midterm 2 Flashcards
1
Q
health inequity
A
unjust or unfair differences in health between persons, often rooted in social, economic, environmental, or systemic conditions that disadvantges certain grousp
2
Q
health inequality
A
observable or measurable health differences in health status or outcomes among different population groups
3
Q
diversity in aging
A
as people age, experiences of health, support, and well-being vary widely based on social determinants of health, which can lead to health inequalities
4
Q
health inequailty in aging
A
measureable differences in health outcomes among older adults in various groups, such as varying levels of moblility, cognitive health, or life expectancy
5
Q
health inequity in aging
A
often stem from lifelong disadvantages, such as poverty, racism or limited access to healthcare, which effect older adults later in life
6
Q
what are health outcomes linked to
A
physical and mental inequalities
- socio-economic factors
7
Q
intro to health inequalities
A
- influence of poverty and disadvantage on health inequalities is consistent over time
8
Q
substantial evidence-based research to show that:
A
- older adults living in disadvantaged areas have less access to health care
- disadvantaged groups have higher mortality and lower changes of survival
- inequalities related to survuval from various health conditions are closely related to age, sex, ethnicity
9
Q
what influences older adults risk for social isolation
A
risk factors related to health inequality and health inequity
10
Q
indigenous peoples living in Canada
A
- were in good health prior to colonization
- included nutritious diets, rich and diverse healing systems, and active lifestyles
11
Q
indigenous and European settlers
A
- have poorer health outcomes
- suffer from more chronic illness and disabilities, including heart disease and diabetes
12
Q
indigenous and racisms (impacts)
A
- racism and loss of support has been direct to poor health outcomes
- type II more common as years go with indigenous
- residential schools
- effects of colonials continues to effect the health and healthy aging of indigenous peoples living in Canada today
13
Q
dementia and different groups
A
- certain ethno-racial groups (black, hispanic, hawwiian) have higher risks of developing dementia
- these difference persist despite similar rate of cognitive decline across groups
14
Q
risk and expression of dementia
A
are influenced by social determinants, discrimination, and access to care
- there are disparities in access, diagnosis and outcomes in dementia care
15
Q
influential factors for dementia
A
- socioeconomic status
- cultural diversity
- geographical location
16
Q
prescription drug access
A
- Canadas public health insurance covers hospital and physician visits but generally does not cover prescription medications
- no policy (national) covers drug prescriptions (resulting in inconsistent access to medications)
17
Q
what does the medication issue led to
A
- health inequities and social injustice amongst some Canadians, disproportionately affecting those without private or provincial coverage options
18
Q
who has better access to medications
A
people with private insurance or provincial drug benefit plans (older adults, ppl with disabilities)
19
Q
oral health inequities
A
- cover based on income and private benefits and typically not included in provinal health plans
20
Q
due to lack of oral coverage
A
many older adults avoid dental care because of high costs
21
Q
poor oral health can impact overall health by:
A
- lost or broken teeth negatively affecting nutritional status= additional health complications
- stigma around poor oral appearance can affect mental health, potentially leading to social isolation
22
Q
caregivers and older adults
A
almost one quarter of seniors 65+ provided care or help to family members or friends with a long-term condition, a physical or mental disability, or problems with aging
23
Q
what happens with caregivers
A
- increased burden, depression, stress, financial problems, poor health, loneliness, social isolation
- Spousal caregivers at greater risk of experiencing loneliness and decreased social support
24
Q
caregiver interventions
A
- physical and financial support through informal assistance
- respite services
- home care or related services
- income and tax relief programs
- education and skills training
- psychological support
- interactive online activities and groups
25
immigrant older adults in Canada
- older adults represented a relatively smaller proportion of immigrants at 3.3% in Canada
- considerable diversity among the immigrant population of older adults
26
what are older immigrants more likely to get
- lonelier than Canadian-born older adults
27
Canadian born older adults
had higher prevalence of successful aging than immigrants
28
health immigrant effect
meaning immigrants are generally healthier than domestic-born Canadian when they first arrive
29
inclusive healthy aging interventions for immigrant older adults in Canada
- additional data collection and research on immigrant older adults in Canada
- culturally linguistically appropriate programs and services (finical aids, language programs, information and referral services)
30
older adults in rural/remote areas
approximately 23% of all seniors in canada live in rural areas
- increase risk of social isolation, smaller support networks, greater loneliness, and lower utilizations rates of health and social services
31
what are rural populations considered
a health disparity group in part because these populations have higher rate of mental health concerns, chronic disease and worse general health
32
what do rural older adults face?
increased risk of morbidity, obesity, diabetes, coronoary hearth disease, cancer, covid, excess mortality
33
strategies for improving healthy aging in remote/rural areas
- reducing
- joining
- developing
- improving
- developing
- stimulating
34
reducing
- reducing health inequlities by providing older people with better access to health and social care services in rural/remote areas
35
joining
joining up transport, housing, health and social care services to improve cost effective service provision and access to services
36
developing
cost effective transport solutions to afford accessibility to services and better social integration
37
improving
housing and local environment conditions to allow older people to age in place
38
developing -2
developing volunteering and community based initiative to improve social integration of older adults in rural/remote areas
39
stimulating
- bottom up social enterprises and collaborative ventures to improve the economic diversity and attractiveness of rural areas to encourage further economic development
40
who are the most financially vulnerable in Canada populations
older adults (especially those who live alone)
41
specifically what older adults are most finically vulnerable
- with less education
- intermittent work histories and low wages
- older immigrants
- indigenous older adults
- those with chronic health conditions
- those with disabilities
42
is the rate of older Canadian living in low income increasing or decreasing
increasing
43
with low income there is also increased risk of ?
loneliness, social isolation, poor health outcomes, lower quality of life, premature mortality
44
what is good about higher income
more years of good health than those with lower incomes
45
programs and services to help low income older adults
- income assistance
- provincial and territorial programs
- residential rehabilitations assistance program (RRAP)
- advanced life deferred annuities (ALDAs)
- variable life payment annuities (VPLAs)
46
income assistance
- low income seniors who don't qualify for the full amount of Canada public pension programs may be eligible for income assistance, disability assistance, or hardship assistance
47
provincial and territorial program
- many provinces and territories offer programs to provide extra support to people receiving the guaranteed income supplement (GIS) or allowance
- can include tax deferment, prescription drug subsidies and rental subsidies
48
residential rehabilitation assistance program (RRAP)
offers financial assistance to create affordable housing for low-income seniors and adults with disabilities
49
advanced life deferred annuities
ALDAs allow individuals to put up to 25% of qualified registered funds into annuity, which can start paying an income at age 85
50
variable life payment annuities
VPLAs provide payments based on pooled investment risk to help ensure that retirees have income at older ages
51
health care professionals- increasing cultural competence in healthy aging
awareness
knowledge
skills
52
culturally sensitive healthcare
all of these overlap
- patient centered care/ health literacy
- cultural targeting
- cultural competence
- under-served needs
53
negative expectations for old age
- smelly
- demanding
- loss of autonomy
- time of loss
- boring
54
what is a age-related stereotypes
are defined as cognitive structures embedding beliefs and expectations that people hold about different age stages
55
what are stereotypes
assumptions and generalizations about how people at or over a certain age should behave
56
explicit attitudes
- previously learned information
- what people consciously endorse or believe
- direct and deliberate
- can be acknowledged
57
implicit priming
- associations that are outside of the conscious awareness
- unconscious and effortless
- indirect and automatic
- involuntarily active
58
what is the stereotype content model (SCM)
- first proposed in 2002
- all group stereotypes and interpersonal impressions form along two dimensions
- the model is based on the notion that people are evolutionarily predisposed to first assess a strangers intent to either harm or help them (warmth) and second to judge the strangers capacity to act on that perceived intention (competence)
59
what are the 2 dimensions of SCM
warmth
competence
60
stone and baker
- self efficacy and biomechanics related to stair navigation in older adults
- primed older adults can navigate stairs with more confidence, quickness and efficiency
61
barber et..
- stereotype threat can impair older adults physical performance
- dependent on tasks objective difficulty and participants subjective evaluations of their own recourses
62
what is ageism?
- refers to how we think (stereotype), feel (prejudice) and act (discrimination) towards other or ourselves based on age
63
everyday ageism
- occurs in day-to-day lives through interpersonal interactions and exposure to ageist beliefs, assumptions, and stereotypes
64
adults every days ageism (50-80)
- 82% experiences one or more forms of everyday
- 65% exposure to ageist messages
- 45% ageism in interpersonal interactions
- 36% internalized ageism
65
what does ageism affect?
organizations, institutions, relationships and ourselves
66
what does ageism affect? workplace?
ageism can affect financial security and mental health
67
what does ageism affect? healthcare
is prevalent in healthcare, through communication, diagnosis, and treatment decisions
68
what does ageism affect? media
ageism is present in the media with negative portrayals, underrepresentation, and framing aging as the program
69
what does ageism affect? legal system
with ageism language, age, restrictions, and accessibility
70
how does ageism affect somebody?
- shortens older adults lives
- poor physical health
- delay in injury or illness recovery
- decreased mental health
- increased social isolation and loneliness
- lower quality of life
71
ageism affect everyone
- cost society billions of dollars
- causes conflict between generations
- causes loss of productivity in the workplace
- causes elder abuse
72
media representations
- portrayal of older adults: never make them the hero. older adults hardly have major roles, and are mostly men
- many portrayed as negative or villainous
73
what does the beauty industry do
try to defeat aging
- makes people want to get rid of their aging features
- fine if someone wants that but not fine if its put on my society
74
categories of everyday ageism
- exposure to ageist messages
- ageism in interpersonal interactions
- internalized ageism
75
ways to combat ageism
- policy and law
- education
- intergeneration
76
policy and law
- can address discrimination and inequality based on age and protect the human rights of everyone, everywhere
77
education- combatting ageism
can transmit knowledge and skills and enhance empathy
78
intergeneration- combatting ageism
can contribute to the mutual understanding and cooperation of different generations
79
combatting ageism with research
- investing resources in research activities, including into formative monitoring and evaluation research
- important for campaigns to foster learning
- ensure research findings are responded to in an appropriate matter
- know what and how to measure, include research in the campagins
80
combatting ageism with community work
engage
involve
include
81
engage
engage, respond to, and incorpate voices of the community
- participatory action research
82
involve
- involve a range of government structures
- middle out approach
- work alongside various partners to enable to effective use of recourses
83
include
- include representatives from affected communities in workshops, marketing and feedback
- create co-researchers
84
what is the social comparison theory
People understand themselves by comparing their attitudes, abilities, and beliefs to others, aiding self-evaluation and self-enhancement.
85
what is the upward comparison
comparison to someone who appears to have thing better. "you are better than me"
86
downward comparison
comparsion to someone who appears to have thing worse
"I feel sorry for you"
87
types of barriers
- physical
- social
- emotional
- spiritual
- environmental
88
physical factors
- age
- advanced age
- gender
- comorbidities
- addiction
- medical events
89
social barriers
- illness and disability
- loss of contact with friends/relative
- lack of supportive community
- lack of acceptable social opportunities
- lack access to quality relationships
- physical and cognitive limitations
- personal responsibilities
- transportation
90
aging and driving
- every 2 years 80+ years have to do a vision + written test, education about new traffic laws, cognitive test in order to keep license
- individual 70+ more likely to crash than divers aged 25 and younger (plus more injuries or death when crashing)
- ppl usually drive 7-10 years longer than they should
- loss of autonomy
91
environmental barriers
- low income
- accessibility
- education
- safety
- community design
- transportation
- services
- programs available
- assisted living
92
primary facilitators to healthy aging
- healthy diet
- physical activity
- mental well-being
- social support
- preventive health and safety
- acceptance of aging
- multimodel interventions
- economic autonomy
93
healthy diet
- eating well can help people meet their energy and nutrient needs and may help prevent chronic diseases
94
physical activity
- regular exerices can help people live longer and better and may reduce the risk of chronic conditions like heart dieases and dementia
95
mental well-being
- maintaining balance, connection with others, and being prepared for challenges can help with mental well-being
96
social support
- social support and encouragement can help people age healthily
97
preventive health and safety
- regular checkup, immunizations, screenings, and checking for vision and hearing loss can help with preventive health and safety
98
acceptance of aging
accepting aging can help people make lifestyle decisions then take into account their physical and social situation
99
multimodal interventions
- incorpating physical activity, intellectual engagement, emotional control, social interaction, and meaning can help with healthy aging
100
economic autonomy
- increasing access to economic autonomy can help people age healthily
101
health promotion
enabling people to increase control and improve their health by developing resources to maintain well being.
knowledge, communication and understanding
102
health promotion, how?
complementing existing health promotion programs to ensure they are adequately meeting the needs of older adults, epically vulnerable population
103
core strategies for promoting healthy aging
- focus on prevention and wellness
- equity and accessibility
- person-centered approach
104
focus on prevention and wellness
- proactive health screenings
- health education
- vaccine and immunization programs
105
equity and accessibility
- address rural and remote access
- support for low-income older adults
- culturally sensitive care
106
person-centered approach
- personalized health plans
- self-management support
- advance care planning
107
6 evidence based strategies for healthy aging
- physical activity
- social/leisure activities
- intellectual engagement
- nutrition
- stress management
- sleep
108
examples of nondrug prevention and treatment stragteies currently under studys
- blood pressure control
- diet
- sleep
- hearing
- cognitive training
- social engagement
- PA
109
intersectionality of physical activity and PA
- highest levels of PA reduce risk of cognitive decline and dementia by 20%
- PA has most positive results on healthy aging in combination with interventions
- reduce anxiety and depression
- improves sleep quality
110
PA programs + cognitiely stimulation exercise =
significant improvement in cognitive health and mental well-being
111
benefits of sleep
- supports brain health
112
bad sleep
not getting enough
sleep disorders
113
lack of sleep
makes the brains emotional center overreact, while reducing control over emotions, increasing the risk of depression, aggression, and attention problems
114
sleep-deprived people
have difficulty interpreting emotional signals and may respond more strongly to negative cues
115
when sleep-deprived
people often perceived neutral thing as negative, leading to a "threat-bias" in their perception
116
intersectionality of social/leisure activities and healthy aging
social relationships (support groups, social groups)= maintain and improve cogntivie and mental well-being
117
relationships between..
1. social acitivity with global cognition, overall executive functioning, working memory, visuospatial abilities and processing speed
2. social networks with global cognition
3. social support with global cognition and episodic memory
118
caloric restriction
has been controversially shown to beneficially effect cognitive aging
- NOT recommended for older adults
- reduce risk of chronic disease and improves cognitive and mental health
119
diets
Mediterranean diet can result in lower risk of dementia
120
vitamin
isolated vitamin deficiencies associated with cognitive disorders
- adequate intake of protein, fiber, vitamin D and omega-3 fatty acids
121
manage stress
chronic stress and high allostatic load speed up aging and raise the risk of age related diseases
- maning stress encouraging healthy behaviours and reducing physiological responses can help lower allostatic load, promoting healthier aging
122
what is gerontechnology?
is an interdisciplinary field linking existing and developing technologies to the aspirations and needs of aging and aged adults
123
what does geotechnology support?
"successful aging" and is a response to the combination of the aging of society and rapidly emerging new technologies
124
subcategories in gerontechnology
- successful aging
- improve communication and mobility
- aging in place
- more
125
subcategory: successful aging
- shifted from primarily biomedical to more holistic view including subjective aspects of the ageing process
- within this process geotechnology may include any device or intervention that contributes to the persons perception of, or ability to successfully age
126
improve communication & mobility: subcategory
- wearables: apple watchs, alerts
- implants and replacements: cardiac implants, cochlear implants
- mobility aids: powerchairs walkers
- cogntivie aids: in extreme cases brain communication interfaces
127
aging in place: subcategories
- most older adults want to keep lving independently for as long as possible or "age in place"
128
within aging in place, gernotechnology can include:
traditional technologies
non-traditional technologies
129
traditional technologies
technologies that facilitates human contact
- can be used to personally connect or for travel
130
non-traditional technologies
robots and voice-first technology can be used to connect with loved ones, assist in daily living etc,
131
what does age in place mean
remaining living in the community, with some level of independence rather than in residential care
132
non traditional technologies: smart home devices
- google home and alexa
- the device is voice activated and can be linked to wifi-capable appliances to create a smart home system, providing autonomy for those facing challenges
133
non-traditional technologies: AAL systems
- ambient assisted lving (AAL) systems are comprised of various sensors that use articial intelligence (AI) to analyze behaviour and compare it to established patterns, identify divergencies and call caregivers as needed
134
AAL systems : RF pose
- RF provides accurate human pose estimation through walls anad obstructions. it leverages the fact that wireless signals in wifi frequencies transverse walls and reflect off the human body
135
ethical considerations- assistance or surveillance? helpful:
- constant vigilance and security
- know the location if fall/unconscious
- quick response time, response goes to appropriate people
136
ethical considerations- assistance or surveillance. harmful:
- personal life becomes known to their caregivers and even family members
- personal privacy: having to explain long time in the bathroom, bedroom etc
- possible 24/7 surveillance nad security risks/fears
137
ehtical considerations?
- a fine line between wanting to help vs relinquishing autonomy
- in the intervention sustainable
- does the intervention require more attention to detail?
138
gerontechnology for the future: nike go flyease
- the project began in 2000 and was finalized in 2021
139
pros: nike Go FlyEase
reduce bending and eliminates the need for hand dexterity
140
cons: Nike Go Flyease
require balance to remove, questionable support
141
gerontechnology for the future: OrCam MyEye
- the OG device was launced in 2015, and the next generation was launched in 2017
142
pros:OrCam MyEye
improves QoL of people who are visually or hearing impaired
143
cons: OrCam MyEye
requires dexterity, needs a baseline level of hearing, doesnt eliminate the need for glasses, cost $4250
144
case example: care predict , senior living
- resident call button with 2 way vocie
- fall detection
- visitor managment
- wander management
- predictive insights
- touchpoint (family view)
- Pinpoint (automatic contact tracking)
- keyless door entry
- precise real-time location
- tracking system (RTLS)
145
case example: care predict, home care
- predictive insights
- smart location awareness
- customizable data collection
146
case example: care predict, at home
- proactive alerts
- location insights
- attention on demand
- "Care Circle" (
- Care Voice
147
case example: care predict does it work?
- 39% lower hositalization rate
- 69% lower falling rate
- 67% greater length of stay
- the staff alert acknoledgment and reach resident times also improved in the + CP communities by 37% and 40% respectiviely
148
plausible explanations for findings
- both staff and older persons who wore the device used it effectively for two-way communication, resulting in immediate response
- staff were able to quickly learn about activities and behaviours in their population
- difficult to ascertain the reason in improved responses times as staff used CP for multiple functions
149
more about geotechnology
- is ever evolving much at the same rate as mainstream tech
important to consider
- the population in question
- the accessibility and sustainability of the intervention
- cost to benefit
150
what are age-friendly communities
recognizing the profound impact of large population of older people on communities and community infrastructures, the WHO initiated the global age friendly cities project in 2007 to promote policies, services, settings and structures that enable older adults to actively age-in-place
151
domains of age-friendly communities
1- physical environment
2- social environment
3- personal well-being
152
physical environment
- outdoor spaces & public buidlings
- housing
- transportation
153
social environment
- respect & social inclusion
- social participation
- civic participation & employment
154
personal well-being
- communication & information
- community support and health services
155
outdoor spaces and public buildings
safe and accessible neighborhoods encourage outdoor activities and engagement with the community
156
outdoor spaces and public buildings
- stop gap ramps
- extending time of cross-walk signals
- age-friendly park checklist, benches and signage in london
157
transportation
the condition and design of transportation related infrastrucuture affect personal mobility
- access to public transit becomes increasingly important when driving becomes challenging or when the privilege of driving is no longer a option
158
examples transportation
- cycling safety workshops
- training for older adults on how to use public transit
- driving safety clinics
159
housing
the availability of a range of appropriate, affordable and supportive housing options that incorporate flexibility through adaptive features and offer a choice of styles are essential for an AFC
160
housing example s
- home sharing programs
- housing directories
- home safety programs
161
social participation
- social participation involves the level of interaction that older adults have with other members of their community
162
examples of social participation
- physical activity programs
- arts based programming
- tea and talk educational and social sessions
163
respect and social inclusion
- community attitudes, such as a general feeling of respect and recognizing the role that older adults play in our society, are critical factors for establishing an inclusive and age-friendly community
164
example of respect and social inclusion
- senior of the year award
- intergenerational programming
- age-friendly business programs
165
civic participation and employment
includes older adults desire to be invovled in aspects of community life
- the ability of an older adult to remain employed or find new employment provides economic security
166
examples civic participation and employment
- support for voting
- volunteer fair
- age-friendly employment programs
167
communication and information
age-friendly communities provide information about community events and services in accessible formats
168
examples communication and information
- newsletter
- resources guides
- fairs or expos
169
community support and health services
access to and awareness of services and mental and physical health programs contribute to quality of life and age-friendliness
170
examples community support and health services
- fall prevention classes
- cooking programs
- community paramedicine
171
individual benefits of age-friendly communities
- increased healthy behaviours
- supports aging in place
- increased opportunities for social interactions and connection
- improved awareness of community and health services
172
community benefits of age friendly communities
- econmic benefits
- volunteerism
- fosters intergenerational connections
- increased housing options
- improved accessibility
173
ontario AFC planning guide
4 interconnected steps
174
the 4 interconnected steps
- define local principles
- assess need
- develop action plan
- implement
evaluations and sustainability as integral and ongoing activity throughout
175
benefits of ontario AFC outreach program
- strengthen community capacity
- increase collaboration
- raise awareness
176
strengthen community capacity
strengthen community capacity to implement, evaluate and sustain age friendly activities
177
increase collaboration
increase collaboration by connecting people, ideas and resources
178
raise awareness
raise awareness about AFC benefits, promising practices and planning principles
179
core facilitation strategies
- monitioring and evaluation: annual survey
- web-based: webinars, website, community profiles, newsletter
- people based: collaborative networks, knowledge broker
180
roles of a knowledge broker
- faciliate collaboration
- build capacity
- support sustainability
- identify and apprasie info
- network development
- support communication
181
what is knowledge brokering
- knowledge brokering is the act of linking people to people to information in order to share learning, better understand each other goal.
- influence each others
- bridge the 'know-do' gaps
182
how to think like a knowledge broker
1. be the helper
2. integrate the evidence
3. build and maintain relationships
4. lead, listen and facilitate
5. avoid one-size-fits all strategies
6. be open to collaboration
7. draw on big ideas
8. macro-mirco mind set
9. todays effort is tomorrows advantage
