Medium Module 4 Textbook

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary purpose of long-term care?

To offer a range of preventative and responsive care for older adults (correct)

To provide short-term hospitalization for acute illnesses

To conduct surgical procedures

To deliver emergency medical services

Which of the following best describes 'aging in place'?

Providing services that allow older adults to stay in their homes (correct)

Offering hospital-based treatments for the elderly

Relocating seniors to warmer climates

Moving older adults into nursing homes

What percentage of Canadians have long-term care insurance?

About 25%

Exactly 40%

Less than 10% (correct)

Over 50%

What is the expected financial burden on families in terms of copayments for long-term care?

$1,000 to $34,000 per month Signup and view all the answers

What demographic has the highest representation among those requiring long-term care?

Older adults aged 85 and older Signup and view all the answers

How much of total health care spending in Canada is attributed to long-term care?

12-16% Signup and view all the answers

Which group is least likely to have appropriate home care?

Older adults living alone Signup and view all the answers

In Canada, what proportion of total home care hours are provided by family caregivers?

75% Signup and view all the answers

What structural change occurs in the lungs during chronic emphysema?

Narrowing of bronchi and permanent alveolar destruction Signup and view all the answers

Which factor is the main cause of Chronic Obstructive Pulmonary Disease (COPD)?

Smoking Signup and view all the answers

What is a common method used to treat COPD?

Inhalers to increase oxygen in the lungs Signup and view all the answers

Which best describes mild cognitive impairment?

A sign that can indicate an increased risk for Alzheimer's disease Signup and view all the answers

What is an important component of social determinants of health?

Income and social status Signup and view all the answers

Which type of amnesia refers to difficulty remembering future events?

Anterograde amnesia Signup and view all the answers

What benefit is associated with prevention in older age?

Reduction of stress on the medical care system Signup and view all the answers

What does effective psychosocial treatment aim to address in neurocognitive disorders?

Emotional and social functioning Signup and view all the answers

What is the primary focus of good palliative care for dying patients?

Holistic care that meets patients' individual needs Signup and view all the answers

Which factor is NOT a typical physiological symptom of bereavement?

Increased creativity Signup and view all the answers

What does the dual process model of coping with bereavement emphasize?

Alternating between dealing with loss and restoration tasks Signup and view all the answers

What is a common risk regarding coronary heart disease?

It results from plaque buildup in arteries Signup and view all the answers

What is the term for the thickening and hardening of arteries that everyone experiences to some degree?

Arteriosclerosis Signup and view all the answers

What lifestyle factor is associated with a higher risk of cardiovascular disease?

Sedentary lifestyle Signup and view all the answers

What defines hypertension according to blood pressure readings?

Greater than or equal to 140 mm Hg systolic pressure or 90 mm Hg diastolic pressure Signup and view all the answers

Which of the following is NOT a criterion for metabolic syndrome?

High physical activity levels Signup and view all the answers

What is a characteristic symptom of chronic bronchitis?

Frequent coughing and sputum expectoration Signup and view all the answers

Which condition is referred to as a 'ministroke'?

Transient ischemic attack Signup and view all the answers

What emotional responses are typical during the bereavement process?

Anger and emptiness Signup and view all the answers

Which of the following is NOT a component of activities of daily living (ADLs)?

Going shopping Signup and view all the answers

What is the main effect of repressive coping in bereavement?

Forgetting the painful event can be helpful at times Signup and view all the answers

Which of the following statements about cardiovascular disease is TRUE?

It is the leading cause of death worldwide Signup and view all the answers

What is the primary focus of adult day programs?

Addressing the needs of older adults through various community services Signup and view all the answers

What is the Green House model primarily designed to achieve?

Create a community feel in long-term care settings Signup and view all the answers

What typically triggers the relocation process to a long-term care facility?

A major health event Signup and view all the answers

What psychological model predicts the optimal adjustment level for individuals in institutional settings?

Competence-press model Signup and view all the answers

Which medication is most commonly prescribed in long-term care facilities?

Antidepressants Signup and view all the answers

What is a significant concern regarding for-profit nursing homes compared to other types?

Higher rates of fraud practices Signup and view all the answers

What is a recommended strategy for successful residential transitions for individuals with dementia?

Strong interprofessional collaboration Signup and view all the answers

What aspect is often overlooked in the provincial standards for long-term care facilities?

Psychosocial aspects of care Signup and view all the answers

What does 'death with dignity' refer to?

Maintaining autonomy over end-of-life care decisions Signup and view all the answers

Which of the following is NOT a symptom at the end of life according to the provided content?

Excessive energy Signup and view all the answers

Which advance directive indicates a person's wishes regarding resuscitation?

DNR: Do Not Resuscitate Order Signup and view all the answers

What phenomenon describes the public attitude towards death in modern society, often leading to isolation of dying individuals?

Social Death Ethos Signup and view all the answers

What common psychological reaction may occur when individuals near the end of life begin to reflect on their past?

Life review Signup and view all the answers

Study Notes

### Long-Term Care

Long-term care involves a variety of services to help older adults and individuals with disabilities.
It can be provided in different settings, including homes, facilities, and communities.
It accounts for 12-16% of Canada's total health care spending.
Over half of Canadians do not feel financially prepared for long-term care costs.
Most Canadians do not have long-term care insurance, making saving for these costs unrealistic.
The majority of long-term care facilities are private, followed by non-profit and then public.
Long-term care facilities are more likely to be rated with quality violations and fraud practices, with lower staffing levels, when they are for-profit.

Home Care

Home care provides assistance to older adults within their own homes.
Services include meals on wheels, drop-in visits, home assistance, and restorative services.
While preferred and less expensive than institutional care, many Canadians lack access to proper home care, especially those living alone, women, and immigrant populations.

Family Caregivers

One in four Canadians provides care to family or friends.
75% of all home care hours are unpaid.
The cost of replacing unpaid caregivers in 2019 was $9 billion, expected to rise to a staggering $27 billion in 2050.

Adult Day Programs

Community services providing medication management, physical therapy, meals, medical care, counseling, and social opportunities.
Can function as respite care for family caregivers.

Supportive and Assisted Living

Offer services like social activities, housekeeping, personal care assistance, and on-call care providers.
Primarily cater to older adults with financial means.

Nursing Homes

Provide comprehensive services like medication management, physical therapy, and social opportunities.
Most residents (86%) require extensive help with instrumental activities of daily living (IADLs).
More often focus on physical needs rather than psychosocial ones.
There is a growing focus on person-centered care.
The use of antipsychotics and physical restraints in nursing homes has decreased in recent years.

Relocation to Long-Term Care Facilities

Often occur after major health events.
Can lead to a mix of feelings, including regret, guilt, depression, and relief.
The transition can be stressful, especially when limited choices are available.
Family involvement and professional support can aid in a smoother transition.

Psychological Issues in Long-Term Care

The Competence-Press Model explains the optimal level of adjustment in institutional settings by matching residents' abilities with the environment's demands.
Long-term care environments can be designed to adapt to residents with diminished cognitive abilities, promoting safety, accessibility, and social engagement.

Green House Model

An alternative to traditional nursing homes, offering small communities, a home-like setting, and increased social interaction.
While promoting a more comfortable environment, research suggests a higher incidence of depressive symptoms among residents.

Culture Change Movement

Encourages person-centered care and creating a sense of "home" within institutional settings.
Emphasizes individualized care and addressing the unique needs of each resident.

Death and Dying

Death is defined as the irreversible cessation of brain function.
Dying is the period leading to death, marked by declining vitality.
Common signs of death include sleepiness, disorientation, irregular breathing, and decreased bodily functions.
The dying trajectory refers to the temporal pattern of the disease process leading to death.
There are four common dying trajectories including: sudden death, terminal illness, organ failure, and frailty.

Sociocultural Perspectives on Death and Dying

Death ethos is the society's prevailing philosophy about death, encompassing rituals, treatment of the dying, representations in art, beliefs about the afterlife, and social conventions surrounding death.
The death ethos has evolved over time, transitioning from familiar "tamed death" to "glorious death" in the 1800s.
The "invisible death" ethos emerged in the 20th century, favoring dying in hospital settings, separated from families.
The "social death" ethos further marginalizes the dying by treating them as non-persons

Psychological Perspectives on Death and Dying

Death can influence how people view others, including their memories and perceptions of their lives.
People may use identity assimilation to deny the possibility of death, identifying strongly with youthful traits and health.
Legitimization of biography occurs when people nearing death seek to leave a legacy, often through internal reflection or external actions.
Awareness of finitude, marked by the passing of others close to them, can prompt serious contemplation of death.
Erikson's ego integrity theory suggests that the awareness of life's end triggers self-evaluation, reflecting on past experiences and seeking atonement.
Terror management theory argues that humans are motivated by a desire to manage the terror of death. This can lead to people adopting positive habits, focusing on personal goals, and enhancing interpersonal relationships.

End-of-Life Issues

Advance directives document an individual's wishes if they become ill or incapacitated, maintaining their autonomy even in compromised states.
DNR (Do Not Resuscitate) orders and DNH (Do Not Hospitalize) orders provide instructions for medical interventions.
The majority of Canadians are unfamiliar with advance care planning and its importance.
Medical Assistance in Dying (MAiD) allows individuals with grievous and irremediable conditions to end their lives.
Hospice Palliative Care is person-centered care that focuses on comfort, support, and addressing physical and emotional needs at the end of life.

End of Life Care

End of life care should be adapted to the patient's needs and situation
Holistic approach, involving the patient and family
Early intervention alongside other medical treatments
Access to specialized care when needed
Choice of setting for care

Bereavement

The process of coping with the death of another
Older adults are more likely to experience bereavement due to their increased life span
Physiological Effects: tightness of chest, shortness of breath, fatigue, sleep problems, digestive issues, weakened immune system
Emotional Effects: anger, depression, anxiety, emptiness, preoccupation with the deceased
Cognitive Effects: impaired attention and memory, social withdrawal, increased risk of accidents
Sociocultural Effects: changes in family and community roles, loss of status, financial burden
Losing a child is the most devastating form of bereavement
Parental bereavement increases risk of death for up to 20 years, particularly for mothers
Attachment View of Bereavement: maintaining emotional bonds with the deceased is beneficial for the bereaved; holding onto objects, thoughts, and memories
The deceased person becomes a part of the survivor’s identity
Dual Process Model of Coping: alternating between two dimensions: loss and restoration
Loss: coping with the emotional consequences of death
Restoration: taking on new tasks or functions
Different coping strategies work for different individuals based on attachment style
Flexible Adaptation: individuals who are best able to cope with loss are able to adapt flexibly
Repressive Coping: forgetting painful events can be beneficial in some cases
Identity Process Theory: choosing to continue identifying with roles related to the deceased, such as wife or mother

Key Concepts in Health and Prevention

Health is a state of complete well-being, not simply the absence of illness or disability
Activities of Daily Living (ADLs): Bathing, dressing, transferring, using the toilet, eating
Instrumental Activities of Daily Living (IADLs): Using the phone, shopping, preparing meals, housework, laundry, transportation
General Behavioral Risk Factors for Chronic Disease: Tobacco use, alcohol abuse, unhealthy diet, sedentary lifestyle, obesity
41 million people worldwide died from chronic diseases in 2018
Chronic diseases are more common in low and middle-income countries and affect individuals under 70 more frequently

Diseases of the Cardiovascular System

Atherosclerosis: Fatty deposits build up in artery walls, reducing blood flow
Arteriosclerosis: Thickening and hardening of arteries; a natural aging process
Coronary (Ischemic) Heart Disease: Plaque buildup in an artery blocks blood flow to a specific part of the body; Coronary refers to the heart
Myocardial Infarction: Severe reduction or blockage of blood flow to the heart muscle
Hypertension: Chronically elevated blood pressure
Systolic Pressure: Pressure during heart contraction
Diastolic Pressure: Pressure between heartbeats
Hypertension occurs with blood pressure greater than or equal to 140/90 mmHg
Atherosclerosis contributes to hypertension by narrowing arteries and increasing pressure
Congestive Heart Failure: The heart cannot pump enough blood to meet the body's needs; leads to fluid buildup and organ dysfunction
Cerebrovascular Disease: Disorders affecting blood circulation to the brain
Cerebrovascular Accident (Stroke): An artery in the brain bursts or gets blocked by a clot
Transient Ischemic Attack (TIA): Temporary blood clot in the brain; also known as a ministroke
Incidence: Heart and cerebrovascular diseases were the second and third leading causes of death in Canada, accounting for about 25% of deaths in 2018
Heart attacks and heart failure are among the top reasons for hospitalization
Cardiovascular disease is the leading cause of death worldwide, with the highest rates in Eastern Europe, Central Asia, and Central Europe

Behavioural Risk Factors for Cardiovascular Disease

Tobacco Smoking: Damages arteries, making them vulnerable to plaque buildup; accelerates aging through DNA methylation
Sedentary Lifestyle: Individuals over 65 have the highest risk of heart disease but are less likely to meet the recommended exercise target of 150 minutes per week. Only 37% of individuals in this age group meet the target
Diet: High Body Mass Index (BMI) increases risk
Obesity: Affects 1 in 4 Canadians, with higher rates among those aged 35-39 and 50-64
Alcohol Intake: High in calories and damages the cardiovascular system and brain

Metabolic Syndrome

A cluster of symptoms associated with increased risk for cardiovascular and related diseases
Criteria: Abdominal obesity, high triglycerides, low HDL cholesterol, high LDL cholesterol, high glucose
Must have at least three criteria to be diagnosed with metabolic syndrome
85% of Indigenous communities studied were at moderate to high risk for cardiovascular disease, citing barriers to healthcare, prescription medication access and affordability as contributing factors

Prevention of Heart Disease and Stroke

Diet: High vegetable and fruit intake, Mediterranean diet can reduce the risk of metabolic syndrome and is the most important preventive measure
Relaxation Training: Helps to manage stress, which is a contributing factor to cardiovascular disease
People often resist change: They are reluctant to adopt healthy habits
Individuals with cardiovascular disease require ongoing monitoring and treatment

Respiratory Diseases

Chronic Obstructive Pulmonary Disease (COPD): Group of diseases that cause airway obstruction
Chronic Bronchitis: Long-standing bronchi inflammation, increased mucus production leading to coughing and sputum
Chronic Emphysema: Permanent destruction of alveoli, causing airflow obstruction
Smoking: The main cause of COPD due to smoke-induced elastase release, which breaks down elastin in the airways
Genetic Factors: ATT gene inhibits elastase, potentially influencing susceptibility to COPD
Prevention of COPD: Medications and treatments including inhalers for oxygen intake and inflammation reduction, lung surgery to remove damaged tissue, and respiratory muscle stimulating devices like SpiroTiger

Neurocognitive Disorders

Neurocognitive Disorder: Decline in cognitive function severe enough to interfere with daily life and social relationships
Dementia: Often used to refer to cognitive decline
Mild Cognitive Impairment: A precursor to Alzheimer's disease
Amnesia: Characterized by significant memory loss
Anterograde Amnesia: Inability to create new memories
Retrograde Amnesia: Inability to recall past memories

Alzheimer's Disease

Requires further research and understanding in terms of: prevalence, psychological symptoms, biological causes, proposed cause, diagnosis, medical treatments, psychosocial treatments

### Social Determinants of Health and Wellness

Twelve Main Determinants of Health: Income/social status, employment conditions, education and literacy, childhood experiences, physical environment, social supports, health behaviors, access to healthcare, biology and genetics, culture, race, and racism
Prevention: Early initiation of preventative measures can significantly benefit older adults and relieve pressure on healthcare systems
Health Promotion: Support of healthy aging across eight domains: outdoor spaces and buildings, transportation, housing, social participation, respect and social inclusion, civic participation and deployment, communication and information, community support and health services

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores key concepts related to long-term care and home care in Canada. Discover the financial preparedness of Canadians for long-term care costs, the types of care settings available, and the role of private and public facilities. Test your knowledge of the challenges faced by individuals requiring care services.