Long-term care (LTC) provides medical and non-medical care for people with chronic illnesses or disabilities who cannot care for themselves for extended periods. This includes physical therapy, nursing care, and assistance with daily living activities. Most LTC is provided informally by family and friends, though formal care options also exist like nursing homes or community services. The ideal system provides a continuum of coordinated care across settings as needs change over time.
Long-Term Care isn't just for the elderly, and it isn't just about nursing homes. It's about having the assistance you need during an extended illness or injury at any time of life. Please read this guide. As always we are here to help.
How many people in this room expect to need long-term care one day? It’s not surprising that few of us do, because it’s hard to face the fact that our health might decline. But statistics suggest that the risk is greater than we think. Approximately 70% of us--that’s 7 out of every 10 people here today--will need some type of long-term care services during our lifetimes at some point after we reach age 65. And though it's good news that people are living longer, a long life span increases the chance of developing serious health problems. In fact, according to the Alzheimer’s Association, one in nine people age 65 and older has Alzheimer’s disease, which often leads to the need for nursing home care. And while older people are more likely to need long-term care, younger people may need care too, as a result of a disabling accident or illness such as multiple sclerosis or Parkinson’s disease.
This isn’t meant to scare you, but rather to remind you that the need for long-term care can happen to anyone at any time. The need to be prepared is real, and something that you shouldn’t ignore.
Long-term care is a growing concern among seniors and Baby Boomers alike. Yet few take the first step to planning for their care. Many don't know where to begin. Use our presentation to understand what LTC insurance covers and learn about alternate strategies to protect your assets, your family and your finances as you age.
It may be difficult to face the fact that your health may decline, but statistics suggest that approximately 70% of people will need long term care services at some point after age 65. This presentation advises on proactive long term care planning, including types of long term care, managing the cost of long term care, and long term care insurance options.
This presentation is intended to serve as an introduction to the long-term care industry, including the scope, purpose and organizational structure of a typical long-term care facility.
While applicable for everyone, this like all of our presentations is specifically designed for caregivers in a long-term care environment.
Long-Term Care isn't just for the elderly, and it isn't just about nursing homes. It's about having the assistance you need during an extended illness or injury at any time of life. Please read this guide. As always we are here to help.
How many people in this room expect to need long-term care one day? It’s not surprising that few of us do, because it’s hard to face the fact that our health might decline. But statistics suggest that the risk is greater than we think. Approximately 70% of us--that’s 7 out of every 10 people here today--will need some type of long-term care services during our lifetimes at some point after we reach age 65. And though it's good news that people are living longer, a long life span increases the chance of developing serious health problems. In fact, according to the Alzheimer’s Association, one in nine people age 65 and older has Alzheimer’s disease, which often leads to the need for nursing home care. And while older people are more likely to need long-term care, younger people may need care too, as a result of a disabling accident or illness such as multiple sclerosis or Parkinson’s disease.
This isn’t meant to scare you, but rather to remind you that the need for long-term care can happen to anyone at any time. The need to be prepared is real, and something that you shouldn’t ignore.
Long-term care is a growing concern among seniors and Baby Boomers alike. Yet few take the first step to planning for their care. Many don't know where to begin. Use our presentation to understand what LTC insurance covers and learn about alternate strategies to protect your assets, your family and your finances as you age.
It may be difficult to face the fact that your health may decline, but statistics suggest that approximately 70% of people will need long term care services at some point after age 65. This presentation advises on proactive long term care planning, including types of long term care, managing the cost of long term care, and long term care insurance options.
This presentation is intended to serve as an introduction to the long-term care industry, including the scope, purpose and organizational structure of a typical long-term care facility.
While applicable for everyone, this like all of our presentations is specifically designed for caregivers in a long-term care environment.
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
Georgia Voices for Medicaid Powerpoint - Fulton countyAlyssa Green, MPA
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
What Is the Medicaid Maintenance Needs Allowance in ConnecticutBarry D Horowitz
Medicaid will pay for help with your activities of daily living. In fact, it pays for most of the long-term care that seniors are receiving. Learn more medicaid monthly maintenance needs allowance in Connecticut in this presentation.
This webinar is about the Medicaid Transformation process currently happening in NC. It will review trends in Medicaid reform on a national level, the history of Medicaid reform in NC, and provide tips to family members and self-advocates about how to effectively engage the system.
Providing Support To Employers And Working Caregivers 6 14 2010 2Elderplanner
Our “Elder Life Planning for Organizations” program allows non-profit and small eldercare enterprises
to offer a comprehensive eldercare program to employers, banks, membership organizations and faith based communities without the significant capital outlay that would otherwise be required.
Navigating the complexities of public benefits and services at the onset of a disability or chronic illness can be confusing and overwhelming. This presentation offers a detailed description of programs including Medicaid, Social Security Disability and waiver services. You will have more clarity on which program is most appropriate for you or your loved one and understand the eligibility requirements for each one.
An estimated four million Canadians act as unpaid or informal caregivers to seniors and persons with disabilities. In her June 3 webinar, Sherri Torjman, Vice-President, Caledon Institute of Social Policy, explores three proposals to protect caregivers from financial ruin: 1) expand Employment Insurance (EI) compassionate care leave; 2) extend Canada Pension Plan (CPP) provisions; and 3) make current tax credits for caregivers refundable.
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
Georgia Voices for Medicaid Powerpoint - Fulton countyAlyssa Green, MPA
This presentation explains what Medicaid program is, who it protects, the creation of the coverage gap and what Medicaid advocacy looks like in the state of Georgia.
What Is the Medicaid Maintenance Needs Allowance in ConnecticutBarry D Horowitz
Medicaid will pay for help with your activities of daily living. In fact, it pays for most of the long-term care that seniors are receiving. Learn more medicaid monthly maintenance needs allowance in Connecticut in this presentation.
This webinar is about the Medicaid Transformation process currently happening in NC. It will review trends in Medicaid reform on a national level, the history of Medicaid reform in NC, and provide tips to family members and self-advocates about how to effectively engage the system.
Providing Support To Employers And Working Caregivers 6 14 2010 2Elderplanner
Our “Elder Life Planning for Organizations” program allows non-profit and small eldercare enterprises
to offer a comprehensive eldercare program to employers, banks, membership organizations and faith based communities without the significant capital outlay that would otherwise be required.
Navigating the complexities of public benefits and services at the onset of a disability or chronic illness can be confusing and overwhelming. This presentation offers a detailed description of programs including Medicaid, Social Security Disability and waiver services. You will have more clarity on which program is most appropriate for you or your loved one and understand the eligibility requirements for each one.
An estimated four million Canadians act as unpaid or informal caregivers to seniors and persons with disabilities. In her June 3 webinar, Sherri Torjman, Vice-President, Caledon Institute of Social Policy, explores three proposals to protect caregivers from financial ruin: 1) expand Employment Insurance (EI) compassionate care leave; 2) extend Canada Pension Plan (CPP) provisions; and 3) make current tax credits for caregivers refundable.
Una palabra que nos enseña el verdadero significado del evangelio y de como éste fue enseñado a la iglesia del primer siglo, una realidad que con el tiempo ha sido acomodada a las facilidades de este tiempo pero debe ser restaurada a su origen para que la palabra de Dios se cumpla en este tiempo
District Care provides home care services that aids independent living, respect for individual choice, cultures and personal values. Professional home care.
2018-04-18 المؤتمر العلمي الثاني للمعهد القومي لعلوم المسنين جامعة بني سويف بعنوان" التحديات والمستجدات العالمية في رعاية المسنين"
http://www.bsu.edu.eg/ShowConfDetails.aspx?conf_id=217
Chapter 1Overview of Long-Term CareWhat You Will Learn.docxwalterl4
Chapter 1
Overview of Long-Term Care
What You Will Learn
• Physical and/or mental deficits that limit a person’s ability to do
regular daily tasks create the need for long-term care. Activities of
daily living (ADL) and instrumental activities of daily living
(IADL) are two common measures used to evaluate functional
status.
• In addition to assistance needed to perform daily living tasks, long-
term care may also be needed for continuity of care after
hospitalization and when specialized environments of care are
necessary.
• Long-term care is complex. It is founded on 10 main dimensions
that can also be viewed as fundamental principles that should guide
the delivery of long-term care.
• Not all elderly need long-term care, but an aging and culturally
diverse population, coupled with social changes, will create ongoing
challenges. People with HIV/AIDS present complex needs and they
are also entering old age.
• Those who need assistance obtain long-term care services through
three subsystems of care: informal, community based, and
institutional.
• Informal care is the largest of the three systems of long-term care.
Community-based services have four main objectives and can be
classified into two groups: intramural and extramural. The
institutional system forms its own continuum of care to
accommodate clients whose clinical needs vary from simple to
complex.
• Non–long-term care services are needed to complement long-term
care. Care coordination between the two systems—long-term care
and non–long-term care—is often necessary to meet a patient’s total
care needs.
Introduction
Long-term care (LTC) is associated with physical and/or mental deficits that
limit a person’s ability to do regular daily tasks that most humans take for
granted. There can be numerous causes for functional limitations. Examples
include complications arising from a person’s prolonged heart disease, onset
of partial or full paralysis after a severe stroke, severe head injury from a
motorcycle or industrial accident, loss of physical capacity by a young adult
from a crippling disease such as multiple sclerosis, a child born with autism,
or gradual loss of memory in an aged person. LTC services are needed
mostly by the elderly—people age 65 and over—hence, most LTC services
have been designed with the elderly client in mind.
Long-term care is a complex system with broad boundaries (Prince et al.,
2013). Diverse LTC services—sometimes referred to as long-term services
and supports (LTSS)—are provided in a variety of community-based
settings. Also, family members and surrogates provide most of the long-term
care that is unseen to outsiders and generally unpaid. Nursing homes and
other LTC institutions play a critical role in delivering advanced levels of
LTC services that cannot be provided effectively and efficiently in
community or home settings. In 2012, almost 8.4 million Americans
received LTC from a variety of formal sources such as adult day care
c.
The course of death and dying has changed tremendously in the past.docxarnoldmeredith47041
The course of death and dying has changed tremendously in the past few decades because of social and technological advances. Increases in average life expectancy due to advances in medical science and technology (National Center for Health Statistics, 2010) have influenced our beliefs and attitudes about life and death. The course of illness and dying has changed; at one time, the onset of illness and subsequent death from certain illnesses was sudden and rapid, but now the typical death may be more prolonged. The place where death occurs has moved from the home or community to the hospital, nursing home, or institutional setting. These changes have posed enormous challenges in end-of-life and palliative care.
PALLIATIVE CARE
Palliative care is an interdisciplinary care model that focuses on the comprehensive management of physical, psychological, and existential distress. It is defined as “the active total care of patients whose disease is not responsive to curative treatment.” Control of pain and other symptoms and psychological, social, and spiritual problems is paramount. “The goal of palliative care is the achievement of the best possible quality of life for patients and their families” (World Health Organization [WHO], 1990, p. 7). Palliative care aims to improve the patient's quality of life by identifying physical, psychosocial, and spiritual issues while managing pain and other distressing symptoms. Palliative care “affirms life and regards dying as a normal process; is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated” (WHO, 2004, p. 3).
The palliative care model applies throughout the entire course of illness and attempts to address the physical, psychosocial, and spiritual concerns that affect both the quality of life and the quality of dying for patients with life-limiting illnesses at any phase of the disease. It includes interventions that are intended to maintain the quality of life of the patient and family. Although the focus intensifies at the end of life, the priority to provide comfort and attend to the patient's and family's psychosocial concerns remains important throughout the course of the illness. In the model's ideal implementation, patient and family values and decisions are respected, practical needs are addressed, psychosocial and spiritual distress are managed, and comfort care is provided as the individual nears the end of life.
Palliative medicine is the medical specialty dedicated to excellence in palliative care. Palliative care specialists, including social workers, typically work on teams and are involved when patients’ disease is advanced, their life expectancy is limited, and medical and psychosocial concerns become complex and more urgent. In practice, these problems ofte.
The course of death and dying has changed tremendously in the past.docxrtodd643
The course of death and dying has changed tremendously in the past few decades because of social and technological advances. Increases in average life expectancy due to advances in medical science and technology (National Center for Health Statistics, 2010) have influenced our beliefs and attitudes about life and death. The course of illness and dying has changed; at one time, the onset of illness and subsequent death from certain illnesses was sudden and rapid, but now the typical death may be more prolonged. The place where death occurs has moved from the home or community to the hospital, nursing home, or institutional setting. These changes have posed enormous challenges in end-of-life and palliative care.
PALLIATIVE CARE
Palliative care is an interdisciplinary care model that focuses on the comprehensive management of physical, psychological, and existential distress. It is defined as “the active total care of patients whose disease is not responsive to curative treatment.” Control of pain and other symptoms and psychological, social, and spiritual problems is paramount. “The goal of palliative care is the achievement of the best possible quality of life for patients and their families” (World Health Organization [WHO], 1990, p. 7). Palliative care aims to improve the patient's quality of life by identifying physical, psychosocial, and spiritual issues while managing pain and other distressing symptoms. Palliative care “affirms life and regards dying as a normal process; is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated” (WHO, 2004, p. 3).
The palliative care model applies throughout the entire course of illness and attempts to address the physical, psychosocial, and spiritual concerns that affect both the quality of life and the quality of dying for patients with life-limiting illnesses at any phase of the disease. It includes interventions that are intended to maintain the quality of life of the patient and family. Although the focus intensifies at the end of life, the priority to provide comfort and attend to the patient's and family's psychosocial concerns remains important throughout the course of the illness. In the model's ideal implementation, patient and family values and decisions are respected, practical needs are addressed, psychosocial and spiritual distress are managed, and comfort care is provided as the individual nears the end of life.
Palliative medicine is the medical specialty dedicated to excellence in palliative care. Palliative care specialists, including social workers, typically work on teams and are involved when patients’ disease is advanced, their life expectancy is limited, and medical and psychosocial concerns become complex and more urgent. In practice, these problems ofte.
This public health presentation educates the community regarding Latino health and the need for more collaborate healthcare services to meet the demand.
End of life care - achieving quality in hostels and for homeless people - a route to success
08 December 2010 - National End of Life Care Programme
This publication aims to provide a practical guide to support hostel staff in ensuring that people nearing the end of their life receive high quality end of life care.
It includes:
Key considerations for delivery of end of life care
When to start thinking about end of life care
End of life care pathway
Step 1: Discussions as the end of life approaches
Step 2: Assessment, care planning and review
Step 3: Co-ordination of care
Step 4: Delivery of high quality care in different settings
Step 5: Care in the last days of life
Step 6: Care after death
Next steps
Useful resources
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
Swu 171 intro to social workDr. Hilary Haseley, PhD, MSW, AC.docxrhetttrevannion
Swu 171 intro to social work
Dr. Hilary Haseley, PhD, MSW, ACUE
Overview
Chapter 11
Definitions
Aging: Changes that occur to an organism during its life span, from development to maturation to senescence
Senescence: The gradual decline of all organ systems, especially after age 30
Ageism: Negative attitudes, beliefs, and conceptions of the nature and characteristics of older persons that are based on age and distort their actual characteristics and abilities
Gerontology: The comprehensive study of aging and problems of older adults
Different conceptions of age
Chronological age: The number of years a person has lived, which is used as a standard to measure intelligence, behaviors, and so forth
Biological age: A measure of how well or poorly one’s body is functioning in relation to one’s actual calendar age. It describes a person’s development based on biomarkers, such as a cellular or molecular event, looking at the person as they are, not just when they were born
Psychological age: A subjective description of one’s experience using nonphysical features
Social age: An estimate of a person’s capabilities in social situations, relative to normal standards
AARP membership begins at age 50, a marker of chronological age
Social security has defined retirement age as 65 (moving toward 67)
People of the same older age have vastly different situations and experiences
Cohort: A group of people of the same generation sharing a statistical trait such as age, ethnicity, or socioeconomic status
Old, Older, Oldest
Young-old: A term used to denote a person who is between 55 and 75 years of age
Middle old: A term that refers to persons 75–84 years old
Oldest-old: A general term that refers to the population over age 85, which is the fastest-growing age group in the United States and some other nations
Centenarians: People who are 100 or more years old
Supercentenarians: A person who is significantly older than 100 years of age
Life expectancy
Life expectancy: How long, on average, a person is expected to live at a given age
Life span: The number of years a person actually lives
Longevity: Living an active life longer than the average person
Based on genetics and lifestyle
Current issues
More of the population is older than ever before
Increased life expectancy, decreased birth rates
Health-care workforce needs to grow in capacity to accommodate the growing older population, especially the oldest-old (85+)
Threats to well-being and lives of older adults living through the COVID-19 pandemic
Gerontological Social Work
Two specialties:
Gerontological social work: focuses on biopsychosocial-spiritual aspects of aging
Geriatric social work: focuses on physiological changes and health care
Evolution of gerontological practice
Older adults seen as target client population beginning in 1960s/1970s
1995: Social workers participated in National Forum for Geriatric Education
Hartford Foundation began fundi.
Elderly Care: Importance, Types of Services, Challenges and Innovations | GQ ...GQ Research
In this article, we delve into the various aspects of elderly care, including its importance, challenges, innovations, and the evolving landscape of caregiving for older adults.
Community Health Nursing is an umbrella term to include many differe.docxjanthony65
Community Health Nursing is an umbrella term to include many different types of nurses within the community health arena. Nurses within the community health world are educated on public health concepts to care for groups of people and groups of culturally diverse populations along with other educational preparedness. There is a population-focused kind of care that involves using the nursing process. The implementation of these health programs and services requires this to happen on the educational level of the group, individual, or population that you are directing care for.
A large number of nurses are employed in Home Health Care providing home health care to individuals who are ill. Community mental health provides care to individuals with mental health illnesses and/or substance abuse. Correctional nonhospital nursing provides care within the correctional facility. Hospice care for patients and families dealing with end-of-life issues. Occupational health ensures the safety and health of all people in the workplace through research and prevention. Community health programs that are in your local and rural health departments promoting health prevent illnesses, injury, and premature death. School nursing brings education, health promotion, and preventative care to children in the school settings to include Colleges and Universities. State, local, community, and rural health departments are utilized by the population to receive immunizations, breastfeeding classes, wellness classes, and child health classes along with education associated with wellness promotion and disease prevention.
Another focus of community health is that of Global or World Health. This is a focus of diseases such at tuberculosis, anthrax, covid19, measles, mumps, rubella, smallpox, among many other diseases. The National Center of Infectious Diseases helps with preventing illness, disability, and death caused by infectious diseases in the United States and around the World. The departments that fall under this category are the National Center for Immunization and Respiratory disease Immunization program, National Center for Emerging and Zoonotic Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB prevention. These programs provide leadership in preventing and controlling human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS), viral hepatitis, STD’s, and TB (Maurer, F. & Smith, C., 2013).
The population that is served in community health are of a wide variety of ages populations, ethnicities, educational backgrounds, and races. A large portion of the population community health serves are those that fall below the poverty level and would qualify for a number of governmental programs such as food stamps, Medicaid, Medicare, social security, low-income housing, CHIP, WIC, and TANIF benefits. These programs are government-funded (paid by the taxpayers). There is a rising number of uninsured due to a fe.
Community Health Nursing is an umbrella term to include many differe.docxtemplestewart19
Community Health Nursing is an umbrella term to include many different types of nurses within the community health arena. Nurses within the community health world are educated on public health concepts to care for groups of people and groups of culturally diverse populations along with other educational preparedness. There is a population-focused kind of care that involves using the nursing process. The implementation of these health programs and services requires this to happen on the educational level of the group, individual, or population that you are directing care for.
A large number of nurses are employed in Home Health Care providing home health care to individuals who are ill. Community mental health provides care to individuals with mental health illnesses and/or substance abuse. Correctional nonhospital nursing provides care within the correctional facility. Hospice care for patients and families dealing with end-of-life issues. Occupational health ensures the safety and health of all people in the workplace through research and prevention. Community health programs that are in your local and rural health departments promoting health prevent illnesses, injury, and premature death. School nursing brings education, health promotion, and preventative care to children in the school settings to include Colleges and Universities. State, local, community, and rural health departments are utilized by the population to receive immunizations, breastfeeding classes, wellness classes, and child health classes along with education associated with wellness promotion and disease prevention.
Another focus of community health is that of Global or World Health. This is a focus of diseases such at tuberculosis, anthrax, covid19, measles, mumps, rubella, smallpox, among many other diseases. The National Center of Infectious Diseases helps with preventing illness, disability, and death caused by infectious diseases in the United States and around the World. The departments that fall under this category are the National Center for Immunization and Respiratory disease Immunization program, National Center for Emerging and Zoonotic Infectious Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB prevention. These programs provide leadership in preventing and controlling human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS), viral hepatitis, STD’s, and TB (Maurer, F. & Smith, C., 2013).
The population that is served in community health are of a wide variety of ages populations, ethnicities, educational backgrounds, and races. A large portion of the population community health serves are those that fall below the poverty level and would qualify for a number of governmental programs such as food stamps, Medicaid, Medicare, social security, low-income housing, CHIP, WIC, and TANIF benefits. These programs are government-funded (paid by the taxpayers). There is a rising number of uninsured due to a fe.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Long term care plus
1.
2. DEFINITION- LTC is a verity of services which help in
meeting both“Medical and Non-Medical needs” of people
with “Chronic illness and Disability” who can not care for
themselves for long period of time (usually 3 months or
more than 3 months).
Medical Needs provided in the form of Physical
therapy, drug therapy, nursing, and hospice care
(chronically, terminally, or seriously ill patients) by
health professionals.
Non Medical needs provided for the person who can not
limits their ability to carry out their basic self care
tasks called “Activity of daily livings (ADL’s)” (Such as
bathing, dressing, and eating)or “Instrumental Activity
of daily livings (IADL’s)” (such as household chores,
meal preparation, and managing money).
3. The immediate cause of population ageing is fertility decline.
However, improved longevity contributes as well, first by
eliminating the demographic necessity of high fertility, and
second by increasing the number of survivors to older ages. By
2050, life expectancy at birth is projected to surpass 80 years in
Europe, Latin America and the Caribbean, Northern America and
Oceania; and it will approach 80 years in Asia and 70 years in
Africa.
••Among today’s young people, survival to age 80 is expected to
be the norm everywhere but in Africa. Worldwide, 60 per cent of
women and 52 per cent of men born in 2000-2005 are expected
to survive to their 80th birthdays, compared to less than 40 per
cent of the women and men born in 1950-1955.
••As populations continue to age during the post-2015 era, it is
imperative that Governments design innovative policies
specifically targeted to the needs of older persons, including
those addressing housing, employment, health care, social
protection, and other forms of intergenerational support. By
anticipating these demographic shifts, countries can enact
policies proactively to adapt to an ageing population.
4.
5. Informal organization – most LT care is provided by
family and friends
Each community may be different regarding
availability of services
Ideal system – client oriented continuum of care.
Organization of LT Care
6. Types, services and supports in ltc
Types
1. Formal care.
2. Informal care.
1.Formal Care
This is also known as paid long term care services provided by
professionals, auxiliaries (health, social, and other workers) and by
traditional caregivers and volunteers either at home or institutions.
These facilities may go under various names, such as nursing home,
personal care facility, residential continuing care facility, etc. and are
operated by different providers.
Long-term care provided formally in the home, also known as home
health care, can incorporate a wide range of clinical services
(e.g. nursing, drug therapy, physical therapy) and other activities such as
physical construction (e.g. installing hydraulic lifts, renovating
bathrooms and kitchens). These services are usually ordered by
a physician or other professional.
7. 2.Informal Care
Most long term care provided unpaid by family members,
partners, friends and neighbours, who provides care out of love,
respect, obligation or friendship.
It is estimated that 90% of all home care is provided informally by
a loved one without compensation.
Approximately 87% of Americans who need long term care (in
2009) receive it from informal or unpaid caregivers. In 2009, 69.7
million people in the US served as informal caregivers to an adult
or child. Of these, 43.5 million provided care to an adult age 50
and older.
According to National Survey of Families and Households (U.S
Department of Health and Human Services) 52 million Americans
(31% of the adult population age 20 to 75) provide "informal care"
to a family member or friend who is ill or disabled. About 37
million of these caregivers provide help to family members and
about 15 million provide help to friends.
10. Chronic – permanent or indefinite period of time
Impaired – a decrease in or loss of ability to perform
Disabled – short or long term; varies by age group
Functional ability – person’s ability to perform the
basic activities of daily living
Who needs LT Care
11. Target groups
The emphasis throughout this report, in conformity with the definition of
long term
care, is on the care of people of all ages who have long-term health
problems and
need assistance with the activities of daily living (ADL) in order to enjoy a
reasonable quality of life. Target groups include:
— people who are chronically ill, whether with communicable diseases
such as
tuberculosis or with non communicable conditions such as cardiovascular
diseases and cancer;
— individuals with disabilities, regardless of etiology, including
developmental
disabilities and disabilities caused by poliomyelitis;
— people with HIV/AIDS;
— people disabled by accidental injuries, e.g. victims of traffic accidents;
— people with sensory limitations;
— mentally ill individuals, including those suffering from depression and
dementia;
— substance-dependent individuals;
12. — victims of natural and other disasters;
— perhaps most importantly, informal caregivers for any of the above,
such as
family, friends, and neighbours.
The circumstances and conditions that dictate how and where people
live may limit
or extend the target groups — and thus their eligibility for services —
and may
include:
— income levels;
— the degree or extent of family and informal support;
— the participation of male and female informal caregivers in the
labour force and
the distance between homes and workplaces;
— whether the home is permanent, transient, or even unstructured (as
with
homeless or street people, including unattached children and
adolescents); and
— whether the home is in an urban or rural area, the impact of climate
and
geography, and the strength of the local community infrastructure.
13. Matches resources to patient’s condition
Monitors the client’s condition and changes services
as needs change
Coordinates care across disciplines
Integrates care in a range of settings
Enhances efficiency, reduces duplication, streamlines
patient flow
Maintains comprehensive record keeping
What is Continuum of Care?
14. Extended care
Acute inpatient care
Ambulatory care
Home care
Outreach
Wellness
Housing
NOTE: Not all LT care clients get this full range of care.
This is ideal that may offset or delay chronic illness.
Categories of Continuum of Care
15. Institutional Long Term Care
‘As per WHO’ Institutional or residential long-term care is
defined as the provision of such care to three or more
unrelated people in the same place.
It includes medical care, nursing care, physical therapy,
personal care, drug therapy etc.
Community services
This support services include adult day care, meal
programs, senior centres, transportation, and other
services. These can help people who are cared for at
home-and their families. For example, adult day care
services provide a variety of health, social, and related
support services in a protective setting during the day.
This can help adults with impairments such as ”Alzheimer's
disease” continue to live in the community, and it can give
family or friend caregivers a needed "break."
Services and Support
16. Home care
It can be given in own home by family members, friends, volunteers,
and/or paid professionals. This care can range from help with shopping
to nursing care.
Some short-term, skilled home care provided by a nurse or therapist
called "home health care."
Another type of care that can be given at home is hospice care for
terminally ill people.
Supportive housing programs (SHELTER SERVICES)
It offer low-cost housing to older people with low to moderate incomes.
The Federal Department of Housing and Urban Development (HUD) and
state or local governments often develop such housing programs. A
number of these facilities offer help with meals and tasks such as
housekeeping, shopping, and laundry.
Continuing care retirement communities (CCRCS)
It provide a full range of services and care based on what each resident
needs over time. Care usually is provided in one of three main stages:
independent living, assisted living, and skilled nursing.
17. Nursing homes
It offer care to people who cannot be cared for at home or in the
community. They provide skilled nursing care, rehabilitation
services, meals, activities, help with daily living, and supervision.
Many nursing homes also offer temporary or periodic care. This can
be instead of hospital care, after hospital care, or to give family or
friend caregivers some time off.
intermediate care facilities
It is home-like settings for mentally retarded. They provide a wide
variety of services to mentally retarded and developmentally
disabled people from youth to old age. Services include health care
services and treatment to help residents become as independent as
possible.
Hospice & respite care
Hospice is a program of care and support for people who are
terminally ill. It helps people who are terminally ill live comfortably.
The focus is on comfort, not on curing an illness.
Respite care is a very short inpatient stay given to a hospice patient
so that their usual caregiver can rest.
18. Hospitals
Nursing homes (average costs $4,500 per month)
Home health agencies
Hospices
Adult day service programs
Housing organizations
Providers of LT Care
19. WHAT W.H.O IS DOING
Systems of LTC ( including palliative care) are
needed in all countries to met the needs of
older people. WHO has identified
3 approaches that will be crucial there are-
1.Establishing the foundation necessary for LTC.
2.Building and maintaining a sustainable &
appropriate work force.
3.Ensuring the quality of LTC.
20. TO SUPPORT THESE APPROACHES
1.Devlop guidelines , provides evidence based guidelines on
how to devlop expand & improve the quality of LTC services
with focus on less resouced settings.
2.Provides technical assistance & support to countries that are
introducing and expanding LTC services.
3.Devlpoing tools & training packages to streghtening formal
and informal caregivers.
21. UK is on an extreme end of the spectrum, where healthcare is
predominantly financed by the government and delivered through
private facilities. There are experiences and learning that can be
drawn from this model.
• Government’s role in both medical and non-medical care: UK is
one of the few countries with a structured financing mechanism by
the government for both medical (through NHS) and non-medical
care (through local bodies).
However, the out-of-pocket component is higher for non-medical
care and is based on need
• Income and need based approach to distribute funds: The means
assessment ensures that tax funds go to those most in need,
thereby
ensuring effective allocation of resources and bringing parity in the
treatment available across the population.
• Limited integration with private payers to drive elderly care: Lack
of private payers specifically for elderly and long term care has
resulted in limited Opportunities for govt. to share burden of care.
22. In India, apart from government program,
various Non-government Organizations and
Trusts with collaborations with international
organizations and individuals from other
countries plays an important role for LTC in
term of palliative care, hospice, old age home,
etc.
LONG TERM CARE IN INDIA
23. The need for elderly care in India
Limited healthcare facilities
focusing on the elderly
Need of
elderly care
in India
Few avenues
(facilities/seats) providing
geriatric care training
Limited government
healthcare expenditure
on the elderly
Increase average life
expectancy
Limited flexible
insurance offerings
for the elderly
Shifting disease burden
towards those who
require prolonged
support
Changing family pattern
Lack of trained manpower
resources
24. In India, apart from government program, various Non-government
Organizations and Trusts with collaborations with international
organizations and individuals from other countries plays an important
role for LTC in term of palliative care, hospice, old age home, etc. Pain
clinic and palliative care service under the department of
Anesthesiology at Gujarat Cancer and Research Institute , Pain clinics at
the Regional Cancer Centre, Trivandrum, with the assistance of a WHO
subsidy, Kidwai Memorial Institute of Oncology, Bangalore, Cipla
Cancer Palliative Care Centre in Pune, Guwahati Pain and Palliative
Care Society (GPPCS) in Assam, Can-support in Delhi, hospice like Shanti
Avedna Ashram, in Mumbai, Karunashraya Bangalore Hospice Trust,
and Bhakti Vedanta hospice are important organizations who plays an
important role in LTC’s.
New concept of friendly neighbors who have been trained in palliative
care leads to “Neighborhood Network of Palliative Care (NNPC”) was
formed in 2001, provides holistic care.
25. 1. 1 LONG-TERM CARE AS A CENTRAL PART OF NPOP.
2. 2 MULTI-MINISTERIAL COORDINATION
At present, the draft national health policy 2015 (Para. 4.3.7.9) addresses long-term
care in the following manner:
The elderly i.e. the population above 60 years comprise of 8.6 [per cent] of the
population (103.8 million) and they are also a vulnerable section. Those above 75
years (20.52 million) are most vulnerable and almost 8 per cent of the elderly
population is bed ridden or homebound (NSSO). India would need to develop its own
cost effective and culturally appropriate approach . . . to addressing the health and
care needs of the elderly. It would necessarily be a more community-centered
approach where care is provided in synergy with family support, with a greater role
for community level caregivers with good
continuity of care with higher levels. A closely related concern is the growing need
for palliative care where in life threatening illness or in end of life contexts there [are]
active measures to relieve pain and suffering and provide support to the patient and
the family. Increasing access to palliative care would be an important objective, and
in this like for all geriatric illness, continuity of care across levels will play a major role.
Recommendations to improve the focus on long-term care of older persons in India.
26. 3 INTEGRATING LONG-TERM CARE AS A COMPONENT OF UNIVERSAL
HEALTH CARE
As India moves towards the goal of universal health coverage,
which is a goal of national policies and the 2030 Agenda for
Sustainable Development, there is an opportunity to integrate
long-term care within it from the outset. A number of countries
have addressed long-term care within universal health care
systems, whether tax-funded or through social insurance.
This could be replicated in India to the extent possible and
allowed by resources.
27. 4 HUMAN RESOURCES TO ADDRESS THE NEEDS OF OLDER PERSONS
PARTICULARLY LONG-TERM CARE
As long-term care needs grow with the ageing of the population, the care
economy will also grow. This care economy will require more workers with
specific human resource skills. In addition to an increased number of
geriatricians and stronger geriatric components in medical and nursing
curricula, the care economy will also require workers with skills in
rehabilitation and physiotherapy, as well as social workers, counselors, care
workers and care coordinators.
As the number of older persons grows, the care economy could be a significant
sector of the labor force.
5 BUILDING INTERGENERATIONAL SOLIDARITY
A number of countries in the region have acknowledged the important role of
intergenerational solidarity in providing long-term care and support for older
persons, as reflected in the schemes and programmes they have implemented.
Volunteers from youth clubs as well as “younger” older persons are engaged in
providing volunteer care services at home for older persons. Intergenerational
support is a key element of a viable community-based long-term care system.