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❶Such hospices are usually subsidized by charitable organizations and the government. The long-term care facility can be either hospital-based or freestanding.

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Unfortunately many facilities are misleading as to what level of care they are providing. Both the government and national organizations are currently addressing this issue. My own experience with an assisted living facility has been quite good.

Formerly my grandmother was a resident of an assisted living facility. The facility was specifically built for seniors and was that of an apartment like structure. The facility provided social and recreational activities on a continual basis. There was also transportation service available for residents who wished to use it. My grandmother thoroughly enjoyed living in an assisted living facility where she had the opportunity to make numerous friends, participate in activities and remain independent.

The long-term care facility can be either hospital-based or freestanding. It consists of an organized medical staff, which provides continuous nursing services under professional nurse direction. State licensure is mandatory, Federal regulation is only necessary if the facility participates with Medicare and Medicaid, and JCAHO standards are voluntary. Long term-care is very expensive and it often becomes a financial catastrophe for the elderly person and their family.

Private insurance is unlikely to cover the full cost of care and Medicare only pays for a limited amount. The person usually must eliminate a substantial amount of their assets to become eligible for Medicaid which covers long term care. Regretfully, the cost is not the only disturbing factor of a long-term care facility. Regular visits by all family members continually raised concerns about the quality of care that he was receiving. Staffing was also a concern for our family. It seemed there was not enough staff to meet the needs of the patients within the facility.

Although licensing agencies regulated these aspects, this was not comforting to our concerns. Fortunately, we were able to move my grandfather to a different facility. The nursing home was newer and better staffed and all family members felt more comfortable about the care he was receiving. The experience of placing a loved one into a long term care facility is one I would prefer to not experience again.

It is comforting to know that there are good facilities availab! These aspects are very important for families to understand before making a final decision when they must place a loved one into a facility.

Hospice Unfortunately the last resort for some patients may be hospice care. Hospice is an organized program that offers dying persons and their families an alternative to traditional care for terminal illness. Hospice enables the patient to receive palliative medical care, while meeting the psychosocial and spiritual needs of the patient, their family and friends. The quality of life of the terminally ill patients relies heavily on the psychosocial skills of their health care team.

The health care team consists of a physician, nurse, social worker, chaplain, home health aide and volunteers. Weekly meetings allow the team to focus on the changing needs of the patient and make adjustments to their plan.

Hospice care can be received in a variety of organizational settings. Hospice care is a covered benefit under Medicare and most private insurance companies. I have found that the medical record content in a hospice program contains an extensive amount of identifying information in regards to the patient and their primary caregiver s.

All aspects of patient care are well documented and assure well-coordinated, continuous care. Conclusion Although there are many options other than those listed for health care after discharge from a hospital, The most important aspect for a person is to be well informed and knowledgeable about the variety of options available. Medical services within the territory of the United States are provided both by private or legal establishments. Various commercial, charitable and state organizations offer patients both out-patient and stationary services Mahar, Family medicine is considered to be a rather developed structure in the USA.

Family doctors examine and observe patients and if necessary, direct them to narrow experts or to a hospital. Such doctors receive payment directly from patients. As a rule, the family doctor has his own office or cooperates with other experts.

Hospitals make the largest component of the general amount of medical services of the USA Wangsness, Hospitalization is the most expensive and most important component of the industry of public health services of this country. However, recently there are appreciable shifts towards other establishments, mainly polyclinics, points of first aid and geriatric homes.

Out-patient services are slowly, but confidently replaced by hospitalization, and home visiting service by staying in geriatric homes. In the USA there are two types of hospitals: US hospitals render a certain volume of the out-patient help in the ERs and in specialized clinics, but basically they are intended for rendering the hospitalization of the patients. A vast amount of attention is given to emergency aid. Besides, USA has a network of hospices for terminal patients with expected life expectancy of six month and less.

Such hospices are usually subsidized by charitable organizations and the government. However, in the USA, as well as in other countries, the concept of the out-patient help includes rendering of medical services without hospitalization of the patient. This makes a big share of rendering of medical aid to the population. Treatment in-home basically is made at the expense of the sisterly organizations and usually is ordered by the doctors.

The private sector of out-patient medical aid is presented by personal doctors experts in internal and family medicine, pediatricians , narrow background experts, for example gastroenterologists, cardiologist, nurses and other medical personnel Roehr, Those American citizens, who do not have private insurance, are eligible for the action of such state programs as Medicare, Medicaid, and also other programs for the needy population offered by different states and local authorities.

One of the major purposes of the US government is the expansion of the sphere of action of these programs on all levels of the population and especially for those US citizens, who truly need them.

For example, the Tricare program is a program for the veterans and their families. In the federal government has introduced the program of the state insurance for children from families that have an income which is higher than the Medicaid admission rate but nevertheless is not sufficient in order to purchase insurance Mahar, By this program has helped millions of children, but in many states it has already faced the problem of insufficient financing.

The government of the USA pays the expenses of the public health services by means of two basic programs — Medicaid and Medicare. These two programs allow providing medical services which are either free of charge or at a very low cost, to poor or indigent citizens of the country. Medicaid annually provides medical aid to over 40 million Americans with low level of incomes, and Medicare provides medical aid to a similar amount of elderly patients and people with limited physical possibilities Roehr, Medicare is a famous insurance state program for senior people who are older than 65 years which was implemented in Before its implementation almost the half of the elderly population of the United States did not obtain the required volume of medical services.

This program coordinates the insurance of all the American citizens who are older than 65 years old and also of those citizens, who are approaching this age and have serious health pathologies. This insurance program covers medical aid during acute conditions right up to hospitalization, various diagnostic procedures, medical services at home and short stay in geriatric homes.

Besides, patients can receive some preventive services, for example vaccination against hepatitis B, flu, pneumococcus and other. Such services as long hospitalization, nurse visiting service, hearing aids and prescription drugs are not covered by this program. Medicare is a rather effective program. It is partially financed from the special tax on workers: The other Medicare part is financed from the general proceeds of surtax.

The Medicaid state program was introduced in and is aimed at insuring American citizens from low-income families. Elderly people, people with severe injuries, invalids, pregnant women and children are also eligible for this program. Medicaid deals with five basic services: This program pays for geriatric homes for aged people who require permanent care and cannot do anything without outside help.

Staying in such establishments is very expensive: Patients in geriatric homes get the largest portion of the Medicaid money Cunningham, The Medicaid program is financed both by the federal government and the states.


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