chapter 8 discussion

Chapter eight talks about how the U.S. and how they have three economic accesses to health services. The three economic accesses to health service are Medicare, Medicaid and private health insurance. Medicare is where for selected groups only. They are for the elderly and disabled who are eligible for social security. Medicaid is for children and adults who need help when it comes to insurance. Private health insurance is where an employer provides for their workers. These three economic accesses do not “fit” together but they do help people in today’s society. Social workers can help people understand what the protocol is when it comes to health insurance. I believe that if you have a medical social worker there at hospitals to explain insurance to the patients then it will clear a lot of questions that they might have.  One thing that is not fair is that not everyone can afford insurance and sometimes people have a hard time to be seen by a doctor because they do not have insurance. More people are becoming uninsured and health care cost is becoming more and more expensive. It is really sad in my opinion. One good direction we could do is to make sure we inform everyone on how to live a healthy lifestyle and try to exercise when they can. That can help them by not getting sick as often. Hopefully one day we will have a society where everyone was eligible for health care and we can all make sure that everyone gets the help that they need.

Fort Cowles, L. A. (2003). Social Work in the Health Field: A Care Perspective (2nd Ed.) Binghamton, NY: The Haworth Press.

Weekly Reflection Ch 8

Chapter eight in this book discusses the U.S. health care system's strengths and problems. "The U.S. "nonsystem" of economic access to health care services represents a mixed model with the following features: 1) Medicare, which amounts to national health insurance for selected groups (elderly and disabled who are eligible for Social Security 2) Medicaid, a public assistance program financed from state and federal general revenue for person who qualify and 3) private health insurance" (Fort Cowles, 2003, p. 319). Unfortunately these three basic sources of health insurance coverage do not include all Americans. They leave gaps and the amount of people without insurance coverage has increased in recent years. In addition to the uninsured population there are many people that have only partial health insurance coverage, requiring out of pocket contributions such as deductibles, coinsurance, and uncovered services. Health care cost is very expensive and its sad that people with no insurance get the worst treatment involving health care if any at all. It was interesting to read that the United States is the only industrial nation in the world, besides South Africa, without a national system for ensuring universal economic access to basic health care, yet the United States also spends more than any of these other industrial societies.

Reference:
Fort Cowles, L. A. (2003). Social Work in the Health Field: A Care Perspective ( 2nd Ed.) Binghamton, NY: The Haworth Press.

Chapter 8 Weekly Reflection

Medicare, Medicaid, and private health insurance coverage are the three economic accesses to health service. Unfortunately these three basic sources of health insurance coverage do not fit together in such a way that all American are included in 1998, 16.3 per. Of the United States population or 44.281 million persons, were without any health insurance. The size of the uninsured population varies across states within the United States. Ethnic variation most advantages in the United States racial and ethnic minority group members tend to fare worse than the white majority. Age variation the elderly are most advantaged in terms of health insurance coverage. A mix model form also characterises the health services themselves, in the hospital, nursing home care agencies, outpatient clinics, and other organisational settings of such services are sometimes public tax supported, sometimes private nonprofit, and sometimes private for profit. Most Americans are very satisfied with the health care services they receive ( Zis Jacobs, and Shapiro, 1996), and professional health care providers, such as physicians, nurses, and allied health care professionals( social worker, physical therapists, occupational therapists, and speech therapists) are generally well traine, with high legal and professional practice standards.

Reference: Social Work in the Health Field A Care Perspective Second edition Lois A. Fort Cowles

Reflection Blog for Chapter 8 Even though the United States has some of the highest qualified doctors and some of the most advanced technology in the world, not all Americans has access to this high quality health care especially the poor, the elderly and the very young. The fact is the uninsured population is rising while health care cost are skyrocketing and we live in a country where basic health care is denied to those in need everyday. An elderly person should not have to decide between medication and food. The number one cause of bankruptcy in America is medical bills. Americans fear the cost of a universal health care system that is working well in other countries. This fear is unfounded though because they are already paying for it through waste, abuse and fraud in our for-profit hospitals. Only thing is, sick people are not the ones benefiting. (Cowles, L.A.F., 2003)In some cases, your medical treatment can be determined by a third party whose only interest is in keeping your health care cost low so that the money saved can be distributed to the CEO's of the corporation they work for. This may sound jaded, but it is a fact. The bright side is, there is a trend that is focusing on promotion and education for a healthy lifestyle and prevention of disease. This focus is on preventing rather that curing and should prove to be more cost effective, not to mention the emotional toll that a disease can have on an individual as well as their family. This is a positive step in the right direction. Unfortunately, the power goes in the direction of the money flow and the American Medical Association is much, much more powerful than all of the poor American put together. References Cowles, L. A. (2003). Social work in the health field: A care perspective. New York: Haworth Social Work Practice Press.

Reflection 8

Chapter 8 discusses the strengths and problems of the health care system featured in the United States. The health care system is made up of many attributes that are beneficial but also have flaws at times. Three of the biggest systems that make up the United State’s health care system are Medicare and Medicaid and private health insurance. Medicare is, “amounts to national health insurance for selected groups, elderly and disabled who are eligible for Social Security, as well as persons who are medially dependent upon expensive renal dialysis treatments for survival as a result of end-stage renal disease that is financed from employee payroll taxes” (Cowles, p.319). Medicaid is just the opposite and is mostly for children or adults who need the extra help. It is a government program which is financed by the state. Along with these a private health insurance is the insurance supplied by an employer to their worker. Although these three systems help out so many and are great programs, they do not “fit” together or cover every person with insurance. The costs of these programs vary. Every year it is mostly changed and depends on the type of insurance that is provided and how much it is put to use. Controlling health care costs is a big goal for the United States and is why a reform has been put to place. “Managed care has emerged in the United States as one method to control health care costs…” (Cowles, p.332). Managed care is a cluster of health service systems who try to control the costs throughout the health care system. In my opinion, the United States has good intentions on health care systems, but it seems like there is always more problems and confusing with ours than needed to be. I feel like new trends need to be added.

Resource:

Cowles, L. A. F. (Ed.). (2003). Social work in the health field: A care perspective. (2nd ed.) Binghamton, NY: The Haworth Press.

Digital Presentation

Reflection 7

In chapter 7 we learn the importance of social work in the hospice care. This type of care was created was a sense of responsibility to help relieve human suffering. "The objective of hospice care is to maximize the  quality of a patient's remaining life and to facilitate his or her 'safe passage'" (Cowles, p. 285). Although hospice is normally mistaken for taking the family's place of taken care, it is not. Hospice provides support and care for the patient and family, especially right before time of death. Hospice workers are to provide strength that recognizes the patient's sense of wholeness and, intactness, and also control. "Hospice care has a holistic perspective in that it directs attention to the needs of the whole person" (Cowles, p. 285). Hospice also includes recognizing the biological, psychological, and also social spheres of a person's life. This refers to relationships with other people through the community, family, society, and cultural influences. Social workers are used in hospice for these reasons. A social worker's prime focus throughout hospice health is the patient's care and their psychological needs. They are to provide comfort to the patient and family through this hard time and to make sure they engage in a "passing death". The social worker also helps the family through their grieving before and after the patient passes. Hospice is a good organization that provides care all over. It provides support and comfort that is needed throughout  a scary time. Social workers also play a huge role and make a difference day by day.

Weekly Blog Reflection Ch. 7

Social work in the hospice care setting can be practiced similarly to the settings of a hospital, home health care, or nursing home social worker thorough public, private, and nonprofit agencies that either employ or contract social workers to perform hospice duties. Therefore, hospice social workers can work within the settings of the other medical social workers, often crossing paths and receiving information for and about the patient. 

  Hospice care is referred in the text as, end of life care that requires social workers to participate in interdisciplinary teamwork as well as, to provide direct care for patients and their families. This care is met by a social worker performing several functions that address, focus, individualize,and meet the holistic needs of a patient's biological, psychological, and social aspects. In addition to meeting the patient's needs a social worker must also address and meet those same needs of the patient's family, so that they may be able to support, transition, and provide care for the dying family member both before and after death. 

   Like other medical social workers, hospice social workers often run into the same organizational, funding, and the overstepping of other professions boundaries, issues, and conflicts while trying to effectively practice and provide care for a patient. However, like in any other medical setting, a hospice social worker must advocate for themselves as well as, the clients right to practice and receive extraordinary end of life care and educate future social workers of these types of situations and steps to prevent and resolve them.

  I believe this chapter really opened my eyes to the possibility of practicing hospice social work and emphasized on the importance of assisting a patient understand their pain, rights, wishes, concerns, and transition into and about their dying process. Something that I found particularly interesting about the chapter on Hospice care, was that the text stated that physician often delays the referral for hospice care for a patient and that many patients die within a few weeks to only of month after receiving services. Clearly this is not enough time for a social worker, a patient, or their family members to perform or receive the due care that they deserve. This doesn't seem very ethical...

Reference:

 Cowles, L. A. F. (2003). Social work in the health field: A care perspective. Routledge.

Weekly reflection 7

Chapter seven discusses the role of a social worker in hospice care. Hospice is a program and a philosophy not just a particular place or setting. Most hospice care is provided in the home, however hospice agencies sometimes follow former home care patients into nursing homes to provide continuity of appropriate care. Some acute care hospitals provide hospice care service on the hospital site.  Client problems and social worker functions relating to hospice care depend on the type of organizational setting. “From the perspective of social worker functions, the problems of patients in hospice care may be classified as those associated with: admission to the hospice service, adjustment to the service or facility, adjustment to the diagnosis, prognosis, or care plan, the lack of information to make informed decisions and take control, the lack of needed supportive resources, such as supportive tools and equipment, support services, income supports, supportive environmental adaptations, and interpersonal supports, and barriers to discharge from the service or setting” (Fort Cowles, 2003, p. 293). I think that being a social worker in hospice care would be very hard. It is a hard job to get to know people and to watch them die even though it is part of life.

Reference:
Fort Cowles, L.A. (2003). Social Work in the Health Field: A Care Perspective. Binghamton, NY: The Hawthorn Press.

weekly reflection # 7

Weekly reflection # 7

Historically, hospice care is based on a moral necessity, value of concern about human suffering and the ethical sense of responsibility to help relieve that suffering (Cowles, 2003).   The hospice care maximizes the quality of a patient’s last days and to provide his or her “safe passage”.  Family care is not substituted by hospice care but rather facilitated and supported based on the patient’s needs. 

Hospice care has a holistic perspective and a biopsychosocial perspective.  The holistic perspective gives the direct attention to the needs of the whole person which involves interaction with the spiritual person of the patient and his or her physical needs.  The biopsychosocial perspective involves biological, psychological, and social spheres of our lives interacting and affecting one another.  Fish (1994) and Germain (1984) mention that terminally ill patients often encounter a variety of physical associated discomforts, such as pain, dyspnea, weakness, eating and sleeping problems, digestion and excretion problems, sensory impairment, paralysis, skin problems, or swallowing difficulty.  My father-in-law who suffers from Parkinson’s disease and is in a bed-ridden stage has the symptoms mentioned above.  Since he is a terminally ill person, his family decided to bring him home last month.  Even though he seems more comfortable staying home rather than at hospital, he is having associated physical discomforts.  Because he weighs only 70 lbs, he is so bony and so weak.  Even though he feels pain all the time because of his muscle rigidity and pressure sores, he cannot complain about his pain because it takes a lot of his energy to speak, and as a result, he feels so sad and cries very often.  Social workers and nurses understand his pain and suffering, so they give him pain relief medication four times a day.  They look after him using holistic and biopsychosocial perspectives.

Reference

Cowles, L. A. F. (Ed.). (2003). Social work in the health field: A care perspective. (2nd ed.) Binghamton, NY: The Haworth Press.

Fish, N. M. (1994). Social work practice in hospice care. Social work practice in health care settings, 403-419.

Germain, C. B. (1984). Social work practice in health care: An ecological perspective. New York: The Free Press.

Current Topic #2

Current Topic #2 Nursing home and Home Health Care The Home Health Care business is predicted to increase by about seventy percent from 2010 to 2020 according to the Bureau of Labor Statistics. There are various reason for the explosion in business being foremost the aging Baby Boomers. Peter Tourian is the CEO of Synergy HomeCare, a private provider of non medical in-home care. He states that over 10,000 Baby Boomers turn 65 every single day.(Farnham, A. 2013) This creates a great, solid, and lucrative opportunity for investors looking for a stable investment as well as others looking for employment and even entrepreneurs. In-home health care services vary based on their licensing and standard of care as well as state regulations. Some are as simple as providing homecare, such as light housekeeping, laundry, cooking and running errands, some provide personal care such as bathing, grooming, and companionship while still others may assist with clinical issues such as administering medication, therapy, counseling, checking for vitals. The latter must done by healthcare practitioner under the direction of a nurse.(Farnham, A., 2013) Another reason for the surge in growth for home health care could be the rising cost of nursing homes and long term care. One in four bankruptcies in America are due to medical costs.It is predicted these cost will continue to rise at rates greater than overall inflation.(Mukherjee, S. 2013). While nursing home care and long term care have increased almost five percent a year, home healthe care services have remained almost flat according to Genworth Financial's 10th annual Cost of Care Survey. The Genworth annual survey tracks care, cost and trends in nursing homes, assisted living facilities, adult day care and home health care. According to CNNMoney, the median cost of living in a nursing home is more than twice the cost of a private college tuition.(Moeller.,P. 2013) An affordable alternative is home health care. A home health care aide is the fastest growing job in America and requires no special schooling or training. The Bureau of Labor Statistics Occupational Handbook predicts that by 2020 there will be more than 1.3 million home health care and personal care aides. Currently the pay average is about $10.00 an hour. Boom Predicted For At Home-Care Industry. (2013, April 23). [Television series episode] In A. Farnham (Producer), Good Morning America. New York, New York: ABC. Moeller, P. (2013, April 9). The Best Life - Money (usnews.com). Retrieved from http://money.usnews.com/money/blogs/the-best-life Mukherjee, S. (2013, April 10). The Median Cost Of Living In A Nursing Home Is Almost 2.5 Times The Average Private College Tuition | ThinkProgress. Retrieved from http://thinkprogress.org/health/2013/04/10/1844341/nursing-home-costs/

Weekly reflection # 6

Weekly reflection # 6

Nowadays, the percentage of older people residing in nursing homes increases as people’s age increase.  Nursing home care is less expensive compared to hospital care (Cowles, 2003). Nursing home facilities are sterile environments, but needed more quality of care like most hospitals.  Olson mentions that many nursing homes provide inadequate rehabilitative services, mental health assessment and treatment services, meaningful social activities, or effort to encourage decision making by the residents (1994), and most of the care is provided by people with little or no training.  Because the providing pain relief is a basic service of caring, patients and family members should inquiry about the policy of pain in nursing homes.  Also, social workers need to be aware of the clients’ transitions, and situations that are at high risk for trauma.

It is interesting to learn about the race and ethnicity in nursing home service.  Racial discrimination in health care facilities was terminated only about 50 years ago along with the passage of Medicare and Medicaid (Cowels, 2003).  Therefore, Freed says that social workers in health care need to be careful about their clients’ race and cultural traditions (1990).  Another issue of the nursing home is sex and sexuality.  Even though nursing homes allow the married couple to share the rooms if they agree, many believe that elderly nursing home residents need more privacy for sexual activities.  Also, most of the nursing homes need to improve in dealing with death and dying clients. The nursing homes should not only provide for their clients’ physical well-being, but also their mental well-being.

References

Cowles, L. A. F. (Ed.). (2003). Social work in the health field: A care perspective. (2nd ed.) Binghamton, NY: The Haworth Press.

Freed, A. O. (1990). How Japanese families cope with fragile elderly. Journal of Gerontological Social Work, 15(1-2), 39-56.

Olson, L. K. (1994). Public policy and privatization: Long-term care in the United States. The graying of the world: Who will care for the frail elderly, 25-58.

Chapter 6 Reflection

Chapter six in this book discusses the role of social workers in nursing homes. Nursing homes today are a mix of private for-profit, private non-profit, and tax supported and non-profit. “The earliest institutional form of care for the elderly, mentally or physically ill or handicapped, and other dependent persons in America was the variously termed county home, poorhouse, poor farm, or almshouse” (Fort Cowles, 2003, p. 231). Social workers have many functions in nursing home. The book describes 23 nursing home social work functions that was developed from 1988 to 1989 by NASW's Nursing Home clinical Indicator Work Group. The main functions of social workers in the nursing home are to assist the residents and their families with the transition into the nursing home by making them feel comfortable. "The functions of the social work program should include but not limited to individuals, families, and significant others; health education for residents and families; advocacy; discharge planning; community liaison and services; participation in policy and program planning; quality assurance; development of a therapeutic environment in the facility; and consultation to other members of the long-term care team" (Fort Cowles, 2003, p. 256. The social work program is directed toward providing services to meet the social and emotional needs of each resident and also their families.

Reference:
Fort Cowles, L.A. (2003). Social Work in the Health Field: A Care Perspective. Binghamton, NY: The Hawthorn Press.

Chapter 6 weekly blog

The history of nursing homes varies with three organisational types,proprietary private for profit, voluntary private nonprofit and public tax supported and nonprofit.the earliest institutional form of care for the elderly, mentally or physically ill or handicapped and other dependent persons in America was the variously termed county home, poorhouse, poor farm, or almshouse. Today the best quality nursing home care tend to be provided in retirement communities or homes for the aged that provide a range of care levels, including supportive living in houses and apartments as well as skilled nursing care units. When I was young nursing homes were always talked about as a negative place to be. Personally I pray that I am able to take care of myself when I get up in age because the last place I would want to be is in a nursing home. On the other hand if I'm not able to take care of myself I would not want to be a burden on my children and their family. A recent thorough study of nursing home state inspection reports for 1998(Harrington et al.,2001) found that investor- owned nursing homes averaged 46.5 percent more deficiency citations overall than nonprofits and 43.0 percent more than public facilities. Investor owned nursing homes deliver lower quality care than do nonprofit or public facilities. I was sitting thinking about all of the people that are in nursing homes with serious illness, and I'm wondering are they being taking care of properly. The first thing that comes to my mind is that if your family members don't have patients with you, how will a stranger.

Reference:

Social work in the health field:  A Care Perspective second edition Lois A. Fort Cowles

Ch. 6 Reflection

 Chapter 6 discusses the history and basics of a nursing home along with the duties and regulations of a social worker in this type of facility. The very first "nursing homes" were founded in the early 1800's and referred to as a county home, poorhouse, poor farm, or almshouse. In these years a nursing home was more used as a safe place to provide care for the homeless, alcoholics, addicted, brain damaged, and demented elderly. Over the years nursing homes have changed tremendously and evolved into a very big and demanding franchise. "Nursing homes in the United States today are a mix of proprietary, voluntary, and public" (Cowles, p.231). In 1997, the average cost a month for residents at a nursing home was $3,643. Although being a residents of a nursing home can be expensive, Medicare and Medicaid, both provide support for those who need it. "Together, Medicare and Medicaid helped pay for nursing home care for a total of 3,164,000 persons during 1998" (Cowles, p. 234). The basic reasons that a nursing home was first created is to provide care for people who have health problems and do not necessarily require hospital care, but are no longer to take care of themselves alone. "This type of care means providing the patient with the tools, equipment, services, environmental supports, income supports, and supportive interpersonal interactions they require to maximize their comfort and function" (Cowles, p. 239). In a nursing home, a social worker  is used to identify and also meet the social and emotional needs of each and every residents. They are in charge of discharge, working with the family and residents to cope with the effects of their illness or disability and the next steps that have to be taken, and also to use the appropriate resources such as; community, social and health. A social worker in the nursing home are a huge help and do everything they can to ensure that the patient feels as safe as possible and their family and friends, also feel the same way. All nursing homes vary in many different ways, but one thing that is the same is that no matter where it is located; a nursing home and their staff strive to help all residents in every way possible.

References:
Cowles, L. A. F. (2003). Social work in the health field: A care perspective. Routledge.