Population Based Health Policy: Elderly
Table of Contents
TOC o “1-3” h z u HYPERLINK l “_Toc326073182” Introduction PAGEREF _Toc326073182 h 3
HYPERLINK l “_Toc326073183” Discussion PAGEREF _Toc326073183 h 3
HYPERLINK l “_Toc326073184” End of life care PAGEREF _Toc326073184 h 3
HYPERLINK l “_Toc326073185” Long term care PAGEREF _Toc326073185 h 4
HYPERLINK l “_Toc326073186” Costs of health care insurance PAGEREF _Toc326073186 h 5
HYPERLINK l “_Toc326073187” Access to quality health care PAGEREF _Toc326073187 h 6
HYPERLINK l “_Toc326073188” Summary PAGEREF _Toc326073188 h 7
HYPERLINK l “_Toc326073189” References PAGEREF _Toc326073189 h 8
IntroductionThe present state that health care reform is in has raised a number of ethical concerns regarding the availability of health care to the general public. The United States government, health care professionals, and professional associations have realized the need to address the issue regarding adequate access to health care. Due to the declining reimbursements rates of Medicare as well as the presently low Medicaid’s reimbursements, it is expected that the elderly in the country may experience additional hardships regarding lack of access to health care. There are several factors that strongly influence the ability of the elderly population to access health care such as insurance coverage and socioeconomic status. This paper will look at the health policy issues related to the elderly including end of life care, long term care and other such aspects.
DiscussionEnd of life care
Due to the existing taboo regarding talk about death, elders find it hard to discuss their thoughts as they live their last stages before they die. As a result, the elders may feel isolated and hold back things that they would like to share with their friends and family as they go through their last stages of life. Individuals aged 65 and over have the highest suicide rates and especially when they are not getting the right care (Bodenheimer and Grumbach, 2009). The development of advance care planning gives hope to the elderly regarding their end of life care. Advance care planning is the process undertaken by an elderly individual where he or she consults with health care providers, family members, friends, and other people that they consider important in their lives (Barbara and Hughes, 2011). The consultation is aimed at helping them make decisions that relate to their future health care if they become incapable of taking part in decisions regarding their medical treatment in the future. The American medical association is one among many professional associations that support legislation on advance care planning and improved end of life care.
There are some potential barriers and challenges to advance care planning for instance the availability of trained staff that has the time as well as competence and confidence to discuss this matter with patients (Barbara and Hughes, 2011). Effective advance planning is very challenging especially when the elderly patient is acutely unwell and he or she has a short length of stay in the hospital before being discharged. End of life care is important to the elderly especially in management of symptoms, avoidance of prolongation of death, achievement of a sense of control and also lessening the burden carried by the family. All involved get to be better prepared for future treatment in case the elderly patient becomes incapacitated to have a say in their medical treatment in the future.
Long term care
When preparing to care for ill members, families have to address numerous confusing information, emotional issues, and complex decisions that range from nursing home care to the protection of one’s life assets. In order to avoid all these complexities, it is better for the families to have documents in place that allow for the intervention of the members in case an illness sets in (World Health Organization, 2012). In many cases, when people are on the subject of long-term care they almost always think of nursing homes. This is a wrong assumption and understanding the basic idea of long-term care can help one to protect their family and also their finances (Health Reform Source, 2012). Long-term care is a continuum of services in care as well as housing that one will need when they live a long life. In the past, a stroke, heart attack, cancer and such critical illnesses would lead to death. Today many people with such illnesses continue to live although they get to receive additional care for instance patients of Alzheimer’s. The longer an individual lives the more likely they are to require care. The patient in long-term care will be assisted with their activities of daily living such as bathing, dressing, and locomotion and in case of cognitive impairment that is extremely severe; the person will be supervised constantly. An individual needing custodial care will more likely receive it from the community and not necessarily from a nursing home. A recent report by the New England Journal of Medicine found an estimated 43% of elderly people over 65 to require nursing home care (Health Reform Source, 2012). However, although this number spends their time in a facility, very few will spend an entire day in one.
Medicare covers the cost of only skilled or rehabilitative care and not custodial care in any circumstance. Custodial care costs get to be covered by Medicaid although primarily in nursing homes. The present legislation does not address home care and assisted living much hence funding them is very limited. There is the idea that VA will cover home care costs and also adult care and assisted living but funding is still limited (Elias, 2006). The constant statements by the federal government encouraging veterans to purchase personal long-term care insurance plans is proof that VA cannot be looked up to cover home care and assisted living costs entirely.
Costs of health care insurance
The senior population is the demographic with the fastest growth rate in America with presently more than 40 million Americans above 65 years of age (Elias, 2006b). As a result, for-profits and non-profit organizations find the senior population to be a huge target market that they can provide numerous varieties of care services to. The services, though, do not come cheaply and the senior population gets to carry the immense burden of paying for these costs. Older adults as well as seniors many times worry about the cost of paying for care services in the future for example in-home services and assisted living. Long-term care is the insurance product utilized in helping the elderly to cover costs of long-term care past a particular period. This insurance generally covers care that is not covered by Medicaid, Medicare and also health insurance. Although this insurance helps the elderly a lot, it is sometimes very costly and the premiums paid are determined by how early the patient individual bought the insurance. An individual in their mid-40s, for instance may have to pay between 50$ and 100$ every month for this insurance whereas one in their 70s would pay 500$ and above every month (Wise, 2007).
This insurance does not replace the need for the involvement of the family in providence of care but rather builds on this element. The insurance makes it possible to pay professionals to help the individual with the toughest tasks like feeding and bathing. In turn, the family is able to give home care well enough and longer. On a financial perspective long-term care insurance allows the retirement plan of the individual to remain intact. It also protects income including pension, IRA, and social security.
Access to quality health care
Disparity in access to health care in the non-elderly is an issue that has been researched and debate over time. The disparity exists primarily because of lack of health care insurance be it public insurance or employer-sponsored. In 2006, the number of Americans less than 65 years of age that were uninsured was approximately 16% (Wise, 2007). Many elderly individuals seek medical care at a clinic or physician’s office but there is a small number that often seek care from government-sponsored clinics and the emergency room. Not all patients requiring medical care can make an appointment to see a doctor or even have one that they can reach by telephone for consultation regarding various medical conditions. Although physical barriers like high costs and lack of transportation have a part to play in the inaccessibility of health care for the elderly, lack of responsiveness regarding concerns of the elderly is also a major barrier. Policies in place to avoid discrimination based on race and ethnic origins have greatly reduced it as a barrier to access to medical care. The other elements that are yet to be addressed include gender, age insurance coverage, and income. There is also the issue of poverty as a barrier to quality health care access for the elderly.
SummaryThe issue of health care for the elderly has received considerable attention in recent times and factors such as end of life care and insurance coverage have become major concerns. The society that seniors live in is one that considers talk regarding death to be a negative element and therefore the freedom of the elderly to plan for and address their last day stages is limited. However, programs and practices such as advance care planning have been put in place to avoid the challenges that arise when an individual becomes incapacitated in participating in their medical care. The elderly can hence consult with the health care providers, their families, and friends and express their take on the manner and extent of medical care in the future in case they get too ill to participate. There are also issues of health care insurance costs which mostly burden the elderly and their families. In a nutshell, access to health care for the elderly is limited by many barriers including costs, transportation, insurance, responsiveness, and government support. However, health reform continues to improve on these issues so that the elderly can access quality health care more easily.
ReferencesWorld Health Organization (2012). Aging and life course. Retrieved May 29, 2012 from http://www.who.int/ageing/en/
Barbara I. and Hughes R. (2011). Advance Care Planning. U.S. Department of Health and Human Services. Retrieved May 29, 2012 from http://www.ahrq.gov/research/endliferia/endria.htm
Bodenheimer, T. S., & Grumbach, K. (2009). Understanding health policy: A clinical approach, 5th Ed. New York: McGraw Hill.
Elias, R. (2006). Financing Long Term Care. Kaiser Family Foundation. Retrieved May 29, 2012 from http://www.kaiseredu.org/tutorials/longtermcare/longtermcare.html
Health Reform Source (2012). Long Term Care. Retrieved May 29, 2012 from http://healthreform.kff.org/Tags/Long-Term-Care.aspx
Wise, D. A. (2007). Economics of Aging Program. The National Bureau of Economic research. Retrieved May 29, 2012 from http://www.nber.org/aging.html
