Canadian Health Care Systems Quiz

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Questions and Answers

What is the main reason for differences in health insurance across Canadian provinces and territories?

Differences in provincial and territorial government policies. (correct)

The overall wealth of each province.

Variations in population density.

Availability of private health insurance options.

What percentage of total health care spending in Canada is accounted for by government spending?

65%

70% (correct)

50%

75%

Under the Canada Health Act, which of the following services are publicly insured?

Optometry services.

Surgical-dental services. (correct)

Long-term care facilities.

Home care services.

What is a primary duty of the federal government under the Canada Health Act?

Set and administer national principles for the health care system. Signup and view all the answers

How did the Canada Health Act come into existence?

It is an amalgamation of previous federal legislation. Signup and view all the answers

Which program is NOT compared among the Old Age Security program, the Canada Pension Plan, and the Quebec Pension Plan?

National Disability Insurance. Signup and view all the answers

What aspect does the process of assessing mental capacity NOT include?

Identifying the best course of action. Signup and view all the answers

What constitutes the majority of private-sector spending in Canadian health care?

Out-of-pocket expenses. Signup and view all the answers

What is a common reason for underreporting elder abuse estimates?

Reluctance to report Signup and view all the answers

Which of the following is NOT a sign of elder abuse?

Proactive financial planning Signup and view all the answers

Which risk factors increase the likelihood of resident–resident abuse in elder care settings?

Cognitive impairment Signup and view all the answers

What should nurses prioritize if elder abuse is suspected during an assessment?

Determining the safety of the victim Signup and view all the answers

Which type of elder abuse involves inadequate care and nutrition in institutions?

Institutional abuse Signup and view all the answers

What is a possible consequence of elder abuse that nurses should address?

Consequences of abuse Signup and view all the answers

Which of the following can be considered a characteristic of residents at higher risk for abuse?

Limited mobility Signup and view all the answers

Which of the following is a key action for interventions in cases of elder abuse?

Hold abusers accountable Signup and view all the answers

What age must an individual be to start receiving CPP or QPP retirement pensions without additional requirements?

65 years old Signup and view all the answers

What is the maximum monthly income from CPP in 2021?

$1203.75 Signup and view all the answers

Which of the following is NOT a component of the survivor benefits provided by CPP?

CPP investment benefit Signup and view all the answers

Why are OAS programs and CPP/QPP important for older Canadians?

They ensure older Canadians do not live in poverty. Signup and view all the answers

What does the low-income cut-off (LICO) measure relate to?

Common measures of poverty Signup and view all the answers

What type of assistance do veterans receive from Veterans Affairs Canada?

Health benefits and treatment Signup and view all the answers

In gerontological nursing, which aspect is crucial when assessing older adults?

Their military or wartime service Signup and view all the answers

What role can gerontological nurses play in combating ageism?

By promoting age-friendly attitudes Signup and view all the answers

What does legal capacity primarily refer to in gerontological nursing?

A person's ability to make decisions Signup and view all the answers

Which of the following best describes the power of attorney?

A designation of another person to act on one's behalf Signup and view all the answers

What type of elder abuse involves harm resulting from a lack of action by a trusted individual?

Neglect Signup and view all the answers

Which of the following is NOT a type of elder abuse mentioned?

Peer abuse Signup and view all the answers

In assessing mental capacity, what is the general assumption about individuals?

They are presumed capable unless clear evidence suggests incapacity Signup and view all the answers

Which group of individuals has the responsibility for various decisions if a person is deemed incapable?

Guardians appointed by a court Signup and view all the answers

What is the most commonly reported type of elder abuse?

Emotional abuse Signup and view all the answers

Which type of power of attorney is valid only for a limited time?

Non-continuing power of attorney Signup and view all the answers

What was the per capita health care spending for older adults aged 65 years or older in 2021?

$11,599 Signup and view all the answers

Which of the following is included in the Old Age Security (OAS) Program?

Guaranteed Income Supplement Signup and view all the answers

In 2021, what was the maximum monthly benefit for a single person receiving the Guaranteed Income Supplement (GIS)?

$919.12 Signup and view all the answers

What is the criterion for Old Age Security (OAS) pension eligibility regarding residency?

Must have lived in Canada for at least 10 years Signup and view all the answers

Which component of the OAS Program is specifically designed for survivors of OAS pensioners?

Allowance for the Survivor Signup and view all the answers

What is unique about the Allowance and Allowance for the Survivor in terms of tax status?

They are exempt from income tax Signup and view all the answers

How does the Guaranteed Income Supplement (GIS) benefit amount vary?

Based on other income and marital status Signup and view all the answers

At what age can individuals start applying for the Allowance program?

Age 60 Signup and view all the answers

Study Notes

Ebersole and Hess' Gerontological Nursing & Healthy Aging in Canada 3rd Edition

This book is a 3rd edition on gerontological nursing and healthy aging specifically in Canada
Authors include Veronique Boscart, Lynn McCleary, Linda Sheiban Taucar, Theris A. Touhy, and Kathleen Jett.
Copyright © 2023 Elsevier Inc.

Chapter 24: Economic and Legal Issues

Learning Objectives (1 of 2)

Explain the reasons for differences in health insurance among Canadian provinces/territories for out-of-hospital care.
Describe the financing of the Canadian healthcare system.
Compare the Old Age Security program, the Canada Pension Plan, and the Quebec Pension Plan.

Learning Objectives (2 of 2)

Compare and discuss the roles of a power of attorney and a guardian.
Explain the process of assessing mental capacity.
Detect and assess elder abuse.
Describe strategies for preventing and detecting the abuse of older adults.

The Canada Health Act (1 of 2)

The Canada Health Act of 1984 combines previous federal legislation.
It outlines the national health insurance plan and the roles of federal, provincial, and territorial governments in the healthcare system.
Healthcare is managed and provided by provinces and territories.

The Canada Health Act (2 of 2)

Medically necessary services, like primary care, hospital care, and surgical/dental services are publicly insured under the Canada Health Act.
Federal government responsibilities include:
- Setting and administering national healthcare principles through the Canada Health Act.
- Collaborating with provinces and territories on national health policies.
- Contributing to healthcare funding through transfer payments to provinces and territories.
Provincial and territorial variability exists in some services, including home care, long-term care, medications outside of hospitals, physiotherapy, and optometry.

Health Care Financing

Total healthcare spending in Canada in 2019 was approximately $265.5 billion.
Government spending consistently accounts for roughly 70% of total healthcare spending.
The remaining 30% is private-sector spending (private insurance and out-of-pocket expenses).
Health care spending for older adults (65+) was $11,599 per capita in 2019, the second highest after infants under 1 year ($12,678).
Increased healthcare expenditures for older adults are partly due to increased service utilization by those in poor health.

Old Age Security (OAS) Program
- Provides income support to older Canadians
- Includes OAS pension, Guaranteed Income Supplement (GIS), Allowance, and Allowance for the Survivor.
- Federally financed through general tax revenues.
- Monthly payment for Canadian citizens/legal residents aged 65+ who have resided in Canada for at least 10 years after age 18.
- Maximum 2017-2021 monthly OAS pension benefit was $615.37.
- OAS is indexed and considered taxable income.

Guaranteed Income Supplement (GIS)
- A monthly benefit for OAS recipients with limited or no other income.
- Benefit amount depends on income, marital status, and whether a spouse receives OAS or GIS.
- Maximum single person benefit (2021) was $919.12, and $553.28 for a spouse.
- GIS is also indexed to the cost of living.

Allowance and Allowance for the Survivor
- Paid to the survivor (widow/widower) of an OAS pensioner.
- Income-tested based on the combined annual income of the couple or survivor.
- Persons aged 60-64 who meet Canadian citizenship/residency requirements are eligible and must reapply annually.
- Maximum monthly benefit (2021): $1168.65 (Allowance) and $1393.05 (Allowance for the Survivor)
- Not taxable income and indexed to the cost of living.

Canada Pension Plan (CPP) and Quebec Pension Plan (QPP)
- Provide retirement pensions and disability benefits for contributors.
- Eligibility: older adults who contributed to the plan, are 65 years or older, or between 60 and 64 and meet additional requirements.
- Maximum monthly income (2021): $1203.75, indexed to the cost of living.
- Survivor benefits include CPP death benefit, CPP survivor's pension, and CPP children's benefit.

Implications for Gerontological Nursing and Healthy Aging

OAS and CPP/QPP programs aim to prevent older Canadians from living in poverty.
Health care services accessibility varies across Canada, sometimes dependent on income and location.
Low income cut-offs (LICO) are a common measure of poverty in Canada.
Nurse assessments should include total income, income sources, and knowledge of OAS and CPP/QPP benefits application.
Gerontological nurses can encourage age-friendly attitudes by understanding the financing of healthcare and the pension system.

Health Care and Services for Veterans

Federal government (through Veterans Affairs Canada) provides veteran and wartime civilian treatment, benefits, and services including:
- Disability pensions
- War veterans allowance
- Home care services
- Long-term care and treatment benefits
- Counselling
- Personalized care planning
- Medical needs assessment
- Advice
- Information and referral
- Legal help with pension/allowance matters and funeral/burial costs.

Implications for Gerontological Nursing and Healthy Aging (Veterans)

Gerontological nurses should be aware of veteran services and support.
Assessments should include questions about wartime military service or civilian service.

Legal Issues in Gerontological Nursing (1 of 2)

Legal Capacity: A person's ability to make decisions.
It's a legal concept, not a clinical diagnosis.
To be considered capable involves understanding relevant information, evaluating data, and appreciating decision consequences.
People are usually presumed capable until legally determined otherwise.
This applies to financial decisions and decisions about daily routines, housing, personal care, medical decisions (including consent to treatment).

Legal Issues in Gerontological Nursing (2 of 2)

Capacity is issue- or task-specific and exists on a spectrum.
Mental capacity is assessed by various people (depending on the decision).
Power of Attorney: legal document to designate another person to act on one's behalf (e.g., family member, friend). - can be continuing (ongoing) or enduring (incapacitated).
Guardians: appointed by a court to manage finances, property, and/or personal care for someone deemed incapable.

Abuse, Mistreatment, and Neglect of Older Adults (1 of 2)

Elder abuse: any action by someone in a trusted relationship resulting in harm or distress to an older person.
Elder abuse occurs across all socioeconomic, racial, and ethnic groups in Canada.
Neglect: a lack of action by someone in a trusted relationship resulting in harm or distress.
Types of elder abuse: physical, psychological/emotional, sexual, economic/financial, spiritual abuse.

Abuse, Mistreatment, and Neglect of Older Adults (2 of 2)

Common types of elder abuse are emotional and financial abuse.
Estimates of elder abuse are likely underreported.
Surveys may underestimate the prevalence of elder abuse due to reluctance to report and because vulnerable older adults are less likely to participate.

Institutional Abuse

Inadequate care, nutrition, standards of nursing care, inappropriate/aggressive interactions, substandard/overcrowded/unsanitary environments.
Risk factors include environment, organizational culture, staff characteristics, and resident characteristics.
Two types:
- Resident-resident abuse (1%-41%).
- Staff-resident abuse. More likely reported from another resident than staff member. High risk residents: female, cognitive impairment, wandering behavior, limited mobility.

Signs of Elder Abuse

Fear, anxiety, depression, or passiveness towards a family member, friend, or care provider.
Unexplained physical injuries.
Dehydration, poor nutrition, or poor hygiene.
Improper use of medication.
Confusion about new legal documents (e.g., wills, mortgages).
Sudden drop in financial holdings.
Reluctance to discuss the situation.

Implications for Gerontological Nursing and Healthy Aging (1 of 2)

Nurses must be aware of potential for abuse, observing for signs/symptoms in interactions with vulnerable older adults.
If abuse is suspected, a comprehensive assessment should be conducted, considering victim safety/desires. Assess the victim's capacity.
See associated Box 24-3: Questions to Ask When Assessing Suspected Abuse.

Implications for Gerontological Nursing and Healthy Aging (2 of 2)

Intervention strategies to stop mistreatment and neglect of older adults.
- Provide care/treatment for consequences of abuse.
- Protect the victim and the public from illegal/inappropriate acts.
- Hold abusers accountable.
- Support offender rehabilitation.
- Order restitution for properties/expenses due to abuse.

Prevention of Abuse

Gerontological nurses should recognize situations with risk of mistreatment and take preventive steps to avoid abuse or neglect.
Educating potential victims of abuse/neglect about available support and options for leaving the situation.

Criminal Code and Reporting

Provincial/territorial laws may require reporting abuse of incapable individuals to the police.
Mandatory reporting of suspected abuse/neglect of residents in long-term care (LTC) and assisted living facilities.

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Description

Test your knowledge on the various aspects of Canadian health care systems, including the Canada Health Act, provinces' differences in health insurance, and elder care. This quiz covers public and private spending, as well as issues related to elder abuse and assessment. Prepare to explore important topics in Canadian health policy.