Deck 10: Long-Term Care and End-Of-Life Care

Question 1

The U.S. funeral industry generates an estimated $ _______ in revenue annually.

A) 50 billion
B) 20 billion
C) 5 billion

Answer 1

B
The U.S. funeral industry generates an estimated $20 billion in revenue annually.

Question 2

What is the purpose of virtual villages?

A) Online social interaction
B) Helping older adults "age-in-place"
C) Peer-to-peer text messaging emotional support
D) Institutionalized retirement communities

Answer 2

B
Virtual villages are nonprofit, dues-paying, membership communities to help older residents stay in their own homes for as long as possible. These communities are often not self-sufficient from dues and depend on local donors to subsidize the services they provide for low-income residents within their virtual village boundaries. The virtual village idea began with the Beacon Hill Village in Boston in 2001. Several friends and neighbors developed a plan to help each other stay in their homes. They used a nonprofit organization to screen and organize programs and services to help accomplish the goal of aging in place.

Question 3

Examine alternative explanations for the Buchwald phenomenon and its impact on hospice use.
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Answer 3

Many people are scared off by hospice because they feel it is a death sentence. To be eligible, patients must be certified by two doctors as having 6 months or less to live, assuming their illness runs a normal course. Yet there are two mitigating factors that make hospice less of a death sentence. First, hospice patients in one study lived an average of 29 days longer than comparable nonhospice patients. This may be due less to the social/emotional support provided by hospice care and more to the lethal nature of aggressive treatment for the terminally ill. Second, there are many terminally ill diagnoses that are not very predictable, certainly much less so than the gold standard of predictability-late-stage cancer. In fact, 17% of the 1.3 million hospice patients in 2006 were discharged. One of those hospice patients was Art Buchwald, the Pulitzer Prize-winning newspaper humor columnist who in his prime was published in more than 550 newspapers. After 5 months in hospice, Buchwald left hospice care in 2006 and eventually died the following year, at the age of 81. After kidney and vascular problems forced physicians to amputate one of his legs, Buchwald decided to refuse dialysis and entered hospice. Expecting to die in a few weeks, Buchwald, to the amazement of himself, his physicians, family, and friends, experienced his kidneys starting to work again. After leaving hospice he wrote about his 5-month experience in a book titled Too Soon to Say Goodbye (2006).

Question 4

How can a smart home equipped with technology enhance older residents' safety and independence?

A) Remind them when they have doctors' appointments
B) Provide energy therapies
C) Transfer data to doctors if a patient is noncomplaint with medications
D) Monitor their health status in their homes

Question 5

Which of the following is the basic premise of the Eden Alternative?

A) Nursing homes should treat residents as people who need attentive care in a home-like setting.
B) Nursing homes should have an equal number of males and females.
C) Older adults should be able to age in their homes.
D) Older adults use telehealth in their homes to enhance older residents' safety and independence.

Question 6

What does PACE stand for?

A) Practitioners Providing of Care for the Elderly
B) Programs of Care for Elderly
C) Programs of All-Inclusive Care
D) Programs of Older Adult Care

Question 7

What is a Certified-Aging-in-Place program?

A) Independent retirement housing
B) Programs that allow for an older adult to have a separate, yet supportive unit to live in, and be close to family members when support is needed
C) Privately owned homes located in residential neighborhoods that are converted into care homes to serve a small number of older (and sometimes younger disabled) adults with ongoing care needs
D) Trained specialists that design a granny flat, or other housing structures, to help an older adult stay safe at home as independently as possible

Question 8

How does guided care keep frail older adults in their home and delay or avoid hospital or nursing home care?

A) Assessing the patient and primary caregiver at home, providing an action plan, promoting patient self-management, monitoring conditions monthly, coordinating the effort of all health care providers, smoothing transitions between sites of care (particularly in and out of hospitals), educating and supporting family caregivers, and facilitating access to community resources
B) Assessing the patient and primary caregiver at home, providing an action plan, promoting patient self-management, monitoring conditions monthly, coordinating the effort of all health care providers, smoothing transitions between sites of care (particularly in and out of hospitals), and educating and supporting family caregivers
C) Assessing the patient and primary caregiver at home, providing an action plan, promoting patient self-management, monitoring conditions monthly, coordinating the effort of all health care providers, smoothing transitions between sites of care (particularly in and out of hospitals)
D) Assessing the patient and primary caregiver at home, providing an action plan, promoting patient self-management, monitoring conditions monthly, coordinating the effort of all health care providers

Question 9

Why was the Patient Self-Determination Act of 1990 enacted?

A) To provide a home care solution in a foreign country
B) To create a premium-funded public insurance program
C) To reduce the chance that a life would be shortened or prolonged against the wishes of the individual
D) To provide coverage under private long-term care insurance

Question 10

Hospice care's distinguishing characteristic is its emphasis on ______________ over aggressive medical procedures.

A) Self-determination
B) Psychosocial and spiritual support
C) Instrumental support
D) Social support

Question 11

Describe the role of a death doula.
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Question 12

Which of the following is an overlooked benefit of hospice care?

A) Bereavement support
B) Companionship
C) Low cost

Question 13

What is the purpose of palliative care?

A) To alleviate pain from serious illness
B) To alleviate side effects from cancer treatment
C) To set up advance directives in terminal care situations
D) To provide cancer support in nursing homes

Question 14

Which of the following is NOT an alternative to nursing home care in the United States?

A) Green houses
B) Virtual villages
C) Dementia cafes
D) Virtual cafes