Considered to be people over 65 years

From a diverse range of experiences

Have a diverse range of values

Have a diverse range of needs, goals and personal preferences

Increasing age is related to long-term health conditions, higher rates of disability and poorer reported health status.

Population ageing, and the health of older people, is likely to impact on the overall health status of the Australian community.(ABS:2006)

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2004 2051 2101

65-74years75-84years85 andover

Females born in 2002-04 are expected to live to 83.0 years and males to 78.1 years

Between 2004 and 2101 the proportion of males in the 85 years or more age group is projected to increase, from 32% of all people aged 85 years or more in 2004 to between 44%-47% in 2101.

This is due to the expected narrowing of the gap between male and female life expectancy (ABS 2005),(OECD 2005).

The differences in marital status for older males and females impact on living arrangements and other forms of support.

Over time older people experience loss, not only of a partner, but often incremental loss of independence through disability and other factors associated with ageing.

The longer life span of females is reflected in the marital status data for older people.

Across the older age groups, the proportion of both males and females in the widowed category increases with age, with more females widowed than males in each age group (ABS 2006a).

Self-assessed health status is considered to be a strong predictor of morbidity and mortality (Gerdtham et el 1999: McCallum et al 1994)

Long-term health conditions are more common with increasing age.

In 2005 nearly 100% of people aged 65 years or more reported at least one long-term health condition.

the eye (90%),

musculoskeletal conditions (66%)◦ osteoarthritis (28%)

circulatory system (57%),

respiratory conditions (15%).

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90

% of older people >65

vision

mobility

circulation

arthritis

respiratory

The leading causes of death- 65 years +◦ diseases of the circulatory system◦ malignant neoplasms (particularly lung, prostate, and colorectal cancers).

Accidental falls significant issue with ageing

◦ with 4% of those aged 75 years and over having reported an injury event from low falls in the four weeks prior to interview.

eye/sight problems (89%),

heart and circulatory problems/diseases (61%),

arthritis (49%) and

diabetes/high sugar levels (36%).

Weight• 33% overweight 15% obese• proportion overweight or obese decreases with age• 28% - 85 years+ • 10% - 85 years+ underweight

Exercise◦ 65-74 years- 36% reported being sedentary in the two weeks prior to interview.

◦ 75-84 years -53% ◦ 85 years or older -68%

Smoking ◦ 8% of older persons -males 10% and 6%females ◦ 65-74 years -10%◦ 75-84 years -4%◦ 85 years and over- 5%

65-74 years ◦ 38% visited the doctor in the two weeks prior to interview

◦ 23% were hospitalised within the previous 12 months.

75-84 years ◦ 47% - doctor

◦ 29% - hospitalised

85 years ◦ 50% - doctor

◦ 25% - hospitalised

Impacts on the individual

Impacts of families

Impacts on social systems

Dynamics of placement/accepting care

Personal responses to asking for help

Loss of: ; home independence control over life decisions space lifestyle

Intrusion of others Claustrophobia! Alienation from family systems

lack of:◦ space ◦ privacy◦ personal time and space

another dependant person

lessening social contact

increasing workload

decreasing dignity of the older person

tiredness

possible strain on other relationship within family

impact on other family members

possible reduction in financial status

possible reduction in social contacts

dependence on government services for assistance

dependence on medical systems

Agreement/ *disagreement Guilt Anguish social attitudes Ignorance financial considerations appropriate care appropriate location

Element 3:

Philosophy of Service Delivery

Mission Statement and a Values system.

Resident focussed care to some degree.

Care delivered in line with Mission Statement and the level of funding received.

Philosophy focuses on residents as the primary concern

Planning for successful ageing outcomes:

◦ Health

◦ Security

◦ Independence

◦ Social connections

◦ Promoting positive community attitudes

Person Centered Care

Palliative Care Approach

Activity Theory

Validation Therapy

Disengagement theory

Social Construction Theory

advocates ◦ to meet the physical needs of a person with dementia (or

without dementia)◦ attend to the structural aspects of the care environment◦ part of a wider approach to caring for and caring about the

whole person (Bradford, 1997, cited in Wylie, Madjar, Walton 2002).

focuses on Dementia mapping ◦ looking for signs of well being and signs of ill being.

Uniqueness of each person

Respect for the past

See the whole person

Focus on the positive – on abilities

Stay in communication/connection

Nourish attachment

Create a sense of community

Maximise freedom – minimise controls

Don’t just give, receive as well

Maintain an environment of trust

Helps reduce the suffering

Encompasses an open attitude towards living in the shadow of death and dying.

Improves the quality of life for individuals ,families ◦ through the prevention and relief of suffering through early

identification, assessment, treatment of pain and other problems, physical psychological and spiritual.

Affirms life and regards death as a normal process

Relief from pain and other distressing symptoms

Intends neither to hasten nor postpone death

Integrates the psychological and spiritual aspects of care

Offers a support system to help people live as actively as possible until death

Offers a support system that helps families to cope during the persons illness and their own bereavement,

Uses a team approach to address the needs of the person and their family

Enhance quality of life and positively influence the course of the illness

Is applicable in the early course of the disease as well as in advanced stages

Activity Theory◦ explains that older people who continue to seek activity in their older page

are more motivated and able to function fully in their older life.

Validation Theory ◦ relates to the recognition and “validation “ of each individual as a person of

worth , with a history of life experiences and belief, philosophies and networks.

Disengagement Theory ◦ relates the powerlessness and social isolation felt by older people as they

leave active employment. The theory is based largely on the effects of capitalism and its influence of our role and status within society. As we get old, younger people in society expect us to fade away or not be functional in retirement. Therefore older people feel powerless and often worthless because of society’s views.

Social Construction Theory◦ relates to influence that ageism has on the status of older people and how

the younger people in society view older people. This influences the way older individuals value themselves, perceive their worth and develop motivation and positive ageing

Element 4:Attitudes and Values

Attitude◦ A belief about something◦ We learn attitudes from family, friends, work

mates, media◦ Attitudes can influence how we act and

interpret

When we feel strongly about something these attitudes are called our values

Carers need to taken into consideration personal values and attitudes when planning and implementing any work activities.

The clients are paying for the service that carers provide therefore ◦ our standard of care should be of the highest quality◦ our attitudes to older people should be accepting and respectful.◦ our work practice should reflect an understanding of the individuality of

ageing. Eg: making sure preference of client are paramount in our care.

Work practices that minimise stereotypical attitudes and myths about older people are essential.

Stereotyping and discriminating against older people simply because they are old

◦ ‘your too old for that

◦ ‘You cant teach an old dog new tricks

◦ ‘You’re a silly old duffer;

◦ He’s loosing his marbles

◦ ‘She’s a dear old thing

◦ She looks great for her age

Losing control over one’s life and accepting the control

of the institution, rather than making decisions for oneself.

Caused by:◦ inflexible systems, ◦ control of social life, ◦ control of medical care, ◦ legal controls. ◦ difficult to resume normal life after leaving.

Those with the highest needs are likely to feel the most effects of institutionalisation.

Education, employment and income

Family and community support

Access to services

Positive attitudes

Good nutrition, exercise

Prevention of disease through lifestyle

Management of impairment

Physiological Ageing is the ageing that all people experience.

Pathological Ageing is the ageing experienced when you

have a specific disease or condition that ages your body

more rapidly.

bone density blood vessels brain including shrinkage muscles and joints and bone gut motility

Skin Wrinkles,

Hormones and enzyme production Sexual function Graying, dry hair

Diabetes

CVA

Arthritis

Heart disease

Chronic airways limitations

Cancer

Depression

Reduce Smoking

Reduce alcohol Intake

Follow a heath diet with all 5 foods groups in proportion

Drink 2 litres of fluid daily

Exercise regularly

Develop positive lifestyle goals

Activities of daily living (ADL)◦ Activities we normally do on a day to day basis

such as washing, eating

Recreational Activities◦ Activities we do for pleasure such as listening to

music, playing cards

To maintain activities you will need to know:◦ Client’s history

Keep active

Maintain skills

Develop sense of accomplishment

Makes us feel worthwhile and feel good

Enhances emotional well-being

Increase physical health

Develop social relationships

Consider–

◦ likes/dislikes,

◦ past history,

◦ suitable environment,

◦ capabilities,

◦ disabilities,

◦ equipment required,

◦ safety aspects,

◦ planning or liaising with others