Guided care reduces the use of health services by chronically ill older adults

Guided care reduces the use of health services by chronically ill older adults

From the March 14 2011 Science Daily news item

ScienceDaily (Mar. 14, 2011) — A new report shows that older people who receive Guided Care, a new form of primary care, use fewer expensive health services compared to older people who receive regular primary care.

Research published in the March 2011 edition of Archives of Internal Medicine ***found that after 20 months of a randomized controlled trial, Guided Care patients experienced, on average, 30 percent fewer home health care episodes, 21 percent fewer hospital readmissions, 16 percent fewer skilled nursing facility days, and 8 percent fewer skilled nursing facility admissions. Only the reduction in home health care episodes was statistically significant.

According to the study, Guided Care produced even larger reductions in a subset of patients who received their primary care from one well managed health system. Guided Care patients in Kaiser Permanente of the Mid Atlantic States experienced, on average, 52 percent fewer skilled nursing facility days, 47 percent fewer skilled nursing facility admissions, 49 percent fewer hospital readmissions, and 17 percent fewer emergency department visits; the differences for skilled nursing facility days and admissions were statistically significant….

More information about Guided Care is available at  twww.GuidedCare.org.
From the Web site…”Guided Care® is a new solution to the growing challenge of caring for older adults with chronic conditions and complex health needs. A Guided Care nurse, based in a primary care office, works with 2-5 physicians and other members of the care team to provide coordinated, patient-centered, cost-effective health care to 50-60 of their chronically ill patients. The Guided Care nurse conducts in-home assessments, facilitates care planning, promotes patient self-management, monitors conditions monthly, coordinates the efforts of all health care professionals, smoothes transitions between sites of care, educates and supports family caregivers, and facilitates access to community resources. ”

For suggestions on how to get this article for free or at low cost click here

 

 

 

Related Articles

• Guided Care improves physician satisfaction with patient/family communications (scienceblog.com)
• Chronic disease care poorer in nursing and residential homes under GP target scheme (eurekalert.org)
• Post Trauma Care: Better Chance Staying At Home (medicalnewstoday.com)

Caring for the elderly: Dealing with resistance

Caring for the elderly: Dealing with resistance
Caring for the elderly can be challenging — particularly if a loved one is resistant to care. Understand what’s causing your loved one’s resistance and how you can encourage cooperation.

Excerpts From the Mayo Clinic Tip Sheet

What’s the best way to approach a loved one about the need for care?

If you suspect that your loved one will be resistant to care — whether from family, other close contacts or a service — you may be hesitant to bring up the topic. To start communicating with your loved one about his or her need for care:

• Choose a time when you and your loved one are relaxed. This will make it easier for you and your loved one to listen to each other and speak your minds.
• Ask questions about your loved one’s preferences. This will help you provide the type of assistance your loved one wants. What type of care does your loved one want or need? Does your loved one have a preference about which family member or what type of service provides care? While you may not be able to meet all of your loved one’s wishes, it’s important to take them into consideration.
• Enlist the help of family members. Family and friends may be able to help you persuade your loved one to accept help.
• Don’t assume that your loved one is unable to discuss care preferences. While your loved one may be ill, he or she may still have care preferences and be able to make some decisions regarding care. If your loved one has trouble understanding you, be sure to simplify your explanations and the decisions you expect him or her to make.
• Don’t give up. If your loved one doesn’t want to discuss the topic the first time you bring it up, try again later.

What are the most effective strategies for managing resistance to care?

Getting an aging loved one to accept help can be difficult. To encourage cooperation, you might:

• Suggest a trial run. Don’t ask your loved one to make a final decision about the kind of care he or she receives right away. A trial run will give a hesitant loved one a chance to test the waters and experience the benefits of assistance.
• Enlist the help of a professional. Your loved one may be more willing to listen to the advice of a doctor, lawyer or care manager about the importance of receiving care.
• Explain your needs. Consider asking your loved one to accept care to make your life a little easier. Remind your loved one that sometimes you’ll both need to compromise on certain issues.
• Pick your battles. Focus on the big picture. Avoid fighting with your loved one about minor issues related to his or her care.
• Explain how care may prolong independence. Accepting some assistance may help your loved one remain in his or her home for as long as possible.
• Help your loved one cope with the loss of independence. Explain to your loved one that loss of independence isn’t a personal failing. Help your loved one to stay active, maintain relationships with caring friends and family and develop new physically appropriate interests.

Keep in mind that these strategies may not be appropriate when dealing with a loved one who has dementia.

Two related resources

• Caregivers (MedlinePlus) has links to overviews, coping materials, organizations, related issues, and much more
• National Association of Area Agencies on Aging provides information on how to locate a local area agency for personalized responses to questions, caregiver support and resource information , and additional resources and programs

 

 

 

 

 

The elder care study: Everyday realities and wishes for change

December 13, 2010 15:33

The elder care study: Everyday realities and wishes for change (PDF)

Source: National Association of Area Agencies on Aging

Although there are many important studies of elder care conducted by a number of pioneers who have blazed the way, we see The Elder Care Study adding to this literature for two reasons.

First, this study is unique in its design. It is typical for research to have to make tradeoffs between breadth and depth. For example, if the study is a nationally representative study, it has breadth, but may lack depth because cost and time constraints limit the number of questions the researchers can ask or the number of times they can repeat the study. If the study is a qualitative study, it has depth, but may lack breadth because the people in the study may not be typical of caregivers.

This study has both breadth and depth. It is based on a nationally representative sample of employed caregivers, drawn from the Families and Work Institute’s ongoing National Study of the Changing Workforce (NSCW). The NSCW is a very comprehensive study with over 600 data points on employees’ lives on and off the job. Based on the 1977 Quality of Employment Survey conducted by the U.S. Department of Labor, the NSCW was first conducted by Families and Work Institute in 1992 and has been conducted every five to six years since then.

With its 54.6% response rate, it provides very rich quantitative information on working family caregivers of the elderly over the past 16 years.

Category:

Age and Aging

Children and families

Social and cultural issues

Source:

National Association of Area Agencies on Aging