PDHPE HSC Enrichment Day A Growing and Ageing Population. · PDHPE HSC Enrichment Day 2016 – Core 1: A Growing and Ageing Population Page | 28 Syllabus Overview – Slide 2 The

PDHPE HSC Enrichment Day 2016 – Core 1: A Growing and Ageing Population

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PDHPE HSC Enrichment Day

A Growing and Ageing Population.


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Syllabus Overview – Slide 2

The aim of this workshop is to provide students with information and resources to support their learning about ‘A growing and ageing population’. This is a health priority issue.

A Growing Population – Slide 3


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Activity 1: Graph Analysis

Analyse and interpret one key point from the graph

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Activity 2: Note taking

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Activity 3: Video clip – Australia’s population reaches 24million

Watch the video clip and answer the following questions:

Q. What is Australia’s current population?

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A Growing Population – Slide 4


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What are the population predictions in age structure from 2016 to 2061?

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Activity 5: Online Activity

ABS Interactive Population Pyramid: http://www.abs.gov.au/websitedbs/d3310114.nsf/home/Population%20Pyramid%20-%20Australia

Go to the website above. Identify the population predictions.

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Significant contributors to Australia’s ageing population trend are the ‘baby boomers’, defined by the ABS as a person born between 1946 and 1964.

Analyse and interpret one key point from the graph

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http://www.abs.gov.au/websitedbs/d3310114.nsf/home/Population%20Pyramid%20-%20Australia


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An Ageing Population – Slide 5


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An Ageing Population – Slide 6


Outline the key points from the power-point slide. ……………………………………………………………………………………………………………………………………………………………………

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Activity 9: Graph Analysis – A growing population

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The proportion of older people is expected to increase to 23% of the total population by 2050.

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THE AUSTRALIAN Ageing population a global problem: RBA AAP NOVEMBER 25, 2015 1:30AM

The increasing number of retirees in parts around the world and record low interest rates are problems for the global economy.

Reserve Bank governor Glenn Stevens says while many believe the US Federal Reserve is likely to raise its interest rate next month the pace of subsequent increases are likely to be slow.

Meanwhile, central banks in Japan and Europe which also have an ageing population are a long way from considering an interest rate rise.

He added that China's working age population is also shrinking as people move into retirement.

Mr. Stevens said the problem with an ageing population was that there were less people in jobs causing a drag on the economy and the ability to pay welfare and public health care costs.

"Instead of five or six people for every retired person there's two or two and a half," he said.

"It may be that jobs will be robotised ... in the long run we may need that to some extent."

Mr. Stevens says the share of services in most economies will continue to increase with health and aged care obvious areas for expansion because of an ageing population.

"The thing we have to most grapple with is to make our children more productive so they can earn enough to pay the taxes and help the capital return to keep us in our dotage," he said.

Mr. Stevens said continued low interest rates around the world would make it hard for people to fund their retirement.

"In a low interest rate world, the problems of providing retirement incomes will become ever more prominent," he said.

"Overall, in a world where a higher proportion of the population wants to be retired and living even if only in part off the return on their savings, those returns are likely, all other things equal, to be lower.

Activity 10: Sum It Up – A growing population.

For each news article on the previous page:

1. Accurately summarise the article in your own words - Do not include opinions or personal info in your summary - Highlight or underline “main idea” words in each article.

2. At the bottom of this sheet, write a 1-sentence summary of both articles, using as many “main idea” words as you can. Imagine you only have $2 and each word you use will cost you 10 cents.

3. See if you can Sum It Up in 20 words.

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Healthy Ageing – Slide 7


Define the concept ‘healthy ageing’.

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Activity 12: Healthy Ageing online quiz

Take the online healthy ageing quiz: http://www.nari.net.au/resources/public/healthy-ageing-quiz-testing

Healthy Ageing represents the beginning of a change in social attitudes. It will benefit both individuals and Australian society. Individuals can expect an additional two to three decades of life beyond the current retirement age with more years in good health.

Healthy ageing should bring the choice of spending longer in paid work, more opportunities for contributing to the community and engaging with their families and more years of independence in their own homes.

http://www.nari.net.au/resources/public/healthy-ageing-quiz-testing




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Increased Population Living with Chronic Disease and Disability – Slide 8


Summarise key points from the power-point slide. ……………………………………………………………………………………………………………………………………………………………………

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Activity 14: Video clip analysis

Identify 3 key points from the video clip. ……………………………………………………………………………………………………………………………………………………………………

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Analyse the graph below. What is the trend in disability?

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Demand for Health Services and Workforce Shortages – Slide 9


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Activity 17: Video Clip Analysis

Identify the key points from the video clip.

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Impact on the Health System and Services – Slide 10

It is projected that Australian governments will face additional pressures on their budgets equivalent to around 6% of national GDP by 2060, principally reflecting the growth of expenditure on health, aged care and the Age Pension.

Population ageing is creating specific impacts and needs in societies as a result of the increasing incidence of age-related disabilities and complex care needs due to end of life illnesses.


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Brainstorm the key points both video clips on the mind-map below.


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Impact on the Health Service Workforce – Slide 11

An ageing population and an increased number of older workers leaving the workforce could mean there are fewer workers available to do the work required in the near future. Staffing shortages are likely to intensify.


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Identify the key points from the video clip. ..............................................................................................................................................................................

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Activity 22: Article Analysis – Get the Gist

Step 1 – Skim the text. Preview the test by looking at the headings, subheadings etc Step 2 – Look. Read the text carefully Step 3 – Highlight The who, what, when, where, why & how of the text Step 4 - Get the Gist Write a one paragraph summary of the information you have highlighted.

Ageing and the Health System: Key Challenges (Source: Australia’s Health, 2014) The ageing of the population will have far-reaching implications for society. Direct challenges for the health system will include changing health profiles, increased demand for health service use, and rising health costs. The challenges are twofold: first, the rapidly growing group of ‘old old’ (85 and over) people who have a range of typical age-related health problems (for example, arthritis, dementia and cancer); and secondly, the younger cohort entering the ‘65 and over’ age bracket with a larger burden of lifestyle-related diseases (for example, type 2 diabetes) than previous generations. A key challenge for the health system will be how to best meet the health needs of an ageing population and, in particular, how to manage the increasing impact of chronic disease. Increasing demand for health services Demand for health services is affected by many factors, but older people are generally higher users of health services than younger people, and so demand is expected to increase with the ageing population. Older people are more likely to visit health professionals than younger people. According to the 2011–12 AHS, 98% of people aged 65 and over had consulted at least 1 health professional in the previous 12 months, compared with 90% of those aged under 65. Among people aged 65 and over, 96% had consulted a GP in the previous 12 months, including 38% who had done so in the previous 2 weeks compared with 82% and 18% of those aged under 65, respectively. In terms of other health services, 57% of older people had consulted a specialist within the last 12 months (compared with 28% of people aged under 65), and around 20% had been admitted to hospital as an inpatient (compared with 11% of younger people).


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The AHS does not include information about people living in residential aged care. Administrative data provided to the AIHW National Aged Care Data Clearinghouse show that, at 30 June 2013, there were nearly 169,000 people living in permanent residential aged care. Between 2003 and 2013, the number of permanent residents in aged care rose by just over 20%. Within this total increase, the number of residents aged 85 and over rose by 37%, with this group accounting for just over 58% of the total population of permanent aged care residents (up from around 51% in 2003). These rises reflect growth in the older population, as well as associated increases in government-subsidised residential places (which are set to increase further following recent aged care reforms). Most permanent residents in aged care facilities are highly dependent, with 82% receiving high-level care at 30 June 2013. Information about the health conditions of residents is collected as part of an assessment of their care needs. Up to 3 mental and behavioural disorders (such as dementia) can be recorded, as can up to 3 other medical conditions that impact on care needs. Circulatory disease was the most common main (first listed) condition (22%) followed by musculoskeletal conditions (19%) and endocrine disease (including diabetes) (8%). Fifty-two per cent of permanent residents had diagnosed dementia. About half of all permanent aged care residents had symptoms of depression (52% at 30 June 2012), and about 45% of people who were admitted for the first time to residential aged care from 2008 to 2012 had symptoms of depression (see AIHW 2013b). Higher use of health services by older people also has implications for the health workforce. The health labour force in Australia is large and diverse, covering many occupations, ranging from highly qualified professionals to support staff and volunteers. An ageing population will require an adequate health workforce—in terms of numbers, distribution, and skill set—to meet changing needs and increased demand (Scott 2009). Future shortages of appropriately skilled workers are also expected to be a particular challenge in the aged care sector (see Productivity Commission 2011). Write a one paragraph summary of the information you have highlighted. ..............................................................................................................................................................................

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Availability of Carers and Volunteers – Slide 12


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Impact on Carers of the Elderly and Volunteers – Slide 13

This increasing life expectancy may enable older Australians to continue contributing socially, culturally and economically to the wider community, through volunteering and informal care-giving. Australia still faces skills shortages in a range of occupations, however mature aged workers have been regarded as an ‘untapped’ skills source. The concept of 'working age' is changing.


Summarise the key points in the table below.

Impact on Carers of the Elderly Impact on Volunteer Organisations


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Take Home Activities

Practice HSC Questions

Multiple Choice

What is the most likely consequence of a growth in the percentage of aged people in the Australian population? a) Higher demand for medical services provided by hospitals. b) Better research into the effects of medication for aged people. c) Increased revenue from private patients in Australia’s health care sector. d) More employment opportunities for aged people in the health care sector.

To which of the following does the concept of ‘healthy ageing’ refer? a) Treating elderly people for commonly reported conditions. b) The behaviours and activities that contribute to quality of life for elderly people. c) Providing appropriate facilities and services to accommodate aged and elderly people. d) Reducing the effects of poor health choices made in early adulthood that create risks to health status in

later life.

What action has been taken to reduce the impact of an ageing population on the health care system in Australia? a) Increasing the Medicare levy for older people. b) Reducing funding available to carers of older people. c) Encouraging older people to remain in the work force. d) Decreasing access to the health system for older people.

How can volunteer organisations reduce the impact of an ageing population on the public health system?

a) By subsidising prescription medicines. b) By transporting the aged to health care services. c) By assisting the aged to remain in their own homes. d) By increasing the number of trained health professionals in the workforce.

Short Response Outline THREE types of carer or volunteer organisations available to help meet the needs of Australia’s ageing population. (3 marks)

Reading – Increased population living with chronic disease and illness

It has been widely reported, the high chronic disease load and the resulting high service utilisation, (and therefore the cost to the health care budget) of people aged 65 years and over.

Considered collectively, these findings suggest we have some challenges ahead of us, but most are merely a by-product of the success of our health system, for example, the ageing population is partly a product of our increased longevity. We are better able to keep people alive, with increased years without disability than in the past. This allows them to extend their years as productive members of the workforce or the community. Medical advances have changed many once life-threatening health events (for example, acute coronary syndrome) into ones for which intervention (for example, stents) can solve (but not cure) the problem, though the patient still has to have ongoing (for example, cardiovascular) management for the rest of their lives.


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The overall effect is that we have more people acquiring and being diagnosed with more conditions, and each condition is being managed for a longer period of time. The resulting exponential increase in chronic condition management must generate a similar growth in the number of GP visits and the number of management actions, such as prescriptions and test orders. The increased use of GP services has no doubt contributed to our increased life expectancy, and is provided at a per-person cost in line with, or less than, that of other countries. Policy changes such as the introduction to Medicare of health assessment items, chronic disease management items, some disease-specific service items payments (SIP) and practice incentive payments (PIP),33 represent efforts to improve primary and secondary health prevention, and facilitate early diagnosis and management of chronic disease. Early diagnosis means that over time, more and more chronic conditions may be managed for an individual, and these chronic conditions will be managed for a longer period because of Australia’s increased life expectancy. For example, a patient diagnosed with diabetes at 45 years of age during a 45–49 years MBS-claimed Health Assessment potentially has 40 more years of life in which management of that problem is required.

Many chronic problems presenting to general practice result from modifiable risk factors. At-risk levels of alcohol consumption and daily tobacco smoking, though lower than adult community averages, may well have contributed to the health problems currently co-existing in older patients. The increasing prevalence of morbid obesity among older patients, more than doubling over the study period, is a growing problem.

Impact on the health system and services Australia’s health system is largely structured on single diseases. The vast majority of specialists work within a single body system, and often sub-specialise within that system. Patients can be referred to multiple specialists, possibly one for each of their diagnosed diseases. Further, guidelines for care are based on a single/disease type; clinical trials and medical research (and its funding) are largely single disease/disease type focused. More broadly, a single disease/disease type focus is the basis of organisations such as Diabetes Australia, the Heart Foundation and Kidney Health Australia, and this flows through to the patient information/education material such groups distribute. Yet, we have shown that in this age group, 84–92% of people with one of these conditions have two or more other diagnosed conditions – multimorbidity is the rule, rather than the exception.

As stated by Barbara Starfield, “Those who … (are) focusing on diseases resist understanding that health is a pattern. Without grasping the pattern, management is at best an approximation of adequate care”. This suggests that the patient is more than just a sum of their individual diseases and needs a ‘whole patient’ approach to management rather than a ‘problem’-based approach. In the future, care of those with complex chronic problems will require better integration of services and coordination of the care given by multiple providers including hospitals, specialists, allied health professionals, and community services. General practices are in a prime position to act as the coordinators of care and help to lower the chance of ‘fragmented care’. In turn, this may help reduce presentations to emergency departments and primary care preventable hospitalisations. Every extra hospitalisation avoided reduces unnecessary testing, extra prescribing and the risk of fragmented care through poor communication. It is likely that any extra resources spent in primary care would be countered by savings though reduced use of more expensive services.

Integration requires effective communication of core health information between different health sectors and different health professionals. Ideally there would be one record for one patient, a record all health providers could access when caring for that patient with structured standardised format for additions to the record made by each provider. Improvements to other forms of communication are also required if we are to move to a more patient-centred approach with shared decision-making between practitioners and the patient.


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Possible remuneration systems for the care of patients enrolled in a medical home have not been widely discussed. The level of multimorbidity present in a patient has been shown to be a good indicator of health care resource use, complexity of care, severity of illness, polypharmacy and adverse events. From the BEACH data we can estimate general practice health resource utilisation (and its cost) for individuals with different numbers of diagnosed chronic conditions, and different combinations of conditions. Remuneration of the medical home for the annual care of an individual patient could be based on the level of their multimorbidity.

As always, this is not as simple as it sounds, since a patient with two diagnosed conditions of uncomplicated hypertension and hyperlipidaemia utilises fewer services and needs less co-ordination of care than an individual patient with insulin-treated type 2 diabetes plus severe osteoarthritis in multiple sites. However, it would be a much more efficient starting point than merely paying for co-ordination of the care of each individual chronic condition, which must inevitably result in multiple payments for multiple diseases for the vast majority of older people.

V.I.P Summary – Very Important Points

After reading the text, write down 3 very important points. Using only your 3 VIPS, write a summary.

VIP Point 1

VIP Point 2

VIP Point 3

Summary:

Documents

PDHPE HSC Enrichment Day A Growing and Ageing Population. · PDHPE HSC Enrichment Day 2016 – Core 1: A Growing and Ageing Population Page | 28 Syllabus Overview – Slide 2 The