Aging: Implications on the Health Care System & Need for Aggressive Medical Interventions - Essay Sample

Introduction

Aging has a critical implication on the health care system. The concept of aging brings complications at the end-of-life. It, therefore, introduces the need for aggressive medical interventions. It entails aggressive diagnostic tests and management of coexisting medical complications such as the use of ICU and other interventions ("Too much treatment?" 2008). In the provision of care, the medical model has some shortcomings, such as being a problem-based model. The physicians have reported that overtreatment is a common issue and is a cause of preventable harm and waste in the health care system (Lyu et al., 2017). It can be postulated that just because a treatment method is available does not mean it should be performed. It is because additional interventions in aggressive care can result in complications. This paper argues that aggressive treatment is not necessary because it can lead to additional medical complications.

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In contrast to aggressive medical interventions, it can be argued that "less treatment is more" approach to treatment, enhancement of patient autonomy, quality over quantity, and culturally appropriate end of life treatment. The treatment approach should help minimize the effects of hegemonic biomedicine and aid patients in dying a "good" death. The current medical model of care provision has not made it easier to care for end-life patients. Dr. Byock explains the shortcoming of the medical model prevalent in many health care systems ("Shortcomings of the Medical Model at the end of life," 2011). First, it is a problem-based model which only focuses on human health problems such as illness or injuries. The main objective of the model is to cure or prolong life, whether the health problem is cured or not. It, therefore, means that the model is inadequate is serving individual going through the end of life process because it only sees their problems. The increases treatments and especially during the last days, leads to unnecessary pain in the intensive care unit due to the uncomfortable machines and surgeries ("Too much treatment?" 2008). The use of aggressive medical care can potentially shorten a patient's life since they are at risk of increased infections and medical errors. It can, therefore, be postulated that that aggressive treatment is not appropriate in serving patients at the end-of-life stage.

In addition to the conventional medical model, Dr. Byock suggests the use of human development to supplements the shortcoming of the medical model. It considers the end of life with the same respect it views the beginning of life. The human development model acknowledges the presence of problems at this stage, but also sees opportunities for an individual to grow within the context of self and as a family ("Shortcomings of the Medical Model at the end of life," 2011). It is the main difference with the medical model, which only focuses on health problems and abandons people to figure out how to live through the process of end of life. Dying is considered not medical, and therefore the human development model could guide as people live through the dying process. The medical model provides solutions to health problems. The human development model completes it by handling the aspects disregarded by the medical model. It guides on issues that are not on the spectrum of medical health problems by being holistic in the provision of care. Death is considered a component of the normal cycle. The human development model provides a detailed understanding of the dying process and more approaches for coping.

The health care system and insurance have not helped in easing the experience at the end of life. Both have reinforced the practice of aggressive treatment for patients at the end of life. It is prudent to the point that aggressive treatment brings more pain to patients. There are ways that health care settings and insurance have enabled the continuity of this problem. For instance, insurance in the United States spends approximately $55 billion to pat doctors and settle hospital bills at the end of life ("The Cost of Dying: End-of-Life Care," 2010). Dr. Byock points out that an estimated 20-30% of the expenses do not result in meaningful outcomes. The maintenance of a patient in the ICU costs approximately $10,000 per day ("The Cost of Dying: End-of-Life Care," 2010). At the end of life, most of the hospital bills are catered for by the government and private insurers, leading to prolonging of life sometimes more than necessary.

The hospital settings is another factor reinforcing the provision of aggressive treatment. First, the hospitals have advanced medical technology that has made prolonging life easier. Also, policies in-hospital support keeping patients admitted to hospitals. Their capabilities have enabled the treatment of patient complications, and this has made the dying process. Dr. Byock mentions that people are dying suffering ("The Cost of Dying: End-of-Life Care," 2010). The care that these patients are affected by two factors in hospitals. First, doctors are compensated according to the number of patients they see, and second, the hospital is paid according to the number of admissions. These factors promote many admission of the patient at the end of life and their prolonged stay. Dr. Elliot Fisher points out that 30% of the hospital stays are unnecessary, leading to wastage ("The Cost of Dying: End-of-Life Care," 2010). It is made worse by the patients desiring as much treatment as available despite some little benefit in some cases. Also, patients and their families are not informed about available options at the end of life like living wills and hospice. Patients subjected to aggressive treatment are not given choices, and most would rather have fewer treatment interventions. Doctors do not meet with the patients and their families, and in most cases, patients are left to figure out dying on their own. Therefore aggressive treatment causes more pain than appropriate and thus unnecessary.

Both Dr. Byock and Dr. Fisher suggest alternative options to aggressive treatment, such as palliative care and hospice. Palliative care is defined as the provision of care that relieves symptoms such as pain, fatigue, constipation, and loss of appetite, among others. It can also help address side effects arising from medical treatments a patient is receiving (Santrock, 2019). It is provided in various settings such as nursing homes, outpatients, at home, and palliative care clinics. Hospice care, on the other hand, is specialized care that emphasizes on quality of care for individuals experiencing life-limiting health conditions. Individuals in the United States are increasingly choosing hospice care at the end of life ("Palliative Care and Hospice Care," 2017). It is ailed in different settings such as home, inpatient facilities, and nursing homes, among others. Other options that can be utilized by patients at the end of life include home-based care, long-term care facilities, and hospital-based care. These options can provide more options at the end of life and, therefore, can help patients face death with dignity.

Conclusion

In conclusion, aggressive treatment interventions provide increased tests and diagnostics to patients at the end of life. However, the big question has centered on whether the additional treatment provided by aggressive medical is necessary. Doctors have claimed that aggressive treatment results in more pain for patients at the end of life instead of helping them deal with their situation. It causes more complications and unnecessarily prolongs life. The problem of aggressive treatment has been sustained by the government and private insurance that pays for additional treatment. Also, the medical model, health care setting, and doctors play a critical in aggressive treatment. However, some doctors are against aggressive treatment, and patients should choose other options, such as palliative and hospice care. It can, therefore, be concluded that aggressive treatment is unnecessary and more focus should be on helping individuals with the end of life process.

References

Lyu, H., Xu, T., Brotman, D., Mayer-Blackwell, B., Cooper, M., Daniel, M., ... Makary, M. A. (2017). Overtreatment in the United States. Plos One, 12(9). doi: 10.1371/journal.pone.0181970

Shortcomings of the medical model at end of life. (2011). Retrieved from https://www.youtube.com/watch?v=hK8IL2-zYN8

The Cost of Dying: End-of-Life Care. (2010). Retrieved from https://www.youtube.com/watch?v=F6xPBmkrn0g

Too much treatment? Aggressive medical care can lead to more pain with no gain. (2008, July). Retrieved April 2, 2020, from https://www.consumerreports.org/cro/2012/04/too-much-treatment/index.htm

What Are Palliative Care and Hospice Care? (2017, May 17). Retrieved April 2, 2020, from https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

Santrock, J.W. (2019). Life-Span Development (17th ed.). New York, NY: McGraw Hill.