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. ”

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Paid Caregivers Struggle to Follow Doctor’s Orders

Struggling to follow doctor’s orders
Paid caregivers may lack the skills to take on health-related tasks in senior’s homes

From a February 22, 2011 Eureka news alert

CHICAGO — Paid caregivers make it possible for seniors to remain living in their homes. The problem, according to a new Northwestern Medicine study, is that more than one-third of caregivers had difficulty reading and understanding health-related information and directions. Sixty percent made errors when sorting medications into pillboxes.

The study will be published in the Journal of General Internal Medicine. It has been published online.***

In a first-of-its-kind study, nearly 100 paid, non-family caregivers were recruited in the Chicago area and their health literacy levels and the health-related responsibilities were assessed, said Lee Lindquist, M.D., assistant professor of geriatrics at Northwestern University Feinberg School of Medicine and physician at Northwestern Memorial Hospital.

“We found that nearly 86 percent of the caregivers perform health-related tasks,” said Lindquist, lead author of the study. “Most of the caregivers are women, about 50 years old. Many are foreign born or have a limited education. The jobs typically pay just under $9.00 per hour, but nearly one-third of the caregivers earn less than minimum wage.”

Lindquist found that despite pay, country of birth or education level, 60 percent of all the caregivers made errors when doling medication into a pillbox. This is an alarming statistic, because patients who don’t take certain medications as prescribed could end up in the hospital, Lindquist said.

“Many of these caregivers are good people who don’t want to disappoint and don’t want to lose their jobs,” Lindquist said. “So they take on health-related responsibilities, such as giving out medications and accompanying clients to the doctor for appointments. Most physicians and family members do not realize that while the caregiver is nodding and saying ‘yes’, she might not really understand what is being said.”

Right now there isn’t a standard test family members or employment agencies can use to gauge a caregiver’s ability to understand and follow health-related information, Lindquist said.

“Currently we are developing tests consumers can use to evaluate caregiver skills as well as studying the screening processes caregiver agencies use,” Lindquist said. “But, if you really want to know if the caregiver is doing a good job and is taking care of the health needs of your senior, start by going into the home, observing them doing the tasks, and asking more questions.”

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The title of the study is “Inadequate Health Literacy Among Paid Caregivers of Seniors.”***

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