Home- and Community-Based Services for Older Adults by unknow

Author:unknow
Language: eng
Format: epub
ISBN: 9780231177696
Barnesnoble:
Publisher: Columbia University Press
Published: 2018-05-01T00:00:00+00:00

• Patient assessment

• Illness management for emergency, acute, or chronic conditions

• Palliative care for patients who are at the end of life

• Follow-up after hospitalization

• “Concierge services” for health promotion and disease prevention

House Calls for Seniors (see box) provides one example of services that may be provided in an HBPC practice. There is a high degree of variability in HBPC practices, and not all programs look alike.

HOUSE CALLS FOR SENIORS

House Calls for Seniors (HCS) is an HBPC provider established in the Indianapolis metro area in 1999. Using a team approach, HCS serves patients age 65 and older who are homebound due to physical, cognitive, or psychiatric impairment. They have served more than 450 older adults since the inception of the program. Patients enroll in the program for an average of two and a half years, and almost all leave due to death or nursing home placement.

Here are the typical services provided by HCS:

• A geriatrician conducts the first home visit to develop a medical care plan. The geriatrician then visits every three to four months, with most visits lasting approximately forty-five minutes.

• A nurse practitioner visits patients every four to six weeks, in between geriatrician visits. The nurse practitioner also handles any urgent or emergency visits.

• A social worker visits patients initially to conduct a comprehensive assessment and to develop a social care plan. The social worker is then available by telephone or in person as needed.

• Weekly care meetings are held with the HBPC team to discuss patients’ status and to address any concerns or needs.

HCS has the ability to conduct complex procedures using advanced technology. For example, they have a portable electrocardiogram machine to monitor heart activity, and they contract with a mobile X-ray provider. HCS also makes arrangements for home health care services (such as nursing assistants and homemaker services), medication management, durable medical equipment, and hospice services as needed. Finally, HCS has partnerships and arrangements with other health care professionals, including psychiatrists, physical and occupational therapists, podiatrists, and dentists.

Source: Adapted from Beck, Arizmendi, Purnell, Fultz, & Callahan, 2009.

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