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Health And Socio-Political Issues In Aged Care

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Question:

What Is The Deep Meaning Of Palliative Approach?

 

Answer:

Introduction

This paper is supposed to provide a deep insight regarding the palliative approach and its associated concerns. In relation to that, there has been the discussion regarding the implementation of the approach to treating the older people living in residential aged care. Thus it can be said that the paper engrosses the details of the policies as well as the advanced care directives along with the funding models.

Generally, when the lifestyle of the old aged care people is involved there is the sudden end of life through many kinds of serious progressive illnesses such as cancer, respiratory disorders, heart disorders and much more. So it can be said that the changing illness trajectories basically try to interfere with the lifestyle of the old aged people within their activities until death. On the other hand Best & Chenault said that, there have been many cases where there are the options by which the old aged people provide opportunity in accumulating the chronic diseases and make them die slowly (Best & Chenault, 2014).

The specification of the chronic illness is it works quite longer that lasts in between diagnosis and death. Thus in that condition, the older aged people experience pain, discomfort as well as various other related symptoms. So in that condition, those people require psychosocial as well as spiritual needs which will provide them peace in the life-threatening illness. For that reason there occurred the emergence of palliative approach or the end-of-life care approach to help the chronic disease patients to address their needs both psychological and mental as well as manage the symptoms in the last months of their life.

The word palliative approach is very meaningfully used in the diagnosis of the patients suffering from chronic illness. In that case, the approach basically provides the diagnosis process in which it will get clear that whether the disease condition is gradual or it can be reversible (Binde, 2014).

Various researches that have been carried out in the history have provided the knowledge that the people those act as the primary care providers should be well aware of the patient’s physical, social and the psychological challenges as per the nature of the illness. Thus the proper definition which will provide the meaning of Palliative Approach is that the approach is not at all confined to the diagnosis alone. In that case, the palliative approach is the part that is aimed towards the improvisation of the quality of life of the individuals who has been suffering from this illness from a long term (Buttigieg, et al., 2015).

It will also help in reducing their sufferings by the help of early identification, assessment as well as the treatment of pain, social, cultural, spiritual and psychological needs. More specifically this illness is the kind that brings the end of life of the patient within a predictable future (Cooke, et al., 2013).

 

Principles associated to the Palliative Approach

 A good health in terms of the old aged people with respect to understanding the perceptions regarding life allows the end-of-life care in an effective manner. Thus this process can be continued as well as planned in an effective manner. It works with open communication, control of the symptoms and the honest prognostics.

As per Coussens, Mason & Oni, the residential care, therefore, provided with the staff members who are quite trained as per the specialist advice and control. As a result, they become able to treat the common illness of the patients that arise in the residential care (Coussens, Mason & Oni, 2017). The researchers basically found these common systems that can be treated by these doctors are nausea, breathlessness, anorexia, constipation, depression, constipation, cough, anxiety, and insomnia (Ferreira-Neto & Henriques, 2016).

In addition to that, the residential care should be that much well equipped so that it will provide honest prognostication. Another vital thing which will help in treating the patient quite well is the open communication that will help in promoting the symptom control and all other discussions regarding the decision of ongoing care.

Thus it can be considered as the condition where there should be the provision of the quality of the life to such people who are approaching the end of life. Moreover, the proper quality of life that has been provided by the residential care starts from a proper diagnosis.

Thus the palliative approach to the end-of-life care is supposed to depend upon few principles. These principles will form the guidelines which will help in providing the patient the proper treatment as per their condition. These principles are the

  • The presence of the effective guidelines which will reflect the autonomy, respect, comfort as well as dignity within the workplace.
  • The honouring of the cultural as well as the spiritual wishes within the residential care. Similarly, the cultural differences are supposed to be respected as well as treated in a sensitive process. It will definitely have some profound effect upon the suffering of the patients irrespective of the cultural boundaries.
  • The patients within the residential care will be able to get the proper access for the people that they wish to be present near them.
  • The place should be filled with the open discussion regarding the health conditions as well as the treatment related to the health condition of the individual. This will make them feel the honesty and this will make them satisfied.
  • The support by the care providers should be well described by the effective management of the pain as well as many other distressing symptoms.
  • The most important principle is the part of the treatment that should be provided to the patient as per his or her health condition should be considered after going through evidence-based treatment options. It is said to be the choice of site of care. In this context, it can be said that the decision of the patient as well as the family should take the decision collaboratively regarding the site of care.
  • The patients should be provided with care excellence that includes the best possible care.
  • The patients need a consistent medical care that goes with an overall plan which should be established as well as reviewed as per each patient. It will further reduce the crisis chances or any kind of medical emergencies which can frighten the patients as well as the relatives.
  • The coordinated care, as well as the continuity of care, is quite needed in the residential care to treat the patients suffering from the chronic diseases.

Thus the main purpose behind the aim of providing the care as well as the support will result in the care providers to get the patients to lead a affirm life along with respect and normal process. In that context, it can be considered that this aspect is the behavioural aspect that is applied to the patients along with the conjunction with many other therapies that are intended for the provision of prolonged life to the patients (Gazibara, et al., 2016).

More specifically the researchers and many authors have provided the information from their research that this approach is not intended to provide any kind of service to postpone death. Rather this approach is supposed to provide the services for the enhancement of the quality of life of the patients during the course of their illness. In return, the life of the patients will get filled with positivity.

 

Improved end-of-life care as per the Ethical and Legal Aspects

The palliative approach is supposed to provide the supplement regarding the skills about those patients who usually end their lives due to stress. Thus the approach includes the management of the conditions psychologically through communication.

This can be fulfilled by going through the integrated care pathways. By that manner, the patient can feel the death seems to be inevitable but not painful or uncomfortable rather the patient can be able to die with a spiritual support.

On the other hand, the presence of the advance directives becomes more and more common that helps the care provider to take necessary as well as the essential information regarding the patient’s interest to provide any kind of consent regarding the patient (Hunt, 2016). These directives are such formulated that it will provide the precise clinical condition regarding the health of the patient in advance. In that case, the patient can be provided with the advance care planning. From the ethical ground, the patient has the right to choose his or her health advocate who will be able to provide health assistance regarding the decisions about the treatment processes.

At the same time the patient does not have any kind of legal rights to die rather they have the rights to decide about the treatment procedure. Again while viewing ethically the palliative approach to the end-of-life care is supposed to address the broad range of issues along with the specific amount of care basing upon their physical, emotional, spiritual and practical level. Thus in that context, Kapoor & Choudhary said that the provided literature also indicates that the palliative care prove itself quite beneficial to benefit as well as the well-being of the patient’s condition. And more specifically the emergence of the palliative approach is supposed to bring improvisation of quality in patient’s life (Kapoor & Choudhary, 2014).  

A palliative approach to the end of life care affecting the residential care that has implications on the funding of residential care:

The palliative care development funding is the initial attempt in creating a set of units which are appropriate for the use across all the palliative residential care right from children to adults (Kelly, et al., 2014). The funding has been helpful by collecting the data through the Palliative Care Funding Pilot which aims at describing the differences in the complications of the palliative care requirements of an individual and the related costs regarding the provision of care.

The funding’s collected for the cost of care and the case mix for every phase of every kind of illness. The palliative care funding has been developed by the recognition of the variables regarding the case mix and the attributes if the patients that are related to the variations of the direct costs regarding the palliative approach to end life care.

As per Kumar, the funding in the palliative approach can be regarded as the driver of the costs which are used for the grouping of data in such a manner that the stages of care relate to within every group which has similar direct cost.  These groupings are further classified and refined to form the assistance which is determined by the variables which are clinically meaningful and measurable (Kumar, 2013). Although the funding is considered which also help in the differentiation and categorization of the need for the palliative care in large varieties of health organizations that facilitate palliative care and a broad range of settings which deliver the palliative care. 

The funding is in demand during the treatments of eth patients suffering from acute diseases, hospice inpatient and during the encapsulation of wide range of services for the non-patients. In order to provide facilities for the development of a unit of minimum care palliative care for the variable set used for funding s which is kept as consistent across the various providers.  For example, the phase of eth sickness or illness has been a driver of costs in all varieties of providers of palliative care. 

In the settings of acute diseases, where several diagnoses are required, especially for the people below the age group of 75, funding is essential for the treatment in order to provide them with better life till death.  According to Lipi, the funding also varies for the community settings and the hospice inpatients along with the status of eth functions which are grouped into low, medium and high which are also related to the variations in the costs that are directed. The phase of the illness is also related to the direct costs associated with the physical severity that is categorized into low, medium and high (Lipina, 2014). 

The diagnosis of the acute diseases has a close association with the variation of the costs which leads to the high requirement for the funding.  Palliative care has various barriers in regards to the acute care, thus, has an approach that is based on the processes that are not appropriate. It is more likely that certain pathway funding that has been accepted in clusters by the palliative healthcare residential units. The funding that is presented to the palliative healthcare residential units is based on the requirements and needs of the patients suffering from the acute diseases instead of the procedure and process that are performed.

Funding to the residential palliative care nursing within the residential care units for the aged has been parallel with the financial development that is addressing the inequalities of the services that are related to the dying in the residential aged care. As per Mitchell & MacLeod, the funding related to the palliative approach provides an opportunity to recognize, adopt and implement the standards and guidelines through various individual residents of funding that are identified by the requirements of health care aspects. The funding that is provided is used in getting more number of beds to the residents (Mitchell & MacLeod, 2014).

The allocation of funding from the general revenue consolidation for the delivery of service is evident. In the context of palliative approach, the funding is made up of the identified units of care that are consistently used as payment between the providers and eth commissioners (Ng, 2015). The funding can be made in various forms such ads they can be made on the basis of a particular procedure that is taken place, the period of time taken over which a patient needs to be treated for an illness or the test of the diagnostics being carried out.

The resources that are used by the equipment, consumables, staff and the location such as drugs and dressings are similar which can be denoted within the funding that will differ from different other methods of financing. The funding will be helpful in getting the materials that are required for the treatment of the patients throughout their treatment in the residential care units till their death.

 

Critical reflection on the approaches and concepts:

Through the research on eth palliative approach, we could find that there is greater engagement and autonomy in the making if the decisions. As per Rühli, et al, a palliative approach provides the individuals and the families the opportunities and information to be engaged in the care in the decision making in a better way through the trajectory of illness. The approach of palliative care of which the open conversations are a part can assist the people in addressing the spiritual or emotional concerns (Rühli, et al., 2015).

These aspects can also assist the people in advance planning of care along with the setting of a goal, therefore, as the progress of the illness occurs, the families along with the individuals are able to make a decision that provides reflection on their personal goals and desires. Palliative approaches can include effective management that would concentrate on the care of eth patients who are suffering from advanced illness or crucial symptoms that are a burden by giving emphasis on eth appropriate goal setting that is meticulous for the control and assessment (Shier & Graham, 2015).

It can also be stated that the goals for the care change with changing times. It is also evident from the that there is no complete cure for the life-threatening diseases that are progressive such as severe chronic pulmonary obstructive disease, congestive failure of heart, and the conditions of progressive neurological disease such as amyotrophic lateral sclerosis, dementia and Parkinson's disease in which the individuals often opt for life-prolonging therapies which depend on their care goals that can alter the progress of the illness.

The main goal of the individual is basically used to prolong the life which is only possible in the initial stage of the trajectory of the disease. Through the passage of time, maintaining the functions like the cognitive or the mobility ability may become very significant which would facilitate the individual to choose the treatments that will assist in prolonging the life; however, it will not be in the capability to operate (Söderberg, Ståhl & Emilsson, 2015).

The comfort becomes the main goals of a palliative acre as the condition of the patients deteriorates and the individual may opt for rejecting the treatments which will lead to pain or would relate she or he has to be hospitalized. When the families and persons gain access to the approach of palliative care throughout their sickness, they have the support and information to have effective decision making which is appropriate for them. This process of making decisions provides a reflection on the personal objectives and goals.

Enhanced quality of life and greater longevity are the resultant of the strong and developed evidence which is an approach to palliative care when associated with treatment which would result in the better outcomes for the individuals and their families along with the caregivers. These would also include improvement in the satisfaction of the patients, quality of life and improvement in the symptoms along with posing fewer burdens on the caregiver (Ståhl, Costa-Black & Loisel, 2017).

Thus, more appropriate association to the application of the hospice and reduced use of intensive acre that would be futile is relevant.  It could be further recognized that the capacity of practitioners who are at the primary stage can act as a barrier to the adoption of palliative care approach. As per Turner, the palliative care can be given best by the practitioners who are experienced and are highly trained (Turner, 2014).

Therefore, a key challenge in the palliative care sector would be to hire and train the primary care practitioners. Moreover, the reluctance of the patients to be receiving the care leads to rejection or resistance to the approach of palliative care. However, the individuals still need to obtain the palliative services when they are mentally prepared and are ready to confront the issues that are associated with the end of life. In certain cases, the disagreements of the families of eth patients act as challenges in the palliative approach. The family members may happen to disagree with the plan of care for a patient or even refuse the preference of an individual (Villar, et al., 2016).

 

Conclusion:

The report deals with various aspects of a palliative approach in residential aged care at international and national level. The description of palliative approach and end of life care is described in brief in the assignment. The directive of advanced care and the significance of funding in palliative approach are discussed in the report. The approaches and the concepts associated with the palliative approach in the residential care have been reflected.

 

References

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Binde, P., 2014. Gambling in Sweden: the cultural and socio?political context. Addiction, 109(2), pp.193-198.

Buttigieg, S.C., Rathert, C., D’Aunno, T.A. and Savage, G.T., 2015. International research in health care management: its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities. In International Best Practices in Health Care Management (pp. 3-22). Emerald Group Publishing Limited.

Cooke, L.P., Erola, J., Evertsson, M., Gähler, M., Härkönen, J., Hewitt, B., Jalovaara, M., Kan, M.Y., Lyngstad, T.H., Mencarini, L. and Mignot, J.F., 2013. Labor and love: Wives' employment and divorce risk in its socio-political context. Social Politics: International Studies in Gender, State & Society, 20(4), pp.482-509.

Coussens, A.K., Mason, P.H. and Oni, T., 2017. Socio-political prescriptions for latent tuberculosis infection are required to prevent reactivation of tuberculosis. International Journal of Infectious Diseases, 58, pp.115-116.

Ferreira-Neto, J.L. and Henriques, M.A., 2016. Psychologists in public health: Historical aspects and current challenges. Journal of health psychology, 21(3), pp.281-290.

Gazibara, T., Kurtagic, I., Kisic-Tepavcevic, D., Nurkovic, S., Kovacevic, N., Gazibara, T. and Pekmezovic, T., 2016. Computer and online health information literacy among Belgrade citizens aged 66–89 years. Health promotion international, 31(2), pp.335-343.

Hunt, S., 2016. An Introduction to the Health of Two-spirit People: Historical, Contemporary and Emergent Issues.

Kapoor, A.K. and Choudhary, V., 2014. SOCIO-ECONOMIC, HEALTH AND PSYCHOLOGICAL ASPECTS OF ELDERLY: ROLE OF ECOLOGICAL DYNAMICS. Man and India: Found in 1921 by Sarat Chandra Roy; Special Issue on Health Ecology, An International Journal of Anthropology, pp.573-583.

Kelly, A., Devitt, C., O'Keeffe, D. and Donovan, A.M., 2014. Challenges in Implementing Inclusive Education in Ireland: Principal's Views of the Reasons Students Aged 12+ Are Seeking Enrollment to Special Schools. Journal of Policy and Practice in Intellectual Disabilities, 11(1), pp.68-81.

Kumar, J.R., 2013. Role of public health systems in the present health scenario: key challenges.

Lipina, S.A., 2014. Green economy and green technologies in Russia: opportunities and prospects: social medicine in the regions that have experienced poor socio-political situation and ways to resolve some of these difficulties. ??????? ??????????? ???????????? ?????? ???????. ?????: ???????? ? ???????????? ?????????????????, (3).

Mitchell, T. and MacLeod, T., 2014. Aboriginal social policy: A critical community mental health issue. Canadian Journal of Community Mental Health, 33(1), pp.109-122.

Ng, I.Y., 2015. Welfare Attitudes of Singaporeans–Ambiguity in Shifting Socio?political Dynamics. Social Policy & Administration, 49(7), pp.946-965.

Rühli, E., Sachs, S., Schmitt, R. and Schneider, T., 2015. Innovation in multistakeholder settings: The case of a wicked issue in health care. Journal of Business Ethics, pp.1-17.

Shier, M.L. and Graham, J.R., 2015. Subjective well-being, social work, and the environment: The impact of the socio-political context of practice on social worker happiness. Journal of Social work, 15(1), pp.3-23.

Söderberg, M., Ståhl, A. and Emilsson, U.M., 2015. Stratified structural and epistemic aspects of the care manager's discretion—a theoretical approach to social work related to older people's potential relocation to a residential home. European Journal of Social Work, 18(3), pp.325-339.

Ståhl, C., Costa-Black, K. and Loisel, P., 2017. Applying theories to better understand socio-political challenges in implementing evidence-based work disability prevention strategies. Disability and rehabilitation, pp.1-11.

Turner, P.K., 2014. The emerging role of alternative midwifery within the wider socio-political sphere. Complementary and Alternative Medicine in Nursing and Midwifery: Towards a Critical Social Science, p.33.

Villar, F., Serrat, R., Celdrán, M. and Fabà, J., 2016. Attitudes Toward Masturbation Among Residents of Spanish Residential Aged Care Facilities. Sexuality Research and Social Policy, 13(2), pp.182-191.

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