Healthcare

Mrs. Granovetter, age 72, lives by herself in a three-room apartment.
Previously worked as a supervisor in a nursing home until she had to quit due to poor health (

Has an aortic aneurysm, described metaphorically as "looks like a bicycle tire with a bubble in it."
Suffers from arthritis, leading to stiff joints that delay her rising until noon some days.

Despite her health issues, she manages to live independently:
1. Receives daily calls from her daughter, who lives on the opposite side of town.
2. Daily interactions with her next-door neighbor.
3. Drives to shopping centers to enjoy watching people, knows where to park and walk to benches.
Last year, she traveled to England with her children and enjoyed the countryside, although not visiting castles.
With help from family and friends, Mrs. Granovetter remains active and enjoys life.

The majority of older women experience arthritis; approximately one in four also face heart issues.
Many coped well with limited assistance and self-report good health.
Statistics from 2018:
1. Nearly half (47%) of Canadians aged 65 and over reported very good or excellent health (Statistics Canada, 2019).
2. One-third of individuals aged 85 and over reported similarly positive health (Centre for Surveillance, 2018).
More than 90% of individuals aged 65 and over are healthy enough to live independently in their communities.
However, older individuals utilize health services more than younger age groups, with increased service consumption and costs as age rises.

The healthcare system includes medical and social services, addressing health promotion, maintenance, and long-term chronic care.
The chapter focuses on three main points:
1. Structure and function of the current healthcare system.
2. How the system meets the needs of older people.
3. Changes to the system for an aging society.

Social scientists use models to simplify complex social systems, which helps understand their basic structures, functions, and values.
Three main healthcare models influence Canada's healthcare system:
1. Medical Model
2. Social Model
3. Health Promotion Model

Typical Healthcare Setting: Delivered mainly in hospitals and doctors' offices.
Role of the Physician: Responsible for medical treatment, prescriptions, and surgeries.
Focus: Treatment of diseases and injuries.
Common Practices: Emphasis on surgical interventions, medication therapy, and physical rehab.
Core Mechanism:
1. Medical history, physical exam, and diagnostic tests form the basis for identifying and treating specific illnesses.
2. Focuses on physical and biological responses to diseases (Farlex, 2011).
Limitations: Physicians are trained mainly in this model with minimal exposure to alternate forms of treatment.

Comprehensive View: Medical care as part of a larger healthcare system, includes counseling, home care, and daycare programs.
Goal: Keep older adults in their own homes, focusing on community-based care, not just institutional care.
Team Approach: Physicians collaborate with a team that includes nurses, physiotherapists, social workers, etc.
Long-Term Care (LTC) Definition: National Institute on Aging (2019): "A range of preventive and responsive care… primarily for older adults… including assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)."
Integration & Decentralization:
1. Decentralized decision making.
2. Single-point-of-entry systems.
3. Shift from institutional to community services.
4. Integration of healthcare and social services for a continuum of care.
5. Ongoing shift toward the social model of care.

Focus Area: Disease prevention and self-care to improve lifestyles and knowledge of health.
Examples of Programs: Fitness programs, anti-smoking campaigns, safety regulations, and pollution control.
Impact on Healthcare Costs: May save healthcare funds long-term by promoting healthier living.
Current Role vs. Medical Model: The medical model remains predominant despite the importance of social and health promotion models.

Significant Insight on LTC Costs: Government spending only covers three-quarters of long-term care costs (totaling $24 billion). Individuals cover the remaining $9 billion.
Burden on Private Expenditures: Nursing home care (accounting for 80% of long-term care spending) shows higher costs for families.

Discussion of how different frameworks cater to older individuals and the financial implications of each model.
Long-term care trends spotlighting the gradual institutional adjustment from costs toward community-focused solutions.

The healthcare system needs to evolve recognizing the complications of aging populations and chronic illnesses, requiring a mix of medical, social, and health promotion approaches.