Week 7: Old age Flashcards

1
Q

What was Bill Thomas’ original thought when he began working at the nursing home? what did he end up discovering?

A
  • he originally thought that the people in the nursing home were so devoid of spirit because of the medications they were taking and because they had an underlying medical condition that wasn’t being treated properly
  • but he found out that it was the nursing home lacked life and was just depressing itself
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2
Q

Bill Thomas believed that a good life was one of maximum _______

A

independence

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3
Q
  1. What are the 3 plagues of nursing home existence?
  2. How were these “attacked”
  3. After attacking these plagues what was the result? Describe what happened to the patients with dementia for example
A
  1. Boredom, loneliness, helplessness
  2. they brought in life into the nursing home, animals, plants, bright colours, activities, gardens
  3. They found out that it was actually possible to give them reasons to live - gave life meaning. For patients with dementia who had lost the ability to remember their life, it gave new meaning and satisfaction
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4
Q
  1. Bill Thomas described _____ as the sum of total shared habitats and expectations
  2. The only way to see life as something with meaning is to see yourself as part of something ________. If you do not _______ is only a horror
  3. Above the self-actualization level of Maslow’s hierarchy of needs, they suggest that people have a _______ desire to see and help other being achieve their potential
  4. medicine focuses on the ______ of health rather than the _______ of the soul
  5. the battle of being mortal is the battle to maintain the ______ of one’s life
A
  1. Culture
  2. greater, mortality
  3. transcendent
  4. repair, sustainance
  5. integrity
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5
Q
  1. Social connection/social protection =

2. social isolation/loneliness =

A
  1. relying on others for protection, part of our nervous system, feeling safe and protection. Reduces disease, mental health sustained, meaning in life
  2. physiological stress, loneliness, helplessness, meaningless, more susceptible to disease
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6
Q

Which is NOT an effect of loneliness on health?

a) poor diet
b) addictive behaviours
c) too little exercise
d) reduced cortisol
e) inflammation

A

d) causes elevated cortisol instead

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7
Q

Explain how each of the following is caused from loneliness:

  1. elevated cortisol
  2. chronic inflammation
  3. poor diet
  4. too much booze
  5. too little exercise
A
  1. Loneliness causes stress which your body interprets as danger. As a result, it releases cortisol. Cortisol is good for dealing with stress because it up-regulates metabolism, immune and cardiovascular systems. However, chronic cortisol increase can dysregulate these systems leading to heart disease, cancer and more
  2. Inflammation normally results in overheating but can also cause a systemic release of blood proteins that prep the immune system to deal with danger or injury. Too much inflammation can again become chronic and lead to a bunch of diseases
  3. poor diet can be from the lack of willpower to want to cook or eat anything. Or can result in binge eating due to stress.
  4. Can lead to addictive behaviours to help cope with stressors
  5. May not have the willpower or want to work out because of depressive symptoms
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8
Q

What is meant by “medicine needs to be humanized”

A

medicine in education preps people to understand biology, anatomy and disease for repairing and diagnosis. But it does not prepare you to treat patients in a humanized way and understand the underlying possibly mental health factors that can influence

  • medicine acts like the body is a machine. It is more than that and can’t just be fixed from medication. It needs other factors like human interaction
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9
Q

Explain the difference between pain and suffering

A
pain = unpleasant sensation from illness or injury 
suffering = ongoing and repetitive pain that can influence a person's will to live. It is subjective
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10
Q
  1. T/F: Suffering is an objective feeling

2. T/F: suffering depends on the physiological makeup of a person

A
  1. F its subjective

2. F is DOES NOT depend on physiological makeup

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11
Q

Based on the Eden alternative experiment:

  1. T/F: The staff were completely on board with Bill Thomas’ plan
  2. T/F: Mr L was not getting better from the Thomas’ implementation plan and he went home after 8 months
  3. prescription spending was down by ____%
  4. Death rate was down by ____%
A
  1. F some didn’t like it because they thought it would make more work for them
  2. F he went home after 5 months
  3. 40%
  4. 15%
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12
Q

Which SDH were NOT at play with the changes of chase memorial. (More than 1 answer):

a) neighbourhood and built environment
b) health and health care
c) economic stability
d) education
e) social and community context

A

c), d)

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13
Q

What did Florence nightingale say about healing environments? How does this relate to modern medical practices?

A

injured patients recovered in specific environments that would bring joy- natural light, good vents
medical professionals recognize the healing power of nature, indigenous and Chinese medicine involves nature and spiritual healing rather than medicated

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14
Q

Why are so many health care systems not following Bill Thomas’ plan?

A
  1. too much money

2. want to use the entire facility for medical purposes (ex: not for pets)

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15
Q
  1. greener environments lower risk of ______ such as …..
  2. access to nature is related to _______
  3. sunlight increase ____ blood cell production, releases ________ and reduces ____ pressure
A
  1. chronic health conditions such as cardiovas disease, diabetes, mental health
  2. wellbeing
  3. white, endorphins, blood
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16
Q

What did Viktor Frankl say about the needs of life?

A

Humans need something outside themselves to keep themselves motivated to live, we do not do well when we have no objective for living or helpless; Connected to control over our lives and autonomy

17
Q

On loneliness:

  1. __ in ____ elderly individuals will face loneliness
  2. loneliness is (objective/subjective)?
  3. T/F: loneliness always has to do with an increase in negative coping behaviours
A
  1. 1 in 3
  2. subjective
  3. F, can cause physiological impacts without behavioural coping changes. Like chronic inflammation, elevated cortisol, diabetes, heart disease
18
Q

What was Dr Carla’s study?

A

loneliness led to people not being able to perform basic everyday tasks and higher mortality rates.

19
Q

An important factor to consider with loneliness is that the _____ of relationships is more important than how many you have.

A

quality

20
Q

Stats:

  1. Over __% of Canadians are dying hospitals and many are not satisfied with what could be their end of life experience
  2. Many deaths in hospitals occur in ___.
A
  1. 60%

2. ICU

21
Q

What are ICU’s?

A

they were made for complex surgeries, serious trauma and infections. Now they are used as the last resource for Canadian’s with a serious illness. They are used because families and health care facilities may want to keep someone alive for as long as they could

22
Q
  1. What is the 3 wishes project?
  2. what is their goal?
  3. How does it occur?
  4. Why is this project so innovative compared to traditional long term care systems?
A
  1. It is a project dedicated to helping make meaningful memories at the end of life
  2. To bring peace to the final days of a patients life and to ease the grieving process as they are passing away.
  3. a set of 3 wishes to honour the dying patient. Ex: feeling the sun on their face, playing music, feeding birds
  4. It honours them and their life. Someone who may have gone un noticed but the purpose is to enforce that their life counted. They are departures from what we expect long term care to be like
23
Q
  1. Culture is the socially ________ and socially ________ constellation of things like practices, ideas, values and norms.
  2. Culture is _____-dimentional.
  3. What are the 3 important points about culture?
  4. Culture includes (Visible/non-visible) aspects
A
  1. transmitted, constructed
  2. multi-dimentional
  3. dynamic, shared, learned
  4. both visible and non-visible
24
Q

What are the visible and non-visible aspects of culture?

A
visible = clothes, music, dances, food, language, rituals 
non-visible = beliefs, values, norms, assumptions, notions of family, emotion
25
Q

what is family centred care?

A
  • recognizing family as the constant in a child’s life
  • child/family/professional collaboration
  • understanding developmental needs
  • recognizing family strengths and individuality
26
Q

What is culturally competent care?

A
  • understanding the meaning of culture and knowing about others
  • being aware of disparities and discrimination that affect racial groups in healthcare
  • being aware of own biases and assumptions as a health care professional
27
Q

what is culturally competent family centred care?

A
  • exploring and respecting child and family beliefs, values, meaning of illness, preferences and needs
  • recognizing and honouring diversity
  • implementing policies and programs that support meeting the diverse health needs of families
  • designing accessible service systems
28
Q

Ideas about what should and shouldn’t happen in the face of illness or approaching death or in a health care setting are also shaped by ______ values and norms

A

cultural

29
Q

Why is the concepts of aging and dying in medicine today limited in creativity?

A

Aging and dying is treated as a biomedical and pathological issue that requires treatment and medications in a depressive setting. But in order to heal and treat patients, we must consider other factors that are creative. Such as what Bill Thomas’ did. This gives meaning to their life and makes them feel as thought they have something to live for and not depressed

30
Q
  1. T/F: Medicine is fearful of old age and dying which has led to ignorance around the possibility that there is something vital of the human experience
  2. T/F: For Bill and Deborah, age and dying are pathological rather than natural and social experiences
A
  1. T

2. F