care?

How do they deal with “rationing” decisions?

What can the service realistically provide?

What enables them or prevents them from providing the level of care they wish to provide?

What services can the access?

How do they co-ordinate care?