Eighty-five-year-old Beverley Minogue is one of the most recent people to begin a new healthcare journey. That amendment was made possible through a special pilot home care program instituted by St Vincent’s Hospital in Sydney. After arriving at the emergency department by ambulance, Minogue expected an extended hospital stay because of her osteoarthritis. So it was a pleasant surprise when she got discharged the next day. Thrilled to be going home, she had round-the-clock care for two weeks.
Dr. Richard Kane, the clinical director of geriatric medicine at St Vincent’s, is the program’s clinical leader and he has been pivotal. It is designed specifically to allow older patients to recuperate safely in their own homes. It features daily home visits and telehealth support from a multidisciplinary team of medical, behavioral, and social health professionals customized to the needs of each patient. This person-centered and holistic approach goes beyond healing medical ailments to promote the mental and emotional wellness of geriatric patients.
A New Approach to Elderly Care
Through Dr. Kane’s Geriatrician in the Emergency Department (GED) service, we’ve expanded our ability to provide timely, high-quality care. It has been shown to positively impact a variety of health outcomes such as heart and lung function, falls and fractures, and delirium. USDAs Community Facilities Direct Loan and Grant program has significantly changed the face of elderly care. Instead, now, almost half of all patients who would have otherwise been admitted to the hospital can receive important support at home.
Patients enrolled in the GED service benefit from daily visits by doctors, nurses, physiotherapists, social workers, and pharmacists, depending on their specific needs. In addition, they have access to a 24-hour medical hotline which can direct them to medical personnel should their medical condition worsen. This greater degree of support means that patients don’t have to figure out their path to recovery on their own.
Dr. Kane expressed confidence in this model, stating, “Once a cause is identified and dangerous causes are excluded, they can recover just as effectively in their own home.” He emphasizes the importance of familiar surroundings in the recovery process, noting that “people tend to recover quicker ‘in their own environment.’”
Personal Experience: Beverley Minogue’s Journey
Once home, Beverley Minogue was provided with a 24-hour network of support recommended by Dr. Kane. For the next two weeks, she had daily home visits from nurses, physiotherapist, and geriatrician. With this supportive holistic care, she was able to better control her osteoarthritis pain and embarrassment without being bedridden in a hospital.
I’ve had osteoarthritis for a long time and it’s just all gone, all the cartilage. … It’s bone on bone,” Minogue said. Even with her severe medical conditions, Home Smart found the home care program to be extraordinarily successful for her. For the first four nights, she slept on the first floor to accommodate her limited mobility and to make sure she had help immediately if necessary.
“It’s wonderful because you can stay home. You don’t have to be stuck in the hospital and not be able to sleep,” she commented on her experience with the program.
Implications for Healthcare Systems
Which leads to bigger questions To us, GED’s success begs crucial questions about hospital capacity and resource allocation in healthcare systems. Sarah Whitelaw, advocate for reform of elder care, exemplified the plight of hospitals, from a system growing ever more strained. She remarked, “The idea that we would decrease our hospital capacity instead of radically increasing it is really quite frightening.”
Dr. Kane acknowledged the necessity of admitting patients who require hospital care but emphasized that most elderly individuals can recover at home when provided with appropriate support. He stated, “There will always be patients who need to be admitted to the hospital, and we’re not about preventing that.”
He noted that by providing more home care, you take some of the pressure off hospital beds. “On any given day, three or four patients’ beds are available for other patients upstairs that would otherwise have been filled by these patients,” he noted.
