Work effectively with older people CHCAC318A

1. Work effectively with older peopleCHCAC318A

2. Element5:Key issues facing older people in our community

3. Who are Older People in Australia • 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

4. Health of Older People Statistics • 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)

5. Projected population by age 2004 to 2101

6. Life Expectancy • 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).

7. Living Arrangements • 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).

8. Health Status • 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.

9. Most common reported conditions (ABS:2006) • the eye (90%), • musculoskeletal conditions (66%) • osteoarthritis (28%) • circulatory system (57%), • respiratory conditions (15%).

10. Leading Causes of Death • 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.

11. Common Health Problems for Indigenous Australians • eye/sight problems (89%), • heart and circulatory problems/diseases (61%), • arthritis (49%) and • diabetes/high sugar levels (36%).

12. Risk Factors 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%

13. Managing Conditions and Lifestyle changes • 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

14. Key Issues for older people • Impacts on the individual • Impacts of families • Impacts on social systems • Dynamics of placement/accepting care • Personal responses to asking for help

15. Impacts on the individual • Loss of: ; • home • independence • control over life decisions • space • lifestyle • Intrusion of others • Claustrophobia! • Alienation from family systems

16. Impacts of families • 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

17. Impacts on social systems • possible reduction in financial status • possible reduction in social contacts • dependence on government services for assistance • dependence on medical systems

18. Placement Dynamics • Agreement/ *disagreement • Guilt • Anguish • social attitudes • Ignorance • financial considerations • appropriate care • appropriate location

19. Element 3: Philosophy of Service Delivery

20. 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

21. Positive ageing Planning for successful ageing outcomes: • Health • Security • Independence • Social connections • Promoting positive community attitudes

22. Positive Ageing Theory • Person Centered Care • Palliative Care Approach • Activity Theory • Validation Therapy • Disengagement theory • Social Construction Theory

23. Person Centred care • 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.

24. 10 Principles of Person Centred Care • 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

25. Palliative Care Approach • 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.

26. Palliative care provides: • 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

27. 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

28. Element 4: Attitudes and Values

29. 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

30. Considerations • Carers need to taken into consideration personal values and attitudeswhen planning andimplementing 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 andmyths about older people are essential.

31. Ageism 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

32. Institutionalisation 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.

33. Healthy ageing • Education, employment and income • Family and community support • Access to services • Positive attitudes • Good nutrition, exercise • Prevention of disease through lifestyle • Management of impairment

34. Physiological and Pathological Ageing 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.

35. Element 5:Physical changes as we Age • 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

36. Common Pathological ageing • Diabetes • CVA • Arthritis • Heart disease • Chronic airways limitations • Cancer • Depression

37. Healthy Ageing Lifestyle and Practice • 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

38. Accommodating interests and lifestyle activities • 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

39. Why interests and lifestyle are important • 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

40. Designing Activities Consider– • likes/dislikes, • past history, • suitable environment, • capabilities, • disabilities, • equipment required, • safety aspects, • planning or liaising with others