The Constraints in Providing Primary Care to Elder Patients with Chronic Disease Causes

a More Challenging Physical and Social Environment

Abstract

According to recent research, it has been established that the majority of health care users are the

elderly. In most cases the provision of the care for the elderly there is many cases of

disorganization since the care is provided by multiple providers. Provision of care to older

people with chronic diseases is usually complicated and thus there is a need for the providers to

take into consideration the factors that are necessary for the provision of the best care for the

elderly. This research paper will highlight the constraints in providing primary care to elder

patients with chronic disease causes a more challenging physical and social environment. The

establishment of primary care units some of which are at the family level is essential in the

knowing about the operations of nursing teams and how they relate with other services that are

provided in the community. This study will also investigate and give a better understanding of

challenges that are present or that are found when dealing with decision-making processes and

the provision of primary care to the elder patients.

Introduction

Due to the shortage of properly educated staff and general funding, elderly patients

receive a low quality of primary care. For the proper provision of care to the elderly, there is the

importance of getting the medical practitioners who are competent and who have the knowledge

on how to treat the elderly. Most elderly people have multiple problems and it can be difficult to

take care of them efficiently if the medical practitioner is not well qualified.
 The old patients with other complications have been on the increment and it is the duty of

the national health departments and the family members to partner and ensure that the elderly

receive the care that they deserve. The main focus is the old patients with other complications

such as dementia and Alzheimer's. The old patients with other complications have been fluxing

and the policies that guide the health care for the patients have to be formulated and amended

make treatments for the old patients.

This paper will highlight the constraints in providing primary care to elder patients with

chronic diseases such dementia, the costs involved such as the costs involved in the social

networks due to stigmatization of people with dementia, and the inability of caregivers to

maintain social networks because of the time it takes to provide care to a person with dementia.

It is thus important to support the families with a member of the family suffering from dementia

because they may have financial difficulties due to the treatments.

Background

According to the assessments that have been done concerning the current primary care

infrastructure has played a large role in showing that the current healthcare system is fractured

(Elliott et al., 2018). Elderly patients with dementia need to receive care from different unrelated

professionals in an episodic nature without a central body that would coordinate and monitor

their complex treatment (Elliott et al., 2018). To improve the care for the elderly people

especially those with dementia it is essential to understand the contexts of operations for the

primary care providers and the processes that are involved during the provision of the

community services (Elliott et al., 2018). Making the primary care provision successful will

require factors such as engagement processes for patients that are enhanced or that have been

enhanced, connecting well with the other community services, having knowledge that is more
advanced on the matters concerning primary health care provision (Elliott et al., 2018). Once the

information has been gathered, then it becomes easy to implement the necessary interventions for

the provision of primary care.

Financial Hurdles

In the provision of primary treatment for the old people especially those with

complications such as dementia, there arise challenges that are financially related (Pearson et al.,

2019). The current health care systems always make it challenging for people who are in the

middle-class bracket to be given primary care, because of the lack of eligibility for the

government-sponsored care and the private sector is too expensive for them. This complicates

things for the people who fall in the category of the middle-class earners specifically due to the

high costs associated with the provision of primary care (Pearson et al., 2019).

The major health determinants that are associated with the social-economic status of the

patients that require primary care are such as the behavior of their health, their exposure to the

environment, and the health care that they are exposed to (Pearson et al., 2019). The increment of

mortality for elder patients may be caused by the chronic stress that comes with low status

economically. For the primary care initiatives to work efficiently, there is a need for the

providers to address the major components that determine the economic status of the patients

such as their education level, their profession, or their income (Pearson et al., 2019). Once these

factors have been put into consideration then it becomes easy to provide the primary care for the

elderly patients based on their financial status.

Elder patients with dementia require finances that can be used for the purchasing of their

medication which can be expensive and that is required to be administered to the patient for a
long time (Pearson et al., 2019). One the income is sufficient; the patient can get access to better

nutrition required for boosting their weak immune systems (Pearson et al., 2019). The levels of

income have been associated with cases of mortality rates where the elder patients who have

access to high financial assistance have recorded a lower mortality rate while those with access

to lower financial support have recorded a high mortality rate.

Some of the problems that may be associated with low financial abilities are such as

hypertension, diabetes, cancer and cardiovascular diseases (Pearson et al., 2019). During the

middle stages of adulthood is when most of the patients who require primary care due to chronic

diseases have the highest mortality rate (Pearson et al., 2019). Also during this stage, there may

be disparities that are caused by financial constraints. It thus becomes the duty of the family of

the elder patient to make sure that they are well funded so that their patient can get the best care.

Resulting Influence On the Elderly

Some of the factors that may make the elderly patients with dementia who are seeking

medical care are such as the disorganization of the primary care systems and also the high costs

that are associated with the care (Conner et al., 2010). During treatment, many elderly people or

patients may feel stigmatized and thus they may opt to stop seeking the medical care that they

need (Conner et al., 2010). This often leads to a high number of elder people who are depressed

due to the stigma.

Gaps in Research

Most of the contemporary assessments and also models are not made while considering

or putting the elderly in mind, but in some cases, universal models are considered (Makris et al.,

2017). However, such models that have been considered might not have the proper
measurements of the expectations and priorities of the patients who are elderly and what the

elderly patients want to be included in their care (Makris et al., 2017). There exist many gaps

especially when dealing with the elder groups of patients. The caregiver should be aware that

most of the diseases that affect the elderly are persistent and they have to be more vigilant on the

underlying illnesses as they may be difficult to detect. The identification of the human anatomy

for the elder people is key in ensuring that the underlying conditions are taken care of (Makris et

al., 2017). During assessments and treatment, the elder patients pose many more challenges

hence it is important for the caregivers to ensure that closer care is taken to avoid misdiagnosis

(Makris et al., 2017). Understanding the underlying conditions of the patients is important as it

may be responsible for the identification of the main illness affecting the elder patient.

Obstacles Between the Patient and the Treatment

Lack of professionals who have been properly educated on elder patient care provision

creates obstacles or challenges between the patient and the treatment. The practitioner's lack of

awareness about the patient's symptoms as well as the nuances of their cultural background

creates the rift between the elderly's family and the medical facility, inhibiting treatment's

progress (Hinton et al., 2006). When accessing the education of the medical practitioners who

are responsible for taking care of the elder patients there may be challenges associated with

accurate assessment (Hinton et al., 2006). Some of the research activities that have been carried

out concerning education when it comes to the provision of care for the elderly suggest that

higher education for the medical practitioners is associated with high morbidity and high

mortality rates for the elderly patients.

One of the most basic components that are important for the treatment of elder patients is

the education of the health care providers (Hinton et al., 2006). Education of the providers of
health care for the elderly patients plays a crucial role in ensuring that they have been equipped

with the necessary tools that are required for the proper care of the patients (Hinton et al., 2006).

Education is the major factor that determines the risk of illnesses affecting the elder patients.

Most of the disparities or conflicts arise when there are misunderstandings between the

family of the elderly patient and the medical practitioners who are responsible for the taking care

of the elderly patient because of lack of education on the cultural background of the patients that

may be complicated (Hinton et al., 2006). Having adequate education is important in ensuring

that there are no conflicts that are brought by a lack of knowledge of the backgrounds of the

patients (Hinton et al., 2006). Also, lack of adequate education may cause misunderstandings

between the practitioner and the patient especially if the patient has other underlying illnesses

such as mental related illnesses.

Treatments that are not conventional are dangerous once they are applied at the same

time as the normal medication (Hinton et al., 2006). There may arise conflicts between the

members of the elderly patient’s family and the patient if the medical practitioner in charge does

not intervene and recommend the right medication for the patient. The other conflicts may arise

due to some of the elder patient’s family members recommending different treatments for the

patient (Hinton et al., 2006). It thus becomes the duty of the medical practitioner to intervene and

recommend the right medication for the elderly patient since most of the patients are not in

positions where they can make the right decisions.

Administration of medication that is pharmaceutical and their implementation is largely

dependent on the knowledge and the level of education of the medical practitioner who is

providing the medical care to the patient who is elderly (Hinton et al., 2006). Some of the

medication that is available for the treatment of chronic diseases especially those that affect the
elderly patients may be harmful to them if not correctly administered (Hinton et al., 2006). The

medical practitioner must ensure that the dosages are correct and that there are no overdose cases

that may be fatal.

Administration of care to the elderly patients may be challenged by the lack of

infrastructure or lack of adequate infrastructure. The infrastructure where the treatment of any

patient is done plays a big role in the recovery process of the patient (Hinton et al., 2006). There

is a need for a proper infrastructure if the patients are to recover fully. If the infrastructure is

poor, then there is a possibility that the patient may contact other secondary infections (Hinton et

al., 2006). Most of the elderly patients have weak immune systems and hence it is easy for them

to contact other illnesses during the period when they are getting the treatment in the home care

facilities. Once these elderly patients contact the secondary illnesses, it becomes more

challenging to treat hem and most of the illnesses may lead to their deaths if not properly treated

or if not detected on time (Hinton et al., 2006).

Many elderly patients may not be able to arrive at the treatment centers on time. Most of

the elderly patients who prefer staying at home and are taken care of by the family members may

find it difficult to get access to treatments promptly due to the long queues in the medical centers

(Foo et al., 2020). Most of these patients cannot stand for long due to their illnesses and thus may

decide to give up on the medication altogether. Giving up on the medication may lead to a high

mortality rate (Foo et al., 2020). The lack of ready treatment and a medical professional available

may also contribute to the high mortality rate of elderly patients (Foo et al., 2020).

The delivery of proper care by the medical practitioners who are responsible for taking

care of elderly patients is greatly influenced by the cultural backgrounds of the patients (Gallant

et al., 2010). The ethnicity of the patients determines the type of treatment provided.
Understanding how these cultural and ethnic backgrounds affect the quality of treatment is

important in ensuring that the patients get the care that they deserve without having to worry

about the cultural and ethnicity factors (Gallant et al., 2010). It is also important for the family

members to ensure that the medical practitioners taking care of the elderly patients are made

aware of any cultural backgrounds that may interfere with the medication or the quality of care

provided before the treatments starts being administered or therapy starts (Gallant et al., 2010).

Conclusion

Many elder patients usually have health complications that range from chronic diseases to

mental health problems and they have been on the increment. The numbers of elder patients who

have been reported to require medical assistance have been rising at an alarming rate. It is the

duty of the national health departments and the family members to partner and ensures that the

elderly receive the care that they deserve. Many elder patients who do not have access to proper

medical care usually contribute to the list of elder patients who have untimely deaths. The main

focus is the Elder patients who have chronic diseases such as dementia and Alzheimer's. Many

other complications are associated with old age and all these complications require a medical

professional to be always available in case the elder patient needs them. The old patients with

other complications have been fluxing. The policies that guide the health care for the patients

have to be formulated and amended. The constraints in providing primary treatment to the old

patients with other complications cause a more challenging physical and social environment.
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