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Caring for frail adults has been a unique experience for the health care providers. Advancing age is associated with physical and cognitive decline that is related to the increase in co-morbid situations that includes arthritis, pulmonary diseases, heart diseases and some times diabetes. United States of America health providers are faced by several challenges especially for the aged people due to lack of continuity and coordination in provision of health. These has been contributed by; nursing shortages, poly-pharmacy and soaring medication cost, and the transportation and access ton these heath medical care.
There are models that are coming up in to improve care for the frail elderly; on the other hand, there are barriers in implementing these models routinely in the current health care systems. These barriers include; lack of long term and acute care as well as lack of coordination in ambulatory. Financing that depends upon employer, age, and type of service is another barrier. The issue of inconsistence in the results of studies of the alternative models of health care. The last but not least barrier is transportation and the access to appropriate health care services. With the growing population of frail elderly people, the health sector has to take in to considerations of addressing healthcare requirements for the needy groups such as the aged and young children. This paper looks at ways of improving the health of frail older adults while promoting high quality, comprehensive and affordable care.
There exist many themes that have been identified that can be used to deal with health care problems that are associated with the increasing number of the old people in the society. Among them; the promotion of individual responsibility for health, the benefits that can be accrued from primary care, benefits of multidisciplinary teams in the care of frail old adults, the issue of ageism and the transition of frail old adults from home to institutional care environments, (Rochon & Bronskill, 2002).
Shared Responsibility of the Health Care
It should be noted that doctors can only do so much but the patients themselves have to realize that they are responsible for their own health. The addition of life to years should be recommended for the purpose of the promotion of individual responsibility in the health care. By encouraging frail older adults to be both physically and emotional or mentally active and make efforts in the reduction in poor health habits is a significant theme in the reduction of their own health problems (Rochon & Bronskill, 2002).Take it for instance, when a frail old adult presents with pains that are as a result of arthritis, the pill that is for all forms of illness, is the approach that should be avoided and encourage the exploration of options that are not pharmaceutical. The weight loss and physical exercise might have a significant role in the process of minimizing the symptoms without the patient being placed at adverse events that might be risky (Mistiaen et al, 2007).
Exercising process has be documented as being a mean of improving muscle strength, hence reducing frailty, decline in functioning and injuries which further reduces hospitalization, cost of treatment, visiting emergency rooms among others. This should be applied to even frail old adults’ residents in nursing homes. Similarly, frail old adults have to be encouraged to stop smoking habits. The issue of stopping smoking has the effects of reducing the risks of cardiovascular diseases, cancer and complications that may result due to respiratory infections. A quarter of older adults have been reported to be smokers allover the world, though in other countries the problem is less than the average, but smoking has been identified to be a significant public health consideration, (Naylor Et al.1999).
The benefits that frail old adults get from having a primary care providers and team work
Most of old adult people are healthy, other than others, particularly these who happen to be having advanced age that have chronic disease are less fortunate. Take it for instance, older adults with multiple medical problems in most of their time, they do take several drugs to treat their situations, making them more vulnerable a series of adverse events. The inputs from primary care can be of great help in reducing this risk by coordinating and monitoring patterns of treatments that happen to be complex. According to a study that was conducted in Japan, it is reported that old adults who happen to be having physicians whom they can see when they are sick, were less likely to be using large number of drugs, which indicates that there are potential a advantages that can be accrued from primary care. In the United Kingdom and some other countries such as Canada, were the facilities of primary health care are well established, there is the existence of opportunities of expanding the scope of primary health care to include greater inputs that accrued from the nurses, social workers, pharmacists among other professionals in order to respond to the needs of individual parents, (Rochon, 1993).
Team work has been reported to be fundamental to geriatric medicine, as the team work approach to geriatric medicine in most cases has been associated with improved quality of life at no additional expenses. Most of the geriatric programs depend on teams for instance geriatricians, social workers, occupational therapy, nurses, and physical therapist that have to work together not only in assisting the frail old adults cope immediate health problems, but also to optimize their functional status for the improvement of their wellbeing. The rehabilitation that is offered in the setting of acute care, usually help to maximize successful discharges to home. In the geriatric medicine it’s important to extend rehabilitation of framework when ever a patient had hip fractures and provide rehabilitation services when they are suffering from acute illness and surgical procedures (Rochon & Bronskill, 2002).
Ageism Factor to Be Discouraged
In obtaining data on the perception and experience of frail old adults with the health care systems, it has been reported that most frail adults are satisfied with the health care that they are provided with. Others reported that they are receiving health services that are poor as compared to younger patients. The issue of using age as an excuse for providing proper treatment should come to an end. Systematic and negative discrimination that is based on age may result to under treatment, (Rochon, 1993).Take it for instance; hip and knee arthroplasty is increasingly vital in improving the quality of life for the frail old adults having arthritis. The discrepancies have been documented, on the other hand, between individual’s who require knee arthroplasty and the individuals who are undergoing the procedure. This is especially the case for frail older women. It has been reported that among older people in the Scotland, varied depending on the social circumstances. The differential access to the health services might contribute to the health status and the outcomes. For instance the socioeconomic status that has been shown to be lower to old people due to low income has been depicted to be associated with the restricted access to invasive cardiac procedures after the myocardial infarction and the increased mortality, (Cohen Et al, 2000).
Many nations worldwide are struggling with the challenges of the population that is aging. There exist a mismatch between what is happening in the clinics and what is being studied in much research. For instance, drugs that are commonly used by frail old adult people have often not been researched upon in similar older population. People happen to know little about what seem to be simple issues like the optimal dose to be used when starting a drug in a frail older people, this shows that, though much medical care has been directed to older individuals, medical research does not sufficiently show this, (Mistiaen Et al, 2007).
Transitions of Care for Frail Old Adults
The transitions of frail old adults to and from home to institutional care environments like hospitals and the long term care facilities has a reasonable impact on their emotional and physical well-being. The transitional care has been defined as a set of activities that are undertaken to ensure coordination and continuity of health care as the patients are transferred between different degrees of care within the same location. In most cases, these transitions magnify the impacts that are associated with inadequacies in the health care systems, (Tempkin Et al. 2004). Many old individuals experience transitions each year from rehabilitation facilities to home. The care that is being provided in the settings of hospitals should be provided in patients’ homes, physician offices, nursing homes among other community settings. The discharge planning requirements of frail old adults should not be influenced by race, language, culture, and urban or rural locations that should be simple and involve simple and less different systems. (Naylor Et al, 1999).
However planning process of discharge to take care of acute care mainly differ from one health institution to another, but they but there should be the development of a comprehensive plan for moving the patient to the next degree of care. The goal is to hurriedly move the patient out of acute care setting and destination determined as much as per the available funding. The family care givers should often be included in the process of decision making as they can be motivated with their inclusion process and make and their proper preparation for meeting the needs of the frail old adults once they are at home. The frail old people having chronic conditions and high risk factors for poor out comes should be discharged to their home when well prepared to manage their needs of care, (Cohen Et al, 2000). Sometimes these individuals, who are prepared well, find themselves not returning to hospital emergency department due to medication management and understanding their treatment regimens and their follow-up care. The comprehensive information management infrastructure which seemingly could transfer information between providers should be placed in the health care delivery systems. This information is required by follow-up providers, patients, caregivers and every one might need it in a slightly different format and at different reading degree. Neylor Et at(2006) states that , there are no recognized point persons in the present health care system care a cross time, profession and place, and little acknowledgement that people with chronic disabilities shift among hospitals, physicians, nursing homes and their own home.
All major health-related accrediting agencies and regulatory agencies require facilities to plan for discharge includes Centre for Medicaid and Medicare among others each having facilities standards by which the facilities are to be judged. Another issue deals with payment. The discharge opportunities for frail old adults should not be vastly limited by available options of payment. Generally, the Medicare and private insurance should not only cover home care if it needs skilled providers and not be limited to illness. They should not piece with multiple payment sources and multiple home care providers resulting to fragmented plan of care. The Medicare and Medicaid, who are the main funders of long term care, should provide wide range of incentives for providing coordinated care transitions (Liang & Fortin, 1991).
In conclusion, there has been genuine understanding of the issues that can be termed as complicated that surrounds the provision of care to frail old adults. This professional report not only describes the challenges but also has gone a step a head in proposing solutions. These solutions when followed the expectations that admission of baby boomers will increase more than 100% will not be realized. This is because the solution improves the quality of the health care delivery in the current health care environment. The quality of the health of frail older adults will be improved while promoting high quality, comprehensive and affordable care.