Health and Socio-political Issues in Aged Care: Report Analysis

This report provides a detailed analysis of palliative care within residential aged care settings. It begins with an explanation of palliative care and its application, followed by a critical discussion of advanced care directives, including their use and application in aged care facilities. The report then delves into the legal and ethical considerations associated with these directives, examining the challenges and complexities that arise. Finally, it identifies and discusses strategies aimed at improving the provision of palliative care services, considering various aspects such as patient care, legal frameworks, and ethical principles. The report incorporates relevant literature and offers a comprehensive overview of the key issues and potential solutions in this critical area of healthcare.

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Health and socio-political issues in aged care
health and socio-political issues in aged care
MAY 23, 2019
STUDEnt Details:

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Health and socio-political issues in aged care
Contents
Introduction......................................................................................................................................2
Health and socio-political issues in aged care.................................................................................3
Evaluation of palliative care in residential aged care..................................................................3
Critical discussion of advanced care directives in residential aged care.....................................4
Critical discussion of legal and ethical considerations associated with advanced care directives
in residential aged care................................................................................................................5
Strategies that may improve the provision of palliative care in residential aged care.................8
Conclusion.....................................................................................................................................11
References......................................................................................................................................12

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Health and socio-political issues in aged care
Introduction
“Palliative care” deliver care and support for the people at “the end of life” to give relief
and to enhance “the quality of life” due to illness. As the people get the aged, incidence of life
ending illness would be increased in the aged peoples. Due to this, aged individuals are more
likely to require palliative care. This care is often provided in “residential aged care” (Stokoe, et
al., 2015). To support the “palliative care” facility in “residential aged care”, “advanced care
directives” would be provided as the key strategy (Martin R. S., Hayes, Gregorevic, & Lim,
2016).
This essay will describe “palliative care” facility in “residential aged care” at the
beginning. This would be followed by a critical discussion of “advanced care directives” in
“residential aged care”. After this, a critical discussion would be done about “the legal and
ethical considerations” linked with “advanced care directives”. The final section of the essay
would discuss the strategies that may enhance the delivery of “palliative care” in “residential
aged care”.

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Health and socio-political issues in aged care
Health and socio-political issues in aged care
Evaluation of palliative care in residential aged care
“Palliative care” is a method to help peoples in the improvement of the quality of their
life. “Palliative care” would be delivered to the peoples having life-ending threats. It would be
provided to the peoples by prevention and relief providing approaches and through the early
detection of the life-ending threats (Rosenwax, Spilsbury, McNamara, & Semmens, 2016).
Palliative care would be done for the peoples by providing treatment at the physical, mental and
social level. By the help of palliative care, release from the painful symptoms. It would provide a
support system to the peoples to help them and their family in grief. During palliative care,
therapies such as recreational therapy, radiation therapy, and respiratory therapy would be
provided to prolong the life of peoples (Organization, 2019). It would be provided by the
resident doctors, medical practitioner and nurses of the palliative care team to the peoples in the
resident. They would provide support and care to ensure comfort and maintenance of dignity
during the end of their life (AIHW, 2018).
Holistic care would be provided to the aged peoples to treat them at the psychological
level, social and physical level. During palliative care, they fulfill their daily requirements like
water, healthy diet and discharge of feces. They would provide safety and security to the peoples.
They provide support and motivation to the peoples to live life with dignity. They would provide
medication and therapy during palliative care (Dwyer, Craswell, Dolene, & Holzberger, 2017).
By the help of palliative care, it would be easy to provide an efficient daily living, effectiveness
in behavior and effective complex health care. By palliative care approach, they enhance the
quality of life and to live with dignity to the aged peoples. Palliative care would be helpful to

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Health and socio-political issues in aged care
cure disorder like dementia, diabetes, coronary heart diseases, lung cancer and prostate cancer at
the end of life of aged peoples (Butler, 2017).
Critical discussion of advanced care directives in residential aged care
“Advanced care directives” are legal and written documents having a living will of the
peoples about their medical situations. These advanced care directives would be used when
peoples suffer from life-ending illness and not able to express their willing about the treatment.
Power of attorney is medical healthcare having the ability to name any close person to take
decisions when the patient would not be able to express decisions about their health situations.
By the help of this, doctors would be able to make decisions about the patient to keep the patient
life or not (Staff, 2018).
It is a way to say what healthcare treatments a people wants to take or do not want to take
when the people would be in very serious condition due to diseases and not able to take any
decision. In these advanced directives, complete information about the wishes of the people that
what are their values and life goals and achievements of life would be mentioned. There are
many medical advanced directives by the help of those medical advanced directives it would be
easy to keep people alive during life-ending illness to enhance their life quality. Many peoples
have wishes about their life that how they want to live their life and which treatment aged
peoples wish to take during “the end of life”. Sometimes family and doctors would not be able to
take decisions that what would be best for the patient and their life. Then these advanced care
directives would be helpful to take a decision during these situations of the patient. By the help
of these “advanced care directives”, doctors and family would be able to take decision easily
about the life of the patient (Health, 2018).

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Health and socio-political issues in aged care
Advanced care directives would be made by the peoples when they think about the
important things during “the end of life”. For the making of the “advanced care directive”, a
person thinks that what would be important during terminating illness, to take treatment and care
or to refuse care. A person would think about that person who would have the right to take a
decision on behalf of them during the inability of the person. A person would be able to decide
that at what place and by whom the person wants to be taken care off during the end of the life.
These advanced care directive would be written on the template or form provided by the
government. These advanced care directive would only be used by the doctors and healthcare
professionals when the person would not be able to take decisions and to communicate about
their decisions related to their treatment. These advanced care directive would be mentioned by
the doctors and healthcare professionals that the advanced care directive would be applicable to
the situation or not. If a person stated about natural death in the advanced care directive, then
pain relief providing treatment would be still provided to the patient. Because doctors and
healthcare professionals would always provide prior important to pain relief and managing
discomfort. Advanced care directive would be kept at the safe place and where the place would
be easily approachable to the family and to the doctors (Health, 2018).
Critical discussion of legal and ethical considerations associated with advanced care directives in
residential aged care
“Palliative care” providing as per “advanced care directives” in “residential aged care”
would be challenging because of “legal and ethical considerations” for providing “palliative care
interventions”. Because for the caring plan not only patient consideration required but his or her
family, economic, legal, institutional and social circumstances around the patient would also be
required. Due to legal considerations of the country where people would undergoing treatment,

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Health and socio-political issues in aged care
doctors and the team of palliative care would not be able to deliver complete care to the patient.
Because the country law would not provide legal right to die by the help of doctors and to take
unwanted treatment which would be harmful to the patient and can lead to the death of the
patient. These situations would lead to the legal action to the patient and to the doctors by the
honorable Supreme Court of that country. Working in a way that would lead to the illegalization
of law would lead to severe consequences to the patient and to the doctor (Pope, Arnold, &
Givens, 2018).
If the patient takes unwanted treatment or refuse to take the required treatment would
lead to severe consequences by the honorable Supreme Court. If the doctor would not mention
clear aspects of the treatment may lead to the action for the civil and criminal sanctions for the
doctors and their team of palliative care. So due to these legal aspects, doctors and their palliative
care team have fear of being the part of illegalization and of severe consequences of the
illegalization (Pope, Arnold, & Givens, 2018). Due to this, the doctors and their palliative care
team provide treatment and holistic care at the “physical, social, mental and spiritual level” of
the patient in a safe area to prevent illegalization. They provide treatment as per “advanced care
directives” written by the patient after considering permission by the honorable Supreme Court.
For this, the advanced care directive of the people about their wishes for life at “the end of life”
would be submitted to the honorable Supreme Court. Then after granting permission by the
honorable Supreme Court, doctors and palliative care team provide treatment as per patient
requirements (Carter, Detering, Silvester, & Sutton, 2015).
These legal considerations of decision making for the patient right of living with dignity
vary from country to country and sometimes by the states also. Many countries like Ireland,
Italy, Poland, and Sweden do not provide permission for providing treatment as per advanced

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Health and socio-political issues in aged care
care directives of the peoples. While other countries provide legislation with specificity for
advanced care directives. These countries provide specific legislation with valid documentation
terms and conditions like one written and two recorded directives by the patient and their family.
They provided specific legislation to make a decision towards “the end of life” due to the living
of “life with dignity” (Flo, et al., 2016).
The ethical principles would be considered during “the end of life care” provided by “the
doctors and their palliative care team” to maintain the dignity of the patient and to prevent
conflict with the right of the patient. The principles of ethics named principle of autonomy,
decision making, the principle of beneficence, the principle of justice would be considered
during “the end of life” support delivered by the doctors and their team. In the principle of
autonomy, the patient has right as a decision maker. The patient would be able to decide about
the end of life care treatment due to their right of self-determination. If the patient would not be
able to take the decision about the treatment and value of their life than motivate patient and their
family about the end of the life care plan and use advanced care directive (McCabe & Coyle,
2014).
“Doctors and their palliative care team” would use advanced care directive written by the
patient to prevent harm to their right to autonomy. In the principle of beneficence stated about
the decisions which would be good or beneficial for the patient. Doctors and their palliative care
team would provide a treatment which would be best for the patient. During the treatment, they
have to take care that the right of autonomy would not be harmed or conflict during the
treatment. The principle of justice for the patient right would state the fairness in the delivery of
care provided by the doctors and their palliative care team. For this, doctors and their palliative
care team would provide a treatment which would not get discriminated and would not harm the

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Health and socio-political issues in aged care
dignity of the patient (McCabe & Coyle, 2014). Ethical issues may generate during the advanced
care directive of the patient would be considered during the decision making by “the doctors and
by their palliative care team” of the patient. Because ethical issues due to the culture of the
patient may rise during the decision making at “the end of life” care for the patient. The family
members and friend of the patient may rise problems during the withholding of the artificial
treatment by the doctors at “the end of life”, as per patient wish for natural death written in the
“advanced care directive” by the patient. The family and friends of the patient may get angry on
the withholding of the treatment at “the end of life” care of the patient. Due to this, many
difficulties may arise in front of the decision makers (Fan & Rhee, 2016).
But ethical issues would be rise due to the physician-assisted suicide which would be
provided to the patient as per their wish to die with dignity. But due to the religious and cultural
ethics would not allow death with their wish. Religious people in the society think that God
provided our life as a gift and life and death would be provided by God. The servants of God
preaches that the good and bad in our life would be provided by God as per our deeds. They
preach that people do not have the right to die by their wish, they have to die with natural death
without any help of doctors (Denniss, 2016). Due to the advanced care directive of the patient, if
the patient wants death with dignity than the death would not be provided by the doctors because
of the Hippocratic Oath of the doctors. In the Hippocratic Oath of the doctor, doctors would have
to take a pledge that they would help the patient by providing bets treatment. But if they would
provide euthanasia means physician-assisted suicide to the patient, they would play
discriminated with their Hippocratic Oath. These ethical issues may arise during the “advanced
care directive” in the “residential aged care” (Askitopoulou & Vgontzas, 2018).

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Health and socio-political issues in aged care
Strategies that may improve the provision of palliative care in residential aged care
To improve the “palliative care” in the “residential aged care” many strategies would be
established. In these strategies, doctors would have to focus on the treatment of all those ills
which would be reversible diseases. “Doctors and their palliative care team” would have to focus
on the treatment which would be life-sustaining and to evaluate the better results in the facility.
They would have to provide treatment for the reversible illness if they would be cured without
leading major suffering to the patient. These treatments would be provided by the patient for
providing relief and comfort in the symptoms of the patient at “the end of life”. They would have
to provide care and comfort by providing terminal care during the end of the life of the patient
(Martin R. S., Hayes, Hutchinson, Yates, & Lim, 2017).
They would have to provide an increment in the education knowledge about “the legal
and ethical principles” to the staff of the palliative care team. They would have to provide
education programs for enhancing skills and confidence of the staff of “the palliative care team
in the palliative care program” (Lewis, Morrell, Ong, Trankle, & Hillman, 2016). They have to
use the linkage strategies with increment in the positive results. Linkage strategies would be
multidisciplinary teams, improved advanced care plans, and strategies, designated linkage
worker, clarification of the role, exchanging and enhancing skills of knowledge and enhancement
in patient-centered care approach. These linkage strategies would be helpful in the improvement
due to palliative care by providing regular discussion about the health of the patient in between
the staff members of the team of palliative care. These strategies would be useful by providing
supportive discussion and documents for the enhancement in the palliative care plans. Palliative
care plans would be enhanced by the help of designated linkage worker because they help in
providing improvement in the cooperation inside the services and care. They would provide

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Health and socio-political issues in aged care
improvement in promoting common understanding and improvement in the stability of palliative
care (Guest, 2019).
By the help of linkage strategies, it would be easy to improve stability in the palliative
care plan due to clarification in the role and duties in between every physician. Improvement in
the palliative care would be done by the help of exchanging knowledge between the team
members of “the palliative care team” to maintain autonomy of the patient (Johnson, Kerridge,
Butow, & Tattersall, 2017). By the help of exchanging knowledge, it would be easy in the
improvement of the skills and would be helpful in enhancing the ability to provide palliative care
to the aged peoples. Patient-centered care would be enhanced by providing enhanced holistic and
spiritual care to the aged person. They would have to provide cost-effective palliative care to the
patient. They would have to provide palliative care in rural areas. They would have to provide an
increment in the understanding and interaction in the company of resident facilities and the
resources (Guest, 2019). They would have to provide effective leadership styles and critical
thinking skills as per the situation of the patient. By the help of this, they would be able to
enhance the quality of life and better improvement in providing relief and comfort to the patient.
They would have to avoid unnecessary treatment during palliative care of the aged peoples. They
would have to avoid high cost having hospitalization during cost-effective palliative care to the
aged peoples in “residential care” (Chapman, Johnston, Lovell, Forbat, & Liu, 2016).

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Health and socio-political issues in aged care
Conclusion
From the above discussion, I have concluded that palliative care provides care and
support to the aged peoples to enhance their life quality at “the end of life”. By the help of this,
in the “residential aged care” doctors and palliative care team provide care and support to the
aged people. Because as peoples get aged, they may suffer from many diseases like dementia,
diabetes, acute coronary syndrome, lung cancer, and osteoporosis. Due to this, they need
palliative care to maintain their “quality of life” and dignity at “the end of life”. For this, they
would be able to write legal documents of advanced care directives. In these “advanced care
directive”, they would be able to mention about the wishes of their own that how they want to
live at “the end of life”. These “advanced care directives” would be used by “the doctors and
their palliative care team” during the time when peoples would not be able to express their
wishes to “doctors and their palliative care team” due to their life-ending illness. Many “legal
and ethical issues” may arise along the “advanced care directives”. Therefore to prevent these
legal and ethical issues and to provide effective palliative care many strategies would be
provided to improve palliative care and to deliver care and relief during “the end of life”. The
strategies which would be helpful in the enhancement of the life would be linkage strategies,
education and skill enhancement programs, and holistic and spiritual care approaches.