Elderly care
Elderly care, or simply eldercare (also known in parts of the English-speaking world as aged care), serves the needs of old adults. It encompasses assisted living, adult daycare, long-term care, nursing homes (often called residential care), hospice care, and home care.
Elderly care emphasizes the social and personal requirements of senior citizens who wish to age with dignity while needing assistance with daily activities and with healthcare. Much elderly care is unpaid.[1]
Elderly care includes a broad range of practices and institutions, as there is a wide variety of elderly care needs and cultural perspectives on the elderly throughout the world.
Medical (skilled care) versus non-medical (social care)[edit]
A distinction is generally made between medical and non-medical care, the latter not being provided by medical professionals and much less likely to be covered by insurance or public funds. In the US, 67% of the one million or so residents in assisted living facilities pay for care out of their own funds.[53] The rest get help from family and friends and from state agencies. Medicare does not pay unless skilled-nursing care is needed and given in certified skilled nursing facilities or by a skilled nursing agency in the home. Assisted living facilities usually do not meet Medicare's requirements. However, Medicare pays for some skilled care if the elderly person meets the requirements for the Medicare home health benefit.
[54]
Thirty-two U.S. states pay for care in assisted living facilities through their Medicaid waiver programs. Similarly, in the United Kingdom the National Health Service provides medical care for the elderly, as for all, free at the point of use, but social care is paid for by the state only in Scotland. England, Wales and Northern Ireland have failed to introduce any legislation on the matter and so social care is not funded by public authorities unless a person has exhausted their private resources, such as by selling the home. Money provided for supporting elderly people in the UK has fallen by 20% per person during the ten years from 2005 to 2015 and in real terms, the fall is even greater. L Experts claim that vulnerable UK people do not get what they need.[55]
However, elderly care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or public authorities, rather than the resident, may be providing the cost of care. If residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern. The Adult Protective Services Agency, a component of the human service agency in most states, is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors or nurses, police officers, lawyers, and social workers.[56]
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During primary care[edit]
There is currently limited evidence to form a robust conclusion that involving older patients with multiple health conditions in decision-making during primary care consultations has benefits.[57] Examples of patient involvement in decision-making about their health care include patient workshops and coaching, individual patient coaching. Further research in this developing area is needed.