Professional Decision Making in Health and Social Care Systems for the Elderly: a Cross Cultural Comparison

Abstract

The problem of providing care for the elderly is commonly represented by professionals in the health and social care systems as that of increasing dependence and where, at a certain point, care provisions are no longer brought to the elderly in their homes but the elderly move to the care provisions (MIZRAHI & HORPE, 1977). The professionals should ideally: be able to respond to the requirements of the elderly in a flexible, graded manner whilst ensuring quality of care; make cost-effective use of available resources and act in a way which preserves the autonomy of the elderly for as long as possible and delay their entry into the professional care networks. A number of studies (GOLDBERG & CONNELLY, 1982) have shown that these criteria are not adequately being met and that there are anomalies in the way care provisions are allocated. These maybe explained as undesirable or embarasing phenomena to be remedied or the logical outcomes of the way the systems function. But it is suggested that greater attention could well be paid to the cognitive and motivational processes involved in and the situational context of decision making by health and social care professionals.