A/HRC/18/37 needs to be done to stress the importance of prevention efforts, regular contact with a general practitioner or other primary health-care provider, and early diagnosis and treatment. Prevention is extremely important, as it allows reaching the individual before the disease takes hold. It needs to be emphasized that early diagnosis and prevention, long before a person grow older and preferably at the primary health-care facility, is one of the key elements in ensuring good health in old age. 43. Due to resource constraints, particularly in developing countries, “best-practice” care may not always be possible. This should not deter States from taking steps to achieve the best possible outcomes for older patients in any given situation. Moreover, it has been acknowledged that personalization of care may, at times, require eschewing of more intensive services and accepting clinical outcomes that are less than the best possible health and function.27 Although this may still look like an anathema to some medical professionals, a shift in focus from curing to caring, particularly in older population, could be necessary to better meet the patient’s personal goals. Presenting patients with options and ensuring that their desired outcomes are achieved through collaborative decision-making should be paramount in the professional-patient relationship. B. Long-term care 44. Long-term care includes a variety of services (medical or otherwise) that help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods of time. Long-term care is manifested in the provision of help with daily tasks such as bathing, dressing up, cooking and so on. According to the Organization for Economic Cooperation and Development (OECD), longterm care can be defined as “a range of services for people who depend on ongoing help with the activities of daily living caused by chronic conditions of physical or mental disability”.28 In the context of the right to health, long-term care must also be understood as the intervention of skilled practitioners to provide assistance in dealing with syndromes associated with chronic diseases or disabilities impeding personal capacities. They are, nonetheless, medical conditions affecting older persons disproportionately. 45. Long-term care takes two broad forms: home care and institutional care. Institutional care is the accommodation and care of a person in a specialized care-giving institution. Older persons in such institutions are often under the authority of the caregiver, who is meant to assist them in their daily activities, including the administration of medicines and health services. Given the growth of such institutions, it is important to examine implications for older persons and their right to health. 46. Home care is generally understood as medical services performed by professionals in the patient’s home, as opposed to care provided in specialized institutions. It generally allows older persons a greater degree of autonomy over their lives than institutional care. However, home care should be understood as medical home care delivered by health professionals, as opposed to informal care that is provided by family members or other individuals. 47. It is essential that appropriate recognition be given to those who care for older persons in informal settings, which has both benefits and risks. Informal care may allow older persons to remain in their homes, and be cared for by a familiar person, an option 27 28 12 David B. Reuben, “Better Care for Older People with Chronic Diseases” JAMA vol. 298, No. 22 (December, 2007), p. 2673. OECD, Long-term Care for Older People (OECD, Paris, 2005), p.3