Provision of Care Services to the Aged - Case Study Example

Factors affecting the provision of care services to the aged Name Institution Factors affecting the provision of care services to the aged The modern society is slowly reconsidering its perception of the aged group to a more positive stance as the group continues to have considerable contribution to communities they live in. It is also becoming clear that if this group is given the necessary attention, they can live a healthier, active and even longer life without placing an extra burden to the people or community they live in. In the meantime, different organizations and movements have risen to challenge the negative stereotypes about the aged (Aged Community Services In Australia, 2005). Such movements include the consumer advocacy movements in Australia. These movements are mostly encouraging the aged and those heading towards the bracket to actively prepare for quality life after their retirement. This shall then challenge the negative stereotypes by projecting the positive impact of the aged on the economy (Dept. of Health and Ageing, 2002). Additionally, the movements encourage all the people to keep physically fit at all stages of their lives to increase the probability of their health life at old age. A considerable proportion of old people in Australia currently live a health and active life. However, there is a portion of the group that need quality residential services due to the complexity of their health and social needs. Apparently, the number is bound to increase due to a number of factors (Aged Community Services In Australia, 2005). The number of Australians with age 70 and above, which is considered a marker of old age, were approximately 9% in 2005. Statistics indicate that the number is expected to increase by approximately 3.3% in the next two decades. Most of the aged in Australia independently live in the community (Aged Community Services In Australia, 2005). It is merely 7% of the entire aged population that receive the services of the government subsidised residential aged care services. Even though the percentage of the aged residing in residential homes is small compared to the total population, the services in these homes improve the living standards for those that receive them (Dept. of Health and Ageing, 2002). As such, the Australian government and non-governmental movements should consider expanding the homes to accommodate even more people. Most of the aged who rely on residential homes are above 80 years. These are mostly single or widowed women. This group is quite vulnerable and often suffer from sensory and cognitive disorders (Ageing and aged care in Australia, 2008). There are a number of factors that have been put in place by the Government to ameliorate the quality of services and thereby life in residential homes. These include the enactment of several policies and rules aimed at increasing the government’s attention towards this group. The residential aged care regulatory system has also incorporated different policies to improve the quality of life and care for residents in these homes (Aged Community Services In Australia, 2005). The policies stipulated in governments acts and the declaration of user right principles allow authority to the resident rights charter and other organization championing the improvement of services in residential homes to operate freely in every territory and state (Aged Community Services In Australia, 2005 ). The Community Visitors’ Scheme acknowledges the eed for community connectedness and maintenance of a good relationship between those in the homes and members of the local community. These details provide a clear outline of the social, structural and organizational context concerning the provision of care to the aged group in Australia (Ageing and aged care in Australia, 2008). Provision of necessary care for the elderly is quite beneficial for both the group and the local community. A considerable percentage of people above the age of 70 continue to live independently in Australia despite having different health problems. The health and physical changes associated with the old age also play a big role in stressing this group (Ageing and aged care in Australia, 2008). Despite several changes in cultural practices particularly with the modern society, aging still receives a negative perception from different groups of people including the aged themselves. Most people lack the knowledge about issues concerning aging, and the realities of aging (Dept. of Health and Ageing, 2002). Such ignorance instils in them fear of getting old which leads to an imbalanced preparation for that time. A growing population of the elderly come with different effects. These include growing health needs, a shift in lifestyles, social policies and family responsibilities. An increase in this population also strains the society with different challenges. According to the National Institute on the Aging (2008), older patients are often less informed about issues concerning health management compared to older patients and have less access to necessary resources. Additionally, the aged often suffer from one or more chronic diseases among other multiple conditions. Among these conditions, mental disorders are often ignored or unnoticed even though they are common to this group and can easily cause physical problems (Aged Community Services In Australia, 2005). Interventions related to chronic disorders are common among the age. Unfortunately, they are expensive in terms of time and money. As indicated by the NAE (2009), approximately 17% of the total hospitalisations of patients with 66 and above years are caused by negative reactions to medications or drugs. The methodologies for testing drugs takes little into account the nature of the elderly. When accessing the response of individuals to medication, it necessary to consider their physical nature rather than their chronological age (NAE, 2009). Considering this, it is important that nurses take great precautions in administering medications to ensure that the entire process is done safely. This is because the safety of the aged is a primary concern and they can be greatly affected by minor errors on the part of medical practitioners (NAE, 2009). To ensure effective care for this group, a thorough assessment of their health status is always necessary at all times. Their health status can be accessed from psychological, physical, social and behavioural factors. Additionally, the functional health status can be accessed from common daily activities such as eating, bathing and moving either inside or outside the house. Cognitive health status can be assessed form the attention span, the ability to learn, intelligence, memory, perception, orientation, judge of things and issues around one, and response to time (Dever, 2006). Doctors and community nurses should understand that care planning for the aged should include both the patients and their families. According to Dever (2006), including the patient in the plans enhances patient participation which is necessary for the interventions to work. Noncompliance should be suspected when the patient does not show any signs of improvement as indicated in the plan, or even gets worse and develops other complications that may not have been envisaged in the intervention plan. For instance, the client can show signs such as fear, reduced self esteem, and cognitive impairment as indicators of noncompliance (Dever, 2006). The service delivery models for the aged care are founded on various principles. The Victorian active service model is an example of a delivery model in Australia which promotes quality aged care and promotes capacity building in implementing restorative care for the aged (Dept. of Health and Ageing, 2002). The aim of this model is to assist those within this bracket to live and independent and quality life. Autonomy or rather independence in this context is the ability of persons to carry out common activities in their daily life including social and community participation. It also involves having the ability to make rightful decisions about one’s life (Aged Community Services In Australia, 2005). The various principles underpinning this model include: the wish to remain autonomous. This refers to the notion that people have to make decisions regarding their life on their own. As such, the elderly should not only be left but also be encouraged and guided to make decisions on their own when it comes to matters to do with their lives (Dept. of Health and Ageing, 2002 ). As they are in a better position to know what they need, this allows them to choose carefully and also request the needed assistance. The next principle is that the elderly should be seen as having the potential to improve their situation. This implies that even though the elderly are viewed as being week and hopeless, they are in a position to play an active role in improving the state of their lives and therefore they should not only be viewed but also be encouraged to vie themselves as such (Dept. of Health and Ageing, 2002). Additionally they should be perceived as still having a chance to contribute positively to the society. This can be enhanced through diffusion of technology, improving Medicare adherence, improving healthcare delivery and employment and work setting (Baggett, 1989). The third principle is that service providers should view the needs of the elderly in a holistic manner. As such, aged care should include relevant education aimed at enabling the individual to live a more responsible and balanced live. This also promotes the person’s ability to be at the centre of the care plan for their lives as it provides them with relevant skills and knowledge (Baggett, 1989). Additionally, the care for the elderly should be prepared around the individual and those providing care for him/her. This implies that the individual should merely be placed in already existing services. The final principle is that a person’s needs can be served best if there exists a goof relationship between him/her and those providing the care. These include care providers in residential homes, family members and other workers proving support (DHHS, 2006). As such, care providers for the aged should always ensure that they establish a good rapport with their clients. Most of the stated entitlements can only be achieved in an aged care system which is reformed. Even with that, the aged care system cannot give everything required to cover the needs of the aged. Majority of the aged to not use residential homes that provide care for the aged, but need to access affordable housing, fair and sustainable income, proper health care, quality food and a range of other services and support (NAE, 2009 ). The Australian government should ensure that a full range of public policies and programs are designed to support people to age well. The diversity of the challenges and issues facing the aged population is projected to increase as the population of this group increases (NAE, 2009). This diversity include: the status. Even though the requirements for medical attention general increase with an increase in age, the health care requirements for old people are unique to each individual. For instance, dementia is rapidly increasing among people particularly the aged (Kongstvedt, 2003). However, this does not imply that all the aged population will have to suffer from this condition. As there needs to be necessary medical advancements to match the adversities and diversities associated with an increase in the number of the aged population. Another dimension is care requirements. It is apparent that the care requirements are likely to diversity with the diversity in their health status. The reliance on residential care is likely to be challenged as the systems designed for long time care may not accommodate the emerging needs (Aged Care in Australia, 2005, March 5). It is clear that not all the needs squarely fall under the deigned long term care and thereby cannot be handled appropriately under these systems. The fact that the needs of the aged are in some cases serviced by hospitals community workers and general practitioners should also be put into considerations. As such, the government and other organizations in this field should establish new models that shall bridge the gap between hospitals and residential homes (Aged Community Services In Australia, 2005). It is thereby clear that aged care stretches beyond the programs funded by commonwealth systems for the aged. The other dimension of the challenges facing this group includes the income, the assets and wealth. Most of the people receiving care under residential homes are pensioners. As such, they tend to have quite a low income (Aged Community Services In Australia, 2005). Most of them had acquired many assets during their active life. These assets have increased in value with time particularly due to property boom. However, the number of aging people extends for those that extremely to those that are extremely poor. This indicates imbalance in wealth distribution in the society. Another element refers to the group that take care of the elderly. Majority of older people are supported by their families at home. About 83% of the aged population get support from their families (Aged Community Services In Australia, 2005). Studies indicate that the rapid increase in the number of the population shall soon outgrow those offering informal and unpaid care. This is also prompted by the fact that the growth in the population also impacts on the resources required to provide necessary care. For instance, it can increase the demand for supported accommodation and residential homes. The issue associated with the increase in the aged population is the people with disabilities under this bracket. Advancement in medical services has seen life expectancy of people with disabilities increase. Consequently, the population of people with disabilities has also risen. Additionally, people with disability tend to get different disorders at an earlier stage compared to those without (Aged Care in Australia, 2005, March 5). This implies that aging people with disabilities pose unique problems to both disability services and aged care system and thereby need to be considered in future. This goes along with this issue people with mental problems who fall in this bracket. For instance, studies indicate that depression often goes undiagnosed and thereby untreated in old people (Aged Care in Australia, 2005, March 5). There is need and a greater demand for appropriate support systems and services for aged people, particularly with community awareness of the mental illness. Another issue dimension that is raising concerns due to the increased number of the aged population is gender and the family structure (Aged Community Services In Australia, 2005). Studies indicate than women survive more than men and thereby the women form a bigger proportion of the aged group. Little has however been done to understand how the needs of the two differ or resemble (DHHS, 2006).the family and its structure is at the centre of the care systems and thereby has great implications on the probability of providing proper care to the aged. There is also a great connection between gender, family and the available wealth or resources to support the aged. As such, these issues should be addressed wholesomely. The highlighted dimensions have various impacts. Increasing in diversity and numbers of the aged population require a more advanced approach if at all the needs of the aged are to be met. There is also need for this to be done in a manner that does not hinder flexibility but rather promote it due to the nature of the arising issues (Aged Care in Australia, 2005, March 5). Admission and accommodation of clients to residential homes and other aged care facilities remain a challenge. Setting up new units will always be limited by the wealth and resources owned by the aged. More so, this could be worsened by the decrease in tax aimed a funding this services (Aged Care in Australia, 2005, March 5). It also remains challenging to meet the needs of those with disabilities and special needs across different categories including those with different cultural backgrounds. There is thereby need for the Australian government to determine the dimensions that shall be dealt with universally and those that shall depend on the ability of people with the aged category to pay (Aged Community Services In Australia, 2005). As such, there shall be need to focus on complex considerations when designing residential homes in future. These considerations include: Address the ever diversifying requirements of the aging. Acknowledging that aged care systems are specific and thereby need to operate within specified contexts. The overall efficiency of care systems should be enhanced. There are various shortcoming s that face the existing current care system in Australia. These include: Underfunding- apparently, the government subsidies have failed to keep with the pace at which the number of aging people is growing. As such, the resources allocated to this sector in terms of finance to do not meet the ever growing needs of this group. The federal budget in 2004 offered relief more funding coming from the Hogan Review on Pricing in Residential Aged Care (Aged Community Services In Australia, 2005). The boosted the residential homes for a short while but failed to find a long term solution over the financial pressure faced by this industry. There was also no budget for the pricing of community services. Another issue is overregulation. This falls under two dimensions. There are many systems of regulation with different requirements and some are over detailing thereby scaring groups with interests to provide services in this sector (Aged Community Services In Australia, 2005). There is also lack of appropriate coordination at different levels the care systems. The allocation of resources is coordinated by the inner circle of care program of commonwealth, however, this circle have very little attachment to the outside (Aged Community Services In Australia, 2005). The criteria for allocating these resources do not include programs that are managed by the state. As well, the criterion used by programs managed by sates to allocate cash is delinked form commonwealth program. Another issue facing the provision of care to the aged is institutionalisation. Residential homes are often perceived to integrate a home environment. As such, many care providers have gone to bigger extends trying to imitate this (Ageing and aged care in Australia, 2008). However, the strenuous economy has encouraged zoning or rather creation of larger facilities which provide a big challenge in integrating the home like environment. Such big institutions are quite economical but less convenient in maximising old people’s autonomy and their social well-being (Aged Community Services In Australia, 2005). There is also the issue of under research. Observers confirm that little is understood about the most appropriate way to provide effective care for the aged population in the society. As such, there is need to substantially invest in research to establish proper mechanism that shall see the needs of the elderly attended to at a very low cost (Aged Community Services In Australia, 2005). There is also the issue of fragmentation. Residential care and other community care providers are characterised by several small units of service providers. This is a great shortcoming in the aged care system. This presents a potential tension is consolidation and maintenance of services available in the community (Aged Community Services In Australia, 2005). Lastly there is also a problem in the availability of skilled work force. The general population of workers in Australia are aging and there is a conspicuous shortage of nurses. The wage schemes and other working conditions in this field have made it hard to attract and maintain staff (Dept. of Health and Ageing, 2002). The general skills and abilities of the current workforce are insufficient and there is likelihood that this increases in future. References Aged and Community Services In Australia. (2005). Retrieved from http://www.agedcare.org.au/who-we-are/about-us/ PDFs/ACSA-Framework.pdf Aged Care in Australia – Setting the Context. (2005, March 5). Retrieved February 6, 2014, from http://www.health.gov.au/internet/publications/publishing.nsf/Content/ageing-iar- final-report.htm~ageing-iar-final-report-3.htm Ageing and aged care in Australia (2008). Canberra: Dept. of Health and Ageing. Baggett, S. (1989). Residential care for the elderly: Critical issues in public policy. New York: Greenwood Press. Blueprint for Aged Care Reform. (2012). Retrieved from http://agewellcampaign.com.au/resources/blueprint.pdf Dever, G. E. A. (2006). Managerial epidemiology: Practice, methods, and concepts. Sudbury, Mass: Jones and Bartlett Publishers. DHHS (U.S. Department of Health and Human Services). 2006. Expanding the Reach and Impact of Consumer E-health Tools. Washington, D.C: DHHS. Dept. of Health and Ageing (2002).Finding solutions: Delivering quality aged care in rural and remote Australia. (2002). Canberra: Dept. of Health and Ageing. Kongstvedt, P. R. (2003). Essentials of managed health care. Sudbury, Mass: Jones and Bartlett Publishers. NAE Website (2009). The Aging of the Population: Opportunities and Challenges for Human Factors Engineering. Retrieved February 6, 2014, from https://www.nae.edu/Publications/Bridge/TechnologiesforanAgingPopulation/The AgingofthePopulation.aspx Read More