Question

Mr. and Mrs. John Thompson age 79 and 82 are having difficulty maintaining their large home since Mr. Thompson had a heart attack and Mrs. Thompson fell and broke her left wrist. Their daughter is exploring alternative living arrangements for her parents, but she is confused regarding what she should recommend for them.

1. What are the positive and negative aspects of each promoting the older person’s health?

2. Consider all aspects of care: long term placement, continue living at home and or adaptation to the present home environment.

3. What criteria can you review with the Thompsons’ daughter about the various living arrangements for older adults, as discussed in this chapter 7?

4. What technological modalities would you design or recommend for the Thompsons to make them feel safe living in their home

Answer 1

ANSWER : 1

Positive Aging

1. Everyone expects death.
Older adults accept that they’re losing abilities as they age, so they begin to leave their networks.

2. Fewer contacts create behavioral freedoms.

3. Men and women differ in their experience.

4. The ego evolves as it ages.
The older adult steps aside so the younger person can take over in whatever role the elder leaves. The older person seeks out personal enjoyment.

5. Complete disengagement occurs when society is ready for it.

6. Disengagement can occur if people lose their roles.

7. Readiness equates to societal permission

8. Relational rewards become more diverse

9. This theory is independent of culture.
It takes on the norms of the person’s culture.

Negative Beliefs on Aging

These beliefs become entrenched in verbal, written and visual media. Stereotypes affect the self-perception of individuals within the group. This can be negative or positive.

There are many stereotypes associated with aging. Some are negative. For example,

older people are frail,

forgetful.

can’t drive, and are slow.

Old people are always sick.

They live in nursing homes. Elderly people can’t learn anything new.

Answer 2:

. Health care is coming home. For a number of reasons, health care is increasingly occurring in residential settings rather than in professional medical settings.

Given converging trends of an aging population, an increasing human life span, medical technology migrating into the home, and design features of the home in contrast to health care institutions, it is important to gain an understanding of the most prevalent and serious threats to safety, the quality of care experienced, and the well-being of care recipients and caregivers.

Overall, health care that occurs at home is a complex experience, involving various types of individuals, tasks, technologies, and environments.

• The people involved in health care in the home include people receiving care, who may care for themselves, and those providing care, who may be professional or lay caregivers, family or friends, or some combination. These individuals have a wide range of personal and health literacy skills, social needs, and economic and social resources. People have different perceptions of the power differential between care recipient and the health care system, different cultural views about health and illness, and different language capabilities and preferences. All of these can affect the form and quality of health care received. The majority of people providing care in the home (care recipients themselves, families, and direct-care workers) vary widely in their training and generally have very limited formal training or credentialing; direct-care workers may be employed by families outside the formal health care system and be involved in reimbursement without oversight.
• The tasks involved in home-based health care include activities for maintaining health, activities associated with episodic care (e.g., in response to illness or injury) or chronic care, or activities to support the end of life. The medical conditions involved may be simple and involve little time and no medical equipment, or they may be very complex and consume many hours every day and require the use of complicated devices.
• The devices and technologies for health care in the home cover a vast range, from simple first aid tools to respiratory equipment, and from meters and monitors to computer equipment and software associated with interconnected electronic systems. Some of this equipment was designed only for professional use but is finding its way into the home nevertheless. A particular concern for health care that occurs outside medical facilities is the use of “legacy” (outdated) equipment, which may not have technical support available or even come with instructions; if instructions are available, they generally were not written for lay users.
• The environments of health care delivered in the home, with few exceptions, are not designed for this use and often contain numerous

ANSWER 4:

Types of Health Care Devices and Technologies Used in the Home

Category	Device or Technology
Medication administration equipment	Dosing equipment (cups, eyedroppers, blunt syringes)
	Nasal sprays, inhalers
	Medication patches
	Syringes/sharps
Test kits	Pregnancy test
	Male/female stress hormone test
	Cholesterol test
	Allergy test
	Bladder infection test
	HIV test
	Hepatitis C test
	Drug, alcohol, nicotine test
First aid equipment	Bandages
	Ace bandage, compression stocking
	Snakebite kit
	Heating pad
	Traction
	Ostomy care
	Tracheotomy care
	Defibrillator
Assistive technologya	Eyeglasses
	Hearing aid
	Dentures (full or partial)
	Prosthetic device
	Orthotic device, including braces
	Cane or crutches
	Walker
	Wheelchair
	Scooter
Durable medical equipment	Hospital bed
	Specialized mattress
	Chair (e.g., geri-chair or lift chair)
	Lift equipment
	Commode, urinal, bed pan
Meters/monitors	Thermometer
	Stethoscope
	Blood glucose meter
	Blood coagulation (PT/INR) meter
	Pulse oximeter
	Weight scale
	Blood pressure monitor
	Apnea monitor
	Electrocardiogram (ECG) monitor
	Fetal monitor

Top of Form

Bottom of Form

Category	Device or Technology
Treatment equipment	IV equipment
	Infusion pumps
	Dialysis machines
	Transcutaneous electrical nerve stimulation (TENS) systems
Respiratory equipment	Ventilator, continuous positive airway pressure (CPAP), bi-level positive airway pressure (BiPAP), and demand positive airway pressure (DPAP) equipment
	Oxygen cylinder
	Oxygen concentrator
	Nebulizer
	Masks and canulas
	Respiratory supplies
	Cough assist machine
	Suction machine
	Manual resuscitation bags
Feeding equipment	Feeding tubes (nasogastric, gastrostomy, jejunostomy)
	Enteral pump
Voiding equipment	Catheter
	Colostomy bags
Infant care	Incubator
	Radiant warmer
	Bilirubin lights
	Phototherapy
	Apnea monitor
Telehealth equipment	Cameras
	Sensors
	Data collection and communication equipment (e.g., computer, smart phone)
	Telephone or Internet connections