Care of the Elderly Patient

Policy Issues and Research Opportunities

Publisher: National Academies Press
ISBN: 9780309040976
eISBN Pdf: 9780309582179
Place of publication: United States
Year of digital publication: 1989
Month: January
Pages: 153
Language: English

Caption

A guiding principle of the Council on Health Care Technology is a special focus on medical technology assessment measures that coincide with patient well-being, quality of health care, and quality of life. Of particular concern is care of the elderly, which constitutes a special and vulnerable patient population. This comprehensive book discusses the appropriate use of technology to minimize risks posed to the elderly patient in the delivery of health care services. It covers home and community care as well as acute hospital care, and system resources and constraints.

Care of the Elderly Patient: Policy Issues and Research Opportunities
Copyright
Acknowledgments
Preface
Contents
Introduction to the Council on Health Care Technology
Quality of Care and the Health Needs of the Elderly Patient
- THE MEANING OF QUALITY
- THE OBJECTIVES OF HEALTH CARE
- THE MEANS FOR ATTAINING THE OBJECTIVES OF CARE
- SOME ASPECTS OF SYSTEM DESIGN
- CONCLUSIONS
Home and Community Care of the Elderly: Introduction
Home and Community Care of the Elderly: Framing the Issues
- CHANGES IN SEVERITY OF CARE
- SITES AND TYPES OF CARE
- LINKAGES BETWEEN ACUTE AND CHRONIC CARE
- GERIATRIC ASSESSMENT
- ALTERNATIVE MODES OF CARE
  - Care Coordination
- QUALITY OF CARE
- RESEARCH OPPORTUNITIES IN TECHNOLOGIES
  - Bar Code Readers
  - Medical Information Systems
- References
Framing the Issues of Home and Community Care: Response
- CASE MANAGEMENT
- CHANGES IN MEDICAL CARE
- OPPORTUNITIES FOR PROGRESS
Special Perspectives on Home and Community Care
- HEALTH SERVICES
- EDUCATION
- RESEARCH
- CONCLUSION
Special Perspectives on Home and Community Care
- INFORMAL CAREGIVERS
  - Demographics
  - Support for Informal Care Providers
  - Respite Care
  - Case Management
  - Private Sector Help for Informal Care Providers
- OTHER CAREGIVERS
  - Professional Nursing
- RESEARCH ISSUES
  - Reimbursement
  - Rehabilitation
  - Ethical Issues
- References
Special Perspectives on Home and Community Care
- PROGRAMS FOR HOME CARE
- HOME CARE PROFESSIONALS
- CASE STUDIES
Special Perspectives on Home and Community Care
- SURVEY OF ABUSE AND NEGLECT OF THE ELDERLY
- PROBLEMS IN CARE OF THE ELDERLY
  - Case Management and Control
  - Autonomy and Social Support
  - Record Keeping
  - Continuity of Care
  - Planning Patient Services
  - Education
  - Payment
- Reference
Special Perspectives on Home and Community Care
- INSURERS' PERSPECTIVES
  - Building a System
Home and Community Care of the Elderly: System Resources and Constraints
- AVAILABILITY OF FINANCING
- AVAILABILITY OF SERVICES
- REIMBURSEMENT FOR COMMUNITY CARE
- AVAILABILITY OF LOW-TECH COMMUNITY CARE SERVICES
- AVAILABILITY OF MANPOWER FOR COMMUNITY CARE
- INFORMAL CARE PROVIDERS
- COORDINATING AVAILABLE SERVICES
- References
Home and Community Care of the Elderly: System Resources and Constraints
- REHABILITATION
- SUPPLEMENTAL VERSUS SUBSTITUTE CARE
  - Human Aides
  - Animal Aides
  - Physical Technology
- ECONOMIC CONSEQUENCES OF SPINAL CORD INJURY
Home and Community Care of the Elderly: Research and Policy Issues
- HIGH AND LOW TECHNOLOGY
- SERVICE DEVELOPMENT
  - Problems in Community Care
  - Providers of Home Care
- FINANCING
- References
Home and Community Care of the Elderly: Research and Policy Issues
- METHODOLOGIC RESEARCH
- POLICY-TYPE RESEARCH
- PROBLEMS IN RESEARCH
- IMPLICATION OF RECENT POLICY STUDIES
- RESEARCH QUESTIONS
  - Functional Assessment
  - Caregivers
- VALUES
  - Community Resources
  - Policy Directions
- Reference
The Acute Care Hospital and the Elderly: Introduction
- References
The Acute Care Hospital and the Elderly: Framing the Issues
- ACUTE HOSPITAL CARE OF THE ELDERLY
- PROBLEMS OF THE ELDERLY IN THE HOSPITAL
  - Hospital Policy
  - Technology in the Acute Care Setting
- PRIMARY NURSING
- Reference
Special Perspectives on Acute Hospital Care
- DEVELOPING A GERIATRIC HEALTH PROGRAM
  - Consultation Teams
  - Geriatric Outpatient Clinic
- COMMUNITY CARE ALTERNATIVES IN BALTIMORE
- ACUTE CARE BACKGROUND
- GERIATRIC ASSESSMENT
- BENEFITS OF A GERIATRIC ASSESSMENT PROGRAM
- CONCLUDING REMARKS
Special Perspectives on Acute Hospital Care
- THE INTERVIEW SAMPLE AND PROCESS
- DEFINITION OF TERMS
- THE DISTRIBUTION OF ELDERLY IN ACUTE CARE HOSPITALS
- THE ELDERLY'S ACCESS TO TECHNOLOGY
  - The Aggressive Use of Diagnostic and Therapeutic Technology Among the Elderly
  - Termination of Life Support Technology in the Elderly
  - Vulnerability of the Sick Elderly to Underuse, Misuse, or Overuse of Modern Technology
- IMPROVING SUPPORT SERVICES FOR THE ELDERLY
- POLICY ISSUES
- RESEARCH NEEDS AND OPPORTUNITIES
- SUMMARY
- References
- APPENDIX
Special Perspectives on Acute Hospital Care
- FAMILIES' INTEREST IN QUALITY OF CARE ISSUES
- ACTIVITIES ADVANCING THE UNDERSTANDING OF QUALITY IN MEDICINE
- IMPEDIMENTS TO QUALITY OF CARE
- ADVANCING THE CAUSE OF QUALITY OF CARE
Special Perspectives on Acute Hospital Care
- NEEDS OF SICK ELDERLY IN HOSPITALS
- POST-HOSPITAL PROBLEMS OF THE SICK ELDERLY
- NEA RECOMMENDATIONS
Acute Hospital Care of the Elderly: System Resources and Constraints
- RESOURCES FOR ACUTE CARE
- POSSIBLE SOLUTIONS
- CONSTRAINTS
- POLICY ISSUES AND RESEARCH OPPORTUNITIES
Acute Hospital Care of the Elderly: System Resources and Constraints
- SEPARATION OF ACUTE AND CHRONIC ILLNESS
- AGE VERSUS LIFE EXPECTANCY
- FOCUS ON LIFE EXTENSION AND FEAR OF DEATH
- DATA FOR MAKING DECISIONS ABOUT TECHNOLOGY USE BY OLDER PERSONS
- NEED FOR REGULATION OF TECHNOLOGY
- REIMBURSEMENT AND FINANCING
- References
Acute Hospital Care of the Elderly: Research and Policy Issues
- CAN WE DEVELOP NON-AGE-BASED OUTCOME CRITERIA FOR SELECTION OF PATIENTS WHO CAN BENEFIT FROM HIGH-TECH THERAPEUTIC…
- THE EFFICACY OF INTENSIVE CARE UNITS
- SPECIALIZED UNITS FOR CARE OF THE ELDERLY
- CONFUSIONAL STATES IN THE ELDERLY
- DIAGNOSTIC-RELATED GROUPS
- CONSULTATION TEAMS
- GERIATRIC EVALUATION UNITS
- References
Acute Hospital Care of the Elderly: Research and Policy Issues
- ISSUES DRIVING CONGRESSIONAL DECISIONS
- MAJOR HEALTH POLICY ISSUES AFFECTING THE ELDERLY
Care of the Elderly Patient: Summation of the Forum
List of Authors