Report on Challenges in Elderly Care and the Importance of Sustainable Development Goals (SDGs)

Case Study: Judy Karofsky’s Experience with Elderly Care

At the age of 99, Judy Karofsky’s mother was unexpectedly discharged from a hospice facility in Wisconsin. Within 48 hours, Karofsky assumed the role of her mother’s primary caregiver, managing medical supplies, medications, and mobility aids.

Overview of the Elderly Care Journey

Judy Karofsky authored “Diselderly Conduct: The Flawed Business of Assisted Living and Hospice”, documenting her mother’s progression through various stages of elderly care including:

1. Independent living
2. Six different assisted living facilities
3. Memory care
4. Skilled nursing
5. Hospice care

Issues Highlighted in the Case

• Hospice Eligibility and Coverage: Despite Medicare coverage for hospice patients expected to live less than six months, Karofsky’s mother was discharged due to a lack of timely doctor verification, illustrating gaps in the healthcare system.
• Assisted Living Regulation: Unlike hospice and nursing homes, assisted living facilities lack federal regulation, leading to inconsistent state-level oversight.
• Quality of Care Concerns: Karofsky reported instances of physical and sexual abuse, medication errors, and neglect during her mother’s stay in assisted living and hospice.
• Systemic Challenges: The eldercare industry faces staffing shortages, inadequate care, neglect, and high costs.

Linking Elderly Care Challenges to Sustainable Development Goals (SDGs)

Relevant SDGs Impacted

• SDG 3: Good Health and Well-being – Ensuring healthy lives and promoting well-being for all ages includes improving elderly care quality and access.
• SDG 10: Reduced Inequalities – Addressing disparities in healthcare access and quality for the elderly population.
• SDG 16: Peace, Justice, and Strong Institutions – Enhancing regulatory frameworks and oversight to protect vulnerable elderly individuals from abuse and neglect.
• SDG 1: No Poverty – Tackling the astronomical costs associated with assisted living to prevent financial hardship among elderly and their families.

Recommendations for Improvement

1. Strengthen Federal and State Regulations: Implement comprehensive oversight for assisted living facilities to ensure consistent standards of care.
2. Enhance Training and Staffing: Address workforce shortages by improving recruitment, training, and retention of eldercare professionals.
3. Improve Healthcare Coordination: Ensure timely and accurate medical assessments for hospice eligibility to prevent premature discharges.
4. Promote Home-Based Care Solutions: Support initiatives that enable elderly individuals to receive care in their homes, aligning with personal preferences and reducing institutionalization.

Conclusion

Judy Karofsky’s experience underscores critical deficiencies in the American elderly care system that conflict with the objectives of the Sustainable Development Goals. Addressing these challenges requires coordinated efforts to improve healthcare quality, regulatory oversight, and social support systems to ensure dignity, well-being, and equity for aging populations.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article discusses healthcare for elderly individuals, hospice care, assisted living, and the quality of medical and supportive care.
2. SDG 10: Reduced Inequalities
   • The article highlights disparities in eldercare quality, lack of regulation, and the impact on vulnerable elderly populations.
3. SDG 16: Peace, Justice and Strong Institutions
   • The article points to issues of regulatory oversight, abuse, and fraud in healthcare institutions.
4. SDG 1: No Poverty
   • The mention of astronomical costs for assisted living relates to economic challenges faced by elderly individuals.

2. Specific Targets Under Those SDGs Identified

1. SDG 3: Good Health and Well-being
   • Target 3.8: Achieve universal health coverage, including financial risk protection and access to quality essential healthcare services.
   • Target 3.d: Strengthen the capacity of all countries for early warning, risk reduction, and management of health risks.
2. SDG 10: Reduced Inequalities
   • Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of age.
3. SDG 16: Peace, Justice and Strong Institutions
   • Target 16.6: Develop effective, accountable and transparent institutions at all levels.
   • Target 16.3: Promote the rule of law at the national and international levels and ensure equal access to justice for all.
4. SDG 1: No Poverty
   • Target 1.2: Reduce at least by half the proportion of men, women and children living in poverty in all its dimensions according to national definitions.

3. Indicators Mentioned or Implied to Measure Progress

1. SDG 3 Indicators
   • Indicator 3.8.1: Coverage of essential health services (including hospice and assisted living care quality and accessibility).
   • Indicator 3.8.2: Proportion of population with large household expenditures on health as a share of total household expenditure or income (related to costs of assisted living).
   • Indicators related to patient safety and abuse cases in healthcare settings (implied through mentions of abuse, neglect, and medication errors).
2. SDG 10 Indicators
   • Indicator 10.2.1: Proportion of people living below 50% of median income, by age group (implied through economic challenges faced by elderly).
3. SDG 16 Indicators
   • Indicator 16.6.2: Proportion of the population satisfied with their last experience of public services (implied by dissatisfaction with eldercare services and oversight).
   • Indicators measuring incidence of abuse, neglect, and fraud in healthcare institutions.
4. SDG 1 Indicators
   • Indicator 1.2.1: Proportion of population living below the national poverty line, by age group.

4. Table of SDGs, Targets, and Indicators

Source: wpr.org