According to the article, there exists an inadequacy of communication between systems related to end-of-life treatment decisions, and a number of residents of nursing homes receive unwanted treatments by the end of their lives although their documented wish state the contrary. Boundaries should be drawn in publicly funded community based services. If public funds are made available for everyone, then the number of demands would generally increase. The participation of families is decreasing and is raising issues regarding demands for the public system. For this, “two relevant trends are unfolding internationally. One is the growing delivery of home and community-based services as alternatives to nursing homes. The other is a shift towards consumer direction of services” (Young, 2003).
A line can be drawn on the services provided to the older adults. Items that are related to personal independence can be exempted from public funds. These include hearing aids, glasses, over the counter drugs, dentures etc. Public funds can be provided for major treatments for older adults, but end-of-life treatments can be cut down and it would be the responsibility of the family to take care of the adult. The efficacy of treatment or program should always be considered. For this purpose ‘multiple trajectories of service recipients and the array of potential outcome measures’ can be taken into consideration. Such reviews have shown both positive and negative results, which have impacted the current trend of treatment.
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