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Caring for the Old
The End of Life Care
End of life care refers to the total care of a person that has an advanced illness that is incurable and does not equate with death. This end of life care can last for a number of weeks, months or even years depending on the state an individual is.it is usually the care which helps those that have advanced, progressive and illnesses that can not be cured to live life as well as possible until they meet their death. End of life care makes it possible for the patient and their family to get supportive and palliative care needs identified and met throughout the last phase when they are living and into the bereavement period. Supportive care is care which helps a patient and the family to cope with the condition and the treatment of that condition right from the pre-diagnosis…
Boswell, Kahana & Worth-anderson, 2006). Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults. Retrieved April 30, 2014 from http://www.case.edu/artsci/soci/documents/Spiritualityandhealthylifestylebehaviors.pdf
U.S. Department of State, (2012).Legal & Financial Issues In Caregiving for Older Adults. Retrieved April 30, 2014 from http://www.state.gov/m/dghr/flo/142266.htm
American Society of Clinical Oncology (ASCO), (2014). Caregiving Considerations. Retrieved April 30, 2014 from http://www.cancer.net/navigating-cancer-care/older-adults/caregiving-considerations
The Joanna Briggs Institute, (2011). Age-friendly nursing interventions in the management of older people in emergency departments. Retrieved April 30, 2014 from http://connect.jbiconnectplus.org/ViewSourceFile.aspx?0=7127
Management Performance Within Elderly Care Homes in Gibraltar
The elderly nursing community in Gibraltar is dispersed and characterized by different institution specific challenges and particularities. The current project assesses the general level of leadership competencies within three pre-selected institutions, the management performance assessments of employees, the basic leadership skills required and formulates a series of recommendations as to how these competencies could be obtained. The approach is predominantly a quantitative one, combining various research methods, such as the questionnaire, the case study and structured interviews.
With the aging of the population, more pressure is placed on the health care system throughout the world, and Gibraltar is no exception. As 15.41 per cent of its population is aged over 65 years (Website of the Central Intelligence Agency, 2015), a question arises regarding the country's ability to provide adequate care for its aging population. In this sense then, the current project sets…
Arras, John, D. (1995). Bringing the Hospital Home. Baltimore: Johns Hopkins University.
Barker, A.M., Sullivan, D.T., Emery, M.J., (2006) Leadership competencies for clinical managers: the Renaissance of transformational leadership, Jones & Bartlett Learning
Benner, P. (1982). Novice to Expert. Am J Nurs, 82(3):402-7
Booyens, S.W., (1998) Dimensions of nursing management, Juta and Company Ltd.
ELDER CARE Psychological and Emotional Issues Related to ElderCarePost-traumatic stress disorder (PTSD) is the one in which a child or adult who has experienced trauma keeps recalling the memory of that mental or physical distressing situation (Osmosis, 2016). Extreme stress of this kind is risky since it can pose serious health issues for adults. This paper aims at elaborating on the effects of stress and its effective coping skills for the health of older adults.The removal of psychological stressors, including traumatic events, chronic or daily stressors, is mandatory for better middle age and adult health to improve quality of life in their later years (Frias & Whyne, 2015). The troubles are more visible in adults in the form of outbursts, stomach problems, high blood pressure or hypertension, memory issues or dementia, obesity, diabetes, depression, irregular sleep patterns, and angry moods (Yaribeygi et al., 2017). Stress can affect individuals differently as…
McGuire, J.F., Lewin, A.B. & Storch, E.A. (2014). Enhancing exposure therapy for anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder. Expert Review of Neurotherapeutics, 14(8), 893-910. https://doi.org/10.1586/14737175.2014.934677
Osmosis. (2016, September 5). Post-traumatic stress disorder (PTSD) - causes, symptoms, treatments and pathology [Video]. YouTube. https://www.youtube.com/watch?v=hzSx4rMyVjI
Solati, K., Ja’Farzadeh, L. & Hasanpour-Dehkordi, A. (2016). The effect of stress management based on group cognitive-behavioral on marital satisfaction in infertile women. Journal of Clinical and Diagnostic Research, 10(7), VC01-VC03. https://doi.org/10.7860/JCDR/2016/17836.8077
Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T.P. & Sahebkar, A. (2017). The impact of stress on body functions: A review. EXCLI Journal, 16, 1057-1072. https://doi.org/10.17179/excli2017-480
Continuum of Elder Care 2Frequently Asked Questions on The Continuum of Elder Care Services AvailableWhat is elderly continuum care?The elderly continuum care refers to the daily care and healthcare that is given to the elderly. Its primary purpose is to enhance advanced medical treatments, recently availed medical technology, and medical procedures to enable people to live their old age well (Hasson et al., 2012).How are the accommodations like?This is usually about the residential quarters, the privacy level one can have, personal effects one has to come with, what inhibited items are, whether or not visitation is allowed. When you need medical assistance, make sure you inquire about the available assistance level and the frequency one would expect to be checked upon. In the majority of communities, living arrangements are provided in varying layouts, locations, and sizes. One, therefore, should consider where they will be most comfortable and the kind of…
Cameron, J. I., Naglie, G., Silver, F. L., & Gignac, M. A. (2013). Stroke family caregivers’ support needs change across the care continuum: a qualitative study using the timing it right framework. Disability and Rehabilitation, 35(4), 315-324.
De Blok, C., Luijkx, K., Meijboom, B., & Schols, J. (2010). Modular care and service packages for independently living elderly. International Journal of Operations & Production Management.
Hasson, H., Blomberg, S., & Dunér, A. (2012). Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care. Implementation Science, 7(1), 1-11.
Meinow, B., Parker, M. G., & Thorslund, M. (2011). Consumers of eldercare in Sweden: The semblance of choice. Social science & medicine, 73(9), 1285-1289.
The emphasis is on normal, everyday activities provided for residents. According to the authors, however, little research has been conducted to investigate the actual effect of such activities and settings upon residents. The assumption is that such settings have a better effect that traditional institutions, but there is little empirical research to support this.
Hence, Verbeek et al. (2010) conducted a study to compare small-scale living with regular care in nursing homes in the Netherlands. Interestingly, they found no significant difference between the quality of life experienced by residents in traditional institutional settings and those in small-scale living facilities. Furthermore, there was also no significant difference in the job satisfaction levels of nursing staff between both types of institution was found. Another important aspect, namely neuropsychiatric symptoms and agitation were also significantly similar for both institution types. According to the authors, a difference was found in the satisfaction level of…
Gaugler, J.E. (2005, Mar.). Family Involvement in Residential Long-Term Care: A Synthesis and Critical Review. Aging and Mental health, Iss. 9, vol. 2. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2247412/
Lyness, J.M., Yu, Q., Tang, W., Tu, X., and Conwell, Y. (2009, Dec.). Risks for Depression Onset in Primary Care Elderly Patients: Potential Targets for Preventive Interventions. American Journal of Psychiatry. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982671/
Simonazzi, a. (2009, Jun). Home care and cash transfers. Effects on the elderly care-female employment trade-off. Retrieved from: http://www.aiel.it/bacheca/SASSARI/papers/simonazzi.pdf
Verbeek, H., Zwakhalen, S.M.G., Van Rossum, E., Ambergen, T, Kempen, G.I.J.M., and Hamers, J.P.H. (2010, Nov.). Dementia Care Redesigned: Effects of Small-Scale Living Facilities on Residents, their Family Caregivers, and Staff. American Medical directors Association. Retrieved from: http://www.unimaas.nl/hcns/websiteVW/publications/Publication%20scans/Verbeek.%20Dementia%20care%20redesigned.pdf
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge…
It is also wise to have it reviewed by a doctor or attorney, the Family Doctor eb site suggests; that way you can be assured that what you wish to have done with you and to you if you become incapacitated is "understood exactly as you intended" (Family Doctor).
The advance directives are sensitive and private, and they are very important for seniors. But the advance directives can be controversial, so it is wise for older people to know the law and understand the facts. To wit, there have been rumors and falsehoods spread on the orld ide eb and elsewhere about the advance directives that are spelled out in the recent overhaul of the healthcare system. Former governor of Alaska Sarah Palin made news in the summer of 2009 by asserting that the advance directives in the healthcare overhaul created a "death panel" of bureaucrats who will "decide, based…
Binstock, Robert H., and George, Linda K. (2010). Handbook of Aging and the Social
Sciences. Maryland Heights, MO: Academic Press.
Black, Jane A. (2008). Notes: The Not-So-Golden Years: Power of Attorney, Elder Abuse, and Why Our Laws are Failing a Vulnerable Population. St. John's Law Review, 82(1), 289-314
Collier, Elizabeth. (2005). Latent age discrimination in mental health care. Mental Health
foundational issues at hand for our culture is the provision of health care for all. Challenging the standard by limiting health care for the elderly is a substantial ethical question. (Etzioni, 1988, pgs. 168-174) Yet, regardless of the bargaining power of organizations who advocate for the elderly the limitations are being made, in more covert and less effective ways. Regardless of public opinion the system we have now adopted is inefficient and not only do the elderly suffer, but all others who are not offered services in economically feasible ways suffer.
The system will continue to be based upon capitalistic standards as long as benefits exist in a manner that provides profits for cutting corners on standard preventative care and offering substantially overblown services to those who can afford to pay for it or who have no voice to say no. (Lamm, 1989, pgs. 158-162) Providing care in such a…
Kutter, Robert. (1988), 'National Insurance Should Fund Long-Term Care."
Lamm, Richard. (1989) "The Elderly Cannot Be Guaranteed Full Access to Health Care."
Sager, Alan. (1988) "The Elderly Should Be Guaranteed Full Access to Health Care."
Difficulties that Elderly People Encounter and Their Life Satisfaction," which was published within the scholarly journal Social Behavior and Personality in 2008, social scientists Kasim Karatas and Veli Duyan analyze the level of life satisfaction experienced by elderly residents of the Ankara region of Turkey, while also exploring the various factors which may negatively influence one's life satisfaction. According to the authors, "the purpose of this study was to examine the sociodemographic characteristics of elderly people and the effects that difficulties they encounter in daily life have on their life satisfaction" (2008), with the dually overriding objectives of determining a causal relationship between life satisfaction and either sociodemographic characteristics or hardships experienced. Relying on the tried and true methodology of administering a detailed survey and questionnaire combination, in this case to a sample of 109 females and 76 males between the ages of 60 and 98 living in the Kocatepe…
Cognitive Disorder in Elderly
Cognitive Disorders in Elderly
Cognitive Assessment & Lab
Kris Thomas, PhD
The research of this study is related to cognitive, dementia, Alzheimer disease, and depression issues with the elderly populations of the United States and in the world in general. Societies with a large number of elderly people such as the U.S.A. are increasingly focusing their efforts on improving the life standards of these people based on the types of services given to them. The well-being of those on palliative and hospice care is as important as the well-being of the family members of these patients. Although many health issues present themselves during the elder years of any patient, there is a lot of attention paid to cognitive and mood issues in this age group. The disorders and maladies that are relevant to this population include, among others, depression, dementia, mild cognitive impairment (MCI)…
American Psycholgical Association (APA) (2010). Ethical Principles of Psychologists and Code of Conduct. American Psychologists Association.
Abby C. (2010). Physical Activity for an Aging Population. Public Health Reviews, Vol. 32. Retrieved from: http://www.publichealthreviews.eu/upload/pdf_files/8/PHR_32_2_King.pdf
Aklin, W. M., & Turner, S. M. (2006). Toward understanding ethnic and cultural factors in the interviewing process. Psychotherapy: Theory, Research, Practice, Training, 43(1), 50-64.
Hawaiian elde cae pofessionals impove patient eldecae sevices to Japanese nationals, taking into consideation Japanese cultual noms and expectations
Caegiving fo eldely paents in Japan
Japan has witnessed a significant gowth in its elde population. In the yea 1950, 4.9% of the Japanese population was aged 65 yeas and above. This figue inceased to 14.8% (1995). By 2025, it is estimated to gow to 25.8% (Yamamoto & Wallhagen, 1997). Japan's 'vey old' population goup (aged 85 and above) is swiftly inceasing in numbe. It has been pojected that by 2025, the nation's 'vey old' population will account fo 4.3% of its total population -- a five-fold ise in thee decades. Futhemoe, it was pojected that as many as 2.62 million Japanese would be suffeing fom senile dementia by the yea 2015; the 1990 estimate fo senile dementia was about one million individuals (11WSA 1996).
Change in the pecentage of Japan's…
references, and Arrangement of End-of-life Care and Decision-Making among Japanese-American Older Adults, ProQuest LLC.
National Asian Pacific Center on Aging. (1998). Growing APA elderly population adds urgency to improving health services. Asian Pacific Affairs, 6 (Dr. 2-3.
SALDOV, M., KAKAI, H., McLAUGHLIN, L. & THOMAS, A. (1998). Cultural barriers in oncology: Issues in obtaining medical informed consent from Japanese-American elders in Hawaii, Journal of Cross-Cultural Gerontology 13: 265-279.
Sato, S. (2015). THE IMPACT OF GENDER AND CULTURAL FACTORS ON THE PATTERNS OF ELDER CARE SERVICE UTILIZATION AMONG FAMILY CAREGIVERS OF JAPANESE ANCESTRY IN THE STATE OF HAWAII, ProQuest LLC
SOROCCO, K.H. (1998). BECOMING A HEALTH ACTIVE OLDER ADULT: THE EFFECTS OF A WORKSHOP FOR JAPANESE-American OLDER ADULTS. ProQuest Information and Learning
Nursing Theorist Grid Dorothea Oren Theory
Over the years, nursing theories have been used in defining the ways healthcare is delivered through the interaction of patients and nurses. This study presents a theoretical discussion of the self-care concept in relation to health care delivery among elderly patients. The self-care concept is popular as Self-Care Deficit Theory of Nursing by Orem. Orem's theory perceives individuals as self-care agents equipped with unique needs. The theory focuses on transactional analysis in enhancing rehabilitative roles of nursing and positively influencing self-care agency among individuals. This creates power component based on self-care behaviors. The theory was initially defined as the analysis of exchanges between people in their interactions and communications with one another. The focus also classifies, understands, predicts and alters human behavior among the well and sick individuals. The theory supports individuals treated as adults and has a higher likelihood of using Adult ego…
Butts, J.B., Rich, K. (2012). Nursing Ethics: Across the Curriculum and Into Practice. New York: Jones & Bartlett Publishers.
Finfgeld- Connet, D (2008). Qualitative Convergence Of Three Nursing Concepts: Art Of Nursing, Presence And Caring. Journal of Advanced Nursing 63(5): 527-534.
Ranheim, A., (2010). Caring And Its Ethical Aspects -- An Empirical, Philosophical Dialog On Caring. International Journal of Qualitative Studies on Health and Well- being. 4(2) p 78-85.
Ranheim. A., Karner, A., Arman, M., Rehnsfeldt, A & Bertero, C. (2010). Embodied reflection in practice- 'Touching the core of Caring'. International Journal of Nursing Practice. 16. p 241-247.
Care Case Study
Slide 1 Footnotes
There have been enormous changes due to introduction of various cultural elements in the continuum of care. Before, when people were admitted to assisted living facilities or hospital settings, there were very little cultural elements outside of the majority culture which had sponsored the facility. For example, if a facility was associated with some sort of church or temple, there were elements of that religion present, but there was little alternatives for members of other cultures or religions.
Yet, today, there are now a much wider array of cultural elements available in assisted living homes and hospital facilities. Assisted living programs are regulated on the level of the state.
As such, different states have different types of programs and policies that impact the degree to which cultural characteristics are included or excluded within various assisted living facilities. Some programs encourage cultural elements of patients…
ALFA - Assisted Living Federation of America. (2009). Assisted Living Regulations and Licensing. Retrieved from http://www.alfa.org/State_Regulations_and_Licensing_Informat.asp
Medicare Payment Advisory Commission. (2011). Report to the Congress: Medicare Payment Policy. Retrieved from http://www.medpac.gov/documents/Mar11_EntireReport.pdf
National Caregivers Library. (2012). Independent Living Facilities. Retrieved from http://www.caregiverslibrary.org
Next Step in Care. (2012). Reducing the Stress of Hospitalization for Patients with Dementia and their Family Caregivers: A Guide. Family Caregiver Alliance. Retrieved from http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2449#researchpractice
Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).
Prioritize the Nursing Care Needs of Margaret
The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…
Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.
Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.
Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.
Journal of Cardiovascular Nursing,25(3), 207-220.
Most of the drug commercials also show the elderly with health concerns and needing help from others. In addition, it is rare to see an elderly contestant on a game show or interviewed on the nightly news, and most commercials star young, healthy, and very vital and attractive young people. When the elderly are featured, it is mostly with health concerns and problems.
Some situation comedies depict the elderly in a better light. For example, in "Everybody Loves Raymond," the two elderly cast members, Peter Boyle and Doris Roberts, are depicted as cranky and eccentric, like many elderly are depicted on TV, but they are also loving, if annoying, parents. They are also funny and warm, and have a mature relationship on the screen. They are funny, but they also add warmth to the show, and great character. It would not seem they were entirely positive, but they certainly are…
Preventing Falls: A Program to Address Elderly Falls Using the Strategy of Education
The goal of this program is to prevent elderly persons from experiencing falls, which can have severe impacts on their health. Falls are one of the most dangerous experiences an elderly person can suffer (Owen, 1985) and so it is important not only for them to be aware of the dangers around them but also for others who care for them or who know them to be aware of how we could help to prevent falls (American Institute of Architects Foundation, 1986). The main goal of this program, therefore, is to spread knowledge and education about elderly fall risks and to adopt preventative measures that can be adopted both by the elderly and by their caretakers, children, neighbors, friends, loved ones -- in short, anyone who comes into contact with them and cares to help them avoid…
Al-Faisal, W. (2006). Falls Prevention for Older Persons. Eastern Mediterranean
Regional Review. Retrieved from http://www.who.int/ageing/projects/EMRO.pdf
American Institute of Architects Foundation. (1986). Design for Aging: An Architect's
Guide. Washington, D.C.: American Institute of Architects Press.
With the help of a thorough clinical evaluation, the risk factors, risks associated with falling and working out adequate intervention methods to curb the rate of elderly falls can be achieved. As per the 2011 AGS / BGS guidelines, (Panel on Fall, 2011) certain particulars need to be incorporated in a particular clinical evaluation: 1: Patient history, physical examination, mental and physical functionality; 2: Number of falls occurring, number of medications taken; issues regarding mobility, balance and gait; blurred eyesight; various mental disabilities; weak muscular strength; uneven heartbeat and rhythm; postural hypotension; problems in feet and risks related to environment (Shubert, 2014).
Strategies to Prevent Elderly Falls and Health elated Consequences
Assistive Devices and Other Protective Equipment: Appropriate footwear is required for particular conditions, for instance, wintery weather necessitates anti-slip shoes whilst warmer weather requires cleated footwear, facilitating decreased falls (Panel on Fall, 2011).
Clinical Disease Management (Acute…
Clemson, L., Mackenzie, L., Ballinger, C. & Close, J.C.T. (2008). Cumming RG. Environmental interventions to prevent falls in community-dwelling older people: A meta-analysis of randomized trials. J Aging Health. 20(8):954-971.
Gillespie, L.D., Robertson, M.C., Gillespie, W.J., Lamb, S.E., Gates, S., and Cumming, R.G. (2009). Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. (2), Art.No.: CD007146
Panel on Fall prevention in Older Persons, American Geriatrics Society and British Geriatrics Society, (2011). Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. J Am Geriatr Soc.;59(1):148-157.
Scott V, Gallagher E, Higginson A, Metcalfe S, & Rajabali F. (2011). Evaluation of an evidence-based education program for health professionals: The Canadian Falls Prevention Curriculum (CFPC). Journal of Safety Research. 42(6):501-507.
Future of Healthcare as it Relates to the Geriatric Population
Description and Problem Statement
The geriatric population in the United States is growing and compared to the population of health care providers the geriatric population growth is advancing much more rapidly. This presents a problem in making provision of health care to the future geriatric population. While there is a growth in the demand for geriatric health care services, there is not a matching growth in the population of health care providers and in fact, a shortage presently exists.
The population of geriatric patients is experiencing rapid growth while the population of health care providers specifically trained in geriatric medicine is seriously lagging behind. In fact, of the approximately 650,000 medical doctors who are practicing, only a small percentage receives the training and education required to provide geriatric care. Exacerbating the problem is the fact that only three medical schools…
Bagel, LM (2011) Designs to Support Aging Acute Care Patients. Elder Care. Health Facilities Management. Retrieved from: http://www.hfmmagazine.com/hfmmagazine/jsp/articledisplay.jsp?dcrpath=HFMMAGAZINE/Article/data/04APR2012/0412HFM_FEA_interiors&domain=HFMMAGAZINE
Gottlieb, S. (2013) Medicare Has Stopped Paying Bills For Medical Diagnostic Tests. Patients Will Feel The Effects. Forbes 27 Mar 2013. Retrieved from: http://www.forbes.com/sites/scottgottlieb/2013/03/27/medicare-has-stopped-paying-bills-for-medical-diagnostic-tests-patients-will-feel-the-effects/2/
Graverholt, B., et al. (2011) Acute hospital admissions among nursing home residents: a population-based observational study. BMC Health Services Research 2011. Retrieved from: http://www.biomedcentral.com/1472-6963/11/126
Healthcare in America: Trends in Utilization (2004) U.S. Department of Health and Human Services. Retrieved from: http://www.cdc.gov /nchs/data/misc/healthcare.pdf
Diversity of Aging Population -- Innovative Healthcare
Over the past several decades there has been an avalanche of research and scholarly narratives focusing on the aging of millions of Americans -- among them the "baby boomers" that were born between 1946 and 1964 -- including their numbers and their health vis-a-vis the impact on the sometimes struggling healthcare system. But there has been a dearth of research on how American healthcare services will respond -- and is currently responding -- to an increasingly diverse older population when it comes to racial, cultural and ethnic identities. This paper points to the numerous issues and challenges that not only face an increasingly diverse older American population when it comes to healthcare, but also the challenges that the healthcare system itself faces as these Americans move into the twilight of their lives.
hat should be the Vision and Mission of Healthcare Professionals in…
Administration on Aging. (2010). A Statistical Profile of Black Older Americans Aged 65+.
Retrieved April 2, 2014, from http://www.aoa.gov .
Bookman, A. (2008). Innovative models of aging in place: Transforming our communities for an aging population. Community, Work & Family, 11(4), 419-438.
Centers for Disease Control and Prevention. (2007). The State of Aging and Health in America
All spending includes state and federal expenditures. Growth figures reflect increases in benefit payments and disproportionate share hospital payments; growth figures do not include administrative costs, accounting adjustments, or costs for the U.S. Territories.
Federal Fiscal Year: Unless otherwise noted, years preceded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. for example, FY 2009 refers to the period from October 1, 2008 through September 30, 2009.
Urban Institute estimates based on data from CMS (Form 64) (as of 12/21/11).
From this entire chart, the entire increase in expenditure of…
Clark, Cheryl et al. "State Medicaid Eligibility and Care Delayed Because of Cost." New England Journal of Medicine, 368 (2013): 1263-1265. Print.
Ellwood, Marilyn Rymer et al. An Exploratory Analysis of the Medicaid Expenditures of Substance Exposed Children Under 2 Years of Age in California. U.S. Department of Health and Human Services, 1993. Print.
Goodnough, Abby. "October 25th." The New York Times. 25th October. 2012. Web. 29th March 2013. [ http://www.nytimes.com/2012/10/26/us/spending-on-medicaid-has-slowed-survey-finds.html?_r=0 ].
Grannemann, Thomas W. And Mark V Pauly. Controlling Medicaid Costs: Federalism, Competition, and Choice. Washington DC: American Enterprise Institute, 1983. Print.
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
Standards of Care/Mental Health/Cultural Competence
EMEGING STANDADS OF CAE/MENTAL HEALTH/CULTUAL
Sometime in 1999, the Surgeon General released Mental Health: A eport of the Surgeon General. Inside this report, it acknowledged that not every Americans, particularly minorities, are getting the equal mental health treatment, a discovery that provoked the Surgeon General to give out a supplemental report on differences in mental health care for individuals of color (Donini-Lenhoff, 2006). The addition, which was available in 2001, sends out one obvious message: culture does actually count. Cultural competency is considered to be one the vital ingredients in closing the differences hole in health care. It is looked as the way patients and doctors are able to come together and then talk about health issues without cultural differences stopping the conversation, nonetheless improving it. Fairly simply, health care services that are deferential of and receptive to the health beliefs, practices and cultural and…
Choi, H.M. (2006). ETHNIC DIFFERENCES IN ADOLESCENTS' MENTAL DISTRESS, SOCIAL STRESS, AND RESOURCES. Adolescence, 41(126), 263-83.
Donini-Lenhoff, F. (2006). HEALTH: Cultural competence in the health professions; insuring a juniform standard of care. The Hispanic Outlook in Higher Education, 65(45), 45.
Furler, J. & . (2012). Mental health: Cultural competence. Australian Family Physician, 39(5), 206-8.
Sawrikar, P. & . (2013). The relationship between mental health, cultural identity and cultural values in non-english speaking background (NESB) australian adolescents. Behaviour Change, 21(3), 97-113.
Innovative Nursing Care Delivery Models a.This website detailed profiles 24 successful innovative nursing care delivery models. These profiles developed part a research project conducted Health Workforce Solutions LLC (HWS) funded obert Wood Johnson Foundation (WJF).
Innovative nursing care model: The Care Transitions Intervention
Innovative nursing care model
I chose the Care Transitions Intervention Model on which to focus because of the increasing importance of geriatric care in the field of nursing. Although my organization serves the needs of persons of all ages, elderly patients are an increasingly large proportion of the patient base. The Model stresses the need for the empowerment and self-care even of patients with high-risk conditions. The Care Transitions Intervention Model allows elderly patients the maximum amount of mobility and autonomy possible given the limits of the patient's condition and enables them to stay in a home setting as long as possible. As its name suggests, the…
Care Transitions Intervention. (2013). Innovative Care Models. Retrieved:
Kurt Lewin Change Model. (2013). Change Management Coach. Retrieved:
Economics of Healthcare
The Economics of Health Care
The healthcare in the United States is a system of economics that has been referred to as a Ponzi scheme and most assuredly, the economics of the U.S. healthcare system are unsound at best. The United States is the only industrialized nation in the world that fails to provide universal access to basic health care and according to the work of Kilchevsky (2004), 'the absence of universal health coverage has been called 'one of the great unsolved problems facing the United States at the onset of the 21st century." (p.1) This work intends to examine the economics of health care in the United States.
Department of Health and Human Services (HHS) reports that national health expenditures for 2009 totaled $2.5 trillion, which is stated to be $58,086 per person. (erdine, 2011, p.1) The estimated total for health expenditures in 2008…
Berdine, Gilbert G. (2011) The Economics of U.S. Healthcare. Luwig von Mises Institute. 8 Aug 2011. Retrieved from: http://mises.org/daily/5496/
Boyapeti, Vijay (2010) What's Really Wrong with the Healthcare Industry? Ludwig von Mises Institute. 26 May 2010. Retrieved from: http://mises.org/daily/4434/
Kilchevsky, Amichai D. (2004) Universal Coverage: A Bridge Too Far? Economics. About.com. Retrieved from: http://economics.about.com/cs/moffattentries/a/universal.htm
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
Business of Health Care
This study highlights essential facts about health care and health in the local, national, and international health care delivery. Healthcare in the U.S. stands at crossroads between opportunities and challenges. Both the local, national, and international health systems face common problems in the delivery of efficient, high quality and equal health services. All these are concurrently happening in times when the amount of care delivered exceeds the resource base. In the U.S., the demand for healthcare, just as in any industrialized country, is rising because of rising public expectation and the ageing population. The combination of technological developments and demographic changes increases the provision costs (Garman, oyer & Johnson, 2011).
Consequently, local, national, and international health care delivery systems are facing same issues of service rationing to cut costs due to a decreasing tax base for paying a rising demand and an increasing demand. Similarly, maintaining…
Garman, A.N., Royer, T.C., & Johnson, T.J. (2011). The future of healthcare: Global trends worth watching. Chicago, Ill: Health Administration Press.
Geisler, E., Krabbendam, K., & Schuring, R. (2013). Technology, health care, and management in the hospital of the future. Westport, CT: Praeger.
Gibson, R., & Singh, J.P. (2012). The battle over health care: What Obama's reform means for America's future. Lanham, Md: Rowman & Littlefield Publishers.
Kolker, A. (2011). Management engineering for effective healthcare delivery: Principles and application. Hershey: Medical Information Science Reference.
Healthcare Delivery System Challenges
The American healthcare system has been criticized as favoring the middle and upper classes while ignoring the lower classes. Based on these speculations, the federal government has constantly tried to institute reforms in the healthcare sector though some of the proposals have failed to overhaul the industry. With rising insurance costs, the number of citizens barred from accessing quality healthcare has increased to more than 45 million uninsured Americans. On the same note, it is hypothesized that with time, the problems currently witnessed in the industry are likely to increase and finding solutions to them will be a tall order for the government (Stolberg & Pear, 2010). Despite the advent of new technology in the sector, which is likely to improve service delivery over the years, it is speculated that the cost of new tests and treatments will outweigh the savings. With the better technology, physicians…
Stolberg, S.G. & Pear, R. (March 24, 2010). Obama signs health care overhaul bill, with a flourish. The New York Times: p. A19. Retrieved March 1, 2013.
Woolhandler, S. & Himmelstein, D.U. (1997). Costs of care and administration at for-profit and other hospitals in the United States. The New England Journal of Medicine 336 (11): 769-774.
Swanson, E. (July 30, 2009). Health Care Plan: Favor / Oppose. Huffington Post.
Blumberg, L.J. & Holahan, J. (2009). The Individual Mandate: an Affordable and Fair Approach
Transitional Care of Older Adults Hospitalized with Heart Failure Experiment
Naylor, M.D., Brooten, D., Campbell, R.L., Maislan, G.,, McCauley, K.M. Schuartz, J. Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized Trial.
This article has an interesting approach to summarizing the experiment that was conducted. Instead of a formal abstract, the article instead summarizes the design and outline in several sections. These sections include objectives, design, setting, participants, intervention, measurements, results, and conclusions. The sections that are listed replace the standard format for an abstract that condenses the design and the findings into one formal section. Personally, I prefer the organization of this format better as it more clearly illustrates all of the factors in the research in a clear and easily identifiable format.
Analysis of the Introduction
The authors of this research do state the problem that they are researching in a clear and coherent manner. The…
Technology and Healthcare
Demographics of the global community are rapidly changing so that each year there are more and more seniors within the population base. This has a profound implication on the healthcare system of many regions since a large number of elderly citizens will be spending their lives in the confines of their home, and some may have chronic illness that require continuous monitoring. Clinical telemedicine is one way to offer greater services to rural or homebound populations. Indeed, a variety of technological advances have made it possible to change the paradigm of healthcare. Clinical information systems, for instance, have expanded in scope and depth. Increased processor speeds and data storage devices have made it possible to collect more data than ever on the detailed encounters that make up the provider-patient care delivery process, and present it more effectively to a wider range of users. Healthcare monitoring is part…
Luppicini, R. And R. Adell, eds., (2008). Handbook of Research on Technoethics. New York: Information Science Publishing Company.
Teo, T., et.al. (2008). "Wireless Healthcare Monitoring Systems. World Academy Of Science, Engineering, and Technology. 42 (1: Retrieved from:
INTENET'S IMPACT ON HEALTH CAE INFOMATION
The Internet's Impact on Health Care Information
The Internet's Impact on Health Care Information
This paper explores some of the best and well-known cites and sites around the world for information and health care. Early in the 21st century, the World Health Organization made its first attempt to rank the quality of health care in approximately 200 countries. (NYT, 2007) The WHO ranked the countries' health care based on factors such as fairness, quality, access, insurance coverage, patient satisfaction, and use of information technology among other factors. (NYT, 2007) According to this research, some of countries in the world that provide the best health care overall are France, Italy, Malta, Japan, and Monaco, among others. (NYT, 2007) As much as the United States of America boasts at being the best in the world at nearly everything, United States health care was not in…
Global Health Council. (2012). Health Linkages. Web, Available from: http://www.globalhealth.org/Health_Linkages.html . 2012 August 26.
Mayo Foundation for Medical Research and Education. (2012). Mayo Clinic. Web, Available from: http://www.mayoclinic.com/ . 2012 August 26.
National Institutes of Health. (2012). Health Information. Web, Available from: http://health.nih.gov/ . 2012 August 26.
No listed author. (2007). Editorial -- World's best health care? The New York Times, Web, Available from: http://www.nytimes.com/2007/08/12/opinion/12sun1.html?pagewanted=all . 2012 August 26.
Adult day care industry is well-known for providing social and basic health assistance to the elderly with physical and mental disabilities. The assistance provided in these adult day care centers include meals, hygiene services such as bathing and cleaning up, therapeutic activities and transportation. This industry is differentiated from nursing homes since adult day cares only operate during normal business hours and therefore do not include home or night care ACH National espite esource Center, 2004.
Companies in this industry depend on three major sources of finance which are grants from donor agencies, fees charged to clients or public funding from the government. Public funding represents 55% of product segmentation while client fees represent 26%. In the year 2013, the industry had gross revenue of 6.2 billion dollars representing an annual growth of 2%. 3,700 businesses operating in this industry made total profits of just over 396 million dollars. According…
ARCH National Respite Network & Resource Center. (2012). Building Blocks for Lifespan Respite: Federal Guide to Funding for Adult's and Children's Respite. (Lifespan Respite ed., Vol. 101): Chapel Hill.
ARCH National Respite Resource Center. (2003). Respite for Persons with Alzheimer's Disease or Related Dementia. (ARCH Factsheet ed., Vol. 55): Chapel Hill.
ARCH National Respite Resource Center. (2004). Adult Day Care: One Form of Respite for Older Adults. Chapel Hill: ARCH Factsheet Number, 54(1), 14.
IBIS World. (2013). Adult Day Care in the U.S. Industry Report OD5942. Retrieved November 10th, 2013, from http://www.ibisworld.com/industry/home.aspx
Obamacare, or formally known as the Affordable Care Act, is a recent healthcare law that will reach its implementation stage in 2014. Healthcare is certainly a fundamental necessity and indispensable to a growing human population. he United States is known for its adequate healthcare, servicing low income people through Medicaid, and the elderly through Medicare. However, recent events have led to a shift in what can possibly negatively impact the healthcare system for the United States.
Obamacare has good intentions in having its purpose be to supply affordable healthcare to everyone within the United States, but certain clauses and modifications have turned it into a dicey and uncertain situation. Not only are the costs piling up, and continue to increase, but the distribution of healthcare services is primarily execute through health insurance coverage. his means that there will be a change in how the healthcare system functions at the core…
The way that Affordable Care Act works, however, is that plans that would have failed to meet the standards of Bronze plan can no longer be offered. Such plans were often popular with either poor people who could not afford a better plan, or young people who are unlikely to have to make a claim. For such individuals, the increase in their health premiums might be significant, and political opponents of the Act are making every effort to collect anecdotes from such people to use as scare tactics (Radnofsky, 2013). The reality is that most young people were almost always going to have to pay more, which in part explains why it is older people who have signed up for plans on the exchanges (Mangan, 2013).
Are there Risks to the ACA?
There also risks with the Act that could jeopardize the way the system works. John (2013) notes that if not enough people sign up, then insurance companies will make smaller profits. He does note that the signups at higher rates
Healthcare and Economics:
Health care costs have continued to increase in the past few decades despite of the numerous health reform initiatives. Currently, these expenditures account for more than 18% of GDP in the United States, a percentage that is expected to continue rising significantly. Actually, it's projected that the share will rise to 34% of GDP by 2040 if health care costs continue to increase at historical rates. The increased health care costs have considerable impacts on households, insurance companies, and government budgets. For instance, households with employer-financed health insurance will have a progressively minimal portion of their total compensation in the form of take-home pay. On the other hand, a progressively larger fraction of compensation will be in the form of employer-provided health insurance. Governments will be forced to cater for more than 50% of health care expenditures if they continue to increase at historical rates. Therefore, the…
Harrington, L. (2011, May). Career Scope: Balancing Quality and Costs During Economic
Downturns. Nursing Management, 42(5), 46-48. Retrieved from http://www.nursingcenter.com/lnc/JournalArticle?Article_ID=1163319&Journal_ID=54013&Issue_ID=1163211
Philipson, T. (2013, October 31). Obamacare or Not, Healthcare Costs are Set to Soar. Forbes.
Retrieved December 3, 2013, from http://www.forbes.com/sites/tomasphilipson/2013/10/31/obamacare-or-not-healthcare-costs-are-set-to-soar/
The Affordable Care Act works on the premise that all Americans should have access to health care insurance. Because this is provided through insurance companies, the system is only enforceable under certain conditions. One of the key tenets of health care reform is the idea that those with pre-existing conditions cannot be denied insurance coverage. This group of people has long had problems getting insurance, and insurance companies spend tens of millions to invent pre-existing conditions that would then be used to deny coverage. Even insurance commissioners have been known to take offensive and absurd stances on pre-existing conditions, arguing that insurance companies should not have to take customers with such conditions because the person is to blame for their pre-existing condition (Ferguson, 2013). With attitudes like this from people connected to the insurance industry, the only way that the Obama Administration was going to achieve universal health care…
Ferguson, D. (2013). Georgia insurance commissioner: It's your fault if you have a pre-existing commission. Raw Story Retrieved December 6, 2013 from http://www.rawstory.com/rs/2013/12/05/georgia-insurance-commissioner-its-your-fault-if-you-have-a-pre-existing-condition/
Klein, E. (2012). Unpopular mandate. The New Yorker. Retrieved December 6, 2013 from http://www.newyorker.com/reporting/2012/06/25/120625fa_fact_klein
Kliff, S. (2013). Washington State provides case study on effects of health care reform. Washington Post. Retrieved December 6, 2013 from http://articles.washingtonpost.com/2012-06-16/national/35461636_1_individual-mandate-health-insurance-insurance-reforms
AARP. (2013). For people 65+. American Association of Retired People. Retrieved December 6, 2013 from
affordable Care Act (also known as the ACA or Obamacare) on the elderly
Obamacare: Its impact upon the elderly
The impact of the Affordable Care Act (ACA) (often called 'Obamacare') upon America is often discussed by politicians as if it had a uniform impact upon all citizens. However, the ACA's effects have been relatively disparate, depending upon the nature of the population. This paper will specifically focus upon the impact of the ACA on the elderly of a variety of socio-economic categories.
One of the criticisms of the American healthcare system before the passage of the ACA was the spiraling cost of entitlement programs such as Medicare, the federally-provided health insurance program for seniors. "One good result of all this [ACA] is that the burden of Medicare for taxpayers in future years has been drastically lowered. In fact, the day Barack Obama signed the ACA into law he cut the…
ACA. http://www.hhs.gov/ healthcare/rights / Accessed November 6, 2014.
FAQ: What retirees and seniors need to know about the ACA? NPR. October 11, 2013.
http://www.npr.org/2013/10/11/231101137/faq-what-retirees-and-seniors-need-to-know-about-the-affordable-care-act Accessed November 6, 2014.
Goodman, John. What seniors have to fear from Obamacare? Forbes. October 28, 2014.
This difficulty does not just stop at causing dietary deficiencies but may also lead to acute dental and non-dental diseases. With early detection and intervention such diseases can be prevented thus the health professionals in senior centers can take a step of screening the seniors for oral problems and take the necessary steps. They can also train the seniors on practicing preventive health and also refer them to appropriate nutritional and dental professionals.
It is common for seniors to rate their health, the good news is that most of them rate their health status as good, very good, or excellent. There is a relation between self-rated health and mortality and expectations for dying, it is therefore necessary to encourage those having positive self-rating so that they can maintain and improve their health. Those with negative self-ratings should also not be ignored but should be assisted to develop a positive attitude…
Alvarado-Esquivel, C. et al. (2004). Prevalence of dementia and Alzheimer's disease in elders of nursing homes and a senior center of Durango City, Mexico. BMC Psychiatry, 4:3.
Farone, D.W. et al. (2005). Use of senior centers as a moderator of stress-related distress among
Latino elders. Journal of Gerontological Social Work, 46(1)
Michinov, N. (2007). Social comparison and affect: A study among elderly women. The Journal
A good example of this can be seen with popular Chinese talk show host Yang Lang donating $72 million, to start his own foundation to: help support and develop the health care system. This is important, because it shows how both international and domestic-based non-profits are addressing these underlying problems facing the health care sector. (Dobryzski, 2010)
Clearly, the biggest challenges facing the health care systems in the United States and China are vastly different. Yet, they are also wrestling with similar problems, as they face the issue of increasing numbers in the elderly population. In the case of the United States, this is challenging because there are a variety of disadvantages that must be addressed to include: they have access to some of the most cutting edge procedures, there is large number of choices about health care providers and the elderly can be able to receive effective treatment for…
Advanced Practice Nurses. (2010). Bukisa. Retrieved from: http://www.bukisa.com/articles/352958_advanced-practice-nurses-a-global-role
Health Systems. (n.d.). WHO. Retrieved from: gis.emro.who.int/HealthSystemObservatory/.../Conceptual%20frameworks. Ppt Health Care in China. (2006). IBM. Retrieved from: http://www-05.ibm.com/de/healthcare/downloads/healthcare_china.pdf
More About RN's. (2011). ANA. Retrieved from: http://www.nursingworld.org/especiallyforyou/studentnurses/rnsapns.aspx
Opportunities in the Health Care Sector. (2006). Grail Research. Retrieved from: http://www.grailresearch.com/pdf/ContenPodsPdf/Opportunities_in_the_China_Healthcare_Sector.pdf
However...generally a vast difference exists between what healthcare providers understand and what laypersons are able to comprehend. This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members.
Seconding Robichaux's argument is ackstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest…
Anderson, R. (2003). "Nursing home quality, chain affiliation, profit status, and performance." Journal of Real Estate Research, Vol. 25, Issue 1.
Backstrand, R. (2006). "Providing a "good death": critical care nurses' suggestions for improving end-of-life care." American Journal of Critical Care, Vol. 15, Issue 1.
Elliot, D. (2006). "Determining the financial impact of hospice." Healthcare Financial Management, Vol. 60, Issue 7.
Imhof, S. (2005). "What do we owe the dying? Strategies to strengthen end-of-life care." Journal of Healthcare Management, Vol. 50, Issue 3.
Strategic Management of a Healthcare Facility in St. Louis
In the late 1800's and early 1900's St. Louis was a major center for automotive and other heavy manufacturing but the industrial restructuring of the Midwest during the latter half of the century has resulted in consistent economic decline of the St. Louis region. Today however as the rest of the country faces a slowing economy this region is showing new signs of growth. [Kotkin, 2002] Due to changing socio-demographics, the demand for health care and advanced medical technologies is growing consistently with a concomitant rise in health expenditure. [Zhou 2001] Health expenditure in the U.S. has risen from 7.4% of the GNP in 1970 to 15% of the GNP in 1995.[Zhou, 2001] The Health care sector deals with not only the clinical medical services, but also include methods which finance them, for e.g. insurance, benefit schemes, Medicare and Medicaid. eforms…
1. Kotkin, J, 2002 St. Louis: On the Way to Somewhere? Rebuz Inc.
2. Author not available, 1997, Economic Report of the President. Government Printing Office, Washington, D.C. [accessed on 4/4/03]: http://www.umsl.edu/services/govdocs/erp/1997/chap3.htm
3.Author not available, 1996, Focus... Non-Elderly Missourians without Health Insurance, March 1996, Vol. 30, No. 1 [accessed on 4/4/03]: http://www.dhss.state.mo.us/MonthlyVitalStatistics/March96Vol30No1.html
4. Author not available, January 1999, Focus... Managed Care (MC+) in Medicaid Population, January 1999 Vol. 32, No. 11[accessed on 4/4/03] at http://www.dhss.state.mo.us/MonthlyVitalStatistics/Jan99Vol32No11.html
Within this section of Chapter One, a historical perspective of NHS will be provided. This discussion will identify problem areas that have emerged in relation to NHS with an attempt made to address the manner in which such problems have historically influenced reform efforts.
With the passage and associated provisions of the NHS Act of 1946, NHS was implemented in the UK in 1948. The NHS Act of 1946 served as the means by which a pattern of health service finance and provision was established in the UK following World War II (Baggot, 1998). According to Baggot, on the basis of the Act, the principle of collective responsibility by the state for the establishment of a comprehensive health service system was introduced, allowing for the planned use of services by the entire population at no cost. It was also intended that equality of access to services would be…
Baggott, R. (1998). Health and Health Care in Britain. London, Macmillan,
Barlow, M. (1998). The Fight of My Life. Toronto: Harper Collins
BMA Central Consultants and Specialists Committee (1990). Guidance on Clinical
Directorates London: BMA.
I wish to make quality care affordable, and create a better quality of life for the older members of the community with better medical assistance and also enriching activities.
From what I have witnessed as my grandmother's care taker, I have come to believe that an efficient and well-trained staff is essential. Having standardized training and staff quality assurance is critical in providing a competent care experience, in my vision of the future of eldercare. Family members must feel that they have left a loved one in the hands of someone who they can trust to take care of their mother or father. Of course, I know there are still many bureaucratic obstacles to overcome in the eldercare field, so that insurance will assume an adequate level of support to care for individuals at the end of their lives. Often maintaining a facility is difficult, even for the most committed…
Leadership & Management, Health Care
Leadership & Management in Health Care
President Clinton's Secretary of Health and Human Services, Donna Shalala, used to tell a story about her mother, who was 86 at the time but still a full-time attorney representing several clients who lived in nursing homes. She would tell Shalala, "Donna, I don't care whether they are good nursing homes or bad nursing homes, you have to watch them like a hawk" (Cited in White House, 1998, quoted by Hovey 2000, 43). Clinton's presidency was very aware of health care issues, even if it was unable to solve them. Shalala's remarks were delivered at a press conference regarding nursing home regulation; arguably, under the current administration, issues of health care for the aged have gotten more problematical rather than less.
Despite relatively little action regarding health care for the aged by the federal government, there is little…
Fox-Grage, W., & Shaw, T. (2000, April). The crisis ahead in long-term care. State Legislatures, 26, 30. Retrieved June 30, 2004, from Questia database, http://www.questia.com .
Froeschle, M.L., & Donahue, P.M. (1998). Academic health care: Leadership in time of change. Journal of Leadership Studies, 5(4), 60. Retrieved June 30, 2004, from Questia database,
Provide sustained technical assistance (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)
Evaluation of the process in rural and small communities includes: (1) scope of the project; (2) goals; (3) critical success factors; and (4) technical assistance." (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Community grants have been focused on the provision of 'personal digital assistant (PDA) systems in assisting with the decision support role. The initiative is stated to include: (1) development of toolkits; (2) leveraging known tools; (3) developing capacity; and (4) disseminating best practices. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)
Ormond, Wallin, and Goldenson report in the work entitled: "Supporting the Rural Health Care Safety Net" (2000) state: "The policy - and market-driven changes in the health care sector taking place across country are not confined to metropolitan areas. Rural communities are experiencing changes impelled by many of the same forces…
Healthcare and Healthcare Insurance Country Report: India (2004) Tata Consultancy Services and Microsoft. WebHealthCentre.com. 2004 August. Online available at http://download.microsoft.com/documents/customerevidence/7144_WebHealth_CS.doc
Expert Panel Meeting: Health Information Technology (2003) Agency for Healthcare Research and Quality (AHRQ) 23-24 July 2003. Online available at http://www.ahrq.gov/data/hitmeet.htm
Silberman, P. And Slifkin, R. (nd) Innovative Primary Case Management Programs Operating in Rural Communities: Case Studies of Three States. Working Paper No. 76 North Carolina Rural Health Research and Policy Analysis Program.
Ormond, Barbara a.; Wallin, Susan Wall; and Goldenson, Susan M. (2000) Supporting the Rural Health Care Net. 15 May 2000 Urban Institute
The way in which these quotes were related to previous research also asserted trustworthiness. The reliability and validity of ethnographic research is often questioned in comparison to experimental research, although there are several strategies recognized to enhance credibility (LeCompte and Goetz, 1982); there is little evidence of use of such strategies in the study.
The findings of the study enabled the researchers' to put forward several indications towards future practice in health care in rural communities, although it was recognized that in order for a comprehensive set of nursing care management regulations and interventions to be identified, further research within the specific types of community used are required.
Summary of critique and conclusions
Overall, the piece of research effectively identified several gaps in the current research regarding the effect of health care transitions in rural communities. The study identified three relevant research questions, although presented little information regarding the current…
Boyd, C.O. (1993) Toward a nursing practice research method. Advances in Nursing Science, 16 (2), 9-25.
LeCompte, M.D. And Goetz, J.P. (1982) Problems of reliability and validity in ethnographic research. Review of Educational Research, 52 (1), 31-60.
Lowenberg, J.S. (1993) Interpretive research methodology: broadening the dialogue. Advances in Nursing Science, 16 (2), 57-69.
Magilvy, J.K. And Congdon, J.G. (2000) the crisis nature of health care transitions for rural older adults. Public Health Nursing, 17 (5), 336-345.
Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.
Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…
Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.
Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.
Moore, G.T. (1991,
April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
U.S. & Norway Healthcare Systems
healthcare system has many advantages and disadvantages which are most revealing when compared to the other health care systems of the world. An analysis between the U.S. healthcare system and a government run healthcare system of Norway provides a deeper understanding of the similarities and differences in the two systems.
Almost every other developed nation in the world has some form of universal coverage which reduces this disparity in care. However, many of these systems are purportedly ridden with their own issues such as high cost and long waiting times. By comparing the U.S. system with the universal system like that of Norway, I can investigate the effectiveness of each in terms of the quality of care provided and the equality of distribution of that care.
A Comparison and Analysis of Healthcare Systems in the United States and Norway
A. United States
The healthcare system…
Goldman, Dana P. And Elizabeth A. McGlynn. (2005). U.S. Healthcare Facts About Cost, Access and Quality [Online]. Retrieved from http://www.rand.org/pubs/corporate_pubs/2005/RAND_CP484.1.pdf
Johnsen, Jan Roth. (2006). Health Systems in Transition: Norway. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0005/95144/E88821.pdf
Tanner, Michael D. (March, 18, 2008). Policy Analysis: The Grass is Not Always Greener: A Look at National Health Care Systems Around the World (policy number 613). Retrieved from http://lib.trinity.edu/research/citing/APAelectronicsources.pdf
The University of Maine. (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive? [Online]. Retrieved from http://dll.umaine.edu/ble/U.S.%20HCweb.pdf
egistered nurses are both qualified, educated, and certified to provide a high quality of various care services that an individual may need in a home setting or elsewhere. Hence, providing these practitioners with the power to certify and provide home care is a solution to an overwhelming problem that has plagued the health care environment in recent years. Nursing practitioners, as a result of the nature of their work, are closely connected to the needs of individual patients. This means that they, more than many other health care providers and institutions, are able to assess the needs of individuals, their households, and the level of care they require. This places them in a position to accurately determine the need and/or of such individuals to obtain long-term home care and when such home care becomes unviable. As such, registered nurses who serve individuals in the home setting are able to maintain…
AARP Public Policy Institute. (2013). FAQs. Retrieved from: http://assets.aarp.org/rgcenter/ppi/ltc/ltss_faq.pdf
Brassard, A. (2011). Removing Barriers to Advanced Practice Registered Nurse Care: Home Health and Hospice Services. AARP Public Policy Institute. Retrieved from:
Case managers are expected to have the necessary education requirements, but also have the personality to effectively communicate between healthcare professionals, insurance agencies, and patients (Case Manager, 2011). Case mangers must be both compassionate and professional to balance the needs of the patient while interacting with healthcare and payer institutions.
Compensation for case managers also varies based on the healthcare institution and level of education and experience requirements. In the United States, the salary range for case managers extends from $25,000/year to $65,000/year (PayScale, 2011). Salary for case managers also differs based on their number of years in the field, and if they have received any additional education or nursing experience (Case Manager, 2011). Case managers who are also nurses can expect to earn $58,000 during their first year in the field, whereas other case managers can earn $27,000 in their first year (PayScale, 2011). Internal recruitment for case manager…
Case Manager: Job Information. (2011). Case Manager: Job Information for Students
Considering a Career in Case Management. Retrieved from http://education-
Daniels, S, & Ramey, M. (2005). The leader's guide to hospital case management. Mississauga,
This is the strategy used in Canada, where drug costs have been substantially reduced.
The challenges presented by this law have spilled over into the current health-care reform debate. Many people and many legislators who might have been more open to engage in productive dialogue during the current debate were no doubt made more leery of the process and of the possibility that there could be significant reform that would bring benefits to more people while bringing down the federal deficit.
The fears of opponents of the bill were correct in their fears that the bill would been even more expensive than originally budgeted. The initial estimate for the net cost was $400 billion for the period from 2004-2013. However, only a month after the bill's passage, that estimate was raised to $534 billion. It has since been raised to over $550. The cost over-runs in this bill will no…
However, they contradict themselves trough supporting one's right to commit physician-assisted suicide, since this would virtually mean that the individual who is no longer willing to live is not provided with health care meant to prevent him or her from dying (Epstein, 1999, p. 1).
Among those opposed to the fact that health care is becoming increasingly better are those who are in their twenties and are obliged to work hard in order to pay for their own medical insurance and for that of the underprivileged (Bonner, 2010).
Contemporary health care is basically provided by groups forced to pay taxes in order for others to benefit out of the process. The fact that health care is a privilege and not a right was made obvious ever since the 1954 foundation of the Department of Health, Education, and elfare. The name contained the term welfare with the intention of highlighting how…
Bloche, M.G. ed., The Privatization of Health Care Reform: Legal and Regulatory Perspectives (New York: Oxford University Press, 2003)
Epstein, R.A. Mortal Peril: Our Inalienable Right to Health Care? (Cambridge, MA: Perseus Books, 1999)
Heirich, M. Rethinking Health Care: Innovation and Change in America (Boulder, CO: Westview Press, 1998)
Sanders, B. (2009). Retrieved from the Huffington Post Website: http://www.huffingtonpost.com/rep-bernie-sanders/health-care-is-a-right-no_b_212770.html
Aaron, H.J. 1994. Thinking About Medical Costs. Health Affairs, 13, 5 (winter): 8-13 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.
Acs, G. And John S. 1995. Trends in Out-of-Pocket Spending on Health Care, 1980-1992. Monthly Labor eview, 35-45 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.
Cote, J. And Latham, C. (2003). Exchanges between Healthcare Providers and Insurers: A Case Study. Journal of Managerial Issues. 15, 2.
Health, United States. (2003). Chartbook on trends in the health of Americans. HHS, Centers for Disease Control and Prevention (CDC). National Center for Health Statistics in Lesnik, J. (2006). Community Health Centers: Health Care as it Could Be. Journal of Law and Health. 19, 1..…
Aaron, H.J. 1994. Thinking About Medical Costs. Health Affairs, 13, 5 (winter): 8-13 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.
Acs, G. And John S. 1995. Trends in Out-of-Pocket Spending on Health Care, 1980-1992. Monthly Labor Review, 35-45 in Hong, G-S and Kim, S.Y. (2000). Out-of-Pocket Health Care Expenditure Patterns and Financial Burden across the Life Cycle Stages. Journal of Consumer Affairs. 34. 2.
Cote, J. And Latham, C. (2003). Exchanges between Healthcare Providers and Insurers: A Case Study. Journal of Managerial Issues. 15, 2.
Health, United States. (2003). Chartbook on trends in the health of Americans. HHS, Centers for Disease Control and Prevention (CDC). National Center for Health Statistics in Lesnik, J. (2006). Community Health Centers: Health Care as it Could Be. Journal of Law and Health. 19, 1..
Marketing in Healthcare
Catholic Healthcare West
Catholic Healthcare West (CHW) is a not-for-profit healthcare organization serving parts of Arizona, Nevada and the majority of California. With 42 hospitals it is the largest Catholic hospital system in this part of the United States. The organization focuses its services upon the poor, who cannot afford private hospital services. Regardless, the aim is also to provide high-quality healthcare to those in need. The target market is thus the poor in the western areas of the United States.
Taking into account the size of Catholic Healthcare West, it should not be a problem to implement new services without a loss of either mission or customers. New services should however be implemented with the proper care to ensure that the focus remains as originally intended.
The service management strategy of CHW has always been collaborative. y collaborating with other groups who share the vision and…
Allen, G. "New Product Development." 1999
Catholic Healthcare West. 2003. http://www.chwhealth.com/
Rice, T., B. Biles, E.R. Brown, F. Diderichsen & H. Kuehn. "Reconsidering the role of competition in health care markets." Journal of Health Politics, Policy and Law. Durham, Oct 2000
American Healthcare System has been at the center of debate for many years. One of the most pressing issues confronting the healthcare system is Medicare and its beneficiaries. The purpose of this discussion is to focus on the ramifications of moving Medicare beneficiaries into managed care organizations (MCOs). Our investigation will illustrate that moving the Medicare beneficiaries into MCOs are a bad idea because there will not to be any real cost savings and many individuals are likely to be denied needed care.
An article found in American Economic Review explains that Medicare is the second largest government entitlement program in the United States. The cost associated with running this program is astronomical. The article asserts that in 1999 the government spent $230 billion or 13% of its budget on Medicare and its beneficiaries. (Antos and Bilheimer)
The major issue with Medicare is that it is expected to…
Healthcare Data Compare Healthcare Grade of Maryland to Florida
Healthcare grades: The Commonwealth Fund
The Commonwealth Fund grades all states on access to healthcare, avoidable hospital use and costs, healthy lives, and prevention and treatment. For example, Pennsylvania ranks 12 on access: nearly
percent of nonelderly adult patients are insured and 92% of children. Florida has around 74% and Maryland around 83% of adults insured and 82 and 91% of children, approximately. In Pennsylvania, 86% of at-risk adults have had a checkup within two years versus 87 and 88% in Florida and Maryland respectively; 90% of patients in PA have not had to forego seeing a physician within the last two years because of cost versus 84% in Florida and 89% in Maryland (approximately). The low rates of insurance coverage in Florida reflect higher unemployment and poverty rates, combined with a higher percentage of workers who labor part-time and do…
State scorecard. (2011). Maps and Data. Retrieved September 26, 2011 at http://www.commonwealthfund.org/Maps-and-Data/State-Data-Center/State-Scorecard.aspx
All figures are rounded up or down, based upon the available data
(Expenditure, 2012) This merciful act is taken because of a simple fact; these elderly are deemed too old to work. Americans younger than 65 have an expectation of work placed on them in order to receive medical care at 65.
The third issue of universal health care is the principle of hard work and earning your keep. In America, health care for the young is seen as a privilege, not a right. There are some who disagree with this, but America at large is skeptical of all forms of welfare and state controlled support. The problem for many is a philosophical challenge to the notion that poor unemployed workers deserve health care paid for by their hard working neighbors.
Centers for medicare and medicaid services. (2012). Retrieved from https://questions.cms.gov/
Expenditure patterns of older americans. (2012, February). Retrieved from http://www.ebri.org/publications/ib/index.cfm?fa=ibDisp&content_id=4992
Henry kaiser family foundation. (2012). Retrieved from http://healthreform.kff.org/federal-funds-tracker.aspx
Centers for medicare and medicaid services. (2012). Retrieved from https://questions.cms.gov/
Expenditure patterns of older americans. (2012, February). Retrieved from http://www.ebri.org/publications/ib/index.cfm?fa=ibDisp&content_id=4992
Henry kaiser family foundation. (2012). Retrieved from http://healthreform.kff.org/federal-funds-tracker.aspx
The problems facing Medicare recipients and the federal government almost seem to be overwhelming. There are proponents of a plan to privatize Social Security and health insurance, placing the onus on the individual to pay for his own health care through savings specifically for this. Some others would have the program go through the private HMOs who have, in the past, contained the costs of care by having primary care physicians manage a patient's care and purposely keeps the costs of care down.
As with Medicaid, the recipients of Medicare would have difficulty obtaining health care without this program. The recipients would most likely have no other health insurance. The trend being what it is, a lot of individuals retiring today are fortunate to have pensions from their companies, much less health benefits. ithout a national health insurance plan, like Medicare, those individuals would have to pay for health care…
Kay, Joseph. "Bush Plans renewed Assault on Medicaid." World Socialist Website. 8 Feb. 2005.
13 Aug. 2005. http://www.wsws.org/articles/2005/feb2005/medi-f08.shtml .
Kay, Joseph. "U.S.: States, Federal Government Prepare Massive Medicaid Cuts." World
Socialist Website. 11 May 2005. http://www.wsws.org/articles/2005/may2005/medi-m11.shtml .
SPENDING IN U.S. HEALTHCAE
July 26, 2013 ASSESSMENT: Policy topic Search Selection. esearch internet key words "Health" "Health Policy" select a policy topic interest. My selection topic "Cost Spending." You policy individual assignment.
Cost and spending: U.S. healthcare
While Americans would no doubt like to think that their healthcare system is the best in the world, the data confirms only that it is the most expensive. According to Kaiser Permanente, 16% of our nation's GNP is devoted to healthcare, "the highest among the world's industrialized nations. Over the past decade, the pace of total health care spending has grown faster than inflation and the growth in national income" (Costs and spending, 2013, Kaiser Permanente). One of the most frequently cited reasons for the high costs of healthcare is the inefficiencies of the American private insurance system. While in nations such as Canada and the United Kingdom there is a 'single…
Costs and spending. (2013). Kaiser Permanente. Retrieved:
Pfeffer, T. (2013). The reason U.S. healthcare is so expensive. Retrieved:
Employer Healthcare Benefit Plans
More than half of the American population is covered by a comprehensive health plan of one type or another. That's approximately 160 million people. The programs that come under the above mentioned coverage include the likes of employer sponsored plans and other government initiatives for instance Medicaid and Medicare, a small proportion of health insurance which is purchased on individual basis may also be included in this. If we proceed to explain employer sponsored health programs, government initiatives and individual healthcare benefits individually, then briefly we can say that the employer benefit plans mostly comprise of group plans and are called "the employee welfare benefit plans"
Table of Contents
The Estimated Effects of PPACA on Coverage
The Number of Uninsured Decreases by 53%
Four Million Children Will Gain Coverage
The Individual Mandate Contributes Most to educing the Number of Uninsured
Manning W. And Marquis S, "Health Insurance: The Tradeoff Between Risk Pooling and Moral Hazard," Journal of Health Economics, Vol. 15, No. 5, October 1996, pp. 609 -- 639.
Manning WG, Newhouse JP, Duan N, Keeler EB, Leibowitz A, and Marquis MS, "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment,"
American Economic Review, Vol. 77, No. 3, June 1987, pp. 251 -- 277.
Pauly MV and Herring BJ, "An Efficient Employer Strategy for Dealing with Adverse Selection in Multiple-Plan Offerings: An MSA Example," Journal of Health Economics, Vol. 19,
Management of Continuum of Care Services
As the new director appointed for the Medicare and Medicaid Services (CMS), I realize the climbing costs of payments of these two programs and have met with the other members to come up with a plan of that will help enforce the strategies and guidelines in the state of North Carolina that can help us follow a budget that will assist the overall national requirements for persistent care. In doing so fellow board members have met with me to look at the Medicare Modernization Act (MMA), Administration on Aging (AoA), and other parts of the medical services to help come up with an arrangement that will help us reduce costs in our particular area that will assist the national healthcare problems that we currently face.
After looking at the problems within our own area we have decided to enforce the guidelines of the current…
Department of Health and Human Services, (n.d.). Administration on aging. Washington, DC: Retrieved from http://www.aoa.gov /aoaroot/about/Budget/DOCS/FY_2012_AoA_CJ_Feb_2011.pdf
Revering, S. (2007). Update on medicare part d. Informally published manuscript, Department of Health, Massachusetts university, Boston, Retrieved from http://docs.google.com/viewer?a=v&q=cache:vFwR3GhqkgkJ:www.mass.gov/Eeohhs2/docs/dmh/prescription_fact_sheet.ppt+medicare+modernization+act&hl=en&gl=us&pid=bl&srcid=ADGEESj-oSY8OF2PkNp5h6mbuap2CtLuhDndi5ccDFVvjGqHqGhGux-tRa0s5PrbP7CSCvtILHI8AE86mRKjnUnetKPMIgY98MGCNV_PE5PG4ZCS7robDOijjRgzUo_mPol6_0rmXtnE&sig=AHIEtbS4whuLInutr1XLxYchmbqxo8OIRw&pli=1
Health insurance has gone up over the past two years as a result of a nationwide increase .insurance companies have the tendency of settling only a percentage of a patient's bill. The truth of the matter is patients are not the only people who suffer due to this crisis the doctors too fall victims as mots of them opt to close down since they are underpaid by the insurance companies as well as being forced to pay the yearly premiums for malpractice .physicians are taken as the ones who are at fault for the ongoing healthcare crisis. This is true to some extent but they are not the bones to blame entirely as there are many parties involved in this issue. First of all when we look at the money involved we can say that this crisis is the fault of insurance companies since they are out there…
Sharfstein J. Fontanarosa P. & Bauchner H.(2010). Critical Issues in U.S. Health Care
Health Care on the Edge. Retrieved March 14, 2014 from http://www.commed.vcu.edu/IntroPH/Introduction/2014/criticvalissues.pdf
Lipthrott, D.(2004). Who is to blame for the healthcare crisis? Retrieved March 14, 2014 from http://www.ethicalhealthpartnerships.org/whoistoblame.html