Health Care Essay, Research Paper

Within the health care arena there is a growing concern about the needs of the elderly. Families

wonder if their loved ones are getting the proper care that they need With the growing costs of health care

and the decreasing resources of primary care physicians it is feared that only the physical needs of the

patient are met. Concerns rise about the social psychological and environmental needs or the elderly. A

study by Barbara Berkman and associates tries to provide some answers to people concerned with this issue

According to the study many people are not aware of the social services they may have available

to them. Because of this, many elderly people are not getting the care they need outside of the physical

care necessary to “live.” It is felt that screening a patient for social or emotional needs is becoming

increasingly important. The focus of this study was to devise a questionnaire to identify the psychological,

social and environmental needs of elderly patients.

Three hospitals from different geographic locations were chosen for this study. At each hospital a

care coordinator was chosen to be responsible for questionnaire review, communication with physicians,

and further assessment and intervention when deemed necessary. Lists of patients 65 and older were

generated from the caseloads of primary care physicians from the three hospital sites. The questionnaires

were mailed out with physicians cover letters and consent forms in the summer of 1993. In the

questionnaire patients were asked to assess their self-percieved notions of there medical and psychosocial

needs, as well as the level of their functioning. Upon reciept of the completed questionnaires the care

coordinators from each hospital assess the results of the survey. Those patients assessed as being high risk

received follow up phone calls. Depending on the situation, high risk patients were given information

only, indirect referrals, or direct referrals.

The findings for the study indicate that approximately 56% of all people surveyed were in need of

intervention. The three highest relative risks for all three sights were: difficulty with food preparation,

difficulty in doing house work, and difficulty getting around the home. All three hospital settings agree

that patients who reported having problems in the survey were judged to need intervention more than those

who did not report having problems.

Although the study had good intentions, I feel the study was unclear in its objectives. The study was to

design an assessment tool that would identify the psychosocial and environmental needs of elderly

patients. Clearly the questionnaire did identify these needs. What is unclear is the purpose of proposing a

questionnaire. Is this a first time attempt to assess the psychosocial and environmental needs of the elderly,

or is it an improvement on past assessment tools? The study appears to present a new assessment

procedure rather than focus on the quality of the questionnaire.

Although I feel there are discrepancies in the focus of the study, I do find it to be very thorough

and accurate. This is a study of current concerns. With the cutting of health benefits and the rise of health

costs many of the elderly do not get the social and emotional help that they may need. I do agree that it

appears that there !

is not enough assessment being done. The authors of the study did an accurate job in preparing for this

study. They consulted with prime focus groups, such as physicians and social workers. A review of past

literature and studies were used to identify which psychosocial and environmental needs should be

addresses in the questionnaire.

This article proved very easy to read. I felt that the language was readable for scholar and layman

alike. I do feel that this article assumes that you have a background in geriatrics. Although it is not

necessary to be an expert in the field, geriatric knowledge would be an advantage. A few of the terms and

concepts were aimed primarily at a professional reader, but not so much to have a student or family of an

elderly person perplexed as to the general concept.

The design of this study was well planned. The methodology is clearly mapped out and in my

view acceptable for an accurate study. The sample size (approximately 3200) was sufficient. The study

used three different geographical sights across the United States. This sufficiently covers the possibility

that research could be flawed by geographic discrepancies. According to the data given the questionnaire

returned data on mark to the information targeted.

There are a few problems with the design of the research however. There appears to be no control

group on which to test the data . A study cannot accurately gauge its impact when researchers have

nothing to which to compare. Second, the researchers cannot be sure that it was their questionnaire that

helped identify high risk elderly. It can not be shown that the questionnaire of the study was the cause or

that any questionnaire at all was the cause. If these elderly patients had not been assessed before the study,

who is to say that the questionnaire is accurate?

The results of this article, in the opinions of the researchers are clear; increased assessment of

elderly patients is necessary. With this research data it is shown that the psychosocial and environmental

needs of many of our elderly citizens are not being met. The article did not try to lay fault or error. It

statistically shows a need for further steps to be taken that will insure that the non medical needs of the

elderly are met.

The limits to this study were minimal and explained thoroughly. The first limit was that the study

used mail- in questionnaires. Only those people who answered the questionnaires were involved in the

study. The researchers sent out second questionnaires to non respondents, and followed through with

phone calls to those who did not respond a second time. Also the study was limited by the cognitive ability

of the eldrly questioned. If the elderly patient was not cognitivly capable to answer the questionnaire

he/she was not used in the study. This leads to the question of an even greater need of those who are not

cognitivly competent. A question that the survey admittedly does not answer. Finally the survey admits a

problem of not having standardized training for the care coordinators. This could lead to an inconsistency

of the assessment of responses. The researches hope to fix this problem in any further studies.

I do not feel that the research questions were answered satisfactory. The scope of the research was

to develop an affective assessment questionnaire. The research does not show what effects their

questionnaire had on identifying the psychosocial and environmental needs of those studied. A surplus of

information was found that identified the needs of elderly people. The article did not make clear if this

information was a goal of the study or not. The study does not show if the questionnaire accurately

assessed the psychosocial needs of the elderly.

The conclusions clearly show that the needs of the elderly are not being met as well as they should

be. The data is well formulated and appears to be accurate (the deviation for error is

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