The Welfare State for Older People - Dissertation Example

Chapter One- Introduction I. The objective of the dissertation Older people are known to suffer from illnesses more often than young people, as well as develop diseases or medical conditions that are related to old age, and which require support, medical and otherwise. It has been shown that a global demographic transition is occurring, and the percentage of old people in the world is rapidly growing (Young, Robinson, Chell, Sanderson, Chaplin, Burns et al., 2005). This suggests the need to pay more attention to the subject of treating elderly people, offering them sufficient and proper care for their various special needs and promoting their independence so they could live and function well. This dissertation comes to examine in depth the subject of elderly dependency, including the causes of their dependency, factors affecting it, measures and methods to dealing with it, as well as the welfare state of older people in the past and the present. II. An overview of the welfare state for older people The global demographic transition has caused health and social care services worldwide to address the needs of older people as a priority. Frail older people, who are elderly people with physical or mental impairments, are major users of these services. Attending to their needs in personal, and to those of the entire population of elderly people, is quite a challenge. Proper care is needed in order to make a positive impact on the health and independence of the elderly. However, the situation today is insufficient and does not always comply with the requirements. Home care for older people in England is often "inflexible, misses opportunities to promote independence and suffers chronic staff shortages", shows a report published by the Commission for Social Care Inspection. The commission has found that services are concentrated on older people with severe needs, and this is why many other older people, who would certainly benefit from home care, do not receive it. Also, the commissions report reveals that some employers attempt to save money on selection and recruitment of home care nurses, and 39% of inspected agencies failed to meet the national minimum standards in this area. Be that as it may, home care services have improved since in the past years. For instance, three-quarters of providers were found to comply with the minimum national requirements, and inspectors of the commission praised certain aspects of personal care, which were associated with "respectful, caring and helpful attitudes of staff"(Hocking, 2006). There are different opinions as to the current welfare state of elderly people today and the services provided- some claim it is highly insufficient and others claim it is evolving well, especially after the report of the commission has been released. Either way, the significance of this matter is obvious and tangible. III. Significance of the situation to the community/society Clearly, it is utmost important to take care and support the fragile and vulnerable parts of the society, among which the elderly are included. Seeing as how the percentage of older people in society is increasing, it is even more significant to make sure that elderly people are well taken care of. Taking good care of older people is important to the entire community, since it may improve the living conditions of everyone (if more clinics and care facilities are opened, for example). Also, everyone in the community has a family member, a friend, an acquaintance who is old, and mistreating the old people can indirectly affect them, as well as directly hurting the old people. Chapter Two- Cause and Assessment of Elderly Independency I. The cause of dependency among the elderly Independence of elderly is defined as "being able to live in the community rather than in institutional fair, and functioning regularly without needing assistance in the everyday lives" (Kelshiker & Rehman, 2006). Older people are, by nature, weaker and more prone to diseases and certain difficulties, and are obviously more dependent on other than younger people. There are several reasons for the older peoples dependency and reliance on others. These reasons are routed in the fact that the elderly tend to suffer more of medical problems and diseases, and these decrease their ability to manage by themselves. Medical conditions such as memory problems (forgetfulness, Alzheimer, etc.), other illnesses caused by old age and mobility problems are some of the reasons why the elderly are dependent on others and require assistance. Old people need easy access to healthcare facilities. This could be quite problematic for them, seeing as how their mobility could be limited. Also, if theyre not feeling well, they need someone to accompany them and be with them. Furthermore, the ability to book appointments in advance and use family or friends to get them to the hospital safely and easily are also important things that older people may have troubles with (Kelshiker & Rehman, 2006). II. Assessment of Elderly Independence There are several key determinants of elderly quality of life that may have a positive effect on their independence. These are: living in a safe neighborhood, having good transportation system and being involved in the community. These things ease their lives and by developing relationships with other members of the neighborhood or community, they have people who can help them in times of need. Having good transportation system helps them reach healthcare facilities quickly when it is needed. The most important marker of independence is probably the ability to manage personal and other routines. If this doesnt occur, it means that the old person is not independent, and requires certain assistance in order to manage and maintain his daily routines, and cannot do it on his own. In order to assess the situation of elderly people and the special needs of this part of the population, the NSF conducts surveys and studies. Their aim is to promote older peoples independence and quality of life by knowing more about what causes their dependency on others, what affects it and how it can be improved. One of the ways in which NSF plans to help elderly people is by a single assessment process (SAP) across health and social services. This means that within 48 hours of the first contact of the old person with the system, there will be an assessment of his situation and needs. Also, the information about the patient will be share among the different agencies and services (with the patients consent, of course) to improve the treatment in him. By cooperating as a unified team working together alongside one another instead of apart, the process of treating the patient and tending to his needs will be much better, faster and more organized (Kelshiker & Rehman, 2006). Chapter Three- Review of Related Literature I. History of the Welfare State among Elderly in the United Kingdom The health and wellbeing of elderly people in particular as well as the entire population in general have always been one of the key interests of people, as we constantly try to develop better, more comprehensive ways to treat diseases and other medical situations better and more efficiently. Throughout the years and especially in the past decades, theres been a very rapid increase in the medical knowledge, tools and systems available to treat people. However, there are always new threats to peoples health, independence and quality of living. This is especially dangerous to old people, since their immune system is weak, and more susceptible to viruses and diseases. In order to take care of older people and help maintain and even enhance their state of welfare, new laws are being passes in their favor, new methods are being developed and implemented and new technology emerges specifically for them. This is why the welfare state of older people in the past was much less than what it is today. Only today, when the subject of old peoples condition is more exposed to the public eye in the United Kingdom, and when people are more aware of the special needs older people require, is the subject progressing and advancing forward rapidly. In the past, there was little awareness to this matter, and special technological devices aimed to help older people live more comfortably and easily were scarce or inexistent. An important change occurred when the government took on a policy aimed at helping the elderly. II. Policies and Programs Addressing the Elderly Welfare State in the U.K The United Kingdom adopted several policies concerning the state of older people in the past few years. The needs of older people have been recognized in a government policy with the publication of the NSF for older people, which was published in 2001 by the Department of Health. One component of this policy-anchored program is the introduction of what is known as intermediate care. This is a new tier of health and social care, who intention is to "provide integrated services to promote faster recovery from illness, prevent unnecessary acute hospital admissions, support timely discharges and maximize independent living (Department of Health 2001a, as cited in Young, Robinson, Chell, Sanderson, Chaplin, Burns et al., 2005). This type of care is a needs-based one, so its primary goals are to meet the patients needs and improve their health and bring their lives back no normal. Due to lack of supporting evidence on the effectiveness of this program, this component of the UKs policy has not met universal support. However, there is a study testing the outcomes of administering intermediate care to old people. The study was done on 823 frail older people in a large metropolitan city in northern England, and revealed several things. First, it showed that the mortality rates during the 12 months follow-up, especially in the first 3 months, were high. Second, it showed greater dependency at 3 months compared to the pre-admission state. Also, it revealed that the functional abilities gradually declined for those surviving the 12 months follow-up. This suggests that theres a need in constant and permanent treatment to old people in order to preserve their health, and as a derivative to it, preserve their independence level. Another thing shown by the studys results was evidence of incomplete early recovery. This also hints to the same conclusion- that theres a need in continuous care, or at the very least observation and follow-ups. Another conclusion of the study is that the services will need to expand to encompass the majority of older people needing care and treatment. Moreover, resources will be needed to enable the proper functioning of the program. The current policy in England for this type of home-based rehabilitation is to have it embedded with a multi-agency approach. It supports incorporating with type of help along with rehabilitation at home, prolonging the treatment or observation time for the old people, etc. (Young, Robinson, Chell, Sanderson, Chaplin, Burns et al., 2005) III. Factors Affecting the Dependency and Independency among the Elderly The factors that affect the level of dependency or independency are closely bound to the cause of dependency or independency. As previously stated, various medical conditions or diseases such as memory problems and mobility problems cause limited independency and create a need for help and assistance to the old people by the surrounding environment, whether it is from family, friends, or healthcare and social facilities. This is the main factor relating to the dependency on other people. Other factors include the following: whether the old person lives at home or in a special institution, whether there are family and friends around to assist whenever it is needed, whether the person has easy access to transportation means and so on. IV. Methods and Measures of the Private and Public Sectors in Addressing Elderly Dependency Both the private and public sectors can contribute to helping promote elderly independence. The private sector can arrange via appropriate organizations help for the elderly, for instance bringing meals to their homes, having volunteers come spend time with them, keep them company and make sure they are alright, arrange for a car service for them in cases of emergency and so on. The public sector, on the other hand, can organize support and assistance for the older people better, since it is public and may ask for help from the government or other authorities relating to the matter. The things they can do for the older people are actually quite similar to those the private sector can do. These are the basic and important things older people require. Also, there are other methods and measures to ease older peoples lives. One of them is by using newly developed technological devices; the other is using all sorts of innovation available while driving (Ball, 2006; Matthews, 2006). Given the fact that technology is an integral part of healthcare delivery, there is an increasing number of different machines, tools and devices of all sorts which detect, diagnose, monitor, transmit information and even treat patients, some of which are specifically modified to suit older people, or simply developed just for this part of the population. The growth rate of these devices is growing, and its purpose is to address the everyday health needs of older adults. This has become utmost important since older people represent a growing market segment of the population, which has needs and capabilities which are often different than those of younger consumers. These devices can be modified to do several different things and they are carried, implanted or ingested within an individuals living environment (or inside the person) without disrupting the persons routine and way of life (Matthews, 2006). Chapter Four- Discussion and Analysis Analysis of the Causes and Measures Implemented in order to Promote Elderly Independence The cause of elderly dependency on others is their inability to manage their lives and daily routines by themselves. This is of course not true to all old people, as some are perfectly able to continue leading healthy and productive lives all by themselves. As for those who cant, they are impaired by medical conditions which make it more difficult for them to maintain their daily routine and perform all the regular tasks a person has to. This is why they require assistance from others. Because older people are becoming an increasingly large portion of the population, their state and special needs have recently been brought up and been exposed to the public, and this led to legislation in favor of them. This gives them special rights and assistances, as they need. Many new programs are being hatched, developed and implemented to help older people. These may include the use of new technological devices, which make it much easier to examine and sometimes even treat the old person. Whether they include it or not, their core and important things are to ease or assist the older people in everyday tasks or in times of need. This means helping them with chores around the house, bringing them meals, providing car services for emergencies and much more. This is where the government can step in and pass new laws to promote older peoples independence and quality of life, by passing laws such as one that would allow older people to buy homes in lower rates than others, preferably in areas which have good access to transportation. Undoubtedly, there is much more to do in this matter. But right now, since the matter is on the agenda of the day and in the public eye, it is being taken care of and many efforts are being invested in order to achieve this important goal of promoting older peoples independence. References Ball, K.K (2006). Driving in an Aging Society: Innovations in Technology. Generations, Vol. 30 (Issue 2), p.31-37. Hocking, J (2006). Commissioning Needs to Move with the Times if Home Care is to Meet User Demand. Community Care. Issue 1645, p.5. Kelshiker A & Rehman K (2006). Maintaining Independence in the Over-85s. Medical Updates, Vol. 73 (Issue 1), p. 83-86. Matthews, J.T. (2006). Existing and Emerging Healthcare Devices for Elders to Use at Home. Generation, Vol. 30 (Issue 2), p. 13-19. Young J, Robinson M, Chell S, Sanderson D, Chaplin S, Burns E et al. A Prospective Baseline Study of Frail Older People before the Introduction of an Intermediate Care Service. Health & Social Care in the Communiy, Vol. 13 (Issue 4), p.307- 312. Read More