(PDF) Evaluation of health care services provided for older

Critical discussion and
evaluation of the primary
health care services and
resources provided to the
older people

INTRODUCTION
Background:
Primary health care (PHC) are defined as the strategies and methods for health
promotion, screening, prevention, intervention and treatment of health services. Aged care
services are essential part of the PHC because old people are required to frequently visit the
hospitals (Murray & et.al., 2017). The study will discuss the importance of such aged care
services and how they are implemented in Australia.
Thesis statement:
PHC services and resources for the old people
Aim:
To evaluate the Primary health care services and resources provided to older people.
Significance and scope:
Along with the physical issues, psychological disorders are also common in the older age.
Thus aged care services are required to more specific and focused on the needs of old people
(Murtagh & et.al., 2016). The study will help to evaluate the effectiveness of different aspects
and resources of elderly PHC.
PHC in NSW Sydney
Aged care services in Australia
Health care services and resources in Australia aims at assuring the overall care for the
aged people. It has been also observed that old people are often not treated with dignity and
respect due to their health issues and functional dependency. Australia health care has introduced
several reforms to assure that aged groups are provided equal treatment and care services
(Alldred & et.al., 2016). The aged care reforms provide complete guidelines related to health
service framework for older people. The multidisciplinary teams which not only regulates the
nutritional and medication requirements but also analyse the rehabilitation and transitional needs.
The key responsibility of the professionals providing PHC services is to regularly
monitor the health needs of old people. It helps to ensure the regular review of the health
condition of the people (Tropea & et.al., 2017). The people above 75 years of age needs regular
health monitoring so that their health issues can be identified and resolved and health associated
risks can be identified. For instance the difficulty in mobility can enhance the fall risk and in
such critical age fall can be a serious concern. Thus, such type of health risk can be eliminated by
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providing home care services. Old people are also in need of continuous home care services so
that their assistance needs can be meet. The health care assistance helps in medications, routine
movement and other functional activities. In Australia the care home centres for elderly also
provides palliative and transitional care as an essential part of the care plan (Turner & et.al.,
2016).
Importance of PHC for older people
The health care needs of old people varies from acute to chronic level. Usually it is
assumed that for aged care multidisciplinary care approach is best because it can meet physical,
cognitive as well as functional needs of aged people. PHC of NSW Sydney promotes integration
and collaboration in health care services so that community members can access care services at
right time (Aged Care, 2019). Many old citizens dose not live with their family members. Thus,
the limited functional ability and knowledge make it difficult for the old people to identify and
approach their health needs. For instance the mobility functionalities are the biggest challenge
for old people.
Along with this the fall risk, lower confidence level and enhanced physical dependency
of old people demands for a holistic approach so that different occupational therapists can make
their living better. As a part of this holistic approach palliative care services, transitional and
rehabilitation services are an integral part of the elderly health care system. The old care homes
are also an essential part of the PHC for old people (Bail & et.al., 2015).
Care centres not only fulfil the health care needs of people but also helps them to live
with the other aged people so that they can overcome the loneliness. The PHC services of NSW
Sydney also regulate that these care homes are accompanied with the multidisciplinary teams
and quality of services is also effective (Kouladjian & et.al., 2016). The integration of palliative
services is essential so that aged people can fight their battle with the fear, anxiety, loneliness
and pain which they are facing as long term impact of their age related factors.
PHC resource and services related to old people
In old age it becomes very challenging for the people to cope up with the decline
functionality as well as with the changing social and psychological aspect. Along with the
physical disabilities many people suffers from depression due to loneliness and reduced social
participation. Thus, along with the availability of proper medications PHC services also includes
various non-medication aspect. For instance occurrence of chronic and terminal diseases in the
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late phases of life can be very painful. In such situations palliative care services can help them to
reduce the symptoms of pain. With the growing age, fear of death is also quite common which
can make people nervous (Comans & et.al., 2016).
Thus, palliative care services aims to make or present death as normal process so that
aged people and their carers can accept it. Along with these care services disabilities are also
quite common in aged people. They may face issues in performing routine functions which can
be one of the cause for their degrading health. Thus, to assure that their quality of health is
improved NSW Sydney also provides rehabilitation services (Primary health care, 2018).
In these centres professional health service providers assist aged people so that they can
regain and cope up with their physical abilities. The support from these centres motivates aged
people so that they are encouraged to enhance their physical participation in their day to day life.
In order to further enhance the quality services for older people another model which is
commonly used in Sydney health care model is transitional care model. For the old people there
is need of continuous care and coordination at all intervals of time (Laver & et.al., 2016). Thus,
when old people are transferred from health institutes to their home or other care centres
transitional care services ensure that same level of care is also provided to them at home. For
example the diet and nutritional requirements of old people must be monitored. Thus, transitional
services ensures that even at home nutritional care of old people is not avoided and their needs of
assistance are fulfilled.
Resource allocation and model evaluation
It has analysed from the above discussion that for the elderly care a comprehensive and
integrated care model is required. Old people needs physical assistance as well as continuous
care and monitoring. However, the use of palliative care services will help them to accept their
age and clinical condition as the normal process without being nervous or panic. The transitional
services are means to assure that the PHC services can identify the needs of old people. Similar
to other social groups old people also have right to access quality health services with dignity
and care (Qi & et.al., 2015). The resource allocation for the different PHC services is
accomplished as follows:
Palliative care services: Palliative care services are provided to old people who are receiving
treatment of terminal diseases or life limiting illness. Palliative care consist of principles such as
integration of spiritual aspects, support system and medications which can provide relief from
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distress. NSW Sydney provides state wide palliative helpline so that palliative care is accessible
to all people. The Australian government provide funds under National palliative care program.
With this program and funds palliative care is provided to disabled and aged people free
palliative services.
Home care services: These services are provided to old people who needs physical assistance for
performing the routine activities as well as old people suffering from dementia and other critical
situations. The service include day care nurses who can help old people at their homes or care
centres. NSW Sydney and other Australian states provides funds for nurses and other community
services which are needed by old people. The residential or home care services for old people
such as respite care, dementia support programs and carer assistance is funded by commonwealth
funds and support. The Australian government also provides funds for the construction and
maintenance of aged home care facilities through resident charges or subsidies.
Thus, the PHC guidelines and models provided guidelines for the health professionals so
that they focus on the needs of these people. Palliative and rehabilitation care service are not
similar to the routine care services. Thus, the health professionals are required to have better
understanding of needs of elderly people (Alldred & et.al., 2016).
Along with the professional skills the PHC service providers must have sympathy and
effective communication with the old people. The emotional bonding and communication with
the old people is one of the most important aspect to understand the needs of such groups. Due to
loneliness and age related changes it has been observed that old people are often mistreated and
thus they hesitate to interact with others. In such cases it is the responsibility of the care service
providers to analyse communication aspects and to act accordingly (Jokanovic & et.al., 2016).
The multidisciplinary teams are vital for the effective person centric and holistic care approach
provided to old people. However, there must be coordination between various health
professionals. The lack of coordination and integration among health professionals can cause
adverse impact on the health outcomes objectives of primary heath services.
CONCLUSION
From the above discussion it can be concluded that aged health care services must not
only include effective medications but it must also focus on various aspects such as palliative
care or transitional care services. It has been also analysed from the above discussion that for
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assuring the quality health services to old age communities additional care needs must be
delivered. It is possible only when their needs and available resources are analysed and evaluated
properly. It has been also analysed from the study that for quality care services health
professionals must also identify the needs of palliative and other care services which can assist in
overall well being of aged groups. Thus, it can also be concluded that PHC services for old
people must not only aims at medication needs but non-medications need as well.
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REFERENCES
Books and Journals
Alldred, D. P. & et.al., (2016). Interventions to optimise prescribing for older people in care
homes. Cochrane Database of Systematic Reviews. (2).
Bail, K. & et.al., (2015). The cost of hospital-acquired complications for older people with and
without dementia; a retrospective cohort study. BMC health services research. 15(1). 91.
Comans, T. A. & et.al., (2016). The increase in healthcare costs associated with frailty in older
people discharged to a post-acute transition care program. Age and ageing. 45(2). 317-
320.
Jokanovic, N. & et.al., (2016). Clinical medication review in Australia: a systematic
review. Research in Social and Administrative Pharmacy. 12(3). 384-418.
Kouladjian, L. & et.al., (2016). Health care practitioners’ perspectives on deprescribing
anticholinergic and sedative medications in older adults. Annals of
Pharmacotherapy. 50(8). 625-636.
Laver, K. & et.al., (2016). Clinical practice guidelines for dementia in Australia.
Murray, S. A. & et.al., (2017). Palliative care from diagnosis to death. Bmj. 356. j878.
Murtagh, F. E. & et.al., (2016). Supportive care: comprehensive conservative care in end-stage
kidney disease. Clinical Journal of the American Society of Nephrology. 11(10). 1909-
1914.
Qi, K. & et.al., (2015). Older peoples’ attitudes regarding polypharmacy, statin use and
willingness to have statins deprescribed in Australia. International journal of clinical
pharmacy. 37(5). 949-957.
Tropea, J. & et.al., (2017). Poorer outcomes and greater healthcare costs for hospitalised older
people with dementia and delirium: a retrospective cohort study. International journal of
geriatric psychiatry. 32(5). 539-547.
Turner, J. P. & et.al., (2016). Polypharmacy cut-points in older people with cancer: how many
medications are too many?. Supportive Care in Cancer. 24(4). 1831-1840.
Online
Aged Care. 2019. [Online]. Accessed through <https://www.swsphn.com.au/agedcare>
Primary health care. 2018. [Online]. Accessed through <https://www.cancer.nsw.gov.au/cancer-
plan/focus-areas/primary-health-care>
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