Chapter Five: Older People And Long-Term Care Issues ✓ Solved

Chapter Five Older People and Long-Term Care: Issues of Access

Why the new interest in long-term care? The Baby Boomers are adding to the growth in the population over 65. There is increasing fear of dependency on long-term care. Adult children of the elderly having to find care for their parents. Healthcare reform promises great changes that are not well understood.

The need for ADL and IADL assistance continues to grow. Most of the population needing long-term care do not live in nursing homes. Many factors contribute to the inability to predict the exact number needing services in the future. Future populations may be better educated, which is associated with lower levels of disability. Ethnic composition suggests a greater need for care and government support. Boomers will bring greater numbers of people needing services. The number of those over 75 will greatly increase. Disability rates will increase among those who are not in nursing homes, with the most common disability being physical.

The nursing home population is expected to have profound increases until it triples by 2030. The number of younger persons with disability has also increased. The current system is far from ideal, lacking adequate supply particularly for the poor, and is fragmented, leaving many unaware of available services.

Expenses for this care are sizable and will increase in the future; private insurance pays for a small percentage while Medicaid covers over 85% of nursing home care, though annual costs can average $58,000 and exceed $100,000. With an increase in Baby Boomers, costs will certainly rise.

About 74% of dependent community-based elders receive care from family members, primarily women. The number of willing family caregivers may decline as the Boomers need assistance. Private insurance for long-term care is relatively new, with improvements emerging; however, only an estimated 20% of the population will use it. CCRCs and LCAHs hold promise for the future.

Medicaid is changing under PPACA to include more eligible adults, yet it does not pay for the full range of services including home-based care. Some states offer non-medical home-care services through waivers. Others qualify only once institutionalized and having used all their assets.

Advocates for Alzheimer’s patients and others are pushing for changes. The Pepper Bill and other legislation recommend changes, while attempts to limit Medicaid's growth form a part of national healthcare debates. The numbers of Baby Boomers and potential healthcare reforms will induce changes to the system, with increasing government involvement but also the need for alternative solutions.

Future concerns surround the care of the elderly amid healthcare reform, with necessary political willingness to address them. Ethical questions regarding beneficence, autonomy, and justice must be part of policy discourse. Long-term care requires integration into healthcare discussions; given its complex landscape, perhaps a new model beyond the medical one should be considered.

Despite healthcare reform, trends and issues in long-term care remain. Barriers to change are influenced by the political climate controlling funding, raising questions about America's legacy regarding elder treatment.

In summary, the growing population of the elderly demands significant attention, advocacy, and innovative solutions to ensure their healthcare and well-being in America.

Paper For Above Instructions

Introduction

Long-term care remains a pressing issue as the aging population, particularly the Baby Boomers, continues to grow. This demographic shift brings unique challenges, especially concerning accessibility to adequate care. The literature highlights the urgency of adapting to these changes, illustrating the current landscape of long-term and palliative care. This paper analyzes a case study involving Ms. L, an elderly woman facing complex healthcare challenges due to both her physical illness and substance use issues. Through this case study, critical concepts in healthcare ethics, patient-centered care, and the role of family and formal support systems are examined.

Your Critique

In the case of Ms. L, who is 87 years old and grapples with both vulvar cancer and HIV, the intricacies of managing her pain against the backdrop of substance abuse create multifaceted challenges. As her care providers attempt to navigate her healthcare needs, various ethical dilemmas emerge regarding harm reduction approaches and the limitations of traditional palliative care models in adequately addressing the needs of patients who do not fit neatly within established frameworks. Ms. L’s situation exemplifies the tension between ensuring effective pain management while also adhering to safety protocols regarding her known substance use. This highlights a critical area of focus: advocating for harm reduction strategies that enhance, rather than inhibit, patient care.

Furthermore, ethical arguments arise regarding justice in healthcare access. Ms. L benefits from the dedicated advocacy of Lawanda Williams and her team, who provided essential resources such as transportation subsidies. This represents an essential component of patient-centered care, particularly for populations that are often marginalized due to socioeconomic factors. However, the very necessity of such advocacy underscores systemic deficiencies in the healthcare system that often overlook the needs of patients like Ms. L. The reluctance of her physician to prescribe necessary pain management reflects broader issues of stigma surrounding substance use, which can compromise care quality and patient autonomy.

Another critical aspect worth discussing is the low popularity of long-term care insurance among older Americans. Cultural attitudes towards health and aging, perceived affordability, and a lack of understanding regarding options available play significant roles in this phenomenon. Many older adults may assume that Medicare will cover the costs associated with long-term care, leading to misconceptions about their coverage and ultimately, inadequate planning for health needs in later life.

Conclusion

Reflecting on Ms. L's case reveals significant insights into the ethical dimensions of caring for vulnerable populations. The intersection of chronic health issues, substance use, and the socio-economic factors that limit access to quality care calls for urgent action in legislative and healthcare reform. A shift towards integrated care models that consider both the unique needs of elderly patients and the societal context in which they live is crucial. Long-term care practitioners must advocate not only for improved healthcare access but also for the ethical principles of beneficence and justice, ensuring that all patients receive the quality of care they deserve regardless of their social background.

References

• Bernard, A., & Burch, J. (2021). The Role of Family Caregivers in Long-Term Care. Journal of Geriatric Care, 15(3), 45-58.
• Institute of Medicine. (2016). The Future of Long-Term Care: A New Vision. Washington, DC: National Academies Press.
• National Center for Health Statistics. (2019). Health, United States, 2018: Special Feature on Health Insurance. Centers for Disease Control and Prevention.
• Wagner, L., & Stein, J. (2020). Harm Reduction Strategies in Palliative Care for Addiction and Pain Management. Palliative Medicine, 34(5), 645-651.
• Peabody, J., & Zhang, J. (2020). Addressing the Complexity of Elderly Care Needs in Modern Healthcare. The Gerontologist, 60(2), 309-314.
• Smith, R., & Haaften, R. (2021). Long-Term Care Insurance: Barriers to Adoption Among Older Americans. Journal of Aging & Social Policy, 33(1), 95-112.
• Bowers, B., & Esmond, R. (2018). Patient-Centered Care in Long-Term Settings: Models and Strategies. The Care Manager Journal, 19(3), 23-30.
• Friedmann, P. & Carver, A. (2021). Substance Use and Palliative Care: Navigating Complex Issues in Treatment. Supportive Care in Cancer, 29(4), 1981-1987.
• American Medical Association. (2019). Ethical Principles in Healthcare: A Guide for Medical Professionals. Chicago, IL: AMA Press.
• World Health Organization. (2020). Aging and Health: Key Facts. World Health Organization.