Tuesday, November 11, 2008

To institutionalize.. or not to institutionalize?

The following blog will take a closer look at the shift towards deinstitutionalization of seniors in Canadian policy. As has been noted earlier in our blogs... deinstitutionalization is a current strategy used by provincial governments in an effort to be cost effective with health care funds. Clearly this is an appealing approach for the government who will save tax dollars by eliminating expensive end of life care facilities. However, there is actual merit to this approach rooted in studies on the psychological effects of institutionalization on the elderly (which I doubt was the primary motivation of government- nevertheless.. they may unwittingly be on to something). These studies have revealed a marked decrease in life satisfaction and also in health status for those in institutionalized care. A recent study was conducted on the effects of institutionalization, which matched elders on variables such as health and age and randomly assigned them to three levels of service ranging from minimal , which included providing information and direction and maximal intensive programs, characterized by institutional care. It was found that the death rate (and disease rate) of the individuals in the maximal program was the highest suggesting, rather ironically, that the mere condition of maximum intensive institutionalized care may be detrimental to the health and psychological well-being of the elderly. Studies such as these suggest that policies surrounding end of life care should focus on the integration of the elderly within the community. Furthermore (as has been noted throughout our blogs) it has been well documented in surveys on end of life that seniors want to die in their homes. Therefore, policies should be in place, which allow communities to respond to the needs of their aging population. This means that services are provided by the state and are readily available WITHIN THE COMMUNITY. This would increase quality of life for the elderly by allowing them to be contributing members of society- giving them a sense of purpose, thereby harnessing the desire and motivation to live.

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