geriatrics week 1 summary.pdf

1.4 ageism Definition of Ageism World Health Organization definition - Stereotypes: how we think. - Prejudice: how we feel. - Discrimination: how we act.; direct toward others or self based how we age - Consequences of ageism - Generational confl...

1.4 ageism Definition of Ageism World Health Organization definition - Stereotypes: how we think. - Prejudice: how we feel. - Discrimination: how we act.; direct toward others or self based how we age - Consequences of ageism - Generational conflict. - Devaluation of contributions from all age groups. - Reduced opportunities for health, longevity, and well-being. depth of ageism - Ageism against and by older adults - Social acceptance compared to other biases. - Impact on various domains: - Workplace - Media - Legal system - Banking and finances - Education - Housing Impact of Ageism on Health and Society - Health and well-being - Shorter lifespan. - Poor physical and mental health. - Slower recovery from disability. - Cognitive decline. - Poor quality of life. - Increased risk of social isolation, loneliness, and elder abuse. - Legal and financial systems - Arbitrary age-based laws (retirement, organ transplantation).- regardless of persons ability - Financial burdens: insurance premiums, loans.; makes aging worse x2 - Media representation - Underrepresentation and negative stereotypes. - Negative portrayal in social media, movies, and TV shows. -social media makes ppl think that aging needs to be disguised - Workplace discrimination - Issues in recruitment, hiring, training, and retirement. - Biased performance reviews and pressures to retire. -judged on performance and interpersonal skills Ageism in Health Care - COVID-19 pandemic impact - Use of age for triaging and public health laws. - Isolation of older individuals in facilities- “protecting them” - Healthcare decisions - Age influencing treatment decisions (ventilator support, dialysis, surgery). - Reduced access to healthcare services. - Exclusion from health intervention research. Elderspeak - Characteristics: slow speech, exaggerated tones, elevated pitch and volume, simple vocabulary, reduced complexity and diminutive language - Negative impacts: increased resistance to care to those w dementia , feelings of isolation, cognitive decline. - Physical therapists' role - Importance of mindful verbal communication. - Awareness of biases affecting perception of older individuals’ health and abilities Ageism in fitness and health - Research by Jen and Harvey (2021) - Perceptions and misconceptions - Impact on physical and mental capacity. - Negative effects on body image and psychological well- being, especially for older women. - Exercise motivation - Positive impacts of meaningful physical activity; making them more motivated and gave them control - Negative effects of youth-dominated activities and biased fitness programs= loss of motivation - Limited adequate opportunities - Insufficient exercise recommendations and guidance. - Passive or less challenging interventions by healthcare practitioners. - Identity as “older exerciser” - Biases towards older exercisers (praise by younger ppl) and non-exercisers (seen as less competent) - Additional challenges for older women exercisers (bias of attraction and sexualization during exercise or sport) Combating Ageism - World Health Organization’s three-pronged approach - Policies and laws. - Education and intervention. - Intergenerational contact interventions. - intersection of racism and ageism in healthcare (Lundberg et al, 2021) - Anti-discrimination laws in workplaces. - Enforcement of behavioral change leading to attitude change by reestablishing social norms - Example: COVID-19 lockdowns in long-term care facilities- pts isolated and loss of physical mobility Education and intergenerational contact - Individualized interactions promoting equal status. - Cooperative activities and sharing personal information- working toward common goal - Examples of successful intergenerational interactions: - Instagram project (2020). - Video games between younger and older participants (2013).- reduced intergenerational anxiety and attitudes among older peripheral - Home share programs (Portugal and Canada).- seniors provide home to students and students help combat isolation, loneliness and improve welfare - PEACE model (Levy et al, 2018) - Positive education about aging and contact experiences - Interactions with positive older adult role models- helping mitigate biases - Combined education and positive interactions to change attitudes and reduce anxiety. - Broad impact on older adults, younger generations, and society.- decreases discrimination, prejudice and stereotyping -can apply to different settings: school, work ect summary Ageism and its intersectionality with other social determinants may have a negative impact on health and rehabilitation Can be effectively combatted through policies, education, and intergenerational interactions  1.5 Diversity in Aging Aging process has 2 different groups with different impacts Normal vs Accelerated impacted by all further impact - genders S equity - sexuality diversity - spatiality inclusion - indigenous culture Gender (socioeconomic effects) differences in - employment - labor participation - wages - pension women higher poverty than men provide unpaid care judged/perceived by looks but decreases with age - in comparison to men are valued by accomplishments and increases w/ age transgender most poverty less access to services for health/domestic abuse, affordable housing, safe housing higher risk of mental health illness/specific health challenge related to trans sx sexuality (lesbians/gays/bi) more likely to live alone - compounding risk for mental health/poorer health outcomes less civil rights to provide care for partner if institutionalized live below poverty line compared to different sex couples of older age less likely to have kids - care from social supports (less intergenerational interaction) - old ppl taking care of old ppl less access’s to healthcare/support bc discrimination/fear barriers in aging - stigmas/discrimination - causes increased isolation, less social support, not belonging to religion higher rates of mental health issues - bc of prejudice, trauma, discrimination Challenges with healthy aging (gay/lesbian/bi) aging w/ HIV 9% LGBTQ 33% gay men - makes them more susceptible to chronic conditions (CVD, diabetes, renal dx, cancer, HIV related dementia bc chronic inflammation) concerned about being recloseted if put in care facility indigenous adults aboriginal ppl = aging faster and more chronic conditions in earlier life elderly beliefs and historical experiences impact aging process - view life as cyclical (NOT LINEAR), continues into spirit world As PTs consider social and structural determinants - historical trauma, ongoing grief consider interaction b/w health abd wellness, engagement & behavior, empowerment & resilience, & connectedness Interventions remember interventions/health promotions should take into account that older generations will pass it down to younger generations should promote interactions b/w generations w/ natural environment (water/land/connecting to community & culture) older adults in rural communities women constrained by lack of transportation men constrained by awareness and interest in social activities actually a higher level of social engagement and larger social networks here half of services available - lack of caregiver support, respite care, affordable housing - leads to burnout in healthcare workers/volunteers - need to travel out of town for services - COVID made it hella terrible ppl had to travel for hours for help Summary aging is a diverse process w/ vast variables impacting one’s experience  1.6 Health Literacy Health Literacy individuals having the capacity to obtain, process, and understand basic health info & services needed to make appropriate health decisions Health Literacy allows individuals find/understand health info take responsibility for own health Lack of health literacy adverse impact on wellness/prevention increase need to access healthcare services European health literacy consortia definition linked to literacy & entails ppl’s knowledge, motivation & comptences to access, understand, appraise, & apply health info in order to make judgements & take decisions in everyday concerning health care, dx prevention & health promotion to maintains or improve QOL - beyond a skill ppl should use - encompasses role of healthcare providers in providing accessible info pts can understand Socioeconomic determinants of health literacy in adults psychosocial effects on health literacy - edu - race/ethnicity - age - income - no differences in gender Chart summary increase in below basic health literacy w/ increased age hispanics = highest percentage of below basic health literacy -> natives -> black ppl PT ensure pt provided on education on exercise/chronic dx prevention/management and health and wellness understand/implement educational topics we provide Older adults with poor health literacy more likely to report health as poor less access to health care reduced positive health outcomes less access to resources to prevent dx/complications less compliant w/ medications/instructions Parker: test of fxnal health literacy in adults (!995) 50 items on reading comp 17 numerical ability 22 min Updated shorter version decreased validity in numerical literacy 36 items 7 min REALM rapid estimate of adult literacy & medicine - asks individuals ro read & correctly pronounce terms Newest Vital Sign (NVS) 6 questions based off fake nutrition label 2-3 min calories/allergies etc ask for non english speakers improving health literacy community based initiatives can help collaborative learning (share health info w/ family, community, healthcare prof) = increased social support = increased health literacy interactive learning opportunities & tailor to audience base in behavioral change framework helps promote health literacy - center: improve individual’s access & ability to understand/appraise/apply health info - can improve health care delivery, dx prevention, health promotion in society, affecting services, behaviors, costs & outcomes - leads to better participation/empowerment & long term sustainability Health literacy has significant + association w/ physical literacy BMI, healthy wt, grip strength, cardio respiratory fxn predicting physical literacy Physical literacy motivation, confidence, physical competence, knowledge/ understanding to value & take responsibility for engagement in PA for life  Physical literacy cont. promoting older adults being PA need safe environment education/promotion of PA intrapersonal motivation w/ social interaction/support for adaptions to enjoy PA sustained engagement in PA contributes to increased knowledge & awareness supported by environment/community changes culminates confidence & physical competence (refer to chart) PTS increase physical literacy and PA Summary increased health literacy & physical literacy can be linked to increased confidence, motivation, & self initiation