Health Science 1000 mizzou exam #1 :Health Literacy, Dementia, Alzheimers

Health Literacy gap

individual skills and attributes aren't enough to meet complexity and demands of health and the healthcare system (a cycle)

Problems with dosing instructions

Lots of ways to get it wrong•

Abbreviation not in dosage instructions•

Use of uncommon measures (drams, cc)

•Dssp?

How many physicians believed their patients knew their diagnosis vs. how many patients actually did?

77%, 57%

How many physicians stated that they at least sometimes discussed their patients' fears and anxieties vs patients who said they didnt?

98%, 54%

What is health literacy according to the Institute of Medicine?

"The degree to which individuals have the capacity to obtain, process, and understand basic health decisions"

Another component of health literacy

Wide range of skills is needed to help people process and act on information in order to live a healthy life

Ability to perform health care tasks for health literacy

Understanding appointment slips› Following instructions on medication labels› Obtain information about illness› Participate in discussions of informed consent› Enroll in Plans and Programs› Make a decision that is right for you

general context can include

Health clinics• Grocery stores• Neighborhoods and communities• Workplaces

Expanded Health Literacy examples

Voting on a local smoking ban• Vaccinating children• Preparing for an emergency• Deciding to wear a bike helmet• Awareness of the causes of diabetes• OSHA regulations

health literacy in America levels and statistics

Proficient: Define medical term from complex document, Calculate share of employee's health insurance costs--12%

Intermediate: Determine healthy weight from BMI chart, Interpret prescription and over-the-counter drug labels--53%

Basic: Understand simple patient education handout--22%

Below Basic: Circle date on appointment slip, understand simple pamphlet about pre-test instructions--14%

Who has poor health literacy?

90 million Americans have difficulty understanding and using health information,Over 40 million additional American's cannot read complex text

Approximately 1.6 million Missourian's how basic or below basic health literacy

affects of poor health literacy

Less likely to comply with prescribed treatments and regimens Use less preventative services

Higher risk of hospitalization and more time in the hospital Inadequate management of chronic conditions leading to more expensive care, poorer health outcomes and increased mortality.

poor patient recall

Patients/Parents forget 40%-80% of what their doctor tells them as soon as they leave the office and nearly 50% of what they do remember is recalled incorrectly

The more information provided, the less a patient/parent can recall

health literacy costs for high literacy vs low

$13,000 annual cost for low health literacy vs. $3,000 for those with higher literacy levels

economic cost of poor health literacy

3.3 to 7 million dollars in a year in Missouri

238 billion dollars per year across the US

Human cost: Increased pain and suffering› Mental Health› Lost work and leisure time

who pays for the rest of the cost of poor health literacy?

medicaid, medicare, employers and patients, other

health literacy affects

health outcomes

how does poor health literacy affect health quality?

Quality is affected in EVERY way›

Later diagnosis› Poor medication adherence› Poor regiment adherence› Fewer Primary Care utilization and more Hospital utilization› Poor Chronic Care Management› More expensive for person and system

universal precaution definition

A communication strategy which assumes that all health care encounters are at risk for communication errors, and aims to minimize risk for everyone

why health literacy now??

Most patient instructions are written› Often complex› Delivered rapidly› Easy to forget in stressful situations

Increasingly complex health system› More medications, tests, programs and procedures› Greater self-care requirements› Shared/informed decision making

Understand how patient's religion, culture, ethical belief and individualism affect decisions

different aspects of health literacy

Culture› Religion› Behavioral Compliance› Health Policy and Health Disparities› Bioethics and Medicolegal› Humanism

6 things universal precautions aim to do

Strive to make visits consumer-centered

Explain things clearly in plain language

Focus on key messages and repeat

Use a "teach back" or "show me" technique to check for understanding

Use consumer-friendly educational material to enhance interaction

Use medical interpretation services

providing explanations in common language

Most patients do not take anatomy in school

We use words differently in health

Use familiar, common, & everyday language. If possible, use the patient's own words

Use analogies that are relatable to the patient

how do visuals improve recall and understanding

Pictures/demonstrations most helpful to patient with low literacy & visual learners

✓ Most health drawings too complicated

✓ Physician drawings often very good (not too complex)

when talking with patients and families:

Use Plain Language

.● Slow down

.● Break it down into short statements.

● Focus on the 2 or 3 most important concepts.

● Check for understanding using teach-back.

take home message:

Health Literacy is important

Lack of health literacy is costly to individual and the greater society

You will need these skills in your professional and personal life so learn about it and learn to love it

how often is someone diagnosed with a dementia disease?

Every 60 seconds

dementia is the ________ leading cause of death among all diseases and one of the major causes of disability among older people

7th

how many seniors die with alzheimers or another dementia?

1 in 3--more people killed than breast and prostrate cancer combined

dementia is a _______ of a disease

symptom

dementia

disabling cognitive impairments

over 100 diseases that have dementia as a symptom such as:

alzheimers--most common

lewy body disease

parkinsons

FTD

ADRD

how a brain stores memories

like assembling rather than remembering. Brain reconstructs your memories on demand with electricity and swirling chemicals. And each time a memory is assembled, it might be built with some different neurons

hippocampus

** first area of the brain to degenerate in Alzheimer's disease

Most areas of the human brain cannot grow new brain cells, but some parts can. One such part is the hippocampus, which is important for learning, remembering, regulating how much you eat, and other biological functions.

leading risk factor for most chronic illnesses of old age including Alzheimer's disease and some other dementia diseases.

aging

main problem of alzheimers

losing our autonomy, losing our ability early on to self-determine our lives. The onset of other issues only exacerbates the disease. I

Instrumental Activities of Daily Living (IADLs)

Managing Finances • Managing Medication • Transportation • Managing living space

Activities of Daily Living (ADLs) - Often used in disability and insurance evaluations

• Walking • Self-feeding • Dressing • Toileting • Personal hygiene - Bathing and Dental Care

other sense affected by brain disease

• Proprioception - Where body parts are and what they are doing

• Nociception - Feeling pain •

Thermoception - Sensing temperature •

Chronoception - Sensing the passage of time •

Interoception - Internal needs awareness (hunger or thirst)

risk factors for developing dementia

Diabetes • Hypertension • Mental illness • Hearing loss • Dental health • Sleep apnea/Insomnia • Other neurodegenerative diseases • Down syndrome • Substance Abuse • Air quality • Education • Shingles

Early assessment and intervention is needed to:

Slow functional decline and delay or prevent memory care placement • Help with future planning - medical, financial, legal, support

The earlier the diagnosis, the sooner medications can be started.

Newest Drugs

- Aducanumab and Lecanemab

when a person is diagnosed with demetia disease, there are two people affected:

patient and caregiver

economic facts

In 2022, Alzheimer's and other dementias will cost the nation $321 billion. By 2050, these costs could reach nearly $1 trillion.

covid affects

• In 2020, COVID-19 contributed to a 17% increase in Alzheimer's and dementia deaths.

Long term COVID-19 symptoms have been found to include cognitive decline, overwhelming neurology providers.

What Can We Do?

Advocate, Educate, and Agitate