What is meant by the term ‘multi-morbidity’?
The co-existence of two ore more long term conditions within a single patient
What are some of the reasons for an increasing proportion of the elderly population around the world?
- Decreasing mortality rates
- Decreasing fertility rates
- Improvement in health education
- Improvement in healthcare services and treatments (especially as it relates to acute and infectious disease)
- Decreasing numbers of young people within the population alongside increasing numbers of the elderly
- Improvement in infrastructure in most countries (for example, more affordable housing and improved sanitation)
- Increase in the availability of more nutritious food
What are some of the reasons for an increasing proportion of the elderly population around the world?
- Decreasing mortality rates
- Decreasing fertility rates
- Improvement in health education
- Improvement in healthcare services and treatments (especially as it relates to acute and infectious disease)
- Decreasing numbers of young people within the population alongside increasing numbers of the elderly
- Improvement in infrastructure in most countries (for example, more affordable housing and improved sanitation)
- Increase in the availability of more nutritious food
- Decreasing number of deaths accompanied by a decreasing number of births
- Increasing life expectancy
What are some of the health implications of an increasing elderly population?
- Increase in the need to care for long term conditions in primary care rather than secondary care
- Increase in the prevalence of long term conditions within the population
- Increase in the need for health education and services specifically targeted at the elderly
- Increase in the number of geriatricians and healthcare services required for the elderly
- Increase in the necessity for facilities to provide healthcare for the elderly
What are some of the social implications of an increasing elderly population?
- Increase in the burden on families to care for the elderly members of their family even while the rest of the family is also increasing in age
- Increase in the demand for services like care homes and increase in demand for those who can work in care services such as these
- Decrease in the likelihood that grandparents will play the role of caring for grandchildren as they used to do
- Increase in demand for social activities within the community specifically targeted at the elderly
- Housing demands will likely change as more and more elderly people are living alone
What are some of the economic implications of an increasing elderly population?
- Increase in the retirement age
- Increase in the demand for pensions and services which are paid for by taxes
- The number of people paying into pension schemes and taxes is decreasing proportionally as the population ages and this may not leave enough money in the system to provide these services
- Younger people may find it more difficult to get work as the number of elderly people still working rather than retiring may ‘block them out’ of the top positions in the workforce
- Elderly people who have not paid into pensions schemes may not receive enough money from a government pension to live alone which may lead to poverty
What are some of the political implications of an increasing elderly population?
- Current political decision making and workforce assessments will require the increasing elderly population to be taken into account
- An increasing elderly population will have more say in political decisions, especially those which affect their group (the elderly)
What are some of the ways that carers provide for the people that they care for?
- Practical tasks such as cooking, cleaning or shopping
- They may keep the person they are caring for company
- They may take the person they care for out
- They may assist the person they are for with financial matters
- They may assist the person they care for in dealing with services such as benefits and other care services
- They may simply keep an eye on the person they care for
- They may help the person they care for with aspects of their personal care
What are some of the options available to patients requiring care?
- Nursing home care
- Sheltered housing
- Residential home
- Living at home with assistance from social services
- Living at home with assistance from family
- Living with a family member or members
What are some of the factors which may influence the kind of care a patient receives?
- Whether they have capacity or not
- Their own personal preferences
- Their own individual needs
- Whether they have any close family to care for them
- How much time, if any, their family can give up to care for them
- Where they live
- Their socioeconomic status
- Whether or not they require any specialist care for one or more of their co-morbidities
- The nature of the long term condition(s) they have and the kind of treatment or care it may require
What is meant by anticipatory care planning?
Anticipatory care planning is a process which places a person at the centre of a discussion with close friends, family members, healthcare practitioners and lawyers among others to consider how they wish to have their health and care handled in the future. This generally means assuring that if an issue arises, it is dealt with in the right way, by an appropriate person and at a suitable time
When is anticipatory care planning done?
It can be done at any point and is often done continuously throughout a patient’s life
Who should do anticipatory care planning?
Anyone who has an appropriate relationship to the patient can do anticipatory care planning
How can an anticipatory care plan be shared?
Anticipatory care plans can be shared by any method of communication but the best way is via a key information summary (KIS)
What are the three main aspects of someone’s care that anticipatory care planning aims to address?
- Legal aspects
- Personal aspects
- Medical aspects
Give three examples of legal aspects of a patient’s care which may be addressed by an anticipatory care plan.
- Guardianship
- Financial power of attorney
- Welfare power of attorney
Give five examples of medical aspects of a patient’s care which may be addressed by an anticipatory care plan.
- Wishes regarding resuscitation/CPR
- Potential problems that may arise
- Home care packages
- Assessment of level of capacity/competence
- Electronic care summary
Give five examples of personal aspects of a patient’s care which may be handled by an anticipatory care plan.
- Cultural/religious beliefs regarding death
- Preferred place of death
- Next of kin
- Who else to consult/inform
- Preferences and priorities regarding treatment
