Almost majority of all elderly Westminster faces disability challenges as well as chronic illnesses during their last days of their life. Thus the problem likely will shot up as the elderly ratio grows when the aging baby nears the retirement. At the moment community and health services cannot channel the attention of care the elderly chronically ill needs. Availability of caregivers for this population is narrowing down and the up keeping of the seniors is getting even more costly. But the future for this population is brighter, it is not glued to mean the end of their life, the seniors even having very serious chronic illness can as well live nicely. The health care of Westminster has adapted renewals demographically before and can as well do the same again. As a matter of fact adapting will comprise of ending care provision in the current ways and visualizing on the deliverance and financing the crucial and necessary services.
Most elderly generation experiences chronic conditions. In my Continentals Evaluation program for the sake of health care planning, there is need to view the conditions in the major categories: the nonfatal, serious, eventually fatal chronic illness and frailty.
The most common nonfatal chronic conditions include hearing, vision or the arthritis. In most cases, majority of the elderly lives with these conditions gradually worsening over time hence posing a threat to live at the advanced stages. The chronic condition eventually leads to health care costs and disability.
Serious, Eventually Fatal, Chronic Conditions
Most cases of deaths occur as a result of the worsening chronic conditions. The fatal conditions which are chronic include cancers, strokes, and dementia and organ system failures (e.g. those affecting the kidney, liver. heart and the respiratory system). Most of the older people have to live with one of these. No research has yet estimated this rate; the fact is that about 40% of those with years above 65 years involve kind of disability.
Majority of the edged Westminster citizens currently faces disability as well as chronic sickness during their final years of life. Thus for those elderly (sick and disabled) who are faced with challenges of accessing care to meet their needs, really proves painful. During this period, to their families it becomes very expensive as well as stressful. So their is a need to address community service delivery, and the health care facilitation which seems to be in the shortcomings of meeting the great and still growing population of elderly undergoing prolonged illness and disability before they die.
Therefore based on those milestones affecting the elderly my evaluation program is to be based in the issues of chronic sickness during the last moments of life. The program is going to seek the demographic description, it will seek to establish the current gaps in the health care systems, it will also reflect on the reform strategies needed to give directives to urgent needs. Basically the evaluation program will be to underline vision in a bid to identify a system of health care confronting the current reality.
My evaluation program will address the following so as to design an immediate response to the challenges emerging before the limit of the point of harmful dysfunctions
- Address the caregivers’ shortages.
- Federal finance policy reform.
- Consider the cost-effectiveness of treatment.
- Plan strategically.
- Building the care system that works.
Address the Caregivers shortages
The number of chronically ill elderly has to be balanced against the number of available caregivers. If the chronically ill and disabled elders cant access day to day competent care then the rest of the health care concerns/reforms are likely not to make sense/impact. For this population paid attendants, volunteers and the care givers usually are paid low wages, un conducive working environments, few or no opportunities for professional development as well as isolation. Thus the following reforms have to be incorporated so as to improve the working conditions and availability of the caregivers:
Pay family care givers.
Offer benefits for the caregivers (health, disability, and retirement benefits).
Improve the professional caregiver’s wages.
Provide adequate training as well as the provisioning of at-home support.
Bring together family care givers through online conversations, organizations as well as through newsletters.
Reforming the Federal Finance Policy
During the final days of life is when the federal dollars make payments for the most health care costs. Unluckily federal payments currently are not directed to promoting continuity of care giving over a long period. Federal payments fails to engulf family and care giver support, symptoms control, supportive home care not even professional developments targeted at narrowing down the rate of decline in patient malfunctions. In the last phases of life Medicare is the major financing method in the last phases for medical services. Of all the persons who die in the United States Medicare covers 84%. Basically under program of fee-for-services, service providers, doctors and hospitals receives the payments for each billed service. Hospitalization whereabouts commonly are packaged and paid in a single fee for the whole hospitalization.
This plan doesn’t contribute to the continuity of care but only encourages billable services. There is no coverage made to cater for classroom education of patients, bereavement support, caregiver training, on-call advice as well as spiritual counseling. Medicare manned care has not contributed enough to manage the high costs of those seriously ill; thus most of the Medicare managed plans cannot potentially capitalize by their own to deliver good care. The attracting members already very ill are perceived to be financially disastrous.
Therefore some of the points outlined below can really align the Medicare coverage closer to the care expected.
- Medicare needs certain/ defined performance criteria specifically for core care elements like the symptom relief, advance care planning as well as the continuity.
- Medicare managed care benefits payment can be highest for the seriously ill, additionally to recent adjustments for gender, diagnosis, age and region.
- For the patients who don’t have advance care planning at their first hospitalization, hospitals need be paid much less for second admission for a same serious chronic condition.
Considering the Cost-Effectiveness of Treatment
The escalating expense of curbing sickness at the end of life has raised issue of concern that few of the Americans have been willing to indulge: The need to give expensive new treatments un to the people whose life expectancy is drastically limited, even in the presence of treatment. However, even raising the subject in re conditioning access to life prolonging treatments (costs, effects upon quality of life, or effects on life span) in Westminster might provoke controversy. T he best and easiest way is to cut back on services which are difficult to track. Thus the challenge is to devise a manner by which the federal budget to care those with fatal chronic sickness to match dominant challenges and concerns of the chronically ill families and elderly, even if the strategies of the program means very costly treatments are at times not available to some of chronically ill elderly who might benefit from.
Practical approaches possible to making this happen
- Tailor services to evidence about what covered population values.
- Need the consideration of life span, competing co-morbidities, and quality of life with treatment in guidelines for professional and Medicare coverage usage of treatments which will be mostly used for the people with serious chronic illness.
- To authorize Medicare including the Medicaid to develop for measuring merits amongst the beneficial treatments and services.
- To consider competing shortened life expectancy and co-morbidities in decisions about the individual treatments.
Extra efficient reform program will depend on the design of pursuing high-leverage strategies and omitting low-leverage ones. Nevertheless in this area, reformers would undoubtedly perform no better with regards to strategic planning
Some of the possibilities which need to improve at the present uncoordinated efforts include
- Carrying out statewide and regional trials of major innovations.
- Calling for stakeholders and others with experience in reform efforts to value options and figure out a short listing of agendas for all to endorse.
- Simulating the innovations effects in model systems.
Building a Care System That Works
A dependable care system which has to help the chronically ill elderly live well at their final stages of their life is supposed to make about seven promises: reliable symptom relief, correct medical treatment, customized care, no gaps in care, a consideration for a family situation, no surprises in the course of care and lastly assist as needed to produce the best of every day.