Health care in America Essay

Healthcare in America is seemingly, chronically an issue of finances. Whether or not the hospital has it or the family of an ill patient has it, it becomes prudent to note that without the country’s currency rubbing the right palms, healthcare becomes an issue, especially for the financially strapped family. Lack of finance equals care-giver burden. Purpose of the Analysis In the following pages care-giver burden will be addressed using five peer-reviewed articles. The articles are in design stressing the issue of guilt and depression when a family decides they don’t have the time or the money to keep a loved one at home and must face putting them in a care facility (Sanders article Shouldering the Burden of Care). Other articles address the issue of keeping a family member at home (child) and the upkeep cost that entails such as home health aid cost, medications, or leaving a job (Wilson, Leslie S. et al. The Economic Burden of Home Care for Children with HIV and Other Chronic Illnesses). Also, the review of patient care for nurses and the burden of lack of authority in administration this presents is another form of care-giver burden (Welchman, Jennifer & Glenn G. Griener, Patient Advocacy and Professional Associations: Individual and Collective Responsibilities). There is also the gender role burden between husband and wife when one is sick and has to be taken care of and the other one lives a full active lifestyle and the issue here is burden of responsibility (King, K. M. & PM Koop, The Influence of the Cardiac Surgery Patient’s Sex and Age on Care-Giving). There are many facets to unravel in the primary care system but for this paper, care-giver burden is the primary concept in terms of money, guilt and love. Antecedents Most care-giving authority is given to nurses; both in a hospital setting and during stay at home cases. The preceding concept or the patient is its important to have a strong trusting relationship with the care-giver in order for them to feel more comfortable and also feel their issues and concerns are being heard. If the patient does not feel comfortable then the care-giver burden becomes apparent in scowling-unreceptive-to-therapy patients. However, in Welchman and Griener’s article, Patient Advocacy and Professional Associations, a rising concern over nurses’ burden when taking care of patients begins to be seen, â€Å"†¦nurses are being taught to be patient advocates and both nurses and patients are the worse for it. The nursing profession’s redefinition of the nurse’s role from loyal handmaid to patient advocate in the 1980s was supposed to protect patients by empowering nurses to think and act autonomously in their dealings with other health professionals. Individual nurses have been burdened with a responsibility that most professions assign†¦to their professional associations. It is not a responsibility that individuals can readily fulfill. Unless or until the duty of advocacy is taken off the shoulders of individual nurses and returned to the professional bodies that represent them, nurses and patients will continue to suffer unnecessarily†(2005). The nurses role in patient care involves everything a patient needs or may potentially need (feeding, bathing, bathroom visits, company) and each of these duties cannot be accomplished without proper support from family/administration, and without this support and the lack of performance in a nurse’s duty a patient will lapse in trust. This is the contention in the make-up of care-giver burden; nurses cannot fulfill their role to maximum potential without the backing of the hospital rules. In the area of patient care and the burden of care giving an interesting side note that should be considered is in the study done by King and Koop which involves a closer look at patient care with the influencing variables of sex and/or age. In their study they revealed that female patients relied on their spouse less than the male counterpart. Also, female care-givers were more often employed outside the home than male care-givers giving rise to a staggering believe of job importance and detachment for men in home care situations. As mentioned in the opening statement, the pivotal issue of care-giver burden is that of money. If a household is not sufficiently funded then the burden of caring for loved-ones either by oneself or with the assistance of an aid, the stress and strain is very detrimental. In Wilson et al. ’s study of patient care for ill and HIV children the stats for financing reflects a tremendous burden, â€Å".. in-home care for ill children (ranging from approximately $19,000 to $36000) is higher than that of hiring caregivers for healthy children (approximately $10,000)† (2005). This burden is further emphasized for the family if they are not equipped to pay a professional care-giver and are dependent upon themselves for such care; this issue raises the other issues of job attendance (some families pass up promotions, decline extra working hours, or quit their jobs entirely in order to care for the ill which makes the financial burden that much more potent). Further in Wilson et al. ’s study they reveal the numbers involved in American care-giver homes, â€Å"It is estimated that 10% to 18% of US children (6 to 10. 8 million children) are chronically ill. According to our cost estimates, the total value of care ranges from $155 to $279 billion per year†(2005). This number is daunting and almost in realms of infinite thought with regards to cost analysis. Consquences The burden is twofold for the nurse and the patient. As Welchman and Griener state in a final cul-de-sac, â€Å"Advocacy for improvements in access to and deliver of health care is best viewed as a collective responsibility of health professions owed to society as a whole, not as the sole province of individual practitioners†(2005). In the case of gender roles playing out in the care-giver burden the consequence is this: dependence is a potential burden to the spouse whose in need of not only assistance in daily routines (bathing, eating, etc) but in companionship. The findings of King and Koop suggest that a patient’s gender has relevance to the availability of home-based care (King & Koop, 1999). The potential cost of in home health care is a care-giver burden as well as a patient burden. The weight stressed here is not one that is easily remedied. When put into perspective the cost is much more than money but also wavers on emotional stress to the care-giver and patient when the care-giver’s stresses are known to the patient. Such stresses as highlighted above are job attendance, quitting a job, and the issue of time spent with a patient as opposed to time spent with other members of a family. As Sanders states in Shouldering the Burden of Care, in which one family is analyzed, â€Å"Faced with her mother’s inevitable decline, she wonders whether she should continue to care for her in her home. But the more important question is, can she? † (2005). Defining Attributes This is the main point of care-giver burden: when faced with a choice of sending the patient to a nursing home, or institute where they can possibly be better attended to, should the family send the patient/family member away, or should they endure? The potential for this question to raise a respite for patient care or to give into the burden of home-health care is pertinent in its prospective view of burden. The relationship between care-giver burden and money is inseparable. The high-cost measurement presented in the Wilson study harkens to the reality of facts and numbers involving patients and their estimated cost of care per year in this country, and when a job is lost or sacrificed for the benefit of the patient the new stress becomes where will the money come from for the upkeep of home health care? Empirical Referents In the area of money, and of authority it is to nurses who are the advocates of the patient in the hospital that studies should be turning. If they are allowed to be sufficient leaders then the trust between them and patient is strong. In an at home environment the dangers of lack of funds arise and the emotional stress on family members and spending time with each other (either children, wife, or husband) and the noncompliance from other family members in putting the patient/loved-one in a home can be daunting. The care-giver burden here is clear. When a family member who isn’t equipped physically or professionally to take care of the ill, then an alternative way must be found and is found with nurses, and the high cost of in-home care. Relationship The defining features of care-giver burden, that of cost, and guilt bears a close relationship to euthanasia. In both cases the issue of money, guilt and pain arise and are handled usually with the confidence of a nurse. A nurse aids a family in decision making for both in-home care or euthanasia. In the relationship between the two concepts it is the burden of the patient on the family emotionally and financially that a decision is made: to either keep them at home or send them away, to either keep them on a ventilator or pull the plug.