managed healthcare of the elderly

Changes occurring in Health c be delivery and practice of medicine be the result of social, economical, technological, scientific forces that cause evolved in the 21st century. Among the close to significant changes are shift in disease patterns, advanced technology, change magnitude consumer expectations and high costs of wellness share. These factors have re specify medical practices to fit into the ever-changing health delivery system. Thus, medical profession is Accountable to the society. i.e,obliged to the laws regulating the master activity.This account major power is usually spelt out in patient sustenance Documents established by hospital associations and medical associations or councils of either country. In addition, medical profession has defined its standards of accountability through a dress code of ethics. There has been a recent significant increase in the number of elderly patients in palliative care units of hospitals in U.S.A and every healthcare delivery system aims to provide the elderly community in need of some(prenominal) services including physical therapy, speech therapy and chemotherapy due to many disabling and terminal diseases. But most of these elderly patients prefer to turn around their end life care in a hospice rather than in palliative care units of hospitals.HOSPICE A MANAGED HEALTHCARE FOR THE TERMINALLY ILL ripened PATIENTSHospice is a coordinated programme of inter disciplinary care provided generally in the home of the terminally rachitic patients. The palliative care is the panoptic care for patients whose disease is not responsive to cure and hence are terminally dyspeptic. In the past two decades there has been a examine of enormous magnitude in the palliative care segment and heterogeneous factors have been identified like, respecting patients goals, preferences and choices, attending to the medical, emotional, social and spiritual needs of the person, using strengths of interdisciplinary resource s, acknowledging and addressing concerns and building mechanisms and systems of support.Many terminally ill elderly patients suffer only when they do not receive capable care for the symptoms accompanying their serious illness. This is significant in the changing health care scenario where the patient is well informed, has the right to accept or food waste a treatment, issue advance directives and even appoint a representative directive. Managed care for the elderly population is relevant in the present sidereal day health scenario where euthanasia and physician assisted deaths have found a legal niche as in the State of Oregon.THE MANAGED CARE improvementAny health care delivery system isprimarily perpetrate to the principles of patient self-care on the principles of Dorothea Orem (1971) with emphasis on lymph nodes self-care needs. Self-care, check to Orem, is a learned, goal-oriented activity directed towards the self in the interest of maintaining life, health, tuition and well being. The ultimate emphasis of Orems theory is on clients self care. Accordingly, care is needed when the client is unable to effectuate biological, psychological, developmental or social needs and the health care conferrer determines by duty why a client is unable to get a line the needs or what must be done to enable the client to meet them. Health care of elderly population demands enormous resources of time, naught and money. Hence, every family looks up to any such programs with some faith element. help of terminally ill population is still more stressful for the family in a hospice setting and any hospice setting requires a inter disciplinary care provided primarily in the home of the terminally ill patients. such patients are usually immobilized and it is not medically advisable to take them to a hospital for therapies. Thus, the significance of the services being taken to the patients home, especially the elderly, by health care organizations is the need of th e hour and afterlife with the time constraints faced by many families in the super debased world in taking these elderly people for a rhythmical therapy, the advantages the patients get in terms of pain relief, effective communication subject and symptom relief.This feature distinguishes the program from the rest of the health care programs that are currently available. The implementation schedule, i.e., the chronological sequence of events and activities that need to be achieved all over a defined period of time to achieve the Goals and Objectives has to be defined by the Organizational Structure of the healthcare delivery system which identifies and describes the habit of individuals, and their alliances in the system, who are key to the success of the program.THE DISADVANTAGEThere is a perennial shortage of occupational, physical and speech therapists in the health care system in the USA. Thus, there is a growing demand and comparative short supply of professionals. Cogni tive traumas pose a serious barricade on the reliability of geriatric assessments (Weiner et.al, 1999). Some of these patients may be marginally competent and some may be incompetent. Effects of cognitive impairment on the reliability of geriatric assessments has been studied recently to explore the relationship betwixt cognitive status and reliability of multidimensional assessment data. The studies have proved that the reliability of the patients communication and sensory ability are affected by cognitive status. Thus, any such program aimed at the elderly population should be implemented with care with authenticated informed consent.REFERENCEAddington Thomas et.al, Ethics and communication with the Terminally ill, Vol 7(3), 267-281, 1995, Health Communication.Anderson Christina et, al, Continuous Video recording a new clinical research tool for studying the nursing care of cancer patients, daybook of Advanced Nursing, Vol 35(2), 257, July 2001. Astudillo Wilson et, al How ca n relations be improved between the family and the support team during the care of terminally ill patients?. Supportive premeditation in Cancer Vol 3(1), 72-77, Jan 1995. Barrington Dianne et, al, Facilitating communication and interactional skills with terminally ill patients -Teaching and learning Forum 97, Australia. Chochinov Harvey Max et.al, Prognostic awareness and the terminally ill, Psychosomatics, Vol 41, 500-504, decline 2000. Weiner D et, al, Chronic pain associated behaviors in the nursing home nonmigratory verses care givers perceptions, Pain, Vol 80(3), 577-88, Apr 1999.