Communications

Putting the ‘Care’ Back in Health Care

Health care is changing to meet elderly and medically vulnerable patients where they are: At home.

Do you remember the good ol’ days when doctors made house calls?

Nope? Me either.

My points of reference come from old movies and TV shows, ala “Little House on the Prairie.” The country doctor, having been summoned by a family member on foot, shows up with his black valise, and, after attending to the patient, leaves with his payment of eggs and buttermilk.

Well, those days — minus the agriculture-related payment — are making a comeback! I am learning, personally, about the extraordinary benefits of this care model.

Care coming directly to you

I first learned about in-home care visits 6 years ago, while working with a local nonprofit, Housecall Providers. Started in 1995 at the dining room table of founder Dr. Benneth Husted, Housecall Providers delivers medical care for an underserved population, the homebound elderly and medically vulnerable in our community.

It has grown to include primary care, palliative and hospice services, and now makes over 135,000 house calls and serves 7,000+ patients. In May of this year, Housecall Providers became an official member of CareOregon, which will further expand their reach into the community.

It seems Housecall Providers is onto something…

 

A few years ago, I became my mother’s escort to her doctor visits. While my father was still willing to take her, neither one of them was remembering details of the diagnosis, or any follow-up instructions. It was time for me to become the manager of her care team, including travel for annual visits, blood work, and any other health issues (like trips to the ER!) that arose.

Last year, when my mom went into memory care due to dementia, taking her to the doctor got even tougher. Getting her in and out of the car was difficult. She couldn’t focus on my directions, and when I’d ask her to do something seemingly simple, like scoot over a few inches and turn her legs toward the driver’s seat, she couldn’t do it. She didn’t understand. I was not strong enough to move her without her help. It got so bad, she would start to whimper when I was trying to talk her through helping me get her in the car.

At that point, I realized we needed to do something else.

Covering patient needs

Then one fortunate day a few months ago, I met a gentleman who works for Medicaid, and he asked if I knew about Elder at Home, a Providence Health Plan Medicare Advantage program. Started in August of 2015, Elder at Home cares for elderly and medically vulnerable patients in their homes. And, lucky for us, they had just extended their services to cover our area.

Along with routine in-home care visits, my mom has access to 24/7 nursing support for urgent issues. Her care team includes physicians, nurse practitioners, physician assistants, clinical social workers, and expands to include chaplains, pharmacists, dietitians, medical assistants and rehabilitation specialists. So far, we’ve met with an intake person, her nurse and pharmacist, and soon a technician will come to draw her blood for some routine tests.

Mom’s primary care physician is still involved, overseeing the care she receives. And all providers share her electronic medical records, so they can collaborate on, and always know about her care plan.

This program has made her care more relaxed, efficient, and — best of all — more personal. I will get a call from a team member, and then we schedule the appointments so I can attend. The whole team works together to make sure my mom’s meds are correct, her wellness checks are managed, and her lab work is taken care of.

An unexpected bonus is that my mom enjoys having periodic “visitors.” She also gets more time with her providers — a luxury that a doctor’s office can’t afford. Everyone we have worked with has been so kind and patient.

The benefits of home-based primary care are not only seen by the patients. Hospital readmissions are reduced, meaning there are fewer trips to already overburdened ERs, and the cost of care is going way down.

I can also attest to personal satisfaction with this model. My mom gets more personal care time with her team, they come to see her in a place where she is comfortable and at ease, and we both get to avoid those tough transportation issues. The change has been beneficial for both of us.

It’s good to see this becoming more commonplace for those of us who are caring for aging parents, or will eventually become those patients. While I doubt we’ll be paying our caregivers in foodstuffs or livestock any time soon, it looks like a care team coming to see us in the comfort of our homes is not only here to stay, but a growing part of the future of healthcare.

In-home Care Resources in Oregon:

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