Aging and Society A Canadian Perspectives 7th Edition Novak Test Bank Full Chapter PDF

Aging And Society A Canadian
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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
2. 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
3. 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
4. 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
5. 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
6. 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.
7. 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
8. 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
9. 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
10. 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
11.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
12. 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
13. 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
14. 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
15. 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
16. Seatbelt legislation is a component of which of the models of healthcare?

a. social model
b. behaviour model
c. health promotion model
d. medical model
17. 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?
a. physiotherapy
b. drugs
c. long-term care
d. physicians
18. 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
19.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
20.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
21. According to the Canadian Healthcare Association (2007), which of the following concerns was most
prevalent among respondents?
a. obesity rates
b. lack of physicians
c. increasing costs
d. wait times
22. Which famous Canadian was named the “father of Medicare?”

a. Pierre Elliott Trudeau
b. Lester B. Pearson
c. John Diefenbaker
d. Tommy Douglas
23. As compared with Americans, which of the following conditions is lower amongst Canadians?
a. obesity
b. arthritis
c. kidney disease
d. Crohn’s disease
24. 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
25. 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
26. 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
27. 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
28. 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.
29. 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
30. 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
31. 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
32. 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.
33. 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
34. 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%.
35. 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.
36. 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
37. 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%
38. According to Ramage-Morin (2009), what percentage of Canadian seniors in institutions use five or
more medications?
a. 31%
b. 42%
c. 53%
d. 67%
39. 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.
40. 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.
41. 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
42. Mackenzie and Rachlis (2010) report that physician payments control approximately what percentage of
healthcare costs?
a. 35%
b. 50%
c. 80%
d. 97%
43. 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
44. 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
45. 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
46. 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
47. What percentage of Canadian healthcare costs are covered by the public sector?
a. 40%
b. 50%
c. 60%
d. 70%
48. 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
49. What percentage of Canada’s GDP was spent on healthcare in 2009?

a. 8.9%
b. 10.7%
c. 11.4%
d. 12.3%
50. 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
51. According to Finlayson and colleagues (2005), which of the following has led to a decrease in acute care
hospitalizations?
a. more physicians
b. a shortage of beds
c. more nursing homes
d. improvements in diagnostic tools
52. 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
53. 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.
54. 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
55.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%
56. 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
57. 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
58. 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
59. Which of the following measures would help to de-institutionalize a nursing home?
a. having three residents to a room
b. allowing residents to decorate their rooms as they choose
c. serving a choice of two entrees for meals
d. allowing family members to visit at any time of day or night
ANS: B REF: 174-175 BLM: HO
60. 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
61. Which of the following models do nursing homes fall under?

a. hospice model
b. healthcare model
c. medical model
d. health promotion model
62. 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
63. 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
64. 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
65. 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.
66. 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
67. 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)?
a. drug therapy
b. occupational therapy
c. Meals on Wheels
d. mental health services
68. 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
69. Which of the following is a part of community care programs?

a. libraries
b. seniors’ recreation clubs
c. adult daycare programs
d. elderhostels
70. 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
71. 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?
a. homemaker services
b. adult daycare
c. nursing homecare
d. home nursing care
72. 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
73. 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
74. 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
75. 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.
76. 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
77. 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
78. 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
79. 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
80. 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
81. According to Carrière (2006), what percentage of seniors aged 65 to 74 years used homecare?
A. 5%
B. 8%
C. 11%
D. 15%
82. 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%
83. 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
84. 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.
85. 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
86. 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
87. 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
88. When compared with their younger counterparts, what health promotion activity do seniors excel at?
a. eating five or more servings of fruit and vegetables daily
b. limiting alcohol intake
c. wearing seatbelts
d. exercising daily
89. 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
90. 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%
91. 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
92. 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
93. 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
94. 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
95. 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.
96. 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
97. 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.
98. 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
99. 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%
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
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
2. 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:
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
3. What challenges are currently being experienced by Canada’s telehealth programs?
ANS:
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:
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
2. 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
3. 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
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Aging And Society A Canadian

Perspectives 7th Edition Novak Test

3. Which of the following is an example of health promotion?

7. What does the social model of healthcare strive to do?

8. In the social model, what is the best way to deliver healthcare?

9. Which of the following is an example of long-term care?

10. What is the major goal of long-term homecare?

12. What does the health promotion model focus on?

16. Seatbelt legislation is a component of which of the models of healthcare?

ANS: C REF: 162 BLM: HO

ANS: D REF: 162 BLM: HO

18. Which model dominates the Canadian healthcare system today?

ANS: D REF: 164 BLM: REM

22. Which famous Canadian was named the “father of Medicare?”

ANS: D REF: 164 BLM: REM

ANS: A REF: 163 BLM: REM

ANS: C REF: 168 BLM: REM

ANS: B REF: 170 BLM: REM

49. What percentage of Canada’s GDP was spent on healthcare in 2009?

ANS: C REF: 171 BLM: REM

ANS: D REF: 172 BLM: REM

ANS: D REF: 173 BLM: HO

ANS: B REF: 174-175 BLM: HO

61. Which of the following models do nursing homes fall under?

ANS: B REF: 177 BLM: HO

68. What is the main focus of the social model?

69. Which of the following is a part of community care programs?

ANS: A REF: 178 BLM: HO

72. What is the purpose of geriatric day hospitals?

73. Which of the following is a service of geriatric day hospitals?

75. Which of the following is an advantage of a geriatric day hospital?

80. How does the Canada Health Act define homecare?

84. Which statement is true regarding the traditional healthcare system?

ANS: A REF: 184 BLM: REM

91. How can one determine if a service is available?

92. How can one determine if a program is accessible?

98. In what way might overlaps between services be avoided?

Romanow’s recommendations included the following:

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

MEDICAL MODEL SOCIAL MODEL

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