U.S health disc 7

2

Unsustainable Expenditure on Health Care

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Alf

Long-term care involves taking care of the older adults who need physical, medical, emotional, psychological support over an extended period. For instance, personal care, house tasks, physical therapy, nursing care, and transportation or meal delivery care. Long-term care services have different settings, from assisted-living to a day or 24-hour medical care of a nursing home. However, some older adults prefer to stay at home as far as they get the necessary care of services (Whitehouse, 2017). There are distinct types of long-term care such as adult day care, where older adults go for socialization, therapy, and other recreational activities. Home health care for the elderly who prefer staying in their own homes. Subsidized senior housing, which is a federal program helping adults of low or moderate income pay for apartments, group homes, nursing homes, and others. 

The most crucial issue affecting long-term care is the costs of care for the elderly. How individuals pay for their care depends on your personal finances and the type of services needed. For instance, some use their retirement income and savings, life insurance, government subsidized programs, financed by their children or family members, especially more millionaires are now taken care of the aging population or parent, as they were taken care of when they young (Grant, 2016). The states of Maryland financed individuals from age 65 above in the long-term setting through Medicaid long term services and supports (LTSS) under the Affordable Care Act established community first choice program option that make it easier for individuals who require an institutional level of care to receive services in home and community-based settings. 

Long-term pharmaceutical companies have contributed their quota to the continuum of care in the long-term care through price rebates and discounts touch points (Stefanacci, 2021). For example, skilled nursing facilities (SNF) prescriptions' program. Most patients in LTC facilities have drug utilization, and though some of them pay out of pocket, most of them pay through Medicare part D prescription program and other medical advantage programs. Pharmacists also help manage age-related issues such as supporting branded treatment prescriptions whereby patients are kept on a regular schedule to ensure quality treatment adherence, and that making high branded utilization decisions successful. 

Most nursing homes are traditionally residential-based practices instead of home-based care where individuals have their choice considered in decision-making. The indication is that culture of adoption occurred less in traditional residential-based practices than in home-based practices. This creates loneliness in nursing homes and assisted living facilities (Jansson, et al. 2017). Unlike other European and some developing countries, home-based care encourages families to assist in quality of care. However, CMS has implemented a 3-year reform for LTC facilities to emphasize improving person-centered care by ensuring that residents choices are integrated into the care plan decision making process. This transition-based approach should be effective in enhancing quality of care for all senior residents (Rosato, 2019). Health is a human right as the previous reading reiterated, and the discussion on beliefs, values, ethics, and healthcare policy shows clearly that every human being has an amiable right to life and death, however, the government healthcare policy on continuum of care (CoC) can prolong the life of everyone regardless of life decision being made by individual mandate.  

                                                          References

Grant, K., & CFP®. (2016, August 24). Turnabout: More millennials helping mom and dad. CNBC.  https://www.cnbc.com/2016/08/24/turnabout-more-millennials-helping-mom-and-dad.html

Jansson, A., Muurinen, S., Savikko, N., Soini, H., Suominen, M., Kautiainen, H., & Pitkälä, K. (2017). Loneliness in nursing homes and assisted living facilities: Prevalence, associated factors and prognosis. The Journal of Nursing Home Research Sciences.  https://doi.org/10.14283/jnhrs.2017.7

Rosato, S. (2021). Determining the characteristics of transition-based interventions most effective in enhancing quality of care for seniors: A systematic review.  https://doi.org/10.32920/ryerson.14648514

Stefanacci, R. (2021, May 3). Pharmaceutical opportunities and challenges facing long-term care facilities. Eversana.  https://www.eversana.com/insights/pharmaceutical-opportunities-and-challenges-facing-long-term-care-facilities

Whitehouse, P. J. (2017). Long-term care for the future. Care Home Stories, 103-110.  https://doi.org/10.1515/9783839438053-011

Luis

Across most first-world countries, improved healthcare systems have translated to increases in life expectancy. Apart from this, in current lifestyles where people are pursuing more and more education, and stress levels are skyrocketing due to working more, more jobs, or more hours, the fertility rates have experienced a significant drop. Therefore, according to study-based statistics by the U.N., the population of individuals aged 80 and above shall triple by the year 2050 (Goldman et al., 2018). The CDC predicts that in the U.S. alone, that number will be 78 million in the next two decades (Harris-Kojetin et al., 2019). This raises the question of how to tackle this issue of an aged population.

     The current number of beds at "long-term care facilities (LTCs)" is less than 2 million, almost at full capacity, with the vacancy rate at 15 percent. Most families and healthcare providers, are trying to come up with cost-effective alternatives that might serve the same purpose (Annicchiarico et al., 2019).  Apart from nursing homes, several other solutions have been devised, including; adult day cares, respite care, adult foster care, home care, and assisted living. It would be an act of prudence for “the U.S. Department of Health & Human Services (HHS)” to establish guidelines and standards that help define the quality of facilities such as nursing homes. 

     Despite the fact that an aging society being exceptionally skilled due to their vast experience and others having acquired lifelong education. There is a need to develop a setup that accommodates the aging individuals willing to work or volunteer; this would help put their experience and expertise to work. This arrangement ought to be well-thought so that it achieves a cohesive environment between generations, eliminating the notions of competition and tension. Young adults struggling to get a footing financially, middle-aged persons aged between 40 and 50 are left with the burden of financially supporting their parents aged above 65. The same middle-aged population is also burdened with the task of raising a child, most likely below the age of 18 (Parker & Patten, 2018).

     They cannot fully depend on the young adults since they are not very stable, and they cannot depend on the middle-aged population entirely as they are also struggling with raising their kids; this leaves the aged population in a very awkward situation since they still need financial support (Parker & Patten, 2018). Everyone has a right to proper healthcare services, quality and affordability. which can difficult to obtain. The elderly are more susceptible to age-related issues such as diabetes, hypertension, and stroke. Also the high cost of medication makes a huge burden on their finances. Some individuals intentionally miss taking their medication, while others voluntarily choose to forgo eating and drinking.

     Culture is also increasingly becoming a factor when dealing with the issue of end-of-life situations (Gysels et al., 2020). Aspects of culture such as values of death and culture-specific disclosure play a huge role when it comes to making end-of-life decisions. Most countries have integrated the care into their medical programs, especially European and Latin nations. Provided the care observes bio-ethical principles and human rights, then most cultures and countries are comfortable with it, including Muslim-majority countries (Abdullah, Guo, & Harding, 2020).

     The aging population due to improved healthcare systems and self-care awareness, populations are expected to live longer. It is therefore important to establish an adequate number of facilities and systems that shall ensure this population is effectively provided quality care during their old age and that their view and opinions are respectfully considered.

References

Abdullah, R., Guo, P., & Harding, R. (2020). Preferences and experiences of Muslim patients and their families in Muslim-majority countries for end-of-life care: a systematic review and thematic analysis. Journal of Pain and symptom management, 60(6), 1223-1238.  https://doi.org/10.1016/j.jpainsymman.2020.06.032

Annicchiarico, R., Adriano, F., Ariño-Blasco, S., & Navarro-Llobet, D. (2019). Roadmap to Expanding Alternatives to Hospitalization. In RADIO--Robots in Assisted Living (pp. 167-176). Springer, Cham.

Goldman, D. P., Chen, C., Zissimopoulos, J., Rowe, J. W., & Research Network on an Aging Society (2018). Opinion: Measuring how countries adapt to societal aging. Proceedings of the National Academy of Sciences of the United States of America, 115(3), 435–437.  https://doi.org/10.1073/pnas.1720899115

Gysels, M., Evans, N., Meñaca, A. E. A., Toscani, F., Finetti, S., Pasman, H. R., ... & Pool, R. (2020). Culture and end of life care: a scoping exercise in seven European countries. The Ethical Challenges of Emerging Medical Technologies, 335-350.

Harris-Kojetin, L. D., Sengupta, M., Lendon, J. P., Rome, V., Valverde, R., & Caffrey, C. (2019). Long-term care providers and services users in the United States, 2015-2016.

Parker, K., & Patten, E. (2018). The sandwich generation. Pew Research: Social and Demographic Trends.

Wax, J. W., An, A. W., Kosier, N., & Quill, T. E. (2018). Voluntary stopping eating and drinking. Journal of the American Geriatrics Society, 66(3), 441-445.  https://doi.org/10.1111/jgs.15200