Rehabilitation and Maintenance in Older Adults Flashcards
What are the 4 main health strategies?
1) Preventive
2) Curative
3) Rehabilitative
4) Supportive
- not mutually exclusive
What is the (i) goals (ii) methods of preventive health strategies?
i) Prevent health conditions/reduce incidence
ii) Health promoting, public health policies
What is the (i) goals (ii) methods of curative health strategies?
i) Cure health conditions/control disease and consequences
ii) Medical and surgical specialties
What is the (i) goals (ii) methods of rehabilitative health strategies?
i) Restore full function/optimise function
ii) rehabilitation/geriatric medicine
What is the (i) goals (ii) methods of supportive health strategies?
i) Preserve independence and autonomy/optimise QOL
ii) Geriatric and palliative medicine
What is the ICF?
International classification of functioning, disability and health
What are the ICF components and their respective negatives?
1) Body function and structures → Impairment
2) Activities → Limitation
3) Participation → Restriction
What are 2 things that can be done for an older person’s cognition and emotional health?
1) Daily reorientation
2) PT/OT, activity engagement
3) Reduce use of psychoactive substances
What are 3 things that can be done for an older person’s mobility, vigour and self-care?
1) Early mobilisation
2) PT
3) Avoid restraints
3) Ready access to walking aids
4) Suitable bed height
What are 3 things that can be done for an older person’s continence?
1) Assisted toileting
2) Call bell within reach
3) Orientate where toilet is
4) Medication review (eg. opioids)
5) Facility mobility
6) Avoid prolonged in-dwelling catheter/diapers/bedpans
What are 3 things that can be done for an older person’s nutrition?
1) Review dietary restrictions
2) Make dentures available
3) Review medications
4) Dietician review
5) Scheduled fluids
6) Assess swallowing and modify diet
What are 3 things that can be done for an older person’s skin integrity?
1) Turning in bed
2) Protective equipment (eg. heel protectors, padded dressing, air mattress)
3) Scheduled diaper changing
4) Protective clothing
5) Maintain good nutrition and hydration
How should a patient with a bad leg go up and down stairs?
Hold handrail on good side
Going up → good leg first
Going down → bad leg first
How do you support a patient with difficulty walking?
you become the walking aid → offer palm facing up, hand at their hip level, other hand support side
When should a walking stick/straight cane be prescribed?
In a patient with mild stability issues eg. sensory ataxia
When should crutches be prescribed?
Healthy with need for weight bearing (ok UL)
When should a walking stick with an offset handle be prescribed?
Instability with need for unilateral weight-bearing eg. hip fracture
When should a 2 wheel walking be prescribed?
mainly for parkinsons to overcome initiation failure + cerebellar ataxia (trunk swaying)
When should a 4 wheel walker be prescribed?
mainly for limited exertional capacity eg. severe COPD, CHF
When should a standard walker/pickup frame be prescribed?
bilateral weight bearing with ok UL
What are 2 local programmes supporting older adults?
1) Council for Third Age (C3A)
- promoting ground up initiatives that encourage older adults to be active and socially engaged
2) National Silver Academy (NSA)
- learning opportunities from Unis and ITE
What are 4 home-based community services for older people?
1) Home-medical
2) Home nursing
3) Home therapy
4) Home personal care
5) Meals on wheels
6) Medical escort and transport
7) Befriending service
8) Home hospice
9) Integrated home and day care (IHDC)
What are 4 centre-based community services for older people?
1) Active Aging Centre (AAC)/ Active Aging Care Hub (AACH)
2) Day care
3) Dementia Day Care
4) Day Rehab Centre
5) Centre-Cased Nursing
6) Day Hospice
7) Integrated Home and Day Care
What are 2 residential community services for older people?
1) Nursing Home
2) Shelter and Senior Group Home
3) Community Hospital
4) Inpatient Hospice
What are the 3 individual healthcare financing options in singapore?
1) Medisave
2) Medishield life (and other insurance)
3) Out-of-pocket (OOP)
What are 2 community healthcare financing options in singapore?
1) Voluntary Welfare Organisations (VWOs)
2) Community Development Councils (CDCs)
What are 3 governmental healthcare financing options in singapore?
1) Subsidies and Schemes
2) Medifund
3) Subventions for public sector health services
What is the Chronic Disease Management Programme?
Covers 23 conditions for which a patient can receive subsidies (if CHAS, pioneer, Merdeka) + can claim medisave
What is the pioneer generation package?
For SGeans born before 1950 and SG citizens before 1987
- MediSave top-ups
- Outpatient care subsidies (additional 50% off the bill after deduction of CHAS benefits)
- Additional participation incentive to join CareShield Life
- MediShield Life premium subsidies
- Pioneer Generation Disability Assistance Scheme (PG-DAS) – lifelong cash assistance $100/month for those who permanently need assistance in at least 3 out of 6 ADLs
What is the Merdeka Generation Package?
For SGeans born 1950-1959 and SG citizen before 1997 OR before 1950 and citizen before 1997 but didnt not get Pioneer gen package
- PAssion Card Silver Card Top-Up – one-off $100 for use on active ageing programmes, ActiveSG, public transport etc
MediSave Top-Ups - Outpatient care subsidies (additional 25% off the bill)
- Additional participation incentive to join CareShield Life
- Additional MediShield Life premium subsidies
What is the Community Health Assist Scheme (CHAS)?
Enables all SGeans to receives subsidies for medical/dental care at participating clinics, regardless of income
- tiered by household monthly income and annual value of home
(in subsidy: blue>orange>green)
What is the National Medical Savings Scheme (Medisave)?
Helps individuals set aside part of their income to pay for personal and approved dependent’s healthcare expenses (eg. outpatient care, vaccinations, scans, hospital stays, health screenings)
What is Medishield Life?
Basic health insurance plan for all SGeans and PRs
- life time overage and auto-inclusion
What is Medifund?
Safety net for SGeans
- endowment fund set up by the government
- for those who face financial difficulties with their remaining bills after receiving government subsidies and other means of payment (eg. Medisave, Medishield life)
What is IDAPE?
Interim Disability Assistance Programme for the Elderly
- government assistance scheme (payout/month)
- Unable to perform at least 3 out of 6 ADLs (washing, feeding, dressing, toileting, mobility, transfers)
- Singapore Citizen born before 30 Sep 1932 OR born between 1 Oct 1932 and 30 Sep 1962 but with pre-existing disabilities as at 30 Sep 2002
- Per capita household monthly income ≤ $2,800 OR no household income and living in residence with annual value ≤ $13,000
What is Eldershield?
Severe disability insurance scheme which provides basic financial protection to those who need long-term care (monthly cash payouts)
- SGeans & PR auto covered at 40 unless opt out
What is CareShield Life?
“ElderShield 2.0”
- lifetime and worldwide coverage
- premiums fully payable by MediSave
