End of Life

Topics: Old age, Health care, Resource allocation Pages: 5 (1713 words) Published: October 27, 2013

According to IOM (2008), the next generation of older adults will be like no other before it. It will be the most educated and diverse group of older adults in the nation’s history. They will set themselves apart from their predecessors by having fewer children, higher divorce rates, and a lower likelihood of living in poverty. But the key distinguishing feature of the next generation of older Americans will be their vast numbers. According to the most recent census numbers, there are now 78 million Americans who were born between 1946 and 1964. By 2030 the youngest members of the baby boom generation will be at least 65, and the number of older adults 65 years and older in the United States is expected to be more than 70 million, or almost double the nearly 37 million older adults alive in 2005. The number of the “oldest old,” those who are 80 and over, is also expected to nearly double, from 11 million to 20 million (Institute of Medicine of the National Academies [IOM], 2008, p. 29). The United States health care system faces enormous challenges as the baby boomer generation nears retirement age. Current reimbursement policies, workforce practices, and resource allocations all need to be re-evaluated, and redesigned in order to prepare the health care system for meeting the needs of the inevitably growing population of older adults. Areas such as education, training, recruitment, and retention of the health care workforce serving older adults will require remodeling. To accomplish this will require the dedication and allocation of greater financial resources, even at a time when budgets are already be severely stretched. “The nation is responsible for ensuring that older adults will be cared for by a health care workforce prepared to provide high-quality care. If current Medicare and Medicaid policies and workforce trends continue, the nation will fail to meet this responsibility. Throwing more money into a system that is not designed to deliver high-quality, cost-effective care or to facilitate the development of an appropriate workforce would be a largely wasted effort” (IOM, 2008, p. 1-12). Ethical Standards for Resource Allocation

Ethics have a paramount role in solving the complex dilemmas surrounding the aging population and health care. There are several ethical standards I believe should be used in determining resource allocation for the aging population and end of life care. Yet realistically, most are unreasonable with the already limited resources available for health care. Unfortunately difficult decisions need to be made in the allocation of resources. Three primary ethical standards that could realistically improve health care for the aging, which I believe should determine resource allocations are: 1. Autonomy: suggest that individuals have a right to determine what is in their own best interest, though that interest may be limited if exercising that right limits the rights of others. 2. Beneficence: means that clinicians should act completely in the interest of their patients. Compassion; taking positive action to help others; desire to do good; core principle of our patient advocacy. 3. Justice: implies fairness and that all groups have an equal right to clinical services regardless of race, gender, age, income, or any other characteristic (Teutsch & Rechel, 2012, p. 1). It is inevitable that difficult decisions have to be made regarding how health care resources will be allocated for the aging and dying. In my opinion scarce health care resources should be offered as fair as possible (justice), to do the most good for the patient in every situation (beneficence), with respect of the individual human right to have control of what happens to their own body (autonomy). Elderly and end of life patients have a right to care that is dignified and honest. The three ethical standards noted above should be the driving force behind determining health care resource allocations, allowing for quality care...

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Institute of Medicine of the National Academies. (2008). Retooling for an aging America: building the health care workforce. Retrieved from http://www.fhca.org/members/workforce/retooling.pdf
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Teutsch, S., & Rechel, B. (2012). Ethics of resource allocation and rationing medical care in a time of fiscal restraint _ US and Europe. Public Health Reviews, 34(1), 10. Retrieved from http://www.publichealthreviews.eu/upload/pdf_files/11/00_Teutsch.pdf
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