Loss of Independence and Helplessness

Question 1

Describe types of residential care for elderly people

Answer 1

• Nursing care homes: Provide nursing care for individuals. Nursing staff on site
• Residential home: Accommodation and may provide some support for day to day activities and personal care
• Elderly Mentally Infirm (EMI): Accommodation, personal care and extra support

Question 2

Outline ‘institutionalisation’

Answer 2

Application of inflexible systems of social and medical management by organisations.
Process of becoming accustomed to life in an institution so that it is difficult to resume normal life after leaving: autonomy, privacy, dependence

Question 3

Describe activities of daily living and the linked nursing model

Answer 3

Activities of daily living: Barthel Index. Individuals are scored according to their level of independence in each domain e.g. continence, mobility, feeding.
Linked nursing model: Roper-Logan-Tierney model states that there are 12 activities of life (maintaining a safe environment, communication, breathing, eating and drinking, elimination, washing and dressing, thermoregulation, mobilisation, working and playing, expressing sexuality, sleeping, death and dying)

Question 4

Explain the concept of health-related quality of life and some typical measures

Answer 4

HRQOL: An individual or groups perceived physical and mental health over time. The way health is estimated to affect QoL
Measures:
- Functional disability scales
Euro QL (EQ-5D) (5 dimensions): Mobility, self-care, usual daily activities, pain, anxiety and depression. Score range 0-1.
Short form 36 (SF36): 36 item questionnaire measuring 8 aspects of functioning. Scored 0 -100. SF-12v2 is a shortened version.
QALY: Takes into account both quantity and the quality of life generated by healthcare interventions. It is the arithmetic product of life expectancy and a measure of the quality of the remaining life-years.
PROM: Patient reported outcome meaure

Question 5

List some features of pneumonia epidemiology

Answer 5

Pneumonia is the second most common infection in nursing homes.

Question 6

Health related quality of life and how to measure it

Answer 6

EQ5D, SF36