Prior research of geriatric access to behavioral health services shows that the primary care provider is typically the provider to assess, diagnosis, and manage medication for depression (CDC, 2010). However, not all seniors have access to a primary care physician or are seen in a traditional clinic due to physical or cognitive impairment. Behavioral health services are one of the largest gaps in geriatric care yet to be closed because of the difficulty in identifying a behavioral health need, referring clients to the appropriate provider, and following through on that referral. Past research has collected useful and informative data from seniors in varying types of healthcare settings (Bayliss, 2015), but has not captured much data from …show more content…
There are several housecalls programs in North Texas. The program covering the largest geographical area, Organization A, will provide the sample for this study. Time series design is applicable because of the number of influencing factors in identifying and treating depression. For example, stress, brain chemistry, or genetics may contribute to the occurrence of depression in older adults (NIMH, 2016). “Depression can also co-occur with other serious medical illnesses such as diabetes, cancer, heart disease, and Parkinson’s disease” (NIMH, 2016). Organization A is affiliated with the largest hospital system in North Texas. This allows the researchers to gather data from a diverse population of participants and test the effectiveness of an integrated healthcare system when applied to the care of homebound seniors. Seniors over the age of 65 who are admitted to the affiliated hospital with one or more chronic disease, have Medicare, Medicaid, or are unfunded, and meet homebound criteria will be referred to Organization A by the hospital Social Work and Care Coordination team. The referred senior will be contacted within 48 hours of hospital discharge and informed of the housecalls program and asked if they want to be admitted for primary care. At the time of admission to the program by a Nurse Practitioner (NP) or Medical Doctor (MD) a patient health questionnaire will be
Our elderly population is living longer than ever before and not all of them are entering into a nursing home. They are choosing to stay in their own home or their caregiver is choosing it for them. Some caregivers are choosing to move their ageing love one in the home with them. Whatever the case may be, there is an increased need for some type of home health as it applies to the elderly population. “Medicare will pay the full cost of professional help only if the physician
The long-term care services delivery system in the United States has changed substantially over the last 30 years . There are approximately 17,000 elderly and disabled persons are receiving care in nursing homes (NNHS, 2004). The number of people using nursing facilities, alternative residential care places, or home care services are projected to increase from 15 million in 2000 to 27 million in 2050 (HHS, 2003). Identifying the best nursing home that would fit their needs can be difficult and time-consuming. Although nursing homes usually provide certain basic care that patients need, some nursing home facilities provides special care for certain types of individuals with special needs. For example, people with dementia, AIDS, ventilator-dependents,
The alternative in providing care for a dependent family member is keeping them in their own home, or the home of a family member. In recent years there has been a move in market place to an idea that is much more cost effective to provide most of the same services that traditionally found in a long-term care facility in the home. It is estimated that providing these services in the home are approximately $21,800.00 a year. It is also important that these figures only cover the cost of providing skilled health care. These figures do not cover additional expenses occurred in the home such as the cost of room and board. In many instances, the idea of keeping family members in the home where their care, may be more closely supervised is becoming increasingly appealing. Many health care providers are recognizing this and providing more and more services available in the home. In today’s market place anyone can find nursing, physical therapy, occupational therapy, and respiratory therapy companies
Mr. Henry and his wife need medical care coordinated throughout the health care system to receive proper treatment and prevent health complications, encouraging their independence by remaining in the same setting. Marek and Rantz highlight that by providing care coordination and health care services for older adults residing in specially designed senior apartments, older adults will not have to move from one level of care delivery to another as their health care needs increase; and they will have the opportunity to “age in place” (Marek & Rantz, 2000). Care coordination starts with a comprehensive assessment of each of Henry and Ertha individual needs for health and social support, and by developing an individualized plan of care for each of them. “Patients should be evaluated, and care plans should be designed and implemented according to the individual needs of each patient (American Geriatrics Society, 2012, p. 1966). As Mr. Henry and his wife health care needs increase, they can receive periodical physical examinations to monitor their underlying health problems, and for early detection of complications remaining in their apartment. This will prevent negative outcomes associated with relocation, and medications and treatment noncompliance.
In these services they would usually be offered help with activities of daily life, such as eating or bathing. Some home services also give them other benefits such as residential services, personal care or case management. To give more open details on experiences of Medicaid beneficiaries who need home and communities based services Musumeci and Reaves discuss nine seniors who are disabled and who live in different states. Those include people with different kind of disabilities which can be either developmental, physical or intellectual and issues such as autism, cerebral palsy, multiple sclerosis and their functional limitations that are there because they aged (Musumeci & Reaves, 2014). Based on interview that were given from these people to the Kaiser Commission in 2013 based on Medicaid and uninsured, these peoples’ profiles clearly show us how beneficiaries funds, well-being, status of their employment are affected by the coverage of Medicaid and the role these services play in their daily lives (Musumeci & Reaves, 2014). In the last years states are trying to work on rebalancing long-term care system by dedicating more spending to home and community care rather than institutional care. The reason is this being the efforts that are driven by beneficiaries who are
Cardiac diseases alone have been estimated, direct and indirect costs, for the overall American population are “approximately $165.4 billion for 2009” (CDC, 2013). A survey found that heart disease accounted for 4.2 million of the hospitalizations in 2006. In 62% of these cases were short stay hospitalizations and occurred amount peoples ages 65 and older. These hospitalization rates also vary by gender, racial, and ethnic groups.
Nursing home facility is for patients who need extended care because they are very sick or unable to function without continued nursing and supportive services in a formal health care facility. These patients are sick and/or are in need of assistance but they are not ill enough that they require the intense treatment and care offered at a hospital. About forty-seven percent of all nursing home facility care is paid for by Medicaid and residents and their families pay approximately one-third of the cost for the facility services. In recent years the length of time one stays at a nursing home has greatly decreased. Even with the decrease in stay there is still a fifty percent chance of an individual in his/her lifetime having to spend some time in a nursing facility. Both of these previous mentioned trends is reflective of the nursing facilities moving toward becoming more technologically sophisticated as well as being able to function as more of a
Vertically integrated health care system that I have chosen is the Veterans Administration (VA) it's accountable for a large patient population for military veterans. As stated, The Veterans Health Administration is America’s largest integrated health care system with over 1,700 sites of care, serving 8.76 million Veterans each year (VA.GOV). The services that's provided to veterans is health care, rehabilitation, employment, education, home loan guaranties, and life insurance coverage. VA control costs by buying in bulk and control costs by engaging in a deep, single-source relationship with each patient. The Assistant Secretary for Management oversees all resource requirements, development and implementation of agency performance measures,
This is despite the findings that 38% of white people were less likely to talk about their depression opposed to only 11% of black people. 6.4 percent of whites, 4.2 percent of African Americans, and 7.2 percent of Hispanics were diagnosed with depression. Among those diagnosed, 73 percent of whites received treatment (either with antidepressants, psychotherapy or both), while 60 percent of African Americans received treatment and 63.4 percent of Hispanics received treatment. The researchers suggest possible ways to minimize the disparities in depression diagnosis and treatment among older minorities. For instance, psychiatrists and other health care workers could be offered public financial incentives for practicing in poorer communities where depressed older people may go untreated.
More and more integrated hospitals and other providers are becoming prevalent in our community; two large systems in the Dallas Fort Worth area are Texas Health Resources and the Baylor Scott White systems. What exactly are these integrated hospital systems? An integrated healthcare system is one that through official agreements or ownership sets up a horizontal and vertical line of healthcare facilities and services to better deliver seamless healthcare to patients. An example to use is Texas Health Resources since its found in most corners of the Metroplex. With any large corporation and system comes confusion and other problems: such as regulatory obstacles, the complexity of operations, and unclear financial ownerships. Integrated healthcare systems appear at face value to be the solution to curbing the
Before hospitalists were introduced into healthcare, the primary care physician provided care for patients in the office, hospital, and, when necessary, the skilled nursing facility (Blount Senior Care Partners, 2014). “Even though the patient’s clinical circumstances were changing, a caring advocate with full knowledge of the individual 's needs and goals could smoothly transition the care of the patient” (Blount Senior Care Partners, 2014). Much has changed in the healthcare field, leaving behind a fragmented system for the vulnerable geriatric population. Blount Senior Care Partners aims to recreate this level of continuity for the patients and families in Blount County and the surrounding area (Blount Senior Care Partners, 2014).
The world of health care is constantly changing everyday by it changing there are less hospitals being opened than clinics. It seems as if people will rather open a clinic this a hospital in which would have all things necessary for health care. Some clinics will specialize in a certain area of health care and not all. The only good part about this is that there are some clinics that are offering emergency services. In my geographic area, there are both horizontally and vertically integrated health care systems available.
According to the Centers for Disease Control and Prevention, “older adults are at an increased risk of depression, because depression is more common in people who have other illnesses, and 80% of older adults have a chronic condition” (CDC, 2017). The CDC also mentions that older adults are often misdiagnosed or undertreated, because the symptoms may be thought to be the cause of something else, or the patient doesn’t understand that treatment would be beneficial and do not seek help.
Mental disorders are becoming more prevalent in today's society as people add stress and pressure to their daily lives. The elderly population is not eliminated as a candidate for a disorder just because they may be retired. In fact, mental disorders affect 1 in 5 elderly people. One would think that with disorders being rather prevalent in this age group that there would be an abundance of treatment programs, but this is not the case. Because the diagnosis of an individual's mental state is subjective in nature, many troubled people go untreated regularly (summer 1998). Depression in the elderly population is a common occurrence, yet the diagnosis and treatment seem to slip
According to the American Psychiatric Association “Studies show that seniors are at greater risk of some mental disorders and their complications than younger people, and many of these illnesses can be accurately diagnosed and treated.”(American Psychiatric Association, 2015, para. 1). Although many of the illnesses can be treated, many go undiagnosed due to the fact that many individuals do not understand mental illnesses and some seniors are reluctant to seek psychiatric care due to being ashamed or believing that their symptoms are a part of aging that everyone experiences. It is not just the seniors and their family or friends that fail to recognize symptoms of mental illness, even their doctors may mistake a symptom of mental illness for another illness or problem associated with older adults.