Aging And Society Canadian Perspectives 7th Edition By by Lori Campbell, Herbert C. – Test Bank

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Aging And Society Canadian Perspectives 7th Edition By by Lori Campbell, Herbert C. – Test Bank

CHAPTER 5: PERSONAL HEALTH AND ILLNESS

 

MULTIPLE CHOICE

 

 

 

  1. How do gerontologists define the maximum number of years that a member of a species can live?
a. the maximum life span of the species
b. the life expectancy of the species
c. the intrinsic age of the species
d. the senescence of the species

 

 

ANS:  A                    REF:   90                  BLM: HO

 

  1. What is the term for the number of years at birth that an average member of society can expect to live?
a. aging parameters
b. life span
c. specific age configuration
d. life expectancy

 

 

ANS:  D                    REF:   90                  BLM: REM

 

  1. Scientists believe that the human life span has remained the same for the past 100,000 years. What is this span of time in years?
a. 75 to 95 years
b. 95 to 110 years
c. 110 to 125 years
d. 125 to 140 years

 

 

ANS:  C                    REF:   90                  BLM: REM

 

  1. What has happened to the human life expectancy in the past 2,000 years?
a. It has remained the same.
b. It has increased.
c. It has decreased.
d. It has fluctuated widely.

 

 

ANS:  B                    REF:   90                  BLM: HO

 

  1. Advances in technology and biomedical research have extended life expectancy. Which of the following summarizes what this suggests about the future for humans?
a. The human life span will rise as more people live past the current maximum human life span.
b. The physical signs of old age will change.
c. Progress will need to be made in extending life span to enable further improvements in life expectancy.
d. More people will live closer to the maximum human life span, and more people will live longer in old age than ever before.

 

 

ANS:  D                    REF:   90                  BLM: HO

 

  1. What are the two primary goals of the study of biological aging?
a. to slow senescence, and to cure the diseases of old age
b. to understand changes in the body that come with age and to apply this knowledge
c. to identify the environmental causes of super longevity, and to develop models for increasing the maximum human life span
d. to develop a comprehensive theory of aging and to lobby for more government funding for aging research

 

 

ANS:  B                    REF:   90                  BLM: REM

 

  1. According to Statistics Canada, by how many years will a girl born in 2008 outlive her male peers?
a 2 years
b. 3 years
c. 4 years
d. 5 years

 

 

ANS:  D                    REF:   90                  BLM: REM

 

  1. According to Alway, Morissette, and Siu (2011), what process plays a part in sarcopenia in later life?
a. pleiotropic genes
b. the Hayflick genes
c. apoptosis
d. senescence

 

 

ANS:  C                    REF:   92                  BLM: REM

 

  1. Which of the following terms describes the process by which cells are controlled and thus produce normal human development?
  2. apoptosis
  3. sarcopenia
  4. the phase III phenomenon
  5. the Hayflick limit

 

ANS: A                     REF: 92           BLM: REM

 

  1. Jolene is 55 years old. Her pituitary gland has stopped producing hormones to stimulate her ovaries. What is the name for this process that occurs in aging women?
  2. the female change
  3. peripause
  4. menopause
  5. menstruation

 

ANS: C          REF: 92           BLM: HO

 

  1. Which of the following scenarios can occur in the body as a result of cross-linking?
a. poor eyesight
b. decreased lung capacity
c. problems with digestive function
d. stiffened connective tissue

 

 

ANS:  D                    REF:   93                  BLM: HO

 

  1. Louisa finds that she has difficulty in walking and her doctor recently informed her that she has some “hardening” of the arteries and loss of kidney function. He said that pollutants like smoke and lead have caused this degeneration of her body over time. What is the name for the process of proteins binding together to cause this damage to Louisa’s body?
  2. atrophy
  3. cross-linking
  4. somatic mutation
  5. sarcopenia

 

ANS: B          REF: 93                       BLM: HO

 

  1. Which of the following is made from oxygen production, and can damage the body’s cells and cellular components?
  2. antioxidants
  3. lipofuscin
  4. free radicals
  5. macrophages

 

ANS: C          REF: 93                       BLM: REM

 

  1. Lewis has developed brown liver spots on his hands and face. His wife tells him they are “age spots.” What is the name of the fatty molecules in the skin that are responsible for causing these spots?
a. lipofuscin
b. T-cells
c. macrophages
d. free radicals

 

 

ANS:  A                    REF:   93-94             BLM: HO

 

  1. Cora’s doctor advised her to consume more foods such as broccoli, green tea, and cauliflower. He told her that the chemicals in these foods hope to bind and neutralize free radicals. What is the name for these chemicals?
  2. carotenoids
  3. coenzymes
  4. polyphenols
  5. antioxidants

 

ANS: D         REF: 94                       BLM: HO

 

  1. According to Morton, Schafer, and Ferraro (2011), physical abuse during childhood can lead to which of the following chronic diseases later in life?
  2. dementia
  3. heart disease
  4. diabetes
  5. cancer

 

ANS: D         REF: 94-95                  BLM: REM

 

  1. Lovell, Cuneo, and Gass (2010) report that after one reaches the age of 70 years, one loses one’s muscle strength by what annual percentage?
  2. 3%
  3. 5%
  4. 7%
  5. 9%

 

ANS: A         REF: 96                       BLM: REM

 

  1. According to Osteoporosis Canada (2011), what is the annual cost to the healthcare system as a result of osteoporosis?
  2. $1 billion
  3. $1.5 billion
  4. $1.9 billion
  5. $2.3 billion

 

ANS: C          REF: 96                       BLM: REM

 

  1. Margaret is 83 years old. All of her life she loved to cook for her family, but now she has very little interest in food, because it doesn’t “taste the same” as it used to. Which of Margaret’s taste buds is commonly known to decline first?
  2. salt
  3. sour
  4. bitter
  5. umami

 

ANS: A         REF: 97                       BLM: HO

 

  1. Ginny is 63 years old, and has osteoporosis. Her physician advised her to perform this type of exercise to help increase her bone density. What type of exercise is Ginny performing?
  2. archery
  3. yoga
  4. boxing
  5. lifting weights

 

ANS: D         REF: 96                       BLM: HO

 

  1. As compared with a 20-year-old, how much do the pupils decrease in size by the time a person reaches 60 years of age?
  2. 1/4
  3. 1/2
  4. 2/3
  5. 3/4

 

ANS: C          REF: 97                       BLM: REM

 

  1. Lukas’ eye doctor informed him that he suffers from an age-related eye disorder in which there is increased pressure within Lukas’ eyes. What is the name of this condition?
  2. macular degeneration
  3. glaucoma
  4. detached retina
  5. cataracts

 

ANS: B          REF: 97                       BLM: HO

 

  1. According to Butler-Jones (2010), what proportion of Canadian seniors view their health as excellent or very good?
  2. 45%
  3. 62%
  4. 70%
  5. 83%

 

ANS: B          REF: 98                       BLM: REM

 

  1. What is the term for a decrease in acute and infectious diseases and an increase in chronic and degenerative diseases?
a. urbanization
b. modernization
c. technologization
d. epidemiological transition

 

 

ANS:  D                    REF:   99                  BLM: REM

 

  1. Through improved public health measures, a society manages to decrease its acute and infectious disease burden; however, this leads to an increase in the chronic disease burden. What is this society going through?
a. a disease burden schism
b. an epidemiological transition
c. the rectangularization paradox
d. pleomorphism

 

 

ANS:  B                    REF:   99                  BLM: HO

 

  1. What percentage of Canadians aged 65–79 report having four or more chronic diseases?
a. 1/3
b. 1/2
c. 2/3
d. 3/4

 

 

ANS:  A                    REF:   99                  BLM: REM

 

  1. Which of the following is an explanation that has been proposed to explain higher rates of institutionalization and healthcare expenditures for older women than older men?
a. a pattern of healthcare use continued from their middle years
b. women live shorter lives than men
c. a more proactive approach to health problems by men
d. physicians’ biases toward finding illnesses in women

 

 

ANS:  A                    REF:   100                BLM: HO

 

  1. Which of the following chronic diseases do women report to have, more so than men?
a. diabetes
b. rheumatism
c. Crohn’s disease
d. emphysema

 

 

ANS:  B                    REF:   100                BLM: HO

 

29 . What percentage of older Canadians say that they have one or more chronic health problems?

a. more than 10%
b. more than 40%
c. more than 90%
d. more than 100%

 

 

ANS:  C                    REF:   99                  BLM: REM

 

  1. According to a study in 2009 by Butler-Jones, which of the following statements can be made regarding chronic disease and aging?
a. Chronic disease decreases with age.
b. Chronic disease is eliminated with access to proper medication.
c. Chronic disease does not necessarily increase with aging.
d. Chronic disease depends upon genetic predisposition.

 

 

ANS:  C                    REF:   100                BLM: HO

 

  1. According to Statistics Canada (2007), what trend occurs with self-reported disability rates as one ages?
a. It increases.
b. It decreases.
c. It remains relatively constant.
d. It has no correlation.

 

 

ANS:  A                    REF:   100                BLM: REM

 

  1. Which of the following activities requires agility?
  2. standing for a long period of time
  3. walking
  4. dressing
  5. sitting

 

ANS: C          REF: 101         BLM: HO

 

  1. More than 75% of elderly persons have at least one chronic condition, but only about what percentage developed a long term-activity limitation?
a. 10%
b. 20%
c. 50%
d. 60%

 

 

ANS:  A                    REF:   101                BLM: REM

 

  1. The National Advisory Council on Aging (2006) found that 7% of older people needed help with ADLs, although which percentage needed help with IADLs?
a. 22.4%
b. 54.3%
c. 63.2%
d. 87.3%

 

 

ANS:  A                    REF:   102                BLM: REM

 

 

  1. According to the text, which of the following is a reason for researchers to study disabilities in later life?
a. An increase in the number of healthy seniors will decrease the cost of resources that the healthcare system will need to provide.
b. Older people who cope with their disabilities can help researchers learn how to rehabilitate disabled seniors.
c. Increased drug use can help prevent or reverse disabilities.
d. Healthy aging can reverse the process of physical decline.

 

 

ANS:  B                    REF:   103                BLM: REM

 

 

  1.    What did Shields and Martel (2006) find in regard to chronic conditions?
a. They do not always turn into functional disability or the need for assistance.
b. They always turn into functional disability.
c. They always receive assistance.
d. They never require assistance.

 

 

ANS:  A                    REF:   102                BLM: REM

 

  1. According to reports, how do older people respond to changing physical problems?
a. by relying on formal social structures for help
b. by avoiding difficult situations
c. by actively training to maintain their functional ability
d. by adjusting their expectations about their activities

 

 

ANS:  D                    REF:   104                BLM: REM

 

 

  1.    Among arthritis sufferers, “replacers” add more passive activities to replace activities they stop doing. Compared to “quitters,” these people tend to be which of the following?
a. type-A, extroverted personality types
b. younger, and have fewer mobility problems
c. unmarried or never-married, and highly goal oriented
d. more responsive to physiotherapy and retraining programs

 

 

ANS:  B                    REF:   104                BLM: HO

 

  1. What is the effect of keeping a positive attitude, cutting down on chores, and relying on others for help for people with activity limitations?
a. These actions negatively affect their sense of well-being.
b. These actions do not bring satisfaction.
c. These actions provide methods to cope with their illness.
d. These actions reduce their quality of life.

 

 

ANS:  C                    REF:   104                BLM: HO

 

 

  1. What happens to sense thresholds—the point where a person can begin to perceive a stimulus—with age?
a. They increase.
b. They decrease.
c. They stabilize.
d. They homogenize.

 

 

ANS:  A                    REF:   104                BLM: HO

 

  1. Around what age do most people notice changes in their senses?
a. 25
b. 35
c. 60
d. 75

 

 

ANS:  C                    REF:   104                BLM: REM

 

  1. Older people tend to use even the simplest assistive devices under which of the following conditions?
a. if they improve their sense of well-being
b. when no one else is watching
c. instead of making changes to their environment
d. if given the opportunity

 

 

ANS:  A                    REF:   105                BLM: HO

 

  1. For what reason will the use of assistive technology by older people increase in the future?
a. Costs will decline as competition increases.
b. New cohorts of older people will feel more comfortable using technology.
c. Older people will want to live fuller and more independent lives than ever before.
d. The need to process more information, faster, in modern society is increasing the impact of sensory declines on quality of life.

 

 

ANS:  B                    REF:   104-106         BLM: HO

 

  1. As a response to the changes of aging, voice-assisted devices, hearing aids, and computers are examples of changes in which of the following?
a. lifestyle
b. environment
c. assistive technology
d. processes

 

 

ANS:  C                    REF:   104-106         BLM: HO

 

  1. In general, how do older people make use of computer technology as compared to young people?
a. Older people use computer technology more.
b. Older people use computer technology less.
c. Older people use computer technology in a more complicated way.
d. Older people hardly use computer technology.

 

 

ANS:  B                    REF:   106                BLM: HO

 

  1. Which of the following best describes computerized solutions designed to meet seniors’ needs?
a. They are not affordable to most seniors.
b. They are within 10 years of becoming available to most seniors.
c. As yet, they have not performed as well as simpler technologies.
d. They may be more viable in the future when older people are more comfortable with computers.

 

 

ANS:  D                    REF:   108                BLM: HO

 

 

  1. Technological aids can help older people stay active, but for these aids to be useful, they must also be which of the following?
a. expensive
b. hand fashioned
c. advanced
d. affordable and accessible

 

 

ANS:  D                    REF:   108                BLM: HO

 

  1. Which of the following is an important influence on determining whether an older person is likely to use an assistive device?
a. health status
b. wealth
c. peer pressure
d. ethnicity

 

 

ANS:  A                    REF:   108                BLM: HO

 

  1. While assistive devices on the whole have had a positive impact on seniors, which of the following factors has a negative effect upon their usage of assistive devices?
a. convenience
b. accessibility
c. improved mobility
d. social isolation

 

 

ANS:  D                    REF:   109                BLM: HO

 

 

 

  1. What is hypokinesia?
a. a physical problem due to lack of movement
b. a degenerative neurological disease that afflicts one in twenty seniors
c. the gradual lowering of the heart rate that occurs with age
d. improved reflexes that occur as a result of practice and increased motivation

 

 

ANS:  A                    REF:   110                BLM: REM

 

  1. According to Shields and Martel (2006), what percentage of seniors who exercised three or more times per week reported good health?
a. 67
b. 33
c. 94
d. 6

 

 

ANS:  A                    REF:   110                BLM: REM

 

  1. Which of the following behaviours shows “strong evidence” of a positive association with obesity?
a. using a wheelchair
b. playing on the computer
c. reading
d. watching television

 

 

ANS:  D                    REF:   113                BLM: REM

 

  1. According to Langlois and colleagues (2009), what dietary factor accounted for higher obesity rates among men?
a. a low water intake
b. a low fibre intake
c. a high sugar intake
d. a high protein intake

 

 

ANS:  B                    REF:   114                BLM: REM

 

  1. According to Fontana and Klein (2007), which of the following conditions is considered a negative effect of calorie restriction (CR) among humans?
a. low muscle mass
b. dementia
c. prolonged menstruation in women
d. digestive problems

 

 

ANS:  A                    REF:   115                BLM: REM

 

  1. Which of the following practices can reduce stress and promote mental and physical health and well-being?
a. watching TV
b. reading self-help books
c. looking after a pet
d. chiropractic treatment

 

 

ANS:  D                    REF:   116                BLM: HO

 

  1. Which of the following measures the number of years that a person will be in a state of independence?
a. disability-free life expectancy
b. dependence-free life expectancy
c. compression of morbidity
d. rectangularization of the survival curve

 

 

ANS:  B                    REF:   117                BLM: HO

 

  1. What does Fries (2006) conclude based on a “squaring” or “rectangularization” of the survival curve?
a. Modern populations can surpass their predicted life expectancy.
b. The near elimination of chronic diseases such as smallpox and polio has doubled the life span of humans.
c. By 2020 there will be more than twice the number of seniors predicted by most demographers.
d. Morbidity is postponed and compressed into fewer years in those with good health habits.

 

 

ANS:  D                    REF:   117-118         BLM: REM

 

  1. What does Fries (2006) state in response to studies done criticizing the compression of morbidity hypothesis?
a. Healthier habits and health policies can compress morbidity.
b. More recent trends show there will be fewer older people with chronic activity limitations than ever before.
c. Variability between individuals makes predicting who will become disabled in old age extremely difficult.
d. Modern society has reached its maximum potential for life expectancy.

 

 

ANS:  A                    REF:   118                BLM: REM

 

  1. Rowe and Kahn (1995) emphasize the importance of lifestyle and environmental influences. What do they believe research should now look at for further guidance?
a. treatment of functional decline
b. physiological aging
c. successful aging
d. extrinsic (determinative) aging

 

 

ANS:  C                    REF:   119                BLM: REM

 

 

  1. Why might the concept of “successful aging” be of little use to the biologist?
a. If the functional decline can be avoided by the organism, it is not true aging.
b. It is a qualitative, not a quantitative, measure.
c. Its main focus is on the clinical application of gerontology.
d. Ancillary processes of aging often cannot be disentangled from intrinsic processes.

 

 

ANS:  A                    REF:   119                BLM: HO

 

  1. Which of the following in general leads to poor health?
a. low income
b. financial planning
c. an apathetic attitude
d. a strong sense of coherence

 

 

ANS:  A                    REF:   120-121         BLM: HO

 

  1. According to Kaplan and Ross (2008), which of the following groups of people are likely to report poor health?
a. those with three or more children
b. those with low education
c. those who are recent immigrants
d. those who are sedentary

 

 

ANS:  B                    REF:   121                BLM: REM

 

  1. Which of the following factors is inconclusive in terms of having an impact on health in later life?
a. exercise
b. chronic childhood illness
c. fetal health
d. diet and nutrition

 

 

ANS:  C                    REF:   121                BLM: HO

 

  1. Having which of the following in one’s lifestyle is pivotal to healthy aging?
a. stress
b. relaxation
c. balance
d. activity

 

 

ANS:  C                    REF:   122                BLM: HO

 

 

 

SHORT-ANSWER QUESTIONS

 

  1. What is “intrinsic aging?” Define the term, and then explain Strehler’s four criteria for intrinsic aging.

 

ANS:

Student answers should include the following:

Intrinsic aging is one of the two types of aging that occur in humans. Intrinsic aging includes changes such as a decrease in lung capacity, hardening of the arteries, and arthritis.

 

Strehler lists four criteria for intrinsic (also known as true) aging:

 

  1. It takes place in all members of a species.
  2. It is basic to the organism: i.e., a decrease in lung capacity.
  3. It is progressive: i.e., the accumulation of debris in cells leads cells to stop functioning.
  4. It leads to decline in physical function. This increases the risk of illness and death.

 

REF: 90-91

 

  1. Describe the three models of interaction between the environment and genetic processes as presented by Shanahan and Hofer (2011).

 

ANS:

Student answers should include the following:

 

Shanahan and Hofer describe three models of interaction between the environment and genetic processes: the sensitive period model, the accumulation model, and the pathway model.

  1. The sensitive period model highlights the effect of the environment on the individual at all critical points of development. While a person’s basic genetic makeup doesn’t change throughout life, “Different genes may be expressed or ‘switched on’ at different developmental periods” (Kremer and Lyons 2011). So poor nutrition in childhood can lead to poor bone development. And this can lead to frailty in old age.
  2. The accumulation model says that deficits early in life can lead to “cumulative disadvantage.” Kremen and Lyons (2011) say that a person’s “genetic endowment” determines a person’s exposure to the environment. Genetic conditions determine to some degree a person’s achievement in school and their social skills. This will influence a person’s socio-economic status throughout life. Likewise, the environment influences genetic expression. For example, poverty in childhood often leads to poor nutrition, and this leads to poor performance in school, low pay at work, and poverty in old age.
  3. The pathway model points to complex patterns of challenges, insults, and advantages. This model allows for creative response to stressful life events. Shanahan and Hofer say that “many people who experience early adversity and possess genetic risk do not show symptoms of specific psychopathologies in later life.” This model says that biology is not destiny.

 

REF: 94-95

 

  1. What is the greatest cause for injury among older Canadians? Describe what measures are currently being taken to prevent this injury.

 

ANS:

Student answers should include the following:

 

Falls rank as the most common cause of injuries among seniors. One in three seniors will fall at least once each year. Illness, poor balance, medications, and cognitive impairment all increase the risk of a fall. Most falls that lead to hospitalization take place in the home. And falls can quickly and negatively impact the health status of seniors and their families.

 

What can seniors and their families do to prevent falls?

  • Seniors can keep their floors clear of slippery rugs and electrical cords.
  • Exercise can help a person maintain good balance and strength.
  • Fall prevention programs can help a person assess risk and take steps to prevent a fall.
  • Seniors can purchase footwear that is comfortable and has good “grip.”

 

REF: 101

 

 

ESSAY QUESTIONS

 

  1. How do improvements in technology benefit today’s seniors? Provide and discuss some examples.

 

ANS:

Student answers should include the following:

 

Today, technology assists older people to cope with aging in numerous ways.

  • Some people wear electric pacemakers to regulate their hearts.
  • People with severe arthritis can have joint replacement surgery.
  • Small utensils have rubber mounted on them for easier grip.
  • There are battery-powered tub seats to lift and lower a person into a bathtub.
  • There are living room chairs that lift the person to a standing position.
  • A bathroom grab bar can prevent slips and falls.
  • There are talking books and computerized reading aids.
  • Many people wear hearing aids that adjust to the environment.

 

Such devices allow older people the dignity and independence to age in place.

 

REF: 105-106

 

  1. Interview a senior about his or her usage of computers and the Internet. How often does he/she use

the computer? For what purpose does he/she use the computer?

 

ANS:

Student answers should include the following:

 

Older people still lag behind the general population in computer and Internet usage; however, many

seniors use their computers for a variety of reasons.

  • older people often use computers to research health-related information
  • some older people use the computer to connect with their friends, grandchildren or family in other cities and towns (they may use Skype or Facebook)
  • some older people like to play games on the computer
  • depending upon how comfortable one is, he/she may use the computer to shop or to do his/her banking online

 

REF: 106-108

 

  1. Discuss the concept of dietary and calorie restriction among older adults. What are the advantages

and disadvantages of this practice?

 

ANS:

Student answers should include the following:

 

Research studies have shown that calorie restriction (CR) “is the only environmental intervention that

consistently and strongly increases maximum life span and retards a broad array of indicators of bio-

logical aging in many of the laboratory rodents studied so far.” Also, research has shown that “CR

conferred a decreased risk of dying from an age-related disease.”

 

Humans are not rodents, however. And long-term studies of CR in humans pose problems of cost

and compliance. Few Westerners, however, have put themselves on the CR diet, because it is found

to be too restrictive. Long-term results for humans are not known. And CR without sound

nutrition could lead to bone fractures, infections, low muscle mass, weakness, and anemia. To date, there

has not been a study that has determined an optimum calorie intake to achieve the best effects from CR.

 

Some relatively current studies have shown that there has been a decrease in fat mass, a reduced

concentration of a marker for inflammation, reduced damage to DNA and RNA, and better heart

function. A study that combined CR with exercise showed the best results. Other studies have

shown that subjects obtain better fasting blood sugar and insulin levels.

 

Furthermore, a group called the Calorie Restriction Society showed a decrease in body fat and a

“profound reduction” in the major risk factors for heart disease, including lower cholesterol and a

“remarkable lowering effect on systolic diastolic blood pressure.”

 

REF: 115

 

CHAPTER 7: HEALTHCARE

 

MULTIPLE CHOICE

 

  1. According to Epp (1986), what is “the resource which gives people the ability to manage and even to change their surroundings”?
a. health
b. power
c. social support
d. technology

 

 

ANS:  A                    REF:   161                BLM: REM

 

  1. Elliott is among the 90% of people aged 65 and over who claim that they can do which of the following?
a. not worry about their finances in old age
b. drive a car for a long distance excursion
c. use two or fewer prescription drugs daily
d. live on their own in the community

 

 

ANS:  D                    REF:   161                BLM: HO

 

  1. Which of the following is an example of health promotion?
a. consuming more fruits and vegetables in the diet
b. exercising to the point of exhaustion every day
c. recycling cardboard and glass and plastic
d. watching less TV and reading more books

 

 

ANS:  A                    REF:   161                BLM: HO

 

 

  1. Surgery, rehabilitation through physical therapy, and drug therapy are the preferred methods of which model?
a. the medical model
b. the health promotion model
c. the hospice model
d. the healthcare model

 

 

ANS:  A                    REF:   161                BLM: HO

 

  1. Which of the following best describes the current Canadian healthcare system?
a. It does not address issues related to symptom relief.
b. It emphasizes disease treatment, and minimally addresses health promotion and injury prevention.
c. It is controlled by physicians who lack training in other forms of healthcare.
d. It has a negative cost–benefit therapeutic index.

 

 

ANS:  C                    REF:   162                BLM: HO

 

  1. Which of the following best describes medical care according to the social model of healthcare?
a. It has little or no place in a “true” healthcare system.
b. It should be used only in extreme cases.
c. It is only a piece of a complete healthcare system.
d. It plays a major role in healthcare, but must be supported by a healthcare team.

 

 

ANS:  C                    REF:   162                BLM: HO

 

  1. What does the social model of healthcare strive to do?
a. reduce the power differential between the elderly and healthcare professionals
b. empower people to take control of their health
c. optimize the benefit to elders through managing resources based on appropriate standards of care
d. keep older people in their homes through a healthcare team

 

 

ANS:  D                    REF:   162                BLM: HO

 

  1. In the social model, what is the best way to deliver healthcare?
a. through the physician
b. through educating people about disease prevention
c. through counsellors and social workers
d. through the healthcare team

 

 

ANS:  D                    REF:   162                BLM: HO

 

 

  1. Which of the following is an example of long-term care?
a. a senior’s recreation facility
b. an acute hospital
c. a nursing home
d. an allergy clinic

 

 

ANS:  C                    REF:   162                BLM: HO

 

  1. What is the major goal of long-term homecare?
a. to prevent disease and promote self-care
b. to reduce healthcare costs associated with iatrogenic illnesses
c. to manage symptoms, and reduce complications, for chronic diseases
d. to provide services that will enable people to stay out of institutions

 

 

ANS:  D                    REF:   162                BLM: HO

 

  1. Béland and Shapiro (1994) project a future shift between which models of care?
a. medical model to social model
b. medical care model to health premium model
c. social model to medical model
d. health promotion model to social model

 

 

ANS:  A                    REF:   162                BLM: REM

 

  1. What does the health promotion model focus on?
a. prevention and self-care
b. medical diagnosis before illness becomes serious
c. community involvement in healthcare
d. the accessibility of medical treatment

 

 

ANS:  A                    REF:   162                BLM: HO

 

  1. Healthy behaviour and environmental improvement are methods used by which model to prevent disease?
a. social model
b. medical model
c. community care model
d. health promotion model

 

 

ANS:  D                    REF:   162                BLM: REM

 

  1. Which of the following is an example of the health promotion model at work?
a. school safety regulations
b. pollution control for factories
c. subsidies to candy manufacturers
d. anti-abortion laws

 

 

ANS:  B                    REF:   162                BLM: HO

 

  1. The social model has gained acceptance as a possible alternative to which of the following?
a. the health promotion model
b. community care
c. institutionalization
d. healthcare

 

 

ANS:  C                    REF:   162                BLM: HO

 

  1. Seatbelt legislation is a component of which of the models of healthcare?
  2. social model
  3. behaviour model
  4. health promotion model
  5. medical model

 

ANS: C          REF: 162                     BLM: HO

 

  1. Kathleen has researched healthcare funding in Canada and was shocked to discover that Canadians spend such a large portion of healthcare dollars on one primary aspect of healthcare. Which of the following is that aspect of care?
  2. physiotherapy
  3. drugs
  4. long-term care
  5. physicians

 

ANS: D         REF: 162                     BLM: HO

 

  1. Which model dominates the Canadian healthcare system today?
a. the health promotion model
b. the medical model
c. the individual model
d. the social-economic model

 

 

ANS:  B                    REF:   162                BLM: REM

 

 

  1. The system of healthcare established by the Canadian government in the 1950s and 1960s is characterized by which of the following?
a. an emphasis on health promotion
b. administration by private agencies
c. universal coverage
d. fee-for-service hospital care

 

 

ANS:  C                    REF:   163                BLM: HO

 

  1. Which of the following is a principle of the Canadian healthcare system as described by the Canada Health Act of 1984?
a. administration of the system by the municipal government
b. portability
c. affordability
d. limited services especially to immigrant Canadians

 

 

ANS:  B                    REF:   163                BLM: REM

 

  1. According to the Canadian Healthcare Association (2007), which of the following concerns was most prevalent among respondents?
  2. obesity rates
  3. lack of physicians
  4. increasing costs
  5. wait times

 

ANS: D                     REF: 164         BLM: REM

 

  1. Which famous Canadian was named the “father of Medicare?”
  2. Pierre Elliott Trudeau
  3. Lester B. Pearson
  4. John Diefenbaker
  5. Tommy Douglas

 

ANS: D                     REF: 164         BLM: REM

 

  1. As compared with Americans, which of the following conditions is lower amongst Canadians?
  2. obesity
  3. arthritis
  4. kidney disease
  5. Crohn’s disease

 

ANS: A         REF: 163         BLM: REM

 

  1. What has the shift of care from institutions to the community led to?
a. an overall increase in the health status of the elderly as measured by life expectancy
b. no significant reduction in the cost of healthcare
c. decreased chronic illness but increased acute illnesses and injuries
d. an increased burden on women, families, and communities

 

 

ANS:  D                    REF:   164                BLM: HO

 

  1. According to the Canadian Healthcare Association (2007), what percentage of Canadians felt that they received quality healthcare services?
a. 27%
b. 35%
c. 57%
d. 74%

 

 

ANS:  C                    REF:   164                BLM: REM

 

  1. What types of surgery in the province of Quebec allow for private coverage?
a. liver, knee, and stomach
b. cosmetic, cataract, and brain
c. gallbladder, heart, and knee
d. knee, hip, and cataract

 

 

ANS:  D                    REF:   165                BLM: HO

 

  1. Cameron is waiting for surgery, but his doctor informs him that there are long wait times for his operation, and recent data shows few improvements in terms of wait times for it. Which of the following types of surgery is Cameron likely scheduled to undergo?
a. knee replacement
b. hip replacement
c. cornea replacement
d. kidney replacement

 

 

ANS:  A                    REF:   165                BLM: HO

 

  1. Which of the following best describes the cost of Canada’s medical care system?
a. It has stabilized at 5.7% of the gross national product (GNP).
b. It grows each year.
c. It has dropped due to a growing use of the health promotion model.
d. It has dropped due to the aging of the population.

 

 

ANS:  B                    REF:   166                BLM: HO

 

  1. In part, why does Canada have such high healthcare costs?
a. because of the high costs of equipment
b. because of the large number of children being born
c. because of the relatively large older population
d. because of the high cost of qualified doctors

 

 

ANS:  C                    REF:   166                BLM: HO

 

 

  1. A look at the healthcare system shows that older people account for what portion of the past increases in healthcare costs?
a. most
b. about two-thirds
c. about half
d. a small part

 

 

ANS:  D                    REF:   166                BLM: REM

 

  1. The aging of the Canadian population may result in which of the following?
a. reducing the cost of the medical care system because younger people more often require surgery and trauma care, the most expensive interventions
b. raising the cost of the medical care system because older people use hospitals more and for longer periods of time
c. reducing the cost of the medical care system because older people require alternate care systems that are less expensive than acute care hospitals
d. raising the cost of the medical care system because older people use almost nine times as much medication as younger people

 

 

ANS:  B                    REF:   166                BLM: HO

 

  1. Which of the following statements describes older peoples’ health problems when compared to younger people?
a. Older people have more problems than younger people.
b. Older people have fewer problems than younger people.
c. Older people have more severe problems than younger people.
d. Older people have less chronic problems than younger people.

 

 

ANS:  A                    REF:   166                BLM: HO

 

  1. Studies show that people in which age group have a higher hospital separation rate than do younger people?
a. 54–60
b. 59–65
c. 64–75
d. 85 and over

 

 

ANS:  D                    REF:   167                BLM: REM

 

  1. Which of the following best describes hospitalization rates for seniors?
a. They have decreased steadily since 1982.
b. They have increased the most among people aged 85+.
c. They have increased for women, while remaining stable for men.
d. They have decreased slowly, while usage by young adults has jumped 200%.

 

 

ANS:  B                    REF:   167                BLM: HO

 

  1. Which of the following best describes the theory that governments spend more money on health services for older people nowadays?
a. The theory is probably correct, given the results of several large, well-designed research studies.
b. The theory is probably incorrect, given the lack of large numbers of time contradictory studies done.
c. The theory is probably correct, given that Canada has a large, aging population.
d. The theory is impossible to prove since system-wide changes are much more influential in medical care usage patterns.

 

 

ANS:  C                    REF:   167                BLM: HO

 

  1. Why do older people tend to use the medical system more today than their counterparts of the past years?
a. a psycho-social dependence on doctors fostered by the medical model
b. the way the system responds to older people’s needs
c. older people contracting more complicated diseases than in the past
d. the increasing size of the older population

 

 

ANS:  B                    REF:   166-167         BLM: HO

 

  1. According to Ramage and Morin (2009, 5), what percentage of Canadian seniors who live in institutions take medications?
a. 67%
b. 79%
c. 86%
d. 97%

 

 

ANS:    D         REF:    168                  BLM: REM

 

  1. According to Ramage-Morin (2009), what percentage of Canadian seniors in institutions use five or more medications?
  2. 31%
  3. 42%
  4. 53%
  5. 67%

 

ANS: C          REF: 168                     BLM: REM

 

  1. According to the text, what is the reason cited as to why older people may use more than one prescription drug?
a. They have multiple health conditions.
b. They have fewer family members to provide support.
c. Most drugs are relatively inexpensive for older adults.
d. Their doctors prescribe them.

 

 

ANS:  B                    REF:   168                BLM: REM

 

  1. Prescription drug use tends to increase for women as they age. What happens to prescription drug use for men as they get older?
a. Drug use increases.
b. Drug use decreases.
c. Drug use remains stable.
d. Drug use slightly decreases, but after age 85, it increases again.

 

 

ANS:  B                    REF:   168                BLM: REM

 

  1. According to the text, which of the following factors is thought to be a major contributor to rising healthcare costs in Canada?
a. population aging
b. increased use of medical technology
c. doctors’ and nurses’ growing salaries
d. increased costs of prescription drugs

 

 

ANS:  A                    REF:   169                BLM: REM

 

  1. Mackenzie and Rachlis (2010) report that physician payments control approximately what percentage of healthcare costs?
  2. 35%
  3. 50%
  4. 80%
  5. 97%

 

ANS: B                      REF: 170                     BLM: REM

 

  1. According to Mackenzie and Rachlis (2010), other than doctors, half of all healthcare costs go to which of the following?
a. nursing care
b. the government
c. hospitals
d. pharmaceutical manufacturers

 

 

ANS:  D                    REF:   170                           BLM: REM

 

 

  1. According to Mackenzie and Rachlis (2010, 8–9), why do healthcare costs seem so high in Canada?
a. Because Canadians support higher levels of healthcare spending in comparison to other countries
b. Because of government decisions to cut taxes and public spending in areas other than healthcare
c. Because chronic diseases like heart disease cause healthcare costs to increase
d. Because economic factors drive healthcare costs up

 

 

ANS:  B                    REF:   170                           BLM: REM

 

  1. According to Constant and colleagues (2011, 21), what factor explains the current increase in healthcare expenditures?
a. new treatment methods
b. improvements in medical science
c. more experienced doctors
d. new prescription drugs

 

 

ANS:    B          REF:    170                  BLM: REM

 

  1. According to Dr. Jeff Turnbull of the Ottawa Hospital, how could many of the diseases of later life be best treated and cared for?
a. by prescription drugs
b. by family support only
c. by care in the community
d. by long-term care institutions

 

 

ANS:  C                    REF:   171                BLM: REM

 

  1. What percentage of Canadian healthcare costs are covered by the public sector?
a. 40%
b. 50%
c. 60%
d. 70%

 

 

ANS:  D                    REF:   171                BLM: REM

 

  1. Uncle George wants to do his part in decreasing healthcare costs, and he opts for one of the current so-called “shifts” in managing his own health, while cutting costs to the healthcare system. What method of care has Uncle George chosen?
a. using acute care hospitalization
b. using homecare and community care services
c. letting nature take its course with his health conditions and challenges
d. moving into a long-term care facility

 

 

ANS:  B                    REF:   171                BLM: HO

 

  1. What percentage of Canada’s GDP was spent on healthcare in 2009?
  2. 8.9%
  3. 10.7%
  4. 11.4%
  5. 12.3%

 

ANS: C          REF: 171         BLM: REM

 

  1. According to the CIHI (2011 Highlights), what factor has contributed to the lower cost of hospital care?
a. fewer acute care hospitalizations
b. better prescription drugs
c. fewer incidences of chronic diseases
d. the great distances between older people and hospitals

 

 

ANS:  A                    REF:   172                BLM: REM

 

  1. According to Finlayson and colleagues (2005), which of the following has led to a decrease in acute care hospitalizations?
  2. more physicians
  3. a shortage of beds
  4. more nursing homes
  5. improvements in diagnostic tools

 

ANS: D         REF: 172                     BLM: REM

 

  1. Most of the older people in Canada living in institutions live in which type of facility?
a. nursing homes
b. multi-level enriched housing
c. hospitals
d. elderhostels

 

 

ANS:  A                    REF:   172                BLM: HO

 

  1. Why are fewer older people now residing in nursing homes?
a. They live in hospitals.
b. They have access to better care.
c. They die before they are admitted.
d. They would rather live with their families.

 

 

ANS:  B                    REF:   172                BLM: HO

 

  1. What type of patients are typically “consumers” of alternate levels of care?
a. patients with mobility problems
b. patients with arthritis
c. patients with heart disease
d. patients with dementia

 

 

 

 

ANS:  D                    REF:   173                BLM: HO

 

  1. According to the CIHI (2011), what percentage of alternate level of care patients died while awaiting transfer to a long-term care facility?
a. 7%
b. 9%
c. 12%
d. 15%

 

 

ANS:  C                    REF:   173                BLM: REM

 

  1. Mr. Jones resides at a nursing home where he requires assistance with eating, bathing, mobility, and behaviour management. At what level of care would Mr. Jones be assessed?
a. five
b. four
c. three
d. two

 

 

ANS:  B                    REF:   173                BLM: HO

 

 

  1. How does the government allocate funds to long-term care institutions?
a. by the number of patients/residents who live there
b. by the number of staff required for the facility
c. by the number of services provided in the facility
d. by the level of care required by the patient

 

 

ANS:  D                    REF:   173                BLM: HO

 

  1. According to a Manitoba study, which of the following characteristics indicates that an individual had more than a three-in-five chance of entering an institution?
a. being aged 75 or older
b. living with a frail spouse
c. having mental impairment
d. using six or more prescription drugs daily

 

 

ANS:  C                    REF:   173                BLM: REM

 

  1. Which of the following measures would help to de-institutionalize a nursing home?
  2. having three residents to a room
  3. allowing residents to decorate their rooms as they choose
  4. serving a choice of two entrees for meals
  5. allowing family members to visit at any time of day or night

 

ANS: B                      REF: 174-175              BLM: HO

 

  1. Who founded “the Eden Alternative,” a philosophy to de-institutionalize nursing homes?
a. Roy Romanow
b. Dr. William Thomas
c. Tommy Douglas
d. the CIHI

 

 

ANS:  B                    REF:   175                BLM: REM

 

 

  1. Which of the following models do nursing homes fall under?
a. hospice model
b. healthcare model
c. medical model
d. health promotion model

 

 

ANS:  C                    REF:   175                BLM: HO

 

  1. The Romanow Report (2002) states that among the immediate healthcare reform priorities, the goal of the Canadian government must be to strengthen which of the following?
a. the Canadian Geriatric Society
b. the Canadian Institute for Health Information
c. the legislative and institutional foundations of Medicare
d. the Commission on the Future of Healthcare in Canada

 

 

ANS:  C                    REF:   175-176         BLM: REM

 

  1. The Romanow Report (2002) proposed 47 recommendations to reform and renew the Canadian healthcare system. Which of the following was included in these recommendations?
a. reduced funding for homecare services and prescription drugs
b. the exclusion of medically necessary homecare services coverage
c. a privately funded healthcare system
d. provisions for the direct support of informal home caregivers

 

 

ANS:    D         REF:    176                  BLM: REM

 

 

  1. Which of the following systems of care receives the least funding from the federal government?
a. acute care
b. transitional care awaiting long-term care placement
c. community care
d. institutional care

 

 

ANS:  C                    REF:   176                BLM: REM

 

  1. With reference to community care programs, what is the benefit of a single-point-of-entry system?
a. It has the potential to adapt to a person’s specific needs.
b. It increases client functional ability and perceived quality of life.
c. It eliminates the high costs related to duplication of services and administration expenses.
d. It allows access to all community social and healthcare services from one point in the system.

 

 

ANS:  D                    REF:   177                BLM: HO

 

  1. Ontario’s use of Community Care Access Centres (CCACs) introduced what aspect to acquiring community care services from providers?
a. competition for contracts
b. standards of care
c. fiscal accountability
d. community representation

 

 

ANS:  A                    REF:   177                BLM: HO

 

  1. Which of the following is an example of a type of therapy that is provided as a part of Ontario’s Community Care Access Centres (CCAC)?
  2. drug therapy
  3. occupational therapy
  4. Meals on Wheels
  5. mental health services

 

ANS: B          REF: 177         BLM: HO

 

 

  1. What is the main focus of the social model?
a. to eliminate the psychological effects of illness on older people
b. to keep people out of institutions
c. to reduce Canada’s dependence on the economic model
d. to fill the gaps in the healthcare system left by the health promotion model

 

 

ANS:  B                    REF:   177                BLM: HO

 

  1. Which of the following is a part of community care programs?
a. libraries
b. seniors’ recreation clubs
c. adult daycare programs
d. elderhostels

 

 

ANS:  C                    REF:   178                BLM: HO

 

  1. Which of the following is an example of a homecare service offered in some provinces?
a. medication monitoring
b. nutrition counselling
c. pet therapy
d. friendly visitors

 

 

ANS:  B                    REF:   178                BLM: HO

 

  1. Your aunt has a non-professional worker come to her home on a daily basis to assist her with cleaning and bathing. What is the name for this type of service that is provided for seniors?
  2. homemaker services
  3. adult daycare
  4. nursing homecare
  5. home nursing care

 

ANS: A         REF: 178                                 BLM: HO

 

  1. What is the purpose of geriatric day hospitals?
a. to plan rehabilitation and care programs for older people
b. to reduce healthcare costs by remaining open only during the day
c. to integrate medical and community care models
d. to provide outpatient surgeries so that patients can recuperate at home

 

 

ANS:  A                    REF:   178                BLM: HO

 

  1. Which of the following is a service of geriatric day hospitals?
a. providing hot meals and recreation programs
b. providing entertainment while family caregivers are working
c. watching older patients at risk in the community
d. running foot care clinics

 

 

ANS:  C                    REF:   178                BLM: HO

 

  1. What is the main difference between adult daycare and geriatric day hospitals?
a. Adult daycare treats the patient at home, rather than in a hospital.
b. Adult daycare looks after rehabilitation outside the hospital, while day hospitals are concerned mainly with care and treatment inside the hospital.
c. Adult daycare responds to the total needs of the individual, whereas day hospitals focus on medical care.
d. Adult daycare offers fewer medical services and more social and recreational services than day hospitals.

 

 

ANS:  C                    REF:   178-179         BLM: HO

 

 

  1. Which of the following is an advantage of a geriatric day hospital?
a. Medication costs are lower.
b. It provides a seamless transition to a long-term care facility.
c. All medical services are provided under one roof.
d. Patients get time away from their families.

 

 

ANS:  C                    REF:   178                BLM: HO

 

  1. Although a wide range of older people use geriatric day hospitals to maintain themselves in the community, which group sees the most improvement?
a. cognitively impaired elders
b. women 85 years of age and older
c. seniors recovering from acute hospitalizations
d. seniors with walking problems

 

 

ANS:  A                    REF:   178                BLM: HO

 

 

  1. The objective of which of the following is to “provide support in the community for those people who cannot stay in their homes without it”?
a. nursing homes
b. geriatric day hospitals
c. adult daycare programs
d. quick response teams

 

 

ANS:  C                    REF:   179                BLM: REM

 

 

  1. Research on adult daycare users has found that adult daycare results in which of the following?
a. significant reductions in the need for physician services and hospital use
b. increased use of outpatient physician services, but significant reductions in hospital use
c. no significant reduction in the use of other services
d. no reduction in use of physician services, but slight reductions in hospital use

 

 

ANS:  C                    REF:   179                BLM: REM

 

  1. Some research shows that adult daycare tends to increase which of the following?
a. the participant’s dependence on social aid
b. the well-being of its participants
c. healthcare costs but significantly reduce the use of other services
d. the use of other services

 

 

ANS:  B                    REF:   179                BLM: REM

 

 

  1. How does the Canada Health Act define homecare?
a. as an extended service
b. as an essential service
c. as an important service
d. as an insured service

 

 

ANS:  A                    REF:   179                BLM: REM

 

  1. According to Carrière (2006), what percentage of seniors aged 65 to 74 years used homecare?
A. 5%
B. 8%
C. 11%
D. 15%

 

 

ANS:  B                    REF:   52                  BLM: REM

 

  1. According to the Canadian Healthcare Association, by what approximate percentage did the number of individuals who received homecare grow between 1995 and 2006?
a.  25%
b.  50%
c.  75%
d. 100%

 

 

ANS:  D                    REF:   180                BLM: REM

 

  1. According to Chappell and Hollander (2011), which type of system will provide the most appropriate care for the lowest cost?
a. harmonized
b. consolidated
c. coordinated and integrated
d. private

 

 

ANS:  C                    REF:   181                BLM: REM

 

  1. Which statement is true regarding the traditional healthcare system?
a. It offers the most hope for improved health.
b. It often causes more problems than it solves, and should be replaced by more holistic systems, such as the health field.
c. It exists only to treat illness.
d. It is only one of the ways within the health field to improve health.

 

 

ANS:  C                    REF:   181                BLM: HO

 

  1. What term did Lalonde (1974) use to describe the collection of traditional medical services, efforts to improve human biology, improvements in lifestyle, and improvements in the environment?
a. unity promotion
b. health field
c. holistic care system
d. unity care

 

 

ANS:  B                    REF:   181                BLM: REM

 

  1. Which of the following statements can be made regarding reaction to health programs, such as the CHOICE program in Alberta?
a. the program reflects the values and lifestyles that seniors bring with them into old age
b. seniors have responded well to health promotion policies
c. older people are slow to change their habits, and respond better to programs directed specifically to younger people
d. ethnic background is the most significant factor for health-promoting behaviour

 

 

ANS:  B                    REF:   182                BLM: HO

 

  1. Kim is 57 years old, and has rheumatoid arthritis. As a preventative health measure, she has learned a Chinese form of a martial art that can help to reduce falls as she ages. What is the name of this martial art?
a. tai chi
b. jiu-jitsu
c. kung fu
d. karate

 

 

ANS:  A                    REF:   182                BLM: HO

 

  1. When compared with their younger counterparts, what health promotion activity do seniors excel at?
  2. eating five or more servings of fruit and vegetables daily
  3. limiting alcohol intake
  4. wearing seatbelts
  5. exercising daily

 

ANS: A         REF: 184                     BLM: REM

 

  1. For long-term care in provinces, what is the term for the difference between what care could/should be, and what takes place?
a. the care gap
b. the universality discrepancy
c. a resource mismatch
d. a service discordance

 

 

ANS:  A                    REF:   184                BLM: REM

 

  1. According to the CIHI (2011), what percentage of seniors with one chronic health condition are able to self-manage their medical treatments at home?
a. 76%
b. 82%
c. 89%
d. 97%

 

 

ANS:  D                    REF:   184                BLM: REM

 

  1. How can one determine if a service is available?
a. if it is offered in a community
b. if it is open at least 18 hours a day
c. if there is sufficient need demonstrated for its presence in a community
d. if an older person can get to it and make use of it

 

 

ANS:  A                    REF:   185                BLM: HO

 

  1. How can one determine if a program is accessible?
a. if it is present within the community
b. if it exists to serve only a particular group of people
c. if it is open 24 hours a day
d. if an older person can get to it and make use of it

 

 

ANS:  D                    REF:   185                BLM: HO

 

  1. With respect to healthcare programs, Denton and Kusch (2006) say that older ethnic people are more likely to experience problems with which aspect of a program?
a. affordability
b. availability
c. accessibility
d. acceptability

 

 

ANS:  C                    REF: 185                  BLM: REM

 

  1. Agloolik is an Inuit infant who has a rare heart condition. Her doctor follows her progress at yearly checkups in Whitehorse, but when Agloolik’s mom has questions about her condition, she can videoconference with Agloolik’s doctor from her home in northern Nunavut. What is the name for Canada’s delivery of medical diagnoses and consultations via technology such as video conferencing?
a. videocare
b. health technology answers
c. telemedical care
d. telehealth

 

 

ANS:  D                    REF:   185                BLM: HO

 

  1. How will the growth of community care increase the need for better coordination and integration of the healthcare system?
a. It will dramatically increase the number of people, especially volunteers, who are involved in healthcare.
b. It will decentralize care by bringing workers from different agencies together.
c. It must be organized to function effectively.
d. It can cost more than traditional forms of healthcare if it is not properly managed.

 

 

ANS:  B                    REF:   186                BLM: HO

 

  1. Which model will provide the best coordination of services for the elderly?
a. continuum of care model
b. single-point-of-entry model
c. social model
d. health maintenance organization (HMO) model

 

 

ANS:  B                    REF:   186                BLM: HO

 

  1. What is the most notable characteristic of the single-entry model for coordinating services for older people?
a. It brings many different agencies together and uses a team-based approach to providing care.
b. No matter where a client enters the healthcare system, his/her case is reviewed by a member of other programs to see if services are needed.
c. It provides a broad range of services to clients.
d. Staff from one agency assess a client’s needs and coordinate service delivery.

 

 

ANS:  D                    REF:   186                BLM: HO

 

  1. In what way might overlaps between services be avoided?
a. by defining the boundaries between the government ministries
b. by unifying all health and social services under a single government ministry
c. by coordinating and integrating services into one system
d. by creating government policies that define areas of responsibility

 

 

ANS:  C                    REF:   187                BLM: HO

 

  1. The SIPA program in Montreal uses long-term and nursing services to serve frail seniors around the clock. This program reports a drop in long term care admission rates of what percentage?
a. 10%
b. 25%
c. 50%
d. 75%

 

 

ANS:  C                    REF:   187                BLM: REM

 

 

100 .   According to the text, what will comprehensive models of healthcare lead to?

a. better health for older people
b. better healthcare for older people, as well as better health
c. better health at all ages
d. less expensive healthcare for older people

 

 

ANS:  B                    REF:   188                BLM: REM

 

 

 SHORT-ANSWER QUESTIONS

 

  1. What are the five basic principles of the Canadian healthcare system, as outlined in the Canada Health Act of 1984?

 

ANS:

Student answers should contain the following:

 

The five basic principles of the Canadian healthcare system include the following:

  1. Universal coverage
  2. Access to services
  3. Portability (people could get the benefits in their new location when they move)
  4. Comprehensive services that include outpatient and hospital care
  5. Administration of the system by a non-profit public agency

 

REF: 163

 

  1. Why was Roy Romanow commissioned by Prime Minister Jean Chrétien? List the important recommendations (as mentioned in the text) that were made in the Romanow Report in 2002.

 

ANS:

Student answers should contain the following:

 

In April 2001, Prime Minister Jean Chrétien commissioned a study of Canada’s healthcare system. He appointed Roy Romanow, Queen’s Counsellor, to chair the Commission on the future of healthcare in Canada. The prime minister charged the commission to study the current system and propose reforms to meet Canada’s future healthcare needs. The commission met with citizens and groups across the country, held televised forums, and received reports from researchers.

 

Romanow’s recommendations included the following:

Recommendation 1: A new Canadian health covenant should be established as a common declaration of Canadians’ and their governments’ commitment to a universally accessible, publicly funded healthcare system.

 

Recommendation 5: The Canada Health Act should be modernized and strengthened by:

  • Confirming the principles of public administration, universality, and accessibility, updating the principles of portability and comprehensiveness, and establishing a new principle of accountability
  • Expanding insured health services beyond hospital and physician services to immediately include targeted homecare services followed by prescription drugs in the longer term
  • Clarifying coverage in terms of diagnostic services
  • Including an effective dispute resolution process
  • Establishing a dedicated health transfer directly connected to the principles and conditions of the Canada Health Act.

 

Recommendation 7: On a short-term basis, the federal government should provide targeted funding for the next two years to establish:

  • A new rural and remote access fund
  • A new diagnostic services fund
  • A primary healthcare transfer
  • A homecare transfer
  • A catastrophic drug transfer.

 

Recommendation 26: Provincial and territorial governments should take immediate action to manage wait lists more effectively by implementing centralized approaches, setting standardized criteria, and providing clear information to patients on how long they can expect to wait.

 

Recommendation 34: The proposed new homecare transfer should be used to support expansion of the Canada Health Act to include medically necessary homecare services in the following areas:

  • Home mental health case management and intervention services should immediately be included in the scope of medically necessary services covered under the Canada Health Act.
  • Homecare services for post-acute patients, including coverage for medication management and rehabilitation services, should be included under the Canada Health Act.
  • Palliative homecare services to support people in their last six months of life should also be included under the Canada Health Act.

 

Recommendation 35: Human Resources Development Canada, in conjunction with Health Canada, should be directed to develop proposals to provide direct support to informal caregivers to allow them to spend time away from work to provide necessary homecare assistance at critical times.

 

The report concludes by stating that “the immediate priorities must be to strengthen Medicare’s legislative and institutional foundations, to stabilize funding, and to address the critical concerns that are eroding Canadians’ confidence in the system. The changes will take place over time, and the implementation plan extends to 2020.

 

REF: 175-176

 

  1. What challenges are currently being experienced by Canada’s telehealth programs?

 

ANS:

Student answers should contain the following:

 

Telehealth faces a number of challenges to its growth and adoption. Telehealth programs will at least need:

  1. A payment schedule to encourage physicians and institutions to use the systems
  2. A training program for health professionals
  3. Regular assessment of program outcomes
  4. Government policy and funding support.

 

REF: 186

 

 

ESSAY QUESTIONS

 

  1. Describe the shift that is occurring from the medical model of care to the social model in long-term

care that we, as Canadians, will begin to experience more as the population ages.

 

ANS:

Student answers should contain the following:

 

The social model sees medical care as only one part of a complete healthcare system. This model

sees personal and family counselling, homecare, and adult day-care programs as part of the healthcare

system. This model of healthcare tries to keep older people in their own homes. Care often takes

place in the community—in a person’s home, at a drop-in centre, or in a counsellor’s office. In this

model, the doctor works as part of a healthcare team that include nurses, physiotherapists, counsellors,

social workers, and other professionals. The social model has grown in importance as more older

people need continuing care or long-term care.

 

Long-term care serves people with chronic illnesses and functional disabilities. Long-term care is “a

combination of medical, nursing, custodial, social, and community services designed to help people

who have disabilities or chronic care needs, including dementia. Services may be provided in the

person’s home, in the community, in assisted living facilities or in nursing homes.” Long-term care

gives people as much autonomy as possible. Long-term care often attempts to keep people out of

institutions. Home care, for example, offers a range of services that allow people to stay in their

homes. Services include Meals on Wheels, homemaker visits, volunteer visits, and physiotherapy.

 

The Canadian healthcare system has begun to shift from the medical to the social model of care.

 

Note: Students can include the information provided in Exhibit 7.1 as an answer to this question.

 

MEDICAL MODEL SOCIAL MODEL
Patient Resident, consumer
Acute patients Chronic clients
Physicians and hospitals Community settings and home
Patient fits organization Organization fits client, changes to fit client if necessary
Rigid system boundaries Open system boundaries
Serves long-term care if it has excess capacity Serves long-term care first
Diagnosis/treatment/cure model Assessment of functional capacity, service needs identified, services delivered
Organizationally inflexible Organizationally flexible and creative
Institutional care Community-based and homecare
Excludes people in the community Includes community members and may include institution
Institution-centred Person-centred
Makes little use of informal network Includes informal support
Medical/physical assessment Multidimensional assessment (physical, psychological, social needs)
Meets patients’ medical needs Helps clients meet their own needs
Patient accepts professional treatment Client plays role in development treatment plan
Professional has most power in relationship Client and professional share power
Hierarchical organization Flat organization, team approach
Expensive resources Lower-cost resources
Major share of healthcare budget Small share of healthcare budget

 

 

REF: 163

 

  1. Interview an older person who has experienced wait times for surgery. What type of surgery was it?

How long did he/she have to wait? How did the wait time affect his/her opinions about the healthcare

system?

 

ANS:

Student answers should include the following:

 

Students will likely make the comment that people are concerned about wait times for surgery in

Canada. Wait times for some services have increased, depending upon location and type of

surgery involved. This has led to some loss of confidence in the system. The loss of confidence also

threatens support for a single government-sponsored system, and some people, including some seniors,

can afford to pay for surgery out of country or to have that surgery at a private clinic.

 

REF: 164-165

 

  1. Interview another individual who receives homecare services. What type of services does he/she

receive? Alternatively, research the homecare services that are provided in your community. What

services are provided, and in your opinion, how could these services be improved?

 

ANS:

Student answers should include the following:

 

Home care, as defined by the Canadian Home Care Association is “an array of services for people of all

ages, provided in the home and community setting, that encompasses health promotion and teaching,

curative intervention, end-of-life care, rehabilitation, support and maintenance, social adaptation and

integration and support for the informal (family) caregiver.”

 

Home care programs differ from province to province, but all the provinces and territories in Canada

have some public homecare and nursing services. Some provinces have extensive homecare

programs that include Meals on Wheels, home repair services, laundry and cleaning help, emergency

alert services, friendly visitors, nutrition counselling, and transportation services.

 

Home care services typically increase as a person ages. In addition, people with chronic conditions

and a need for activities of daily living support tend to use homecare services.

 

Home care services could be improved by further assessment and more funding into the social model

of healthcare. Research has proven that homecare can be a lower-cost alternative to residential

services such as hospitals and long-term care institutions. There needs to be a coordinated and

integrated system of care for the Canadian homecare and healthcare systems.

 

REF: 179-181

 

 

 

CHAPTER 13: SOCIAL SUPPORT

 

MULTIPLE CHOICE

 

 

 

  1. What phrase does the text use to describe the life of a spouse of an Alzheimer patient?
  2. as living on a rollercoaster
  3. as living in limbo
  4. as living in terror
  5. as living in chaos

 

ANS: B                                    REF: 309                     BLM: REM

 

  1. What is “social support?”
  2. a financial method by which a person is able to survive
  3. a network of colleagues who advise us on various life matters
  4. the help and assistance we give to and receive from others
  5. a group of individuals who are experienced in providing community assistance

 

ANS: C                                    REF: 309                     BLM: HO

 

  1. According to Keefe (2011), how many Canadians aged 65+ use formal home care services?
  2. 1 million
  3. 1.2 million
  4. 1.5 million
  5. 1.75 million

 

ANS: B                                    REF: 309                     BLM: REM

 

  1. Which of the following individuals provides a formal support in the community?
  2. a doctor
  3. a janitor
  4. a banker
  5. a lawyer

 

ANS: A                                    REF: 309                     BLM: HO

 

  1. According to Keefe (2011), what estimated percentage of support to older Canadians is actually given to them by an informal support network?
  2. 40–50%
  3. 50–60%
  4. 60–70%
  5. 70–80%

 

ANS: D                                    REF: 309                     BLM: REM

 

  1. Which of the following is an example of an informal support?
  2. a trip to the doctor’s office
  3. a visit from one’s neighbour
  4. a home visit from a foot care professional
  5. a trip to the social worker’s office

 

ANS: B                                    REF: 309                     BLM: HO

 

  1. Which of the following statements can be made about high users of formal services?
a. They have little need for informal support.
b. They have low life satisfaction.
c. They actually have the least need for the services.
d. They still rely on their informal care network.

 

 

ANS:  D                    REF:   309                           BLM: HO

 

  1. According to Cranswick and Dosman (2008), who provides the majority of informal support, especially in cases of high-intensity care?
  2. women
  3. men
  4. nurses and doctors
  5. grandchildren

 

ANS: A                                    REF: 310                     BLM: REM

 

  1. Studies on the formal home care system show that people usually turn to which of the following only after the informal system breaks down?
a. the formal system
b. their religious leaders
c. caregiver support
d. community supports

 

ANS:  A                    REF:   310                           BLM: REM

 

  1. Formal care tends to increase with which of the following?
a. income
b. educational level
c. age
d. level of health

 

 

ANS:  C                    REF:   310                           BLM: HO

 

  1. What can buffer stress from life events like widowhood or illness?
a. good health
b. informal supports
c. psychological counselling
d. new social roles

 

 

ANS:  B                    REF:   311                           BLM: HO

 

12 . According to research, what percentage of care is provided by informal caregivers?

  1. 1/4
  2. 1/2
  3. 2/3
  4. 3/4

 

ANS: C                                    REF: 310                     BLM: REM

 

  1. What is the term used to describe the family and close friends who give help to an older person and who can expect help from the older person?
a. an associative infraculture
b. a tesseract
c. a hierarchical compensatory structure
d. a task specificity model of support

 

 

ANS:  D                    REF:   311                           BLM: REM

 

 

  1. The task specificity, the hierarchical compensatory models, the functional specificity, and the convoy models demonstrate which of the following?
a. organization patterns of long-term care facilities
b. levels of functional competence
c. how people use informal supports
d. rehabilitation objectives following accidents

 

 

ANS:  C                    REF:   311                           BLM: HO

 

  1. What is stated in the hierarchical compensatory model?
a. different groups offer different types of support
b. formal supports do not play a significant role in the lives of most older people
c. the type of support an older person receives depends on whether or not he/she lives with someone
d. people first choose their supports from close family, and then move outward

 

 

ANS:  D                    REF:   311                           BLM: HO

 

  1. Which model of support recognizes that “one tie may provide one type of support for a broad range of support dependent on how the relationship has been negotiated over the life course”?
a. the task specificity model
b. the convoy model
c. the functional specificity of relationships model
d. the hierarchical compensatory model

 

 

ANS:  C                    REF:   311                           BLM HO

 

  1. Which model of support sees people as having a dynamic network of close ties with family and friends?
a. task specificity model
b. hierarchical compensatory model
c. functional specificity model
d. convoy model

 

 

ANS:  D                    REF:   311                           BLM: HO

 

  1. According to the hierarchical compensatory model of informal support, to whom does a married older person turn to first for assistance?
  2. a social worker
  3. a spouse
  4. a child
  5. a friend

 

ANS: B                                    REF: 311                     BLM: HO

 

  1. Studies of older people’s use of informal support, such as Penning (1990), have found which of the following?
a. Strong support exists for the task specificity model.
b. Older people tend to use a variety of supports at the same time, and not in a specific hierarchical order.
c. Older people actively manage their support networks to insure coverage and prevent overlap.
d. Friends and neighbours, more than relatives, provide the basic supports for older people.

 

 

ANS:  B                    REF:   311                           BLM: REM

 

  1. Which of the following factors influences the type of social support that an older individual may receive?
  2. living with someone
  3. being wealthy
  4. having a chronic disease
  5. being ambulatory

 

ANS: A                                    REF: 312                     BLM: HO

 

  1. Researchers have concluded that the emphasis on family and community care can place a heavy burden on which of the following?
a. informal caregivers
b. formal caregivers
c. elderly men
d. elderly women

 

 

ANS:  A                    REF:   312                           BLM: REM

 

  1. Which of the following groups does Keefe (2011) identify as personal caregivers?
a. middle-aged men
b. nurses
c. middle-aged women
d. grandchildren

 

 

ANS:  C                    REF:   313                           BLM: REM

 

  1. Which group provides much of the support needed by older people?
a. their children
b. physicians and nurses
c. siblings
d. neighbours

 

 

ANS:  A                    REF:   314                           BLM: HO

 

  1. Which of the following influences an adult child’s level of involvement with his/her older parent?
  2. the adult child’s financial status
  3. the adult child’s age
  4. the adult child’s employment status
  5. the adult child’s marital status

 

ANS: D                                    REF: 314                     BLM: HO

 

  1. According to Williams (2005), when compared with working sons, how much time do working daughters spend in providing care to an older parent?
  2. almost twice as much time
  3. almost four times as much time
  4. almost seven times as much time
  5. almost ten times as much time

 

ANS: A                                    REF: 314                     BLM: REM

 

  1. Which of the following is an example of a government support given as a financial support to caregivers in Canada?
  2. the aging Canadian rebate
  3. the caregiver benefit
  4. the compassionate care benefit
  5. the Canadian caregiver benefit

 

ANS: C                                    REF: 315                     BLM: HO

 

  1. Which of the following provinces or territories currently provides financial support to caregivers of older family members?
  2. Nova Scotia
  3. Alberta
  4. Yukon Territory
  5. Newfoundland

 

ANS: A                                    REF: 315                     BLM: REM

 

  1. Keefe and colleagues (2008) propose that government programs provide multiple measures of compensation and support for caregivers. These include which of the following?
a. financial payment and workplace support
b. financial payment and home help services
c. workplace support and formal services
d. financial and workplace support, and informal services

 

 

ANS:  B                    REF:   315                           BLM: REM

 

 

  1. Why do childless older people report as much life satisfaction as older people with children?
a. They have better health and fewer chronic illnesses.
b. They are more financially secure.
c. They create a network of supportive friends.
d. They have more freedom and fewer obligations.

 

 

ANS:  C                    REF:   316                           BLM: HO

 

  1. According to Plotnick (2009), what percentage of wealth do older, unmarried, childless women have over their older, unmarried mother counterparts?
  2. 17%
  3. 24%
  4. 29%
  5. 33%

 

ANS: D                                    REF: 316                     BLM: REM

 

  1. Compared to people with children, how do childless older people feel about their financial benefits, personal freedom, and career flexibility, according to Connidis (2010)?
a. They are less satisfied.
b. They are more satisfied.
c. They feel more in control.
d. They are less concerned.

 

 

ANS:  B                    REF:   316                           BLM: REM

 

  1. Which of the following does an older, unmarried woman have, as opposed to an older, married woman?
  2. more male friends
  3. more health issues
  4. more free time
  5. more wealth

 

ANS: D                                    REF: 316                     BLM: HO

 

  1. Older people get more enjoyment out of visits with which of the following groups of people?
a. friends than with family, in part because they tend to have more in common with them
b. family than with friends, mainly because they have deeper ties that lead to feelings of security and love
c. social workers than with family, because they will listen to the older person’s problems and give them attention
d. family than with friends, because their visits produce feelings of generativity

 

 

ANS:  A                    REF:   316-317                   BLM: HO

 

  1. Studies show that older people often rely on friends their own age for which of the following?
a. care in old age
b. financial support
c. a satisfying social and emotional support network
d. healthcare

 

 

ANS:  C                    REF:   317                           BLM: REM

 

  1. According to Moremen (2008), who do older women state are their closest confidants?
  2. their daughters
  3. their friends
  4. their sons
  5. their husbands

 

ANS: B                                    REF: 317                     BLM: REM

 

  1. What do friends, siblings, and pets exemplify for older people?
a. formal support
b. informal support
c. responsibilities
d. problems

 

 

ANS:  B                    REF:   317-318                   BLM: HO

 

  1. Which of the following situations would a Rosemary, an older woman, avoid sharing about with her closest confidant, Carol?
  2. physical health concerns
  3. financial issues
  4. diet and exercise advice
  5. personal care tasks

 

ANS: D                                    REF: 317                     BLM: HO

 

  1. According to the 2007 Canadian General Social Survey, what percentage of friends and neighbours accounted for the caregiving tasks for seniors?
  2. 7%
  3. 13%
  4. 19%
  5. 24%

 

ANS: C                                    REF: 317                     BLM: REM

 

  1. Fay is 73 years old, and she has 3 other older siblings. According to Spitze and Trent (2006), what percentage of older adults has at least one living brother or sister?
  2. 20%
  3. 40%
  4. 60%
  5. 80%

 

ANS: D                                    REF: 317                     BLM: REM

 

  1. Which of the following conditions, according to the text, can a person deal with better if he/she has a pet?
  2. diabetes
  3. stress
  4. cognitive problems
  5. social interaction

 

ANS: B                       REF: 318                     BLM: HO

 

  1. Georgia like to sit on the sofa at night and watch the news. Her faithful dog, Scruffy, likes to sit with her. What chemical is released, reducing anxiety and stimulating well-being, when Georgia strokes Scruffy’s fur?
  2. oxytocin
  3. progesterone
  4. estrogen
  5. cortisol

 

ANS: A                                    REF: 318                     BLM: HO

 

  1. Other than dogs, what animals can be used as an effective part of an animal-assisted therapy in a long-term care home?
  2. ferrets
  3. pot-belly pigs
  4. rabbits
  5. gerbils

 

ANS: C                                    REF: 318                     BLM: REM

 

  1. Which of the following methods can be useful to a caregiver who wants to learn more about his/her care receiver’s condition?
  2. television shows and DVDs
  3. the Internet
  4. friends
  5. books and medical dictionaries

 

ANS: B                                    REF: 319                     BLM: HO

 

 

 

  1. According to the 2007 General Social Survey, what percentage of caregivers who were responsible for a senior with a long-term health problem were women?
  2. 16%
  3. 29%
  4. 44%
  5. 57%

 

ANS: D                                    REF: 319                     BLM: REM

 

  1. Research indicates that seventy-five percent of caregivers belong to which of the following age groups?
  2. 35–55
  3. 40–63
  4. 45–64
  5. 50–65

 

ANS: C                                    REF: 319                     BLM: REM

 

  1. Most studies report that giving care to a physically or cognitively impaired older person can lead to what type of feelings for the caregiver?
a. suicide
b. remorse
c. caregiver burden
d. happiness

 

 

ANS:  C                    REF:   319                           BLM: REM

 

  1. Which of the following refers to problems and stress due to caregiving?
a. informal supports
b. quasi-widowhood
c. functional specificity
d. caregiver burden

 

 

ANS:  D                    REF:   319-320                   BLM: HO

 

  1. Research suggests that which group of caregivers suffer a greater burden than caregiving adult children?
a. spouses
b. friends
c. adult grandchildren
d. doctors

 

 

ANS:  A                    REF:   320                           BLM: REM

 

  1. Which of the following solutions can help to ease the caregiver burden experienced by a spouse?
a. get more formal support
b. get more informal support
c. show a positive appraisal of their spouse and marriage
d. have health problems themselves.

 

 

ANS:  C                    REF:   322                           BLM: HO

 

  1. Which of the following describes caregivers who can identify some positive feelings about providing support?
a. They have lower rates of depression.
b. They are paid better.
c. They live longer.
d. They have more fun.

 

 

ANS:  A                    REF:   322                           BLM: HO

 

  1. What is experienced by wives who place their husbands in nursing homes or institutions?
a. depression
b. quasi-widowhood
c. confusion
d. happiness

 

 

ANS:  B                    REF:   322                           BLM: HO

 

  1. Ross et al. (1997) found that what percentage of wives visited their husbands at least several times a week?
a. more than 10%
b. more than 50%
c. more than 80%
d. more than 90%

 

 

ANS:  C                    REF:   323                           BLM: REM

 

  1. According to Calasanti and Bowen (2006), what percentage of men are spousal caregivers?
  2. 10%
  3. 20%
  4. 30%
  5. 40%

 

ANS: D                                    REF: 324                     BLM: REM

 

  1. Which of the following provide the majority of care to older men?
a. men
b. women
c. spouses
d. nurses

 

 

ANS:  C                    REF:   324                           BLM: HO

 

  1. Studies report that about what percentage of spousal caregivers are men?
a. 33%
b. 40%
c. 60%
d. 75%

 

 

ANS:  B                    REF:   324                           BLM: REM

 

  1. Bertha takes on her caregiving responsibilities to her husband, Roger. She prepares his meals, bathes him, and invites Roger’s former work colleagues over for frequent visits or chess games. Bertha performs several jobs that were once her husband’s tasks, such as cutting the lawn. How does Calasanti describe this type of caregiving responsibility for Bertha?
  2. as emotion work
  3. as strenuous work
  4. as unpleasant work
  5. as routine work

 

ANS: A                                    REF: 324                     BLM: HO

 

  1. According to Calasanti and Bowen (2006), what did both husbands and wives do in terms of their household and domestic caregiving tasks?
a. felt more depressed with
b. felt dissatisfied with
c. crossed gendered boundaries in
d. received praise and recognition for

 

 

ANS:  C                    REF:   324                           BLM: REM

 

  1. In a 2006 study by Russell, many men felt that “the locus of care work, the home, represented a location in which they became as invisible as the work they performed.” What type of emotion did this situation bring about in many men?
  2. an increased sense of social isolation
  3. an increased sense of frustration
  4. a decreased sense of self
  5. a decreased sense of autonomy

 

ANS: A                                    REF: 325                     BLM: REM

 

  1. According to Keefe (2009), how do the majority of adult children who are long-distance caregivers feel about their role?
  2. relieved
  3. guilty
  4. satisfied
  5. tense

 

ANS: B                                    REF: 325                     BLM: REM

 

  1. According to Caron and colleagues (2006), what is the average length of time from the point of decision to institutionalization?
  2. 6 months
  3. 1 year
  4. 18 months
  5. 2 years

 

ANS: D                                    REF: 326                     BLM: REM

 

  1. Once a family member has been institutionalized, how does the primary caregiver’s role seem to change?
  2. The primary caregiver now becomes an emotional support.
  3. The primary caregiver is relieved of his/her duties altogether.
  4. The primary caregiver now becomes the physical support.
  5. The primary caregiver can now seek care for him-/herself.

 

ANS: A                                    REF: 326                     BLM: HO

 

  1. Which of the following is an example of a method proposed by researchers to ease caregiver burden?
a. empowerment
b. family support
c. job flexibility and respite care
d. social policies and services

 

 

ANS:  C                    REF:   327                           BLM: HO

 

  1. Family counselling, support groups, and respite services are all examples of which of the following?
a. eldercare programs
b. informal supports
c. ways to ease caregiver burden
d. home care

 

 

ANS:  C                    REF:   327                           BLM: HO

 

  1. In which situation does family counselling ease the burden of caregiving work best?
a. when the care receiver is not present at the sessions
b. when there are no conflicts between family members
c. when it considers the entire family system
d. when the older person’s disability level is relatively low

 

 

ANS:  C                    REF:   326                           BLM: HO

 

  1. What has been shown in research on the effectiveness of intervention methods for caregivers?
a. an increase in caregiver anxiety and guilt
b. they do not completely do away with feelings of burden
c. no effect on caregiver burden
d. strong positive effects

 

 

ANS:  B                    REF:   327                           BLM: REM

 

  1. Practitioners and policymakers must move to which type of approach to caregiving?
a. more institution-oriented
b. more government-oriented
c. more community-oriented
d. more education-oriented

 

 

ANS:  C                    REF:   328                           BLM: HO

 

  1. In the future, families will serve as only one of many resources available to support seniors. What is expected to happen to demands for support in the future?
a. They will increase.
b. They will decrease.
c. They will remain stable.
d. They will slowly decline.

 

 

ANS:  A                    REF:   328                           BLM: REM

 

  1. What is projected to happen to the amount of informal support older people will get in the future?
a. It will increase.
b. It will decrease.
c. It will remain relatively stable.
d. It will fluctuate from decade to decade.

 

 

ANS:  B                    REF:   328                           BLM: REM

 

  1. What is the main characteristic of semiformal structures?
a. a voluntary support structure of the family
b. a semi-professionalized structure of the health and social service system
c. reliance on bonds of reciprocity and of mutual benefit
d. based on formal bonds of kinship

 

 

ANS:  C                    REF:   328                           BLM: HO

 

  1. Rosenthal (1994) believes that which of the following should play the central role in social support?
a. formal support
b. informal support
c. the government
d. the police

 

 

ANS:  A                    REF:   329                           BLM: REM

 

  1. Research has shown that most elder abuse comes from which of the following?
a. professional caregivers
b. neighbours
c. family members
d. youths

 

 

ANS:  C                    REF:   329                           BLM: REM

 

 

  1. According to Podnieks and colleagues (1990), and Turcotte and Schellenberg (2007), female victims of abuse outnumber male victims of abuse by what ratio?
a. 5 to 1
b. 4 to 1
c. 3 to 1
d. 2 to 1

 

 

ANS:  D                    REF:   329                           BLM: REM

 

  1. Podnieks et al. (1990) found that some groups of elderly are at a higher risk for some types of abuse than others. For example, material abuse tended to be reported among people in which of the following groups?
a. those who live isolated lives and have poor health
b. those who belong to ethnic minorities that lack cultural prescriptions for old age
c. those who are married and have incomes below the poverty level
d. those who live in large institutions or urban centres

 

 

ANS:  A                    REF:   329                           BLM: REM

 

  1. What form of abuse was reported by about 4% of seniors in Fisher and Regan’s (2006) American study of abuse of older women?
a. material abuse
b. social deprivation
c. physical violence
d. denial of access to grandchildren

 

 

ANS:  C                    REF:   330                           BLM: REM

 

  1. Which of the following statements reflects the reality of older people and abuse in Canada?
  2. Men who are neglected report poor health.
  3. Most cases of abuse are related to physical violence.
  4. Percentages of abuse are probably underestimated.
  5. Women report more financial abuse than men.

 

ANS: C                                    REF: 330                     BLM: HO

 

  1. According to Stratton and Moore (2007), when compared with older women, which type of abuse do older men run a higher risk of experiencing?
  2. financial abuse
  3. abandonment
  4. neglect
  5. verbal abuse

 

ANS: B                                    REF: 329                     BLM: HO

 

  1. Which of the following is the likely scenario for people who report chronic verbal abuse and physical violence?
a. They were generally people with low morale and a dependence on others for help.
b. They always had incomes at or below the poverty line.
c. They said that most of the abuse came from their spouse.
d. They also reported frequent victimization by gangs.

 

 

ANS:  C                    REF:   330                           BLM: HO

 

  1. One theory holds that which of the following leads to elder abuse?
a. emotional problems
b. caregiver stress
c. financial problems
d. alcohol

 

 

ANS:  B                    REF:   330                           BLM: HO

 

  1. According to a study by Beaulieu and colleagues (1999), 40% of domestic violence cases between couples had been continuing for how many years?
  2. 25 years
  3. 20 years
  4. 15 years
  5. 10 years

 

ANS: A                                    REF: 330                     BLM: REM

 

  1. What is the term for regulations and guidelines on how to deal with abuse against older persons?
a. abuse issues
b. abuse research
c. abuse policies
d. legal actions

 

 

ANS:  C                    REF:   330-331                   BLM: REM

 

  1. Which of the following Canadian provinces has a law regarding the reporting of elder mistreatment/abuse in institutional environments?
  2. Saskatchewan
  3. Alberta
  4. Ontario
  5. British Columbia

 

ANS: B                                    REF: 331                     BLM: REM

 

 

 

 

  1. What was involved in the most successful interventions for caregiver abusers?
a. support groups
b. mandatory reporting
c. medication
d. individual stress counselling, education, and training

 

 

ANS:  D                    REF:   331                           BLM: HO

 

  1. According to Nahmiash and Reis (2000), what was involved in the most successful abuse intervention strategies?
a. support groups
b. help from medical and homemaking services
c. volunteer advocates
d. information about available resources

 

 

ANS:  B                    REF:   331                           BLM: REM

 

  1. Researchers believe that the sudden interest in abuse and neglect of the elderly may be due to which of the following?
a. the recent “discovery” of abuse as a social phenomenon
b. new laws enacted to prevent abuse
c. studies showing recent dramatic increases in prevalence
d. the increased political power of older people

 

 

ANS:  D                    REF:   332                           BLM: HO

 

  1. Older people in the future will have fewer children and siblings in comparison to older people today. This could lead them to rely more on which of the following?
a. the medical community
b. fictive kin
c. relatives
d. television for social support

 

 

ANS:  B                    REF:   333                           BLM: HO

 

  1. The term “fictive kin” refers to close relationships with which of the following?
a. neighbours
b. psychologists
c. pets
d. relatives

 

 

ANS:  A                    REF:   333                           BLM: REM

 

 

SHORT-ANSWER QUESTIONS

 

  1. Explain the concepts of formal and informal social supports, and provide examples of each.

 

ANS:

Student answers should include the following:

 

The term “formal support” refers to help given by professional caregivers such as doctors, nurses, and

social workers, as well as paid homemakers and other healthcare services. People pay for formal

supports either from their own resources or through their taxes. Studies find that few older people

who need help with daily chores or healthcare use only formal care; more often people use informal

supports for everyday help.

Informal support refers to the unpaid help given by friends, neighbours, and family. Informal support

includes everyday help such as rides to the doctor or to a shopping centre, help with house cleaning or

yard work, or just a visit from a neighbour. Informal supporters can also help an older person cope

with a personal crisis, adjust to a change in health, or locate a formal service. It is estimated that 70 to

80% of informal support received by older adults comes from family and friends. After spouses,

children are the most important source of social support for older family members.

 

REF: 309-311

 

  1. List and explain the four models that describe the way that people use informal supports for care.

 

ANS:

Student answers should include the following:

 

Studies have looked at how older people choose their informal supporters out of their potential group of

supporters. Studies have also looked at the tasks informal supporters perform. Four models describe

the way people use informal supports:

 

  1. The task specificity model says that different groups (family, friends, neighbours) have different

abilities and offer different types of support. Each group plays a specific role in supporting the older

person. For example, a spouse might provide companionship, while adult children provide everyday

support, and friends act as confidants.

 

  1. The hierarchical compensatory model of support states that people choose all types of support first

from their inner family circle. This typically means their spouse and children. They then move

outward to get support from less-intimate people if more intimate ties are not available or are unable to

meet their needs. This model says that a married older person will get help first from a spouse, while a

widow or widower will get help first from a child (most often a daughter). The older person will then

turn to friends, siblings, or other family members, then to neighbours, and then to formal supports, in

that order.

 

  1. The functional specificity of relationships model recognizes that a relationship (i.e., between a son

and mother) can lead to different kinds of support. In one case, the son may play an active role in

support, for example, visiting and running errands. In another case, the son may manage formal care

to his mother. This model says that people negotiate their relationships and support based in part on

the history of their relationship. Gender, marital status, parenthood, and proximity of helpers all

influence the amount and type of support a person will get.

 

  1. The convoy model of support sees people as having a dynamic network of close ties with family

and friends. This model uses concentric circles to position close relationships around the individual,

with the closest ties in the closest circle. Outer circles show ties that are less close. These ties form

a “convoy” that travels with individuals throughout life, exchanging social support and assistance.

The nature of this convoy can grow and change over time with changing life circumstances.

 

REF: 311

 

  1. What is elder abuse? Define it, and explain the types of abuse that are experienced by older

Canadians.

 

ANS:

Student answers should include the following:

 

At present, no single definition of abuse against older persons exists. But a broad definition refers to

abuse and neglect as “any action or inaction by ANY person, which causes harm to the older or

vulnerable person” (Council Against Abuse of Older Persons, 2008).

 

Abuse against older persons includes physical abuse, psychosocial abuse, financial abuse, neglect

(active or passive), institutional abuse, and domestic violence.

 

REF: 329

 

 

ESSAY QUESTIONS

 

  1. Interview an older Canadian about the types of social supports that he/she uses. How many types

of services does he/she use, and are they formal or informal supports? How does he/she feel about

these supports?

 

ANS:

Student answers should include the following:

 

Answers should encompass the concepts and principles as outlined in chapter 13 about formal and

informal supports, found on pages 309 through 319 of the chapter.

 

REF: 309-311

 

  1. Interview someone who is responsible for caregiving to an older adult. What types of tasks does he/

she perform? For how long has he/s he been performing these tasks? Has he/she experienced

caregiver burden? What types of feelings does this individual have about the role of caregiver?

 

ANS:

Student answers should include the following:

 

Answers should encompass the concepts and principles as outlined in Chapter 13 about the role of the

caregiver, which is covered extensively in Chapter 13. The goal of the essay is to get a firsthand

perspective from someone who has “walked in the shoes” of a caregiver. Caregiver burden is covered

on pages 319-326.

 

REF: Chapter 13

 

  1. Interview someone (an adult child or a spouse) who has either a parent or a spouse who resides in an

institution. What types of feelings did this person experience throughout this process? What role

does he/she now play in the institutionalized person’s life? What has this experience been like for this

child/spouse?

 

ANS:

Student answers should include the following:

 

Answers should encompass the concepts and principles as outlined in chapter 13 about the process of

institutionalizing a loved one, which is covered at length in Chapter 13. The goal of the essay is to

help the student to become aware of the challenges of institutionalization of older Canadians. The

challenges to spouses of an institutionalized partner information is found on page 326.

 

REF: Chapter 13

 

 

 

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