Managed Care of Chronically Ill Older People - Case Study Example

Introduction: In the recent past, the rate at which the proportion of people aged over 60 years is growing is faster than any other age group, and this is being attributed to the fact that longer life expectancy and declining fertility rates are being witnessed in many of the developed countries (Rose, 2005). This however means that we have to review our policies in order to ensure that the aged get the best health management and assistance as possible. We are also entitled to review the public policies that are inline with their medical needs (Mark, 2008). Though the survival of this ageing population can be attributed to good health policies, the society is taking time to adapt and this is a challenge to the old people as there is a need to maximize the health and functional capacity of the of these people as well as their participation in social activities and for their own security. Literature review: The current statistics show that the aging of the U.S population is one of the major public health challenges faced in the 21st century. This is because the basic health issues have been catered for promoting and protecting their health. Conversely, this has brought about a major shift in the leading causes of death some of the new causes being infectious and chronic diseases which are degenerative illnesses. The following two factors, long life span and aging baby boomers, have combined to double the current statistics of people aged 65 and above and it is projected that the statistics will increase by the year 2030 to about 70 million (state of aging and health in America, 2007). Several behaviors that are inherent in old age have been found to be severely affected by these factors and it is of importance that the old people are treated from these factors to increase their life span. It has been found that poor diet, smoking and physical inactivity contribute greatly to poor health among the aged population. These three factors are said to cause chronic diseases which are the leading killing factors among the aged. They are the leading causes of heart diseases, cancer, stroke and diabetes. These chronic diseases make the need for assistance to the old people to be very urgent because there is a need for them to be guaranteed not only long life, but also good and healthy life. This will be done through the encouragement of the people to adopt healthy living standards and also the need for them to obtain regular health screenings that will reduce the risk for many chronic diseases, help decrease health disparities and also help in reducing health care costs. Many of the researches done have proved that most of the people in the old age have relatively little hope of living up to the old age successfully. This has been revealed to be based on the fact that the people in this age bracket did not believe in seeking good health care (Sarkisian, 2002). It was pointed out that the people in these age bracket required continued encouragement from their care givers and also from the health centers to ensure that they give the best manageable health care to offer more assistance to the people that are in this age. The people in the health center ought to provide up to date health care to ensure that the people get improved medical care when they attend the health centers. As Von Maanane and Hanneke (1987) stated, the nursing process was the vehicle for methodological nursing intervention. In their research, Flood and Buckwalter (2009) provided important details on how the nurses needed to handle the patients when they have depression and anxiety issues as these are brought about by their frailty and the continued changes in the economic and natural environments. Social isolation is also a major cause in the rise of depressive state that are experienced by the old people and this implies that the people in the vicinity should be tasked with taking care of them it is evident that the care givers are in this respect are tasked with the need to be close and observant as they take care of these aged people. Methods: The most commonly used methods in the research of old people is survey and interviews. There is also a need to include the art of observation in this area to include the people that are in participation of this research. Looking at the variables that were of major importance in relation to the needs and the problems facing the people in these age bracket, it is also important to have the demographic knowledge of the common statistics that are frequent among these people. Also there is a need to apply questionnaires to the caregivers to get they required response on some of the observations that they made in their day to day attendance to these people. It was fundamental for us to cover all the sectors that affected the people and the need for us to be clear on the way that we can give assistance to the people in terms of a comprehensive and qualitative research that requires the expert to take care of all the problems and provide answers to frequently asked questions and experienced problems (Stevens, Corso, Finkelstein, Miller, 2006). Questionnaires will also be offered to the nurses and the doctors to help us note the different policies that the health department has applied to the sector. Results: It is noted that the aging population is continually causing ripples in the health and social sectors. It was noted that 35% of the participant were found to be infected by a chronic disease and it has been evident that this would rise given the fact that poor health conditions and negligence are the top key obstacles that hinder the provision off good health care and lessen the life of these aged people. It is also established that there is an alarming rate at which the people are increasingly getting depressed due the changing financial fortunes. It was noted that 70% of these old people were depressed due to the fact that they were about to lose their life savings given the current financial recession that is facing America at the present moment. It is also noted tat the global warming and changes in the environment and climate in general means that they will be affected largely given their frail conditions and their low resistance to climate changes (Kane, 2003). Less than 24% of the people were actively involved in some social activities like walking or even home activities like mowing their lawns or even sweeping their drive ways. It was noted that physical activity was the least in achievement and the medical fraternity needed to work on this area to have a close monitoring of the situation in advance. The people that were mostly affected were the females as 60% of the physically inactive elderly people happened to be females (Boult, Kane & Brown, 2000). Of the respondents that were tested on the area of oral care, it was noted that 68% of the aged people were reluctant to seek any medical care just because they did not believe. It was of any importance to them it was noted that the people with the highest prevalence in healthy eating habits was among the old people and there were cases reported of obesity. This was true as 35% of the respondents were obese or had diet related complications as they were eating unhealthy foods in the form of snacks and manufactured foods that were not of assistance to their bodies. It was also noted that the caregivers needed to be given some literacy education as the aged were suffering under their care. It is important to note that the social workers need be taught on how to look after the older people and this implies that the aged face a lot of injustices under the care givers. 60% of the old people also found it a fundamental process to age and that it was an expected part of aging to become depressed, to become more dependent, to have more aches and pains, to have less sexual pleasures, and to experience less energy due to their aging process and the individual’s expectations (Sarkisian, Hays, Mangione, 2002). Research questions directly pointing to the nurses and other caregivers show that 58% of the respondents were well aware of the interventions such as good nutrition, exercise, resting and short term goals that were essential for the old people to handle the on coming problems. They were also accredited for monitoring the patient’s treatment outcomes such as medication and acting accordingly from 78% of the respondents that were attending the health care centers. Discussion: Researchers have found out that the aging process increases the vulnerability of the elderly people to age-related diseases. It is also true that the genetics of a person determine the resistance capability of a person and also the vulnerability of an individual. It is said that the aging process is a complex process that requires the people to be taken care of with utmost care and with the most quality steps to ensure that the person gets to his golden years still healthy and fit (Stevens, Corso, Finkelstein, &Miller, 2006). This implies that the aged persons require very detailed care that will enable them get the best health as they grow old. The caregivers attending these people often than not neglect them and leave them at the risk of acquiring more diseases and also coming to unnecessary injuries that could be prevented outright had they received the necessary attention. It was noted that most of the cases that the doctors handled into the centers were due to negligence and also due to lack of good and proper feeding habits. It is important to note that the old people require proper nutrition as it is the only way that they are going to regain the lost energy. The WHO organization has developed proper feeding policies that need be followed to ensure that the aged received the required nutrition surplus (WHO, 2009). They stipulate that a normal aging person without any complications should be fed using foods that are meant to reduce and prevent the burden of disabilities, chronic diseases and premature mortality. They are also supposed to feed on foods that reduce the risk of diseases that are non-communicable and those that result to functional decline as they age. They are meant to maintain the dignity of the aged and also enable them to contribute on the issues that are surrounding them day to day. This has been seen to reduce the levels of stress and depression maintaining healthy minds and cognitive stability. W.H.O. suggests that the different policies that are meant to provide a continuum providence of quality health care among the aged people should be adopted and used. It is important to note that the doctors should participate fully in the providence of quality health care and this means that they need to be ell trained to offer these services and also to be able to administer them in the most desired and appreciated way as possible (WHO, 2009). They also suggest that there should be defined ways in which the doctors should help address the health disparities among the older adults and also check on the minority issue where the people are supposed to be treated equal irrespective of their race and color or affiliation. It is evident that the people with minority representation in the population get little attention in comparison to those that are of the dominant groups (State of aging in America 2007). The policies in a country should be effective in the improvement of oral care among the older persons to ensure that they end their life in perfect fitness. It is important for people in the social working section to commit themselves in increasing the physical activity among the older people by promoting environmental changes and also introducing environmental friendly conditions that face the older generations. The care givers also have the responsibility of encouraging the older people to attend clinical services and attention to ensure that they continue to age in peace and in health as well. The older people should also be encourage to communicate more frequently to their care givers or to trusted confidants to ensure that they communicate their wishes on the care they would like to receive and how they would wish it be administered to them. The state of Aging and Health in America 2007 give the indication that the society needs to let the aging people do so in peace and with dignity. It is important to note that the society needs to alleviate the end of life suffering and also prevent of cognitive decline to enable the people to come up with better livelihoods in their golden years. The only way to achieve this is through the proper and relevant nutrition that needs be given to the people in this age bracket to give them the strength they need to have a future worth looking forward to. It is important to have proper training given to these caregivers because it is important to offer the best care possible to the aged people. The people that most require the assistance are the people that are disabled or those that are chronically affected tat may inhibit someone from doing any physical exercise or from any free movement. This will be also done through the seminars that will be offered to all the health workers that are mandated to offer this assistance to the people and also to the medical staff to ensure uniformity in dealing with selected cases (Burns & Grove, 2007). It true that the medical people have to be progress in order to increase the efforts of combating health issues and also coming up with key improvement issues and also come up with ways in which they can improve the quality of life fro the older Americans. It is established in a report in The State of Aging and Health and in America 2007, that cognitive health is not static but its occurrence means that there is a need for the medical staff to check on the extent of the diseases. Taking care of them means the caregiver has to be very patient and trustworthy as the aged need to rely on you first before they feel free to express their discontent. Among the many cognitive diseases that are related to the cognitive is dementia that has bee found to be to so rampant among the elderly and this implies that the people in the aging bracket need to be diagnosed early enough and steps towards averting their damage are taken. Conclusion: The research came up with evidence that needed the aged people to be taken care of and given priority in terms of medical and nutrition attendance. The people who are tasked with care of the people are the ones that are supposed to offer this care to the people. It is important to first give them proper training before they are tasked with the care of these people and also the people be accepted by the old people for them to have a good atmosphere where they can share their end-of-life wishes with them. References Boult, C., Kane, R.L., Brown, R. (2000). Managed Care of Chronically Ill Older People. The US experience. BMJ 2000; 321: 1011-1014. PMID: 11039975. Retrieved May 15, 2009, from http://www.Proquest.umi.com Burns, N. & Grove, S. (2007). Building an Evidence-Based Practice. Understanding nursing research. (4th ed.): St. Louis, MO. Saunders Elsevier. Flood, M. & Buckwalter, K.C. (2009). An Overview of Depression and Anxiety. Recommendations for mental health care of older adults. Journal of Gerontological Nursing (J Gerontal Nurs) 35(2); 26-34. Kane, R.L. (2003). The contribution of health services research to active aging. Annals o Internal Medicine, 139 (5 part 2). Retrieved May 15, 2009, from http://www.cinahl.com/cgi-bin/refsvc?jid=686&accno=2004010702 Mark, S. M., Wayne, R. B., Keith, R. R. (2008). Aging and Health. Phytochemicals, CRC Press Rose, D. F. (2005). Promoting a National Falls Prevention Action Plan. In Falls Free: Washington, DC. The National Council on the Aging; Sarkisian, C., Hays, R., Mangione, C. (2002). The Association between Expectations Regarding Aging and Beliefs. Do older adults expect to age successfully? Journal of American Geriatric Society. 50: 1837-1843. Stevens, J. A. Corso, P. S., Finkelstein, E. A., Miller, T. R. (2006). Cost of Fatal and Nonfatal Falls among Older Adults. Injury Prevention; 12(5):290–295. The Center for Disease Prevention and Control (2007). State of Aging and Health in America 2007: Whitehouse Station, N J. The Merck Company Foundation Available at www.cdc.gov/aging Van, M., Hanneke, M.T. (1987). Being Old does not always mean being Sick. Perspectives on conditions of health as perceived by British and American Elderly. Journal of Advanced Nursing. 13. 701-709, and (2006) 53 (1), 54-64. W. H. O. (2009). What is Active Aging? Retrieved 15 may, 2009, from http://www.who.int/ageing/active_ageing/en/index.html Read More