Introduction
As the United States population of older adults increases, there is a growing concern regarding the availability and quality of healthcare services, particularly related to palliative care. For older adults with severe illnesses, palliative care is an essential element of healthcare. It concentrates on alleviating symptoms and stress associated with the illness, which enhances the well-being of both the patient and their family (Mercadante, 2018). However, the lack of access to palliative care and the low Medicare reimbursement rates for this type of medical care is becoming an increasingly pressing issue.
The current shortage of healthcare professionals trained in palliative care is a major challenge that is further exacerbated by the aging population. This shortage makes it difficult for older adults to access palliative care when they require it most, leaving them to suffer needlessly with limited medical support (Mills & Ven, 2019).
Additionally, financial constraints resulting from low Medicare reimbursement rates for palliative care services have led to many healthcare providers being unable to offer this service to their patients (Duckett, 2018). This lack of access to palliative care has significant consequences for both patients and their families, including an increased risk of hospitalization, unnecessary pain, and suffering, and reduced quality of life. Moreover, as the population of older adults continues to grow, this issue will only become more pronounced.
Addressing this problem requires a concerted effort from policymakers, healthcare providers, and the wider public. It is essential to increase funding for palliative care programs, increase public awareness of the importance of palliative care, and promote initiatives that train healthcare professionals in palliative care to ensure that they are well-equipped to meet the needs of the aging population. Ultimately, improving access to palliative care is crucial for the well-being and quality of life of older adults with serious illnesses and is a key challenge that must be addressed.
Stakeholders
The impact of the aging population health policy issue on the social service and healthcare systems is of interest to many stakeholders. Each stakeholder group has a distinct viewpoint on the matter, a vested interest in it, and the ability to support or oppose associated policies. Understanding older adults’ perspectives and interests is crucial to developing healthcare policies that meet their needs and advance their overall health and well-being.
Firstly, healthcare policies relating to the aging population have a direct impact on older adults. They have particular demands in terms of both their physical and non-physical well-being that must be met, such as help with managing a chronic illness and daily living activities (Bao et al., 2022). They are therefore more likely to support legislation that improves their access to long-term care services, support for caregivers, and overall health and wellbeing.
Secondly, healthcare professionals are another stakeholder group with an interest in regulations concerning the aging population. The demand for their services may increase, making it more difficult for them to provide the care that elderly people with complex needs need (Lester et al., 2019). Hence, depending on how aging population policies affect their practices and financial security, healthcare providers may be both supporters and opponents of the programs.
Thirdly, in an attempt to directly influence lawmakers, lobbyists support legislation that advances the interests of their clients. By highlighting pertinent news and opinions, media outlets can affect how the general public views aging and healthcare legislation (Shu & Woo, 2020). They could impact the process of creating policy in both beneficial and negative ways. On the one hand, they can draw attention to crucial concerns and give decision-makers vital data to make wise choices (Mattig, 2019). However, they may also promote particular interests that aren’t always the greatest for society as a whole.
Alternative Policies and Recommendation
Increase Awareness of Palliative Care Education
The first policy alternative is increasing awareness of training and education of palliative care courses. The alternative is based on social issues affecting the sector, such as inadequate staffing and stressful working conditions. Lester et al. (2019) argue that the primary challenge in the shortage of palliative caregivers is knowledge deficits and a lack of awareness about palliative among the public leading to an inadequately trained workforce. Consequently, the workforce shortages in the sector are due to the inadequate absorption of fresh professionals, while the current experts in the industry are old and nearing retirement.
According to Kamal et al. (2019), the number of professionals exiting the sector is 60% more than the number of fresh professionals joining palliative caregiving. Thus, there is a vast professional gap leading to staff shortages for effective caregiving. Changing the requirements will effectively enhance knowledge about palliative caregiving among all healthcare professionals, such as nurses, social workers, physicians, and case workers (Kamal et al., 2019). Thus, increasing workforce personnel through training and recruiting fresh individuals ensures adequate caregivers and less workload for effective services allowing more individuals to access palliative care.
Reimbursement
Another policy involves timely and sufficient reimbursement for palliative caregivers. The policy involves economic and social issues affecting the industry. Duckett (2018) argue that Palliative care programs and nursing homes for the aging cut nursing positions to reduce costs increasing nursing to patient ratio to 1:4 or 1:6. Cutting the cost places caregivers at a loss since they end up with a huge workload that leads to burnout, stress, and possible quitting from the sector.
At the same time, Medicare does not pay hospitals not accredited by accrediting bodies such as The Joint Commission. According to Duckett (2018), very few palliative care programs meet the accreditation standard, leading to inadequate financial support for health workers. Hence, they depend on institutional funds and charities to fund the positions, which is insufficient.
Improving reimbursement for palliative care services boosts caregivers’ financial and social status, motivating them to offer the best services to the sick and aging population regardless of work overload. Similarly, more people will be encouraged to train as palliative caregivers leading to an increased workforce (Kamal et al., 2019). The policy can be effective as it ensures a conducive working environment with reduced burnout and stress levels which are detrimental to caregivers and can lead to quitting. Therefore, reimbursement policies must change to allow sustainability of caregivers and quality services in palliative care
Invest in Advanced Learning
Besides training fresh individuals and changing accreditation requirements to fill the workforce shortage, the healthcare system should have policies that facilitate advanced learning for palliative care. Issues regarding this policy include political and economic factors supporting palliative care fellowships. Although the policy exists, the training and funding resources are insufficient to train a large population. The training system lacks adequate infrastructure and human resources to accommodate the vast population of healthcare workers seeking advanced training in palliative care (Flaherty & Bartels, 2019).
Likewise, existing palliative care fellowships for advanced training have limited funds to support the cause leading to few individuals attending the training courses (Dudley et al., 2018). Therefore, the federal government, healthcare institutions, and health organizations should invest in sufficiently funding the training programs for professionalism and an increased workforce. The policy’s strengths lie in ensuring a future with an adequate workforce and enhancing access to palliative care for the aging population.
The ‘Do Nothing’ Policy
Finally, the fourth alternative is the ‘do nothing’ policy which is a passive approach to solving a situation. This policy alternative involves not taking any action by decision-makers and shareholders due to various social, economic, and political reasons. In palliative care, the policy would mean not increasing the workforce to care for aging due to economic reasons. According to Kamal et al. (2018), the shortage of caregivers in the sector results from the increased aging population, which occurs naturally and may decline with time.
Therefore, there is no need to invest in increasing the workforce and using the economic resources in other areas. This alternative may not be effective as it does not provide a solution to the immediate crisis. Ignoring the problems increases the workload on existing caregivers and staffing issues, which affects service delivery and accessibility to palliative care. Thus, the ‘do nothing’ policy is not viable in the present circumstances.
Recommendation and Conclusion
The best alternative policy would be reducing workforce shortages by introducing fresh palliative care professionals in the health sector. The gap left by retirees and the increasing aging population significantly influenced the crisis. Data from Kamal et al. (2019) shows that more than 41% of palliative care professionals are 56 years and above, approaching their retirement age, while the intake of fresh palliative caregivers is less than 10% annually. Thus, the number of fresh intakes does not match that of those leaving the sector, leading to staffing and burnout.
Training a fresh individual to fill the gap eases the workload leading to a conducive work environment and fewer cases of quitting. At the same time, the alternative will ensure adequate personnel for palliative care who are young to replace the retired, creating a diverse and energetic workforce for effective palliative care (Dudley et al., 2018). The recommendation is based on its economic and social feasibility, which makes it suitable for solving the immediate crisis. According to Kamal et al. (2019), the recommendation is socially and economically feasible as it allows the public to gain employment through education using personal funds. Thus, the health sector and policymakers will not be obliged to raise funds to support the policy.
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