Ageing population

Question 1

What are the key challenges of the ageing population

Answer 1

KEY CHALLENGES OF AGEING POPULATION
• Strains on pension and social security systems
• Increasing demand for health care
• Bigger need for trained health workforce
• Increasing demand for long-term care
• Pervasive ageism (denying older people the rights and opportunities available for other
adults)

Question 2

What are the main causes of the ageing population?

Answer 2

• Improvements in sanitation, housing, nutrition & medical interventions
• Life expectancy is rising around the globe
• Substantial falls in fertility (higher age of first pregnancy?)
• Decline in premature mortality
• More people reaching older age while fewer children are born

Question 3

What is intrinsic ageing?

Answer 3

INTRINSIC AGEING: natural, universal, inevitable

Question 4

What is extrinsic ageing?

Answer 4

EXTRINSIC AGEING: dependent on external factors (UV ray exposure, smoking, air pollution, etc.)

Question 5

Gives some examples of physical changes that come with ageing

Answer 5

• Loss of skin elasticity and hair colouring
• Decrease in size and weight
• Loss of joint flexibility
• Increased susceptibility to illness
• Decline in learning ability and less efficient memory

Question 6

What declines in sensory effectiveness come with age?

-visual/hearing/taste and smell

Answer 6

DECLINE IN SENSORY EFFECTIVENESS
• VISUAL
i Need 3x more light
ii Depth/colour perception
iii Narrowing of visual field
• HEARING
i High frequency loss
ii Speech comprehension 20%
• TASTE & SMELL
i 50% loss of taste buds

Question 7

What is gender bias?

Answer 7

• Women (83) live longer than men (73)
• In very old age, the ratio of women:men is 2:1
• Causes are:

20%biological (premenopausal women are protected from heart disease by hormones)

80% environmental – men take more lifestyle risks than women

Question 8

Name some consequences of higher life expectancy

Answer 8

• Pensions will have higher pay outs than those currently planned
• Chronic and comorbid conditions will prevail
• Rising inequalities as more affluent groups will use health services for longer

Question 9

Name some different types of dementia

Answer 9

• Alzheimer’s disease 62%
• Vascular dementia 17%
• Mixed Alzheimer and Vascular 10%
• Lewy bodies 6%
• Fronto-temporal 2%
• Other types 3%

Question 10

What are some alternatives to hospital admission for older people?

Answer 10

• Supporting discharge from inpatient hospital care
• Providing alternatives in acute care within the community
• Supporting chronic disease management within the community

Question 11

What was Glaser & Strauss (1965) awareness of dying? What are the 4 different types of dying awareness.

Answer 11

-An observational study of interactions between dying people, relatives and staff in USA
Hospitals

1. Closed awareness – pt does not recognise impending death, although everyone else does
2. Suspected awareness – pt suspects others know and attempts to confirm/invalidate his/her suspicions
3. Mutual Pretence awareness – all sides know but pretend the others do not
4. Open awareness – everyone knows and openly admits it

This is also complicated by uncertainty (diagnosis, prognosis, does the pt want to know)

Question 12

What is a social death?

Answer 12

when people die in social and interpersonal terms before their actual
biological death - lonely, impersonal death

Question 13

What is a good death?

Answer 13

palliative care became a specialty, aiming to demedicalise death - a
reaction against the impersonal medical city

Question 14

What are some benefits of hospice death?

Answer 14

Hospice
i open awareness, compassion, honesty
ii multi-disciplinary teams
iii emotion and relationships - modeled on a family approach
iv holistic care