Tutorial 4 - Ageing and Multimorbidity Flashcards

1
Q

What does ‘successful ageing’ depend on?

A
  • managing limitations in physical or other abilities
  • addressing negative impact of significant life changes on social support and social networks e.g. retirement
  • maintaining and improving performance in areas the older person values
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2
Q

What is ageism?

A

a process of systematically stereotyping and discrimination against people just because they are old

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3
Q

What does a ‘stable’ population pyramid say about a population?

A

shows unchanging patterns of fertility and mortality

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4
Q

What does a ‘stationary’ population pyramid say about a population?

A

(looks like a parabola) typical of countries with low fertility and low mortality, very similar to a constrictive pyramid

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5
Q

What does an ‘expansive’ population pyramid say about a population?

A

very wide base indicating high birth and death rates

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6
Q

What does a ‘constrictive’ population pyramid say about a population?

A
  • cones in at bottom

- the general population is older on average as the country has long life expectancy and low death and birth rates

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7
Q

What are some reasons why the number of old persons is expected to exceed the number of young by 2050?

A
  • migration
  • decreasing fertility
  • decreasing premature mortality
  • health education programmes
  • malaria prevention
  • improvements in public health in relation to housing, clean water and nutrition
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8
Q

What is the fastest growing age group in the world?

A

80+

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9
Q

Why is there expected to be a dramatic shift in population age pyramid by 2031 in Scotland?

A
  • baby boomers born after WW2 will be in their 80s

- overall mortality rates are expected to continue to improve

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10
Q

What health implications will there be of having a larger aged population?

A
  • need more geriatricians and other healthcare professionals involved in care of elderly
  • increased elderly health care facilities
  • shift of care of long term conditions from secondary care to primary care
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11
Q

What social implications will their be of having a larger aged population?

A
  • as the population ages, they will become increasingly dependent on families/ carers who are also ageing
  • demand for home carers and nursing home places increase
  • role of elderly as grandparents and carers of grandchildren is likely to change
  • housing demands change as more elderly people live alone
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12
Q

What economic implications will their be of having a larger aged population?

A
  • retirement/pension age increase
  • finding employment may become harder for young people
  • less people paying into tax and pension funds
  • lacking a private pension fund may disadvantage elderly by relying on state fund only
  • increasing cost of ‘free personal care for the elderly’ policy in Scotland
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13
Q

What political implications will their be of having a larger aged population?

A
  • current decision making and workforce planning must take account of ageing population
  • increasing elderly population may have power to influence political decision making in relation to their specific concerns
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14
Q

What is ‘multi morbidity’?

A

the co-existence of 2 or more long term conditions in an individual

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15
Q

What is an anticipatory care plan?

A

Anticipatory care planning involves discussing an individual’s goals and wishes, and recording these decisions so that in the event of a gradual or sudden decline , those providing care have clear guidance on what that person would wish to happen.

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16
Q

The should an anticipatory care plan be made?

A
  • at any time in life that seems appropriate

- continuously

17
Q

Who should make the anticipatory care plan?

A

by anyone with an appropriate relationship

18
Q

How should an anticipatory care plan be formulated?

A
  • thinking ahead and making plans

- carefully

19
Q

How can an anticipatory care plan be shared?

A
  • key information summary (KIS)

- other communication

20
Q

What may happen if there is no anticipatory care plan in place? (reactive journey)

A
  • go to GPs, district nurses and have ad hoc arrangements
  • no discussion with patient or family on condition, outlook, anticipated problems, place of care
  • problems with pain, sickness, constipation, anxiety
  • crisis calls out of hours-no plan or drugs in the home
  • admitted to hospital 999
  • dies in hospital after failed CPR
  • family given minimal grief support
  • no reflection by professional team on care
21
Q

What is positive about being proactive and seeking an anticipatory care plan?

A
  • on GP register - discussed at team meeting
  • social, financial support and info given to patients and carers
  • usual GP and district nurse proactive support visits/phone calls
  • assessment of symptoms, partnership with specialists
  • care assessed including respite and psychosocial needs
  • preferred place of care noted and organised
  • care plan and medication issued for home
  • end of life pathway used
  • dies in preferred place, family bereavement support
  • staff reflect
22
Q

What are the 3 main sections to an anticipatory care plan?

A
  • legal
  • personal
  • medical
23
Q

What are secondary preventative medications for CVS?

A
  • antiplatelets
  • statin
  • additional hypertensive if BP not controlled
24
Q

What drug classes have been shown to increase survival in heart failure?

A
  • ACEI

- beta blockers

25
Q

Why might the elderly not take diclofenac for joint pains?

A
  • other nephrotoxins

- history of heart disease

26
Q

What blood monitoring is required if you are on spironolactone?

A

potassium must be monitored

27
Q

What is the role of a care manager?

A

responsible for planning and coordinating care of the elderly and others with physical and/or mental impairments to meet their long term care needs, improve their quality of life and maintain independence for as long as possible

28
Q

How can professional care managers help individuals, families and other caregivers adjust and cope with the challenges of ageing and disability?

A
  • conduct care plan assessments
  • screen, arrange and monitor in-home help and other services
  • review financial, legal or medical issues
  • offer referrals to specialists to avoid future problems and conserve assets
  • assist with moving clients to or from retirement complex
  • provide client and family education and advocacy
  • offer counselling and support