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

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1. Which topic have psychologists in the field of aging spent more time studying than any other?

a.	stress
b.	memory
c.	reaction time
d.	dysphoria

ANS: B REF: 126 BLM: REM

1. Researchers break the process of remembering into a series of steps. Which of the following is a step in this information processing model?

a.	sensory memory
b.	motor memory
c.	intermediate memory
d.	working memory

ANS: A REF: 126 BLM: HO

1. Ike is hoping to remember the phone number of a girl he just met at a college party. In the process of remembering, Ike will store information in which type of his memory?

a.	sensory
b.	short-term
c.	long-term
d.	working

ANS: C REF: 126 BLM: HO

1. Which of the following has been found in much of the research on memory and aging?

a.	no significant decline in memory with age
b.	improvements in some types of memory with age
c.	some decline in memory with age
d.	that most declines in memory are due to psychological disorders or distress, which become more likely with age

ANS: C REF: 126 BLM: HO

1. Which of the following scenarios is an example of latency?

a.	As her memory ages, Josephine can’t remember her doctor appointments.
b.	As his reflexes get slower, Frank doesn’t drive as often.
c.	As her osteoporosis worsens, Pauline doesn’t exercise as often at the local gym.
d.	As his cataracts worsen, Paul purchases large-print novels to read.

ANS: A REF: 127 BLM: HO

1. Which type of memory shows a much greater decline with age than others?

a.	non-episodic
b.	short-term
c.	sensory
d.	episodic

ANS: D REF: 127 BLM: HO

1. Which type of memory shows a greater decline with age than non-episodic memory?

a.	working
b.	functional
c.	explicit
d.	episodic

ANS: D REF: 127 BLM: HO

1. Which process requires a person to take in new information and put it together with already stored information?

a.	association
b.	processing
c.	elaboration
d.	encoding

ANS: D REF: 127 BLM: HO

1. According to Hoyer and Verhaeghen (2006), which type of memory stores, manipulates, and processes new information while temporarily storing other information?

a.	non-episodic memory
b.	working memory
c.	episodic memory
d.	latent memory

ANS: B REF: 127 BLM: REM

1. In research using speeded trials to determine differences in learning, what did older subjects tend to do more often than younger subjects?

a.	rely more on implicit memory
b.	rely more on mediators
c.	miss more verbal and pictorial items
d.	encode late items at the expense of earlier items

ANS: C REF: 127 BLM: REM

1. According to Small and colleagues (2008), which part of the brain declines in function with age?

a.	the pons
b.	the hippocampus
c.	the medula
d.	the prefrontal cortex

ANS: B REF: 128 BLM: REM

1. The Berlin Aging Study points to which of the following factors as a source of cognitive decline in older adults?

a.	physical change
b.	lack of education
c.	decreased income
d.	increased sensory ability

ANS: A REF: 128 BLM: REM

1. Which of the following does Park and Reuter-Lorenz (2009) propose is the source of neural decline in older people?

a.	chronic disease
b.	presence of neurofibrillary plaques and tangles
c.	acute disease
d.	a lack of education

ANS: B REF: 129 BLM: REM

1. According to Wilson (2011), what types of activities should older people engage in, in order to maintain cognitive health?
2. activities that are stress-free and exciting
3. activities that are complex and challenging
4. activities that are relaxing and fun
5. activities that are difficult and thought provoking

ANS: B REF: 130 BLM: REM

1. Which approach to memory holds that memory is influenced by many conditions such as the environment of learning, the individual, and the situation of recall?

a.	associative
b.	sociological
c.	environmental
d.	contextual

ANS: D REF: 131 BLM: HO

1. Charness (1981) studied the contextual approach to memory. When older chess players who were of the same skill level as younger chess players were compared, what was discovered?

a.	The older players played more slowly.
b.	The older players could visualize more moves ahead.
c.	The older players had more difficulty recalling positions.
d.	The older players did not have the same stamina levels, and therefore could not concentrate for as long.

ANS: C REF: 131 BLM: REM

1. Older chess players have more difficulty recalling positions accurately. Charness (1981) attributes this to which of the following?

a.	working memory deficits
b.	less efficient organization strategies
c.	poorer retrieval ability
d.	interference from irrelevant information

ANS: C REF: 131 BLM: REM

1. Charness (1981) used a neural network model to measure recall. He found which of the following to be true among chess players?

a.	Skill level, not age, determines a player’s ability.
b.	Older players could visualize more moves ahead than younger players.
c.	Younger players took almost 50% longer to move.
d.	Speeded games cause younger players to make more mistakes.

ANS: A REF: 131 BLM: REM

1. According to researchers, which of the following can influence performance in mental tasks and can improve with age?

a.	semantic memory
b.	working memory
c.	competence
d.	episodic memory

ANS: C REF: 132 BLM: REM

1. Hoyer and Verhaeghen (2006) found which of the following to be true regarding semantic memory (the storing of factual information)?

a.	Older people perform as well as younger people in some studies.
b.	When level of education is controlled for, older people perform as well as younger people.
c.	Although speed of recall decreases with age, accuracy remains stable or increases.
d.	Differences in performance between younger and older people may be related to differences in what the groups perceive as meaningful.

ANS: A REF: 132 BLM: REM

1. According to Hoyer and Verhaeghen (2006), there are several methods to improve memory as one ages. These include memory training, an enriched environment, and which of the following?
2. increased sleep
3. physical fitness training
4. increased consumption of omega-3 fatty acids
5. activities such as games and puzzles

ANS: B REF: 134 BLM: REM

1. Which of the following statements can be made regarding more recent research into intelligence and aging?

a.	The research concentrates on halting or reversing the effects of aging on intelligence.
b.	The research has validated the perception of decreased intelligence with age.
c.	The research questions a simple connection between senescence and intelligence.
d.	The research has found problems with using IQ tests to compare intelligence across age cohorts.

ANS: C REF: 136 BLM: HO

1. What are the two main definitions of intelligence used by psychologists?

a.	quotient and scalar paradigms
b.	the interpretive model and the constructive model
c.	the global view and the pragmatic view
d.	concrete and abstract reasoning

ANS: C REF: 136 BLM: HO

1. What does the pragmatic view of intelligence used by psychologists refer to?

a.	what intelligence tests measure
b.	the integration of memory and skills to solve a problem
c.	a person’s ability to negotiate environmental demands
d.	reasoning, abstracting, and concept formation

ANS: A REF: 136 BLM: HO

1. What are the two types of intelligence described in Horn and Cattell’s (1966) model of intelligence?

a.	fluid intelligence and crystallized intelligence
b.	cerebral intelligence and cerebellar intelligence
c.	longitudinal intelligence and cross-sectional intelligence
d.	creative intelligence and cognitive intelligence

ANS: A REF: 136 BLM: REM

1. According to Horn and Cattell (1966), which type of intelligence relies on how well the physical nervous system works?

a.	fluid intelligence
b.	crystalline intelligence
c.	pragmatic intelligence
d.	physiological intelligence

ANS: A REF: 136 BLM: REM

1. Which of the following shows a decline as the biological system ages?

a.	fluid intelligence
b.	creative intelligence
c.	functional intelligence
d.	cross-sectional intelligence

ANS: A REF: 137 BLM: HO

1. Studies of crystallized intelligence and aging show which of the following?

a.	variations depending on the educational level of the subjects
b.	stability and even increases with age
c.	declines, highly correlated with functional decline, from the teen years on
d.	no changes from approximately age 24 on

ANS: B REF: 137 BLM: REM

1. How does Dr. Gene Cohen describe the wisdom that can grow or improve with older age?
2. as later stage wisdom
3. as cumulative intelligence
4. as developmental intelligence
5. as aged intelligence

ANS: C REF: 138 BLM: REM

1. Amy’s doctor says that she does not need to go to a nursing home just yet. However, Amy’s children insist that she become a resident “before it’s too late.” Amy is confused about the differing opinions of her doctor and her children. Which of the following terms describes Amy’s ability to suspend judgment while trying to resolve these contradictory opinions?
2. dualistic thinking
3. cognitive thinking
4. relativistic thinking
5. systematic thinking

ANS: A REF: 138 BLM: HO

1. What did Lehman find through research into creativity through analysis of the works of creative people and their achievements?

a.	In most fields, achievement steadily decreases after age 45.
b.	Scientists and mathematicians peak much later than musicians or artists.
c.	People in almost every field peak at about the same age.
d.	Greatness of work is not an effective or accurate measure of creativity.

ANS: A REF: 138 BLM: REM

1. Which of the following represents a significant difference between the studies of creativity by Dennis (1968) and Lehman (1953, 1968)?

a.	Dennis studied the number of works produced, rather than quality of works.
b.	Dennis looked at only scientists and mathematicians, to eliminate subjectivity of judgment.
c.	Dennis compared people with different lengths of life.
d.	Dennis studied only people who were still alive, so that they could be interviewed to find similarities in personality.

ANS: A REF: 138 BLM: HO

1. Dennis’s (1968) research on creativity shows that differences in peak age of creativity for disciplines may depend as much on which of the following as it does on chronological age?

a.	family support
b.	personality
c.	success in social-psychological growth
d.	a field’s social structure

ANS: D REF: 138 BLM: REM

1. Simonton (2006) concludes from review of research on creativity that, assuming a normal life span, a creative person’s peak output occurs at what point in life?

a.	during all stages of one’s career
b.	during retirement
c.	between 19 and 34 years of age
d.	between 45 and 60 years of age

ANS: A REF: 139 BLM: REM

1. Which idea is proposed by the “constant-probability-of-success model” to explain the quality of a creative person’s works?

a.	Truly great creative work occurs only during the ages of 25–34 years.
b.	The most creative people have a constant creative output and great works are produced at regular intervals.
c.	The ratio of quality works produced during a career stays the same at every stage of the career.
d.	The number of great works produced in a person’s life rises rapidly to a peak and then declines gradually.

ANS: C REF: 139 BLM: HO

1. Galenson’s (2006) work shows that the production of great works has more to do with which of the following characteristics of the artist rather than with his or her age?

a.	personality
b.	education
c.	personality and approach
d.	social and economic status

ANS: C REF: 140 BLM: REM

1. What do some psychologists who study the individual in society focus on?

a.	intersocial attitudes
b.	personality development
c.	intrapersonality conflicts
d.	social-psychological perceptions

ANS: B REF: 141 BLM: HO

1. Who developed one of the best-known stage models of the life cycle, which describes eight stages of ego development?

a.	Rose Caldwell
b.	Robert Peck
c.	Erik Erikson
d.	Leonard Levinson

ANS: C REF: 141 BLM: REM

1. What is the basis of Erikson’s model of the life cycle?

a.	psycho-pathological problems that inhibit development and must be overcome
b.	individual developments through social changes
c.	conflicts between the self (ego) and the environment
d.	specific stages of ego development with each stage containing a crisis

ANS: D REF: 141 BLM: REM

1. How does Erikson explain the development of a psychopathology in a person?

a.	It is the result of the progression of one of the eight stages within a person’s life cycle.
b.	It is the successful completion of the adolescent stage.
c.	It is an unsuccessful resolution of a crisis within a stage of ego development.
d.	It is the product of the identity versus role confusion conflict.

ANS: C REF: 141 BLM: REM

1. According to many psychoanalytic thinkers (Buhler, Jung, Erikson), old age is a time of which of the following?

a.	inwardness, reflection on the past, and the closure of life
b.	openness, care for others and the world, and achieving that which was not accessible in youth
c.	concern for the future of the individual and of the world
d.	rejection of the old views and an acceptance of the new world

ANS: A REF: 141 BLM: HO

1. Martin Luther King Jr. was a person who gave an inspiring “I Have a Dream” speech, which motivated young people to trust in the American culture and follow its prescription for action. King’s speech was an example of which one of the following terms?

a.	integrity
b.	community involvement
c.	disengagement theory
d.	spirituality

ANS: A REF: 141 BLM: HO

1. According to Einolf (2011), how does generativity come about?
2. through learning
3. through prayer and reflection
4. through medical consultation
5. through service to others

ANS: D REF: 142 BLM: REM

1. According to Lindsay (2008), what percentage of older Canadians say that they engage in religious activity at least once a week?

a.	22
b.	37
c.	43
d.	65

ANS: B REF: 142 BLM: REM

1. According to Idler (2006), for an individual who has lived approximately 90 years, “it is difficult to name any other aspect of those lives […] that would have changed so little.” To what is Idler referring?
2. fashion
3. politics
4. religion
5. technology

ANS: C REF: 142 BLM: REM

1. Yolanda is not a typical grandmother. She takes a woodworking class, rides a motorcycle, and is a certified black belt holder in karate. Her female friends think that her interests are strange. What is the term that describes prejudice that is based upon an individual’s inability to fit a female role ideal in later life?
2. genderism
3. sexism
4. feminism
5. ageism

ANS: A REF: 145 BLM: HO

1. Which of the following is an example of a non-normative event?

a.	a new job
b.	a second marriage
c.	the birth of a baby
d.	a sudden job layoff

ANS: D REF: 146 BLM: HO

1. Which of the following do sociologists define as social guidelines that prescribe how a person of a certain age should act?

a.	social readjustment
b.	age norms
c.	social norms
d.	ageism

ANS: B REF: 146 BLM: HO

1. Which of the following describes history-graded events?

a.	events that have little effect on an individual’s personal life
b.	events that create a condition of lowered expectations
c.	events that are less stressful than non-normative life events
d.	events that change the lives of many age cohorts

ANS: D REF: 146 BLM: HO

1. Which of the following is an example of a cohort?

a.	a group of individuals who went into grade 6 in September 1972
b.	a family who exercises together
c.	a softball team with many ethnic players
d.	a craft class for seniors aged 75 to 80 years

ANS: A REF: 147 BLM: HO

1. As cohorts age, they replace one another in society’s age structure. What do Riley, Johnson, and Foner (1972) call this?

a.	trans-societal aging
b.	the age stratification system
c.	cohort flow
d.	generation reproduction

ANS: C REF: 147 BLM: REM

1. The age stratification system acts to do which of the following?

a.	filter historical events through a generation, altering the event’s effects on the different age groups within the period
b.	replace older cohorts in society with newer cohorts as its members age
c.	ensure an even distribution of ages within a generation
d.	introduce new values to society through the young, and acceptance of the new values as the young move into middle age

ANS: A REF: 147 BLM: HO

1. When compared to the theory of life stages, how do Braun and Sweet (1983–84) explain the “generational event” theory of personality in terms of the differences between age groups?

a.	better
b.	worse
c.	less accurately
d.	more superficially

ANS: A REF: 147 BLM: REM

1. What is the term for the theory of personality development that says attitudes for a generation form during their teen years?

a.	cohort reaction theory
b.	generational event theory
c.	life stage theory
d.	age-graded event theory

ANS: B REF: 147 BLM: REM

1. Which of the following statements can be made about the attitudes developed by people in their teens?

a.	They change drastically somewhere between the ages of 20 and 35.
b.	They change slowly and in stages as a person overcomes conflicts in their life.
c.	They remain relatively stable throughout life.
d.	They will change at least three times before a person reaches old age.

ANS: C REF: 147 BLM: HO

1. Anthropologists report that all societies move people through a series of age grades. Which of the following statements most accurately reflects age grades?

a.	They place limits on the opportunities available to members of age groups, removing those members slowly from activity.
b.	They define the rights or responsibilities given by a society to a member of a particular age group.
c.	They are conflicts or crises that a person must overcome to reach a new stage of development.
d.	They provide a chance for individuals to look at various paths for development and choose those most suited to their needs.

ANS: B REF: 147 BLM: HO

1. What is the purpose of an age grade?

a.	to slowly remove the aged from society and thereby provide opportunities for the young
b.	to expand a person’s perceptions and ensure a successful old age
c.	to create status levels within a society and establish roles for its members to play
d.	to give order to a person’s life and help people to judge their development

ANS: D REF: 147 BLM: HO

1. Andre and Janet were married at 47 and 45 years of age, and a year later, they became the parents of a baby boy. Which term describes this later life experience for Andre and Janet?

a.	age-grade exclusion syndrome
b.	a tenuous social status
c.	non-normative stage development
d.	age-status asynchronization

ANS: D REF: 148 BLM: HO

1. In terms of life events, which of the following statements can be made about women?

a.	Women go through different life events than men.
b.	Women go through more extended life events than men.
c.	Women go through two fewer life events than men.
d.	Women go through three more life events than men.

ANS: A REF: 148 BLM: HO

1. How is a person’s life cycle mainly regulated?

a.	by the person’s subconscious
b.	by the educational level the person has attained
c.	by the person’s needs or desires
d.	by the social groups that the person belongs to

ANS: D REF: 148 BLM: HO

1. According to Milan and Vezina (2011), what percentage of seniors reported feeling “happy and interested in life?”
2. more than 25%
3. more than 50%
4. more than 75%
5. more than 90%

ANS: C REF: 148 BLM: REM

1. Which of the following conditions is a disease of the brain?
2. Down syndrome
3. dementia
4. depression
5. diabetes

ANS: B REF: 149 BLM: HO

1. Alzheimer’s disease accounts for what percentage of all dementias?
2. 49%
3. 52%
4. 57%
5. 63%

ANS: D REF: 150 BLM: REM

1. According to the Ontario Alzheimer Society, what percentage of the Canadian population is projected to suffer from Alzheimer’s disease by 2038?
2. 1.5%
3. 1.9%
4. 2.5%
5. 2.8%

ANS: D REF: 150 BLM: REM

1. Your Aunt Tilley has recently heard a report by the Alzheimer’s Society that discussed methods to build a “cognitive reserve” to help her as she ages. What types of activity can your aunt become involved in to build up her cognitive reserve?
2. ride a bike
3. play chess
4. learn yoga
5. practice a musical instrument

ANS: B REF: 150 BLM: HO

1. According to the Slaughter and Bankes (2007) report, those with Alzheimer’s disease lose one functional ability every how many months?
2. 5
3. 4
4. 3
5. 2

ANS: D REF: 150 BLM: REM

1. Research shows that 89% of the time, the Alzheimer Predictive Index can predict the onset of Alzheimer’s disease within how many years?

a.	2
b.	10
c.	20
d.	50

ANS: A REF: 151 BLM: REM

1. Which of the following conditions is considered to be a functional disorder?
2. diabetes
3. arthritis
4. depression
5. hypertension

ANS: C REF: 153 BLM: HO

1. Because they interfere with how a person functions, psychological problems such as emotional upset, anxiety, and depression are known as which of the following?

a.	functional disorders
b.	organic disorders
c.	dementia
d.	autodidactic disorders

ANS: A REF: 153 BLM: HO

1. In general, what have studies found about the risk of depression in later life?

a.	The risk decreases.
b.	The risk remains constant.
c.	The risk increases.
d.	The risk decreases slowly until middle age, and then increases sharply by about age 65.

ANS: A REF: 153 BLM: HO

1. Stones and colleagues (2004) studied residents of long-term care facilities and found that what percentage of people in these settings do not get treatment for depressive symptoms?

a.	10–20%
b.	25–35%
c.	40–55%
d.	60–75%

ANS: C REF: 154 BLM: REM

1. Research has shown that a large percentage of older Canadians shared the greatest tendency toward depression because of which of the following factors?

a.	stress
b.	financial instability
c.	anxiety
d.	the inability to get out and a loss of social support

ANS: D REF: 154 BLM: REM

1. Which of the following statements can be made about the relationship between mental health experts and older people?

a.	Mental health experts have not learned about many of the problems unique to older people
b.	Mental health experts have little success treating older people
c.	Mental health experts often ignore the needs of older people
d.	Mental health experts treat older people the same as younger people.

ANS: C REF: 154 BLM: HO

1. Which of the following is true for older people with functional problems?

a.	Few treatments are readily available.
b.	Many treatments are available for a wide range of problems.
c.	Successful recoveries are rare.
d.	Institutionalization is the most frequent result.

ANS: B REF: 154-155 BLM: HO

1. Lewis suffers from insomnia and he does not want to take a prescription drug to relieve it. His physician describes a new method to treat Lewis’ sleeplessness. What do some clinicians use to help relieve insomnia?

a.	large doses of thiamine
b.	milieu therapy
c.	encounter therapy
d.	behaviour therapy

ANS: D REF: 154 BLM: HO

1. Which of the following phrases describes the concept of competency?

a.	the exercise of rights by all citizens
b.	the loss of civil rights when a person comes into protective care
c.	the loss of ability to make decisions
d.	the ability to understand the information relevant to the decision to be made

ANS: D REF: 155 BLM: HO

SHORT-ANSWER QUESTIONS

1. What does research by Cohen (2005) illustrate regarding mental growth and development in later life?

ANS:

Student answers should include the following:

Cohen lists four findings from recent brain research that describe mental growth and development in later life:

1. The brain reorganizes itself in response to new information and experience.
2. Brain cells grow in later life.
3. The brain’s emotional centres grow more advanced with age.
4. Compared to younger people, older people use both halves of the brain more equally.

REF: 129

1. Describe Park and Reuter-Lorenz’s (2009) scaffolding theory of aging and cognition.

ANS:

Student answers should include the following:

This theory was developed to account for the changes in the brain that occur due to the aging process. The researchers say that the brain responds to functional and structural decline by reorganizing itself. They propose that the brain forms neural scaffolds or protective structures that buffer mental decline. They also propose that individual experiences can increase neural scaffolding. This means that “new learning, social and cognitive engagement, exercise, and cognitive training could all improve mental function in later life” (Park and Bischof 2011; also Nussbaum 2011).

REF: 130

1. According to Baltes and colleagues (Schiebe, Kunzmann, and Baltes, 2007), what are the five criteria of wisdom, and what is important about these criteria?

ANS:

Student answers should include the following:

The five criteria of wisdom include the following:

1. A store of factual information about human nature
2. Rich procedural knowledge about handling life’s problems
3. An awareness of life’s contexts and how they change over the life span
4. Understanding the relativism of values and tolerance for others
5. Understanding of how to deal with uncertainty.

These abilities make wise older people good decision makers and advisors.

Wisdom allows a person to critically view cultural illusions and to act on the basis of universal principles.

REF: 137

ESSAY QUESTIONS

1. Explain how physical exercise can be beneficial to the brain and cognitive development in older age.

ANS:

Student answers should include the following:

It is known that exercise increases cardiovascular fitness and endurance. But scientists also find that

exercise leads to more connections between brain cells and growth in brain size.

One research study showed that an inactive group of seniors had fewer small blood vessels in the brain

and less predictable blood flow through the brain.

Weinstein and Erickson (2011, 92) found that “Physical activity, such as aerobic exercise, might

be both an effective prevention and treatment for late-life brain atrophy and cognitive decline …

[A]erobic exercise interventions are consistently associated with increased cognitive performance and

greater brain volume in older adults.”

Poon and Harrington (2006) report that even mild physical activity leads to increased production

of brain cells. Some evidence suggests that exercise also increases blood flow that brings oxygen to

the brain and increases the efficiency of neuronal function. High levels of fitness may lead to more

efficient mental processing especially for complex and demanding tasks (Park and Bischof, 2011).

Aerobic conditioning leads to improvement in simple and complex mental tasks. Colombe and

colleagues (2006) found that aerobic exercise increased grey and white matter in the brain. And

Erickson and colleagues found increases in brain volume as well as improved spatial memory due to

exercise.

In addition, conditioning improves complex tasks the most. Kramer and colleagues (2006) found that

exercise leads to improvements in the brain that include neuronal survival, the growth of new

connections between neurons, and the growth of new capillaries in the brain.

In a Canadian study, cardiovascular health, blood flow to the brain at rest, reserve capacity of blood

vessels in the brain, and cognitive functions were measured. The active women had better vascular

blood flow to the brain and lower blood pressure, and the active group also had better cognitive

function.

Researchers continue to study the link between exercise and mental function. But current research

points towards the value of living an active lifestyle for good mental function.

REF: 135

1. Describe the life course perspective and its main principles.

ANS:

Student answers should include the following:

The life course perspective takes a grand view of the life cycle. It includes growth through social roles

and stages of life, it takes into account social institutions, and it places all of this in a historical context.

There are five main principles to the life course perspective:

1. Developments in multidimensional and multispheral: People develop biologically, physically,

psychologically, and socially. Development in each dimension takes place at different rates. Like-

wise, development takes place in many spheres of life—in the family, at work, through leisure, and so

on.

1. Development is multidirectional: People change throughout the life course. They may grow

and develop a particular dimension. They may decline or experience stability on another dimension.

1. Development takes place from birth through death: Development takes several forms – it occurs

at different rates, on different dimensions, and within different spheres—at different times in life.

Early views of human development focused on childhood and youth. The life course perspective

looks at the whole of life.

1. Development takes place through continuity and discontinuity: Some development takes

place at specific times in life; other developments happen throughout life. Physical growth or

maturation takes place from childhood to young adulthood. But learning and growth of wisdom

occur throughout life.

1. Development takes place in a historical context: Historical, social, and demographic events

shape the lives of individuals and age cohorts. The baby boom generation has lived through a time

of prosperity and peace in Canada. Post-World War II prosperity, television, mass advertising, mass

education, and the rebellious years of the 1960s all shaped the lives of baby boomers. They will

bring these unique experiences with them into old age.

The life course model proposes that older people give meaning to the events that shape their lives.

Some people accept events and build them into their life plan. Other people resist change and fight

to hold onto their former selves. The life course model also says that older people can reshape

society.

Older peoples’ responses to aging differ by gender, age cohort, and social class. All of these

differences create varied patterns of aging. The life course model turns the researchers’ attention to

the social context to explain the differences in the time of onset, direction, and duration of develop-

ment in later life.

REF: 144

1. The Alzheimer Society made several recommendations in 2010 as to how to deal with the increasing

rates of the disease, as well as other forms of dementia in Canada. Discuss and explain these

recommendations.

ANS:

Student answers should include the following:

The 2010 Alzheimer Society report, Rising Tide, made the following recommendations for a

Canadian response to the increase in dementia cases:

1. Increase the investment in dementia research: Ultimately, medical science needs to find a cure

for Alzheimer’s disease and other forms of dementia. The Canadian Institutes for Health Research

spend about $21 million per year on dementia research. Ninety-five percent of these funds go to

biomedical and clinical research.

1. Provide support for informal caregivers: This can take the form of training, respite programs, and

support groups. Care for the caregiver will ensure better care for people with dementia. Researchers

say that “efforts should … be made to increase the awareness of older persons and their caregivers

related to available services for … parental dementia.” Knowledge and use of community supports

would help caregivers cope with parental care. The researchers also call on physicians and other

health providers to link family caregivers to dementia care community supports.

1. Emphasize prevention and early intervention: Improved methods of detection and diagnosis

will allow for early intervention. Some methods such as exercise and diet may delay or prevent

some types of dementia.

1. Build an integrated system of care: This would link home care, respite care, and institutional

care. It will allow people with dementia to get the care that suits their family’s needs and the stage

of the client’s illness.

1. Strengthen and supplement the dementia workforce: Canada needs to recruit and educate

workers who understand the treatment needs of dementia patients. This includes training programs

for future workers and on-the-job training for current workers.

REF: 150

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