Demand of transparency of health care systems has evolved over the last years. Some of the domains expected to conduct transparenly are pricing and quality of care . Likewise this concept is different for health care consumers, physicians and health care organizations administrative staff. My question refers to what should be the expectations of elderly people, elderly patients and their care givers in terms of transparency?
In my opinion there are several factors that could be relevant: communication of risk to benefit ratios of therapies and Interventions, defining relevant geriatric outcomes for treatments, the inclusion of topics such as end of life decisions and of course inclusion of patients into the decision making process.
Transparency of healthcare systems for elderly to my opinion would consist of at least the following:
- The provided treatment is discussed with the patient (and his family) and alternatives have been provided in order to give the patient the option to choose the treatment that best suites to his or her needs and situation. Especially for elderly, the option of no treatment should be discussed as well.
- To know whether health care is provided according to pre-defined protocols and if health care providers would prefer to deviate from these protocols, that this is discussed with the patient (and his family)
- Patients would have to know how they can file a complaint if something went wrong in the provision of care
- Patients should have sufficient information to choose between healthcare providers on issues that are important to them.
- In the boards of hospitals/ resident homes there should be a patient representation and a patient council should advice the board on future direction of care
- The provided care should be evaluated regularly and adapted if necessary
- For family members, their role in supporting their spouse or their parents should be clear. This is especially important when the elderly are no longer able to take care of themselves because of for instance Alzheimer.
Undoubtly there will be more issues that are important for transparency in health care from the point of view of the elderly, but I think that when the above mentioned points have been addressed in a health care system, transparency is already met to a large extent.
The meaning of " health care system transparency " to geriatric patients and their care givers and vice versa:
a.Expectations of elderly people: Elderly are generally neglected in my country ie India. What would elderly expect from health system is to 'LISTEN' to them, to 'UNDERSTAND' what is really wrong with them and to 'EMPATHIZE' with them'.
The question is whether the 'health care system' does Listen, Understand, and Empathize?!
b. elderly patients: In a state where elderly already feel lonely and neglected sickness adds to their plight. They are not able to ask for appropriate services: due to inability to reach hospitals due to loco-motor problems, or may be due to financial constraints or due to dementia setting in.
When the geriatric population of the nations is on the rise we need to set up systems where 'something' could be done for elderly patients.
c. their care givers: Care givers of elderly patients are usually turning old themselves ie my mother is 87 plus and my eldest brother who is 65 years old is taking care of her. He himself will require a care taker within a few years time. What happens to my oldest old mother!
I think we have to bring back the notion of empathy amongst the newer generations to see what we are seeing. By the way I am also 60.
The new generation health care system providers need to learn about geriatric Care from technical and from humane point of view.