The family members or close associates of the patient are also consulted. However, it is the physician who is authorized to decide the discharge and give his final opinion. The concerned family member needs to consult the discharge planner who may be a nurse, the administrator or even a social worker who has taken the responsibility of the patient. It is important to trace the discharge planner or find out by asking whether there is a planner appointed. Above all, it needs to be ensured at any cost, that the discharge is safe and all right for the patient's health. It needs to be assured that the place where the patient is shifted does not pose any immediate danger to his health condition and the right kind of health care plan is undertaken to look after the patient's well being. Then nursing orientation for aged is to be full and professional. For instance as nursing and therapeutic tools now there are a range of evidence based cognitive, behavioural and family interventions.(Mari & Adams,1996;Drury et al,1996) which could be easily deployed in aged mental in-patient care; however these ere rarely used by nurses. These approaches were meant to achieve the target of weaving a participative style of mental health treatment so that risk factors are broadly dispersed.
Aged people in most countries, especially in third world nations are the most neglected family members. It is often found that even an affluent family does not want to take the financial responsibility of the useless old member. Old age homes are there but a charitable organization may not be able to provide the entire cost of treatment, taking into consideration that this age group is more prone to severe illnesses. Hence one needs to depend on reimbursement programs on a large scale.
However, these organizations are mostly profit oriented and hence the reimbursement facility granted to the old people is much less than the rest. It is assumed that risk is greater to aged people's life. Thus a risk measurement and analysis is an important component of health care programs. Often, the hospital would tell the patient to go home once the reimbursed amount is exhausted. It would now depend on the mercy of the social organizations or the consideration of the family members.
The cost based reimbursement plan is more accountable for such consequences. However, the shift from cost based reimbursement to prospective based reimbursement plan is a significant move. In the Medicare program, this shift is very crucial for the health of aged people. It essentially ensures that this program mostly affects adults aged above 65 years. This program emphasizes on cost containment, an important step taken in the direction of discharge planning for aged people. The idea is to provide them safe and adequate care under the supervision of the hospital services.
The ageing process - physical aspect
The process of aging is a natural one; it is progressive and irreversible physiologically. Despite the proper kind of nutrition and regular health care activities, age is bound to control every human being. Biologically we may define the aging process, as a set of altered or modified rates of progressive changes is response to the genetic background of an individual and