The greatest challenge for health care is for the Elderly. The elderly population has been rising steadily for the past few decades. The elderly population is usually defined as people aged 65 years or above. However, a longer life span in the elderly population brings along poorer health. This involves an increased demand for health care services for elderly people.
About two-thirds of the elderly largest source of carbon emissions population has limited or no monthly income and this generation will have to bear the burden of financing the provision of health care services for the elderly. Long-term care services for the elderly represent a significant share of total health care spending and an area of increasing concern for legislatures.
Nursing home and home health care counts for almost 15 percent of personal health expenditures in 1995, and were approximately 14 percent of all state and local health care spending. Neither private insurance nor Medicare covers long-term care to any major extent, and less than 5 percent of older adults have private long-term care insurance. “Medicaid is the main source of public financing for long-term care for the elderly, and expenditures are projected to more than double in inflation-adjusted dollars between 1993 and 2018 due to the aging of the population and to price increases in excess of general inflation”(American Health Care, 1997). In order to be eligible for Medicaid in nursing homes, single individuals must have less than $2,000 in non housing assets and all of their income must go toward the cost of their care, except for a small personal needs allowance generally $30 a month (Weiner, Hanley & Harris, 1994). Many of the nursing homes provide excellent care; however, far too many of them do not. Understaffed, underpaid and poorly trained employees make many nursing homes push the bottom line so far that they endanger the lives of their patients. Abused, neglected and defenseless, some nursing home residents may suffer physically and emotionally. Broken bones, painful bedsores or even premature death can result from negligent and outright abusive treatment. For some elderly people with caring families, nursing homes are not an option. Many families assume the role of caring for an elderly parent or grandparent in order to keep them from being placed in a nursing home.
As a daughter of a 98 year old father, I have seen firsthand the problems of health care for the elderly. Recently, I was told by a doctor, who was in his early 20s, that the expected life span for a person is only 80 years. Once a person reaches that age limit, health problem cannot be treated like a typical 20 or 30 year old. His perception of treating my father was that he has lived a good life and should be left alone to die in peace. Techniques that could be used on younger people were not an option for my father. I think the family and the physician should hold discussions about treatment options, including the length and invasiveness of treatment, chance of success, overall prognosis, and the patient’s quality of life during and after the treatment. In an ideal world, these discussions should continue as the patient’s condition changes but most times it doesn’t happen. Due to my father’s age, the physician felt that the family should make decisions based on what we thought my dad would want. However, I think it should be understood that health care providers should have the same attitude towards aging as other Americans. Without proper geriatric care training, doctors and nurses can fall into the same snare of treating the elderly differently from younger people. According to the Alliance for Aging Research 2008, “In recent years evidence has been mounting to suggest that, at all levels in the delivery of healthcare, there is a prevailing bias -ageism – that is at odds with the best interests of older people. Ageism can be defined as “any attitude, action, or institutional structure which subordinates a person or group because of age or any assignment of roles in society purely on the basis of age” (Traxler, 1980). This bias perspective against the old in American healthcare is evidenced by scores of recent clinical studies, surveys and medical commentaries”. In a report published by the Office of the Assistant Secretary for Planning and Evaluation (1994), five key dimensions of the ageist bias in which U.S. healthcare fails older Americans was outlined: “Healthcare professionals do not receive enough training in geriatrics to properly care for many older patients, older patients are less likely than younger people to receive preventive care, older patients are less likely to be tested or screened for diseases and other health problems, proven medical interventions for older patients are often ignored, leading to inappropriate or incompletetreatment, older people excluded from tests for drugs, even though they are the largest users of approved drugs.” Ageism is pervasive in health care with patients less likely to receive preventive care, and deprived of professionals trained in their needs. Bias attitudes and health care policies that discriminate against older adults prevent them from getting the treatment they need and deserve. This is such a tragedy of our medical system. I recently read an article that stated out of the 145 medical schools in the US, only 5 have full geriatric medicine departments. Only 10 percent of medical schools require course work or rotations in geriatric medicine and fewer than 3 percent of medical school graduates take electives courses in geriatrics. Unless there are mandates that require increased training and education of health care providers, more research into aging, the inclusion of older patients in clinical drug trials, and education for both patients and physicians in proper screening and prevention methods, ageism will continue to be prevalent in the US and our elderly population will not get the medical treatment that they too deserve.