Service Program

Summative Assessment

The service program that is necessary in the community is health services for aged people. Health trends among elderly people are intricate, and there is limited ability to treat effectively one of the most disabling common disorders, cognitive decline, and the accumulating burden of disease due to the obesity epidemic. The capability of aged people to remain healthy and independent requires the provision of a supportive environment, including well-designed living conditions, access to economic resources, and appropriate health care. Health and social policies will accordingly need to deliver appropriate systems to respond to the needs of ageing populations. The elderly progression is considered to be an end product of demographic transition or demographic achievement with a decline in both birth and mortality rates and consequent increase in life expectancy at birth and older ages. The pervasiveness and incidence of diseases as well as hospitalization rates are much higher in older people than the total population because the elderly population is likely to increase in the future, and there is a explicit shift in the disease pattern, i.e. from communicable to non-communicable. It is high time that the health care system gears itself to growing health needs of the elderly in an optimal and comprehensive manner with a definite need to emphasize the fact that disease and disability are not part of old age and help must be sought to address the health problems.

The health service program comprised in our community aims to

• provide aged people with an alternative treatment setting to hospitalization during an acute phase of their mental illness, and prevent hospitalization where possible
• provide intensive treatment in the aged person’s home during an acute phase of a mental illness, when the person and their family or career expresses their wish
• Minimize the length of stay in an inpatient unit by providing ICT during an acute episode of illness.

The program’s target group includes:

• aged people whose acute treatment for their mental illness can be delivered safely in their home as an alternative to being admitted to an aged persons mental health acute bed
• aged people who have family or other career supports available for the period of treatment
• Aged people whose length of stay in hospital can be minimized through intensive treatment at home.

The present report outlines about how the service program will help in engaging these people to utilize the service needs.  

• Engage consumers in the analysis of service needs

Health consumers actively contribute in their own healthcare and in health policy, planning, service delivery and evaluation at service and agency levels. The consumers are engaged in the analysis of service needs by:

• mapping the consumers to access health services;
• understanding the potential consumers who don’t access the services as the delivered services don’t meet their needs or act as access barriers;
• understanding the diversity of the people who are current or potential users of health services;
• identifying key relationships that need development to reach and engage appropriately with the local community;
• identifying engagement mechanisms that are currently active in terms of what works, what has been successful in delivering the outcomes needed, what can be built upon, and where are the opportunities to be innovative and responsive to develop new engagement mechanisms, and
• Identifying the opportunities to work collaboratively with consumers, the health and community services sector.  

• Develop the program

Aged adults are at high risk for developing chronic illnesses and related disabilities. These chronic conditions include:

• Diabetes mellitus
• Arthritis
• Congestive heart failure
• Dementia

Many experience hospitalizations, nursing home admissions, and low-quality care, and also may lose the ability to live independently at home. Chronic conditions are the leading cause of death among aged adults.

We have developed a health service program which will cater to the needs of aged people. The objectives on aged adults are designed to promote healthy outcomes for this population. Many factors affect the health, function, and quality of life of aged adults.

• Individual Behavioral Determinants of Health in Aged Adults

Behaviors such as participation in physical activity, self-management of chronic diseases, or use of preventive health services can improve health outcomes.

• Social Environment Determinants of Health in Aged Adults

Housing and transportation services affect the ability of aged adults to access care. People from minority populations tend to be in poorer health and use health care less often than people from nonminority populations.11

• Health Services-Related Determinants of Health in Aged Adults

The quality of the health and social services available to aged adults and their caregivers affects their ability to manage chronic conditions and long-term care needs effectively.

• Emerging Issues in the Health of Aged Adults

Emerging issues for improving the health of aged adults include efforts to:

• Coordinate care;
• Help aged adults manage their own care;
• Establish quality measures;
• Identify minimum levels of training for people who care for aged adults;
• Research and analyze appropriate training to equip providers with the tools they need to meet the needs of aged adults.

 Implement and monitor the program

Once the health service program is developed, the next phase is to implement and monitor. The steps include:

• Respond to the special health requirements of the aged adult

• Work with an understanding of physical changes that take place as part of the ageing process their families
• Allow for the fact that drugs and medicines have different effects in the aged person
• Assist the aged person to maintain health lifestyle practices
• Communicate effectively with aged person experiencing sensory loss
• Work with an awareness of own values, attitudes and beliefs towards ageing and the aged person
• Work with an awareness of common stereotypes associated with ageing and the influences they can have on the care of the aged adult

• Contribute to care plan development for the aged person

• Assess the aged client to determine their health status in consultation/collaboration with registered nurse
• Assist the aged client to identify self-care abilities and disabilities
• Implement care as per nursing care plan and monitor work allocated to others
• Share information regarding aged person's health status with other members of health care team
• Ensure client, family and/or significant other understand the implications of their admission to the health care setting

• Assist to evaluate outcomes of planned nursing care of the aged client

• Document responses of aged client
• Report changes in aged client response
• Convey information clearly and accurately to appropriate staff member
• Take in account complex and dual diagnosis issues in addressing aged care
• Provide information on community services available to aged person and their family

• Practice within the aged care environment

• Work with an understanding of the funding mechanisms impacting on aged care provision
• Take into account the variety of areas of practice within the aged care environment
• Take into account the changes and impacts of those changes to the delivery of health care for the aged person
• Work with an understanding of the changing demographics of the aging population
• Work with an awareness of own values, attitudes and beliefs towards ageing and the aged person
• Promote health maintenance for aged person and their family
• Provide information on community services available to aged person and their family
• Provide care of deceased person
• Provide support, comfort for grieving family/client
• Take into account the impact of complex issues involved in aged care on carer(s)

• Address contemporary issues in aged care practice

• Work with an awareness of the current legal and ethical issues involved in aged care practice
• Work with accurate knowledge of the role of guardianship, advanced health directives and legislation in aged care practice
• Recognize and support the rights and responsibilities of the aged person
• Work with an awareness of elder abuse as a significant contemporary issue for aged persons
• Act as an advocate for the client and their family
• Demonstrate respect for individual culture, spiritual and religious practice for the aged person
• Observe and respond appropriately to physical, emotional and mental signs of stress in the aged adult

• Develop and implement strategies to minimize impact of challenging behaviors

• Observe and document behaviors to determine triggers which may be related to: physical and emotional health; environment; tasks; and communication
• Consider the potential impact of the behaviors on the person or other persons in determining an appropriate response
• Consider a range of options when developing effective responses for inclusion in the person's care plan Implement best practice strategies which minimize the impact of behaviors
• Regularly review strategies that are implemented to ensure maximum effectiveness

• Evaluate the program

Evaluation is a method that assesses an achievement against preset criteria and has a variety of purposes, and follows distinct methodologies (process, outcome, performance, etc).

In order to assess health service program, one needs to be apparent about the service needs. The policy significance of morbidity data for aged persons is plain. The development, maintenance, and evaluation of health service programs that provide resources for the prevention, treatment, or rehabilitation of various diseases require detailed knowledge of the occurrence, severity, and functional impact of those conditions. This type of information can often be acquired from health care data, and its acquisition is becoming easier as a result of computerization of clinical encounter records in both ambulatory and institutional settings. Conversely, obtaining a population view of morbidity occurrence may require population sample surveys, since health system coverage may not correspond with geographic regions and applies only to actual users. Population surveys can add this critical viewpoint, but information obtained from aged lay persons in this manner may be incomplete or only partially valid. Some persons may not fully understand or be able to name their own conditions, and some conditions may not have been clinically evaluated. For instance, adult-onset, non-insulin-dependent diabetes remains unnoticed in at least a third of aged Americans. Consequently, morbidity rates should be obtained from combined population and institutional sources for maximum validity and policy value.