Wk 2 Aging in Place Post - PPT Presentation

Wk 2: Care Across the Continuum: Ageing in Place David Reid RN MN What do you remember from last week? Reflective Assignment #1: Due Sept 19 @ 2355 This assignment aims to encourage you to explore and reflect on your perceptions and beliefs about older adults and the aging process. This wil...

Wk 2: Care Across the Continuum: Ageing in Place David Reid RN MN What do you remember from last week? Reflective Assignment #1: Due Sept 19 @ 2355 This assignment aims to encourage you to explore and reflect on your perceptions and beliefs about older adults and the aging process. This will contribute to your self- awareness and personal growth, and help to prepare you for compassionate, informed care of older adults in your nursing practice (posted) Include a personal experience or example e.g. personal, professional, or cultural) Template posted  Clarity & Depth; Writing Quality  marked out of 10 = 5% course grade 1 – 2 pages, submit via Assignment link on OWL Class Goals and Outline Define and describe ageing in-place Explain age friendly communities Identify barriers to ageing in-place Identify policies needed to support ageing in- place Explain the role of homecare and community nurses in supporting ageing in-place Home Care Home care a key part of a sustainable health care system First evident in what is now Canada in early 17th century  nuns from religious orders Provide care and support to Canadians in their own homes and communities (von.ca) VON = Established in 1897 to ensure that care was available, affordable and accessible to everyone in Canada Home Care and Community- Support Services refers to care that is provided in home-based settings rather than in a hospital or a LTC home; allows individuals to remain independent in the community Home care can be grouped into two types: home care services & home support services Home care focuses on the provision of health care services by trained professionals Home support services focus on facilitating ADLs and include non-medical services (e.g. personal care) Home care may be supplemented with community-based support services (e.g. adult day programs) to help older adults engage with their social and physical environments …continued Generally consists of: nursing care, personal care, physiotherapy, occupational therapy, social work , dietetics, speech language therapy, medical equipment and supplies (Stamler) ~3/4 publicly funded  insurance, private pay Home care includes acute, chronic, rehabilitative, palliative Increasing need for chronic and rehab (ageing pop’n) Differing roles Challenge of identifying number of home care nurses due to variation of titles Public Health Nurse e.g. schools, churches, community health centres, homes Home Health Nurse e.g. home school clinic, shelters, street Community Health e.g. health centres Stats While the average Canadian aged 64 years and younger costs the public health care systems $2,700 per year, the average Canadian aged 65 years and older costs them $12,000 per year The health and community care system has not kept pace with a rapidly growing older population Canadians aged 65 years and older comprise 19 % of the pop’n, but already account for 47% of all health care spending Canada spends a significantly larger portion of its care expenditures on institutional LTC rather than home and community care despite home being “overwhelming preferred by Canadians” Ageing & Chronic Illness How has illness shifted over time? Acute  chronic What are common illnesses? Not all adults with complex care needs require care in LTC homes Estimates suggest that between 11 & 30% Canadians admitted to LTC homes could have potentially remained at home/community with adequate home care and community supports A serious question to consider as we discuss ageing… Imagine you are at the end of your life…where do you want to be? Final weeks? Final days? Factors re: home care vs. LTC Don’t want to live in LTC Didn’t plan for it Waiting lists Costs Ageing at home – does not include LTC National Institute on Aging The National Institute on Ageing (NIA) is a public policy and research centre based at Toronto Metropolitan University The NIA is dedicated to enhancing successful ageing across the life course It is unique in its mandate to consider ageing issues from a broad range of perspectives, including those of financial, psychological, and social well-being The intent of the expert panel… To understand what is needed to successfully age at home and to support well-being and quality of life (QOL) of older persons Reflect on older adults you know – what helped them age successfully at home or what gaps exist in care and supports? Age in Place Most older persons in Canada prefer to age in their homes and communities. In a 2020 survey, as many as 96% of Canadians aged 65 and older reported that they would do everything they could to avoid going into a long-term care facility (National Institute on Ageing, 2022). Traditionally, Canada’s spending on LTC has been more heavily weighted toward institutional care than the home and community-based care that is both less expensive and overwhelmingly preferred by Canadians (decreased hc burden) Aging at home Aging at home can be understood as enabling healthy aging in one's home and community It also refers to the ability to live safely, independently, and comfortably in one's own home and community, regardless of age, income, or capacity Aging in place is a term often used by practitioners, policymakers, and researchers Aging in the right place is used by many organizations and researchers The term extends the concept of aging in place to the ability to live in a dwelling with the closest fit to the person's culture, identity, needs and preferences, which may or may not be one's home (National Institute on Ageing, 2022) What barriers/facilitators might ‘ageing @ home’ include?  https://www.cbc.ca/player/play/video/9.4234781 Ageing at home Decreased ER visits “You have your independence, and your independence means so much to everyone” “age in place as long as they possibly can” Risks/what Ageing in Place shouldn’t look like Literally ageing in place…in a chair Risk of very limited mobility, extreme isolation Barrier of cost for care…cheaper health care What is wait list for home care? Government of Canada (June 2024) Final Report of the Expert Panel. Supporting Canadians Aging at Home: Ensuring Quality of Life as We Age https://www.canada.ca/content/dam/esdc-edsc/documents/national- seniors-council/programs/publications-reports/aging-home/NSC- ExpertPanel-AgingAtHome-FinalReport-EN-20240621.pdf  Final Report: Values guiding ageing in place 1. Ensures low-income and equity-deserving people can access equitable services 2. Upholds human rights of older persons and be based on the engagement of them, their loved ones, caregivers, and care providers 3. Ensures programs and benefits are designed and delivered with empathy in a manner that enhances older person's dignity and honors their contributions to society, where respect is at the core of all programs, services, and benefits 4. Promotes self-expression and, where possible, empowerment so older persons can make decisions and have choices, including the choice to live at risk 5. Enhances older persons' intrinsic capabilities and capacities using a strength-based lens and an asset- based perspective 6. Is person-centred and oriented around the needs of the older person with a team-based and multi- disciplinary approach 7. Ensures the health and social care workforce (care providers) are respected, valued, and appreciated. Building capacity and competency, having access to training and professional development opportunities 8. Ensures that family, friends, neighbours, and caregivers are respected, acknowledged, valued, supported, and recognized for their contribution to society 9. Ensure that governments at the federal, provincial, territorial, and municipal levels work collaboratively and in partnership and takes overall responsibility for the stewardship of support systems. Sets standards on the quality of care and support and implements evidence-based decision-making 10. Adopts innovative approaches to aging at home by ensuring a balance between technology-based (high- tech) approaches and in-person care and support (high- touch). It should also be conditional to technology acceptance by older persons _____ % of people over age 65 use the internet 11. Ensures older persons achieve quality of life as they age and receive equitable services, no matter their geographical location in Canada https://youtu.be/ytmPYOTxUjg? si=pL_KGuMFPQnhYHT_ 1. Move naturally --- go for a walk 2. Purpose – engage! 3. Stress – relieving. Sleep 4. Mindful eating 5. Eat plants 6. Alcohol? 7. Belonging (relationships) 8. Loved on (relationships) 9. Social circles – community…groups of friend t/o life How can we promote QOL for ageing at home? The Quality of Life Framework for Aging in Canada The Expert Panel’s recommendations are tagged to the 4As. This is to showcase how the recommendations are expected to have the most significant impact in supporting older persons in Canada to age at home. Barriers to Aging at Home The 4 As have become pillars for policy development 1. Availability 2. Accessibility 3. Affordability 4. Accountability Quality of Life (QOL) framework for Aging in Canada Health care transformation? Recognizes that: aging at home requires a holistic effort and a broad range of services and support aging at home should not strictly aim at helping people stay at home. Instead, it should help people live fulfilling lives at home successful aging at home policy will lead to improved quality-of- life indicators for older persons living in the community Policy Domains 1. Prosperity Income insecurity (particularly women) utilize government benefits to facilitate income security Note e.g. of benefits during COVID Policy Domains 2. Health What are key health challenges? health care workers in the home…how many can you identify? enhance palliative care health promotion (e.g. list of ‘9’) Policy Domains 3. Society Housing! Affordable housing Grants/programs that provide longer-term funding for housing Support caregivers e.g. funding, caregiver associations Policy Domain 4. Environment Technology access Digital literacy Age-friendly communities Local public transportation Policy Domain 5. Good Governance This means enacting legislation on home care e.g. implemented national quality standards as is often done for LTC On that note, create national standards for LTC Notably, this includes prevention of mistreatment/abuse Convention on the rights of older persons What this might look like, based on what we’ve discussed… Some of these are ‘big ideas’ e.g. policy, while some are ‘individual’ e.g. your (daily) practice What do you need vs. what we can give you i.e. community! e.g. foot care, vaccines, paramedic, exercise Streamline homecare Better supported, feel healthier, avoid ER visits Accessibility, healthcare, and emergency services must be tailored to support a predominantly senior population Nursing Role: enable healthy ageing Focus on disease prevention and health promotion Invest in a new national public awareness campaign and broad disease prevention, health promotion strategy and action plan Include disease prevention and health promotion activities: physical, mental and brain health community and work force engagement anti-ageism safety awareness, etc. Activities could be diverse: exercise, balance, stress reduction, nutrition and cognitive stimulation Other examples are social connections, community engagement and management of chronic diseases, e.g. diabetes Which of the following is a normal age-related change in older adults? a. Decreased ability to understand language b. Reduced lung capacity c. Increased bone density d. Enhanced immune response Naturally Occurring Retirement Communities (NORCs) A growing phenomenon in Canada, reflecting a broader trend towards ageing in place. Unlike traditional retirement communities that are built specifically for seniors, NORCs evolve organically as a significant number of residents within a community age together. These communities can be found in diverse settings, from urban apartment blocks to suburban neighborhoods and rural areas. NORC – e.g. apartment, condo, or neighbourhood Co-living Multigenerational but mostly seniors  “…but we are gifted with the interactions seniors give us," she said. "The elderly are the frame work of any given community. They have so much to offer that you want to engage with them." www.cbc.ca What we have learned so far… What ageing looks like in Canada How can it be improved? What are common illnesses/health concerns What nursing interventions can you identify? Types of test questions (and therefore studying) Note the difference… A) How many QOL Policy Domains are there? Name them. Vs. B) Describe how you could improve QOL through policy.