Elderly Population's Needs During Crisis

Categories: Eldercare

Essay, Pages 9 (2086 words)

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Over the next fifteen to twenty years, the average age of the population will continue to rise in what would be considered a generational phenomenon. The baby boomer generation has created an influx within the elderly population. It is estimated that in 2020, one in four Arizona residents will be over the age of sixty (Napolitano, 2005). The increase in the aging population will raise many challenges and opportunities to change the service delivery system for the senior population. The crisis system is one of the most important services available to help navigate the elderly population to the appropriate resources.

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The crisis system has become one of the primary services utilized to serve the elderly population. Due to the lack of transitional support to direct them to the right services, hospitals and emergency response have become a revolving door for seniors. According to the article, Aging 2020 Goals, the main goal is to make it easier for aging Arizona residents to access an integrated array of services.

Accessibility will be the key to help seniors continue to have meaningful lives (Napolitano, 2005).

Currently, there is a lack of in-home caregivers available to the elderly. The article presents that in the year 2000, twenty-five percent of people over the age of 65 lived alone, and this number is continuing to grow. This is concerning because the number of emergency calls and hospital visits increases when no one is available to help seniors (Napolitano, 2005). Many seniors require crisis services at some point, but a great number of them may not have access to the services they may require in an emergency.

Some of the problems that are attributed to seniors not having access to appropriate services when in crisis include overcrowding of emergency rooms at local hospitals, and lack of resources available to them during nontraditional hours. A short term inpatient respite program for the elderly in crisis would be a great start for implementing a crisis delivery system that 2 meets the needs of the aging population. The program would be open 24 hours a day. It would be utilized by different people, including hospital staff, first responders, adult protective services, and families in need.

The facility would provide short term care for ambulatory seniors who need being connected to appropriate services. The elderly population is the most affected by the need for a more suitable crisis system. The elderly population must have a crisis system that is designed to allow them to safely return to the least restrictive environment in the shortest amount of time. One of the goals of the article Aging in 2020, is to provide quality of care in all aging services; resulting in the aging population wanting to seek services in preventative measures, instead of experiencing needless pain and suffering (Napolitano, 2005). The system should provide fully integrated care for the population, including having services that are available to them at all times. Families are also affected by the need for an integrated crisis system for the elderly population. Families are typically relied upon to be caregivers to the aging population. They also depend on community resources to help them learn how to care for their aging relatives. Families often struggle to care for older family members because of the lack of resources and education on services for the elderly. Society plays a significant role in the resources and services available to aging adults (Gillen, Mills, & Jump, 2015).

Some examples of what families may face include: having an aging loved one start to show signs of dementia or Alzheimer's wandering the streets at night. Families who work full time and are unable to provide 24-hour caregiving for an aging loved one. Lastly, families who are struggling financially not know what to do when an elderly family member is sick. 3 Hospitals and first responders are also affected by the need for an integrated, accessible crisis system for the elderly population. Emergency rooms are continuously overcrowded with seniors who may not have the proper support network to allow them to return home. Hospital social workers are often faced with the impossible task of locating resources that are not available 24/7. For instance, in Maricopa County, the Adult Protective Services agency is only open Monday through Friday from 9 am to 5 pm. If there is an immediate danger for a senior to return home, the hospital social worker is forced to find alternative resources. Many organizations are affected by the lack of resources for the elderly in crisis. In eighteen short years, 53 million Americans (one in six United States residents) will be aged 65 or older. Today 12.4 percent of the U.S population is 65 or older; in 2020, that figure will approach 20 percent (Feingold & Hooks, 2002). America needs to prepare for these changing demographics.

These staggering numbers indicate that there is a growing need for services and resources to assist the aging population. A few of the organizations that would be considered stakeholders in need of appropriate crisis care for the elderly population include hospitals, first responders, Arizona Department of Health Services, Adult Protective Services, and Arizona Health Care Cost Containment System. Many of the stakeholders are interdependent; they all work together to provide the most efficient care for members of the community. These agencies are aware of increasing numbers of aging adults in the community because of the influx of aging adults requiring their services. Hospital overcrowding affects the hospital system, and the increased prevalence of the aging population in the emergency room is a growing concern (Gardelleni, et al., 2013). While creating the hospital discharges, many staff do not have the time to link the elderly population to 4 outpatient services and follow up appointments. Hospitals would benefit from creating linkage and development of a respite program that would allow more time and care for each senior patient. First responders are also experiencing an increase in repeat callers from the elderly population.

Most calls to 9-1-1 or the fire department from the elderly population are 'injury/ fall,' 'altered level of consciousness,' and 'ill person.' Some fire engines will respond to the same elderly person multiple times a day because the elderly person, and the family, do not have the resources or education to provide adequate care for the members. Often, if an elderly person is considered vulnerable, and the living situation is unsafe, the elderly person will be brought to the hospital because there is nowhere else for them to go. The fact that there are not enough resources or placements during the middle of the night is a clear indicator that a respite program would benefit the community. Arizona Department of Health Services, Adult Protective Services, and Arizona Health Care Cost Containment System are community stakeholders because it is costly and inefficient for the elderly population to depend on emergency services for every situation. The economic burden will be a significant concern for the elderly, their families, hospitals, first responders, and society as a whole if the service delivery system does not adapt to the demographics. According to the article, The 2030 Problem: Caring for the Aging Baby-boomers, 'the economic burden of the aging population should be no greater than the economic burden associated with raising a large number of baby-boom children. In the 1960s.' (Knickman & Snell, pg. 853, 2002).

The economic burden could be lessened by changing the way that society organizes community services to provide more education and more accessible services (Knickman & Snell, 2002). The respite program would offer relief to families and society by 5 allowing an allotted amount of time and services for seniors in crisis to be navigated through the confusing service delivery system. In addition, the respite program would allow emergency department staff to have more time dedicated to true medical emergencies because it would be a service that is always available and accessible. Vulnerable adults are entitled to a system that can meet those needs, without shuffling them through the current crisis system and referring them to services that are only available during traditional hours. Currently, there is a lot of education and literature written about the increase in the aging population and the changes in the delivery system. In 2005, the Governor, Janet Napolitano, issued an Executive Order for state agencies to develop a plan to serve the changing population (Napolitano, 2005). In this Executive Order, state agencies came together to develop goals such as increasing awareness, help older adults remain active, increase safety, and to have an integrated well trained professional workforce (Napolitano, 2005). These goals are broad and provide many facts about the growing needs of the elderly population. The article was informative and direct, and because it was issued by the Governor, it grew statewide support. The article addressed the long-term care needs of the elderly population; however, it did not discuss in detail the short term needs or crisis services that could benefit the Aging.

The immediate need for a comprehensive respite care system that serves the elderly population in crisis is past due. The elderly population has increased over the years and will continue to increase at larger rates than before. National studies have shown that between 2000- 2025 there will be a 135% increase in the elderly population (Weiner, 2002). As this population continues to grow, the demand/need for assistance in health care, home care, and other services is growing as well (Weiner, 2002). The reality is that services, agencies, and organizations that serve this population are not growing along with this population. The organizations that provide 6 services for this population only operate in traditional hours. Nurses and caregivers describe that their most difficult cases consist of trying to secure services for clients outside of regular business hours (Robinson, pg. 262, 2012). The lack of resources available for this population outside of traditional business hours places a strain and creates challenges for others. With no agencies or other resources available, this population has no other option than to call 911 for assistance. First responders are bogged down and overwhelmed with repeat and frequent callers because of this. In an article written by Kristen Batchelder in the Fasny magazine, she wrote that there was an increase within the elderly population and their many calling for emergency services during crisis situations. In 1990 there was a research study conducted on the use of Emergency Medical Services (EMS).

The study was based on how often the services were used, and how often there was transportation to medical facilities. The results of the study showed that there was an increase in services when it came to individuals 65 or older (Wilson, 1998). First responders are often faced with the dilemma of what to do with these elderly patients that do not have a medical emergency but are in crisis. The only alternative in most cases is to transport these individuals to a local hospital. Due to the increase in non-emergency calls, many cities such as Phoenix and Glendale have implemented a community assistance program. This program has three crisis response vans that are staffed by interns, volunteers, and some paid staff. These teams are dispatched to assist fire departments and police departments with crisis situations. The crisis teams help provide relief to first responders with repeat and frequent callers, which allows them to get back in service. Unfortunately, these teams still face the same challenges of not being able to secure assistance for this population outside of business hours.

There is a lack of transitional services and overnight programs to serve this population 7 (Robinson, 2012). The only alternative that first responders and the crisis teams have is to transport these individuals to the hospital as a last resort. Hospitals are now being overwhelmed by these individuals. The lack of services for the elderly population is not only affecting them but the community as well. First responders are being tied up on non-emergency calls, which creates longer response time for other calls. It also has created longer wait times and increased costs at hospitals. In summary, researchers have identified that there has been, and continues to be, a significant increase amongst the elderly population. This pandemic has created a need for respite services available after hours. Due to the lack of resources available for these individuals during the crisis, it has created a strain on first responders. With no viable alternatives, first responders have had to transport these individuals to a local hospital. In closing, by incorporating an after- hours respite and transitional care system for this population, it would dramatically decrease the strain on everyone who is a stakeholder or adversely affected by this need.