Health Economics: Public and Private Goods in Healthcare - Essay Example

Answer End of life or palliative care of elderly people with dementia needs to be addressed within the wider perspective of public good. Dementia refers to damage of brain cells that control memory and memory retention. People with dementia have progressive memory loss and tend to forget people, events, place or even their names and address etc. leading to serious concern for their own safety (Harris, 2006). They require constant help to attend their daily needs including personal hygiene, meeting medical needs etc.

For elderly with dementia, palliative care becomes hugely critical issues because of myriad health associated problems and difficulties especially age related issues like general physical decline, chronic diseases, vision and hearing impairment, joint pains, cardio diseases, diabetes etc. This makes it hugely difficult for families to manage effective palliative care, thus requiring societal inputs government assistance and necessary medical intervention. WHO (2002) defines palliative care as an approach that improves quality of life of patients and family when they are faced with life threatening diseases through interventions that reduce pain and promote physical, psycho-social and spiritual well-being.

Palliative care for dementia patients becomes more complex because patients are not able to inform others about the extent of their pain or problems. Hughes & Robinson (2006) emphasize that external factors hugely influence good palliative care for elderly with advanced dementia. They are effective communication mechanisms, organization and education vis-à-vis awareness regarding diseases and specialist knowledge and skills required for caregiving. Answer 2 The distinction between public versus private good is important as the economic implications of end of life care for elderly with dementia are significantly impacted.

As private good, while the various cost of palliative care could be increased, the overall quality of the same may reduce to increased age related problems. Intervention cost, medicine and constant vigilance of the patients become crucial because of the degenerative symptoms that are compounded by the patients’ inability to communicate the same. Scholars believe that dementia makes it difficult for physicians and clinicians to predict or identify the trajectory of death for elderly with dementia (Robinson et al.

, 2005; Moss et al., 2002). They further assert that short time or long time different care therefore requires systematic planning thereby, significantly increasing the overall cost of palliative care. But as it also enhances the quality of end of life care, the public good factor emerges as key issue to impact effective palliative care.In America, end of life care incorporates the wishes and decisions of the patients which considerably make it easy for the caregivers to deliver medical care.

In the case of patients with dementia, advanced instructions for their end of life care have increasingly become common. The financial implications in developing supportive environment, increasing clinical capacity vis-à-vis training clinicians and caregivers in addressing the unique issues of palliative care for dementia patients are very considerable as they include consumer directed components and public expectations for high quality end of care delivery. Mitchell et al. (2007) reveal that in USA, nursing home residents, especially dementia patients are foregoing hospitalization through advanced instructions or through proxy by relatives who make decisions on their behalf.

This also leads to increased cost due to organizational features like increased funding requirements, staffing and individual specific care. (words: 543)ReferenceHarris D. (2006). Forget me not: Palliative care for people with dementia. PostgraduateMedical Journal, 83, 362-366Hughes J.C., & Robinson L. (2006) General Practice Perspectives: Co-ordinating end-of-life care, In J. C. Hughes (Author), Palliative Care in Severe Dementia. London: Quay Books.Robinson L., Hughes J., Daley S., Keady J.

, Ballard C., Volicer L. (2005) End of Life Care with Dementia. Reviews in Clinical Gerontology, 15, 135-148.Mitchell S.L et al. (2007) Decisions to forgo hospitalisation in advanced dementia: A nationwide study. Journal of the American Geriatric Society, 55( 3), 432-438.Moss M.S., Braunschweig H., Rubinstein R.L. (2002) Terminal Care for Nursing Home Residents with Dementia. Alzheimers Care Quarterly, 3(3), 233-246.World Health Organization. (2002). WHO Definition of Palliative Care. Retrieved from http://www.who.int/cancer/palliative/definition/en/