Health Care

Within the health care arena there is a growing concern about the needs of the elderly. Families
wonder if their loved ones are getting the proper care that they need With the growing costs of health care
and the decreasing resources of primary care physicians it is feared that only the physical needs of the
patient are met. Concerns rise about the social psychological and environmental needs or the elderly. A
study by Barbara Berkman and associates tries to provide some answers to people concerned with this issue
According to the study many people are not aware of the social services they may have available
to them. Because of this, many elderly people are not getting the care they need outside of the physical
care necessary to "live." It is felt that screening a patient for social or emotional needs is becoming
increasingly important. The focus of this study was to devise a questionnaire to identify the psychological,
social and environmental needs of elderly patients.
Three hospitals from different geographic locations were chosen for this study. At each hospital a
care coordinator was chosen to be responsible for questionnaire review, communication with physicians,
and further assessment and intervention when deemed necessary. Lists of patients 65 and older were
generated from the caseloads of primary care physicians from the three hospital sites. The questionnaires
were mailed out with physicians cover letters and consent forms in the summer of 1993. In the
questionnaire patients were asked to assess their self-percieved notions of there medical and psychosocial
needs, as well as the level of their functioning. Upon reciept of the completed questionnaires the care
coordinators from each hospital assess the results of the survey. Those patients assessed as being high risk
received follow up phone calls. Depending on the situation, high risk patients were given information
only, indirect referrals, or direct referrals.
The findings for the study indicate that approximately 56% of all people surveyed were in need of
intervention. The three highest relative risks for all three sights were: difficulty with food preparation,
difficulty in doing house work, and difficulty getting around the home. All three hospital settings agree
that patients who reported having problems in the survey were judged to need intervention more than those
who did not report having problems.
Although the study had good intentions, I feel the study was unclear in its objectives. The study was to
design an assessment tool that would identify the psychosocial and environmental needs of elderly
patients. Clearly the questionnaire did identify these needs. What is unclear is the purpose of proposing a
questionnaire. Is this a first time attempt to assess the psychosocial and environmental needs of the elderly,
or is it an improvement on past assessment tools? The study appears to present a new assessment
procedure rather than focus on the quality of the questionnaire.
Although I feel there are discrepancies in the focus of the study, I do find it to be very thorough
and accurate. This is a study of current concerns. With the cutting of health benefits and the rise of health
costs many of the elderly do not get the social and emotional help that they may need. I do agree that it
appears that there !
is not enough assessment being done. The authors of the study did an accurate job in preparing for this
study. They consulted with prime focus groups, such as physicians and social workers. A review of past
literature and studies were used to identify which psychosocial and environmental needs should be
addresses in the questionnaire.
This article proved very easy to read. I felt that the language was readable for scholar and layman
alike. I do feel that this article assumes that you have a background in geriatrics. Although it is not
necessary to be an expert in the field, geriatric knowledge would be an advantage. A few of the terms and
concepts were aimed primarily at a professional reader, but not so much to have a student or family of an
elderly person perplexed as to the general concept.
The design of this study was well planned. The methodology is clearly mapped out and in my
view acceptable for an accurate study. The sample size (approximately 3200) was sufficient. The study