A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community
Article Abstract:
A program of in-home evaluation of the aged and their living conditions may reduce the risk of disability and long-term stays in nursing homes. A total of 215 people over 75 were enrolled in a three-year assessment program and compared to 199 people over 75 who were not enrolled in the program. The program involved visits from gerontologic nurse practitioners who performed annual physical examinations, evaluated social support and safety in the home, made risk-reducing recommendations, and monitored the implementation of these recommendations. During the program, 9 people in the program and 20 people in the control group were admitted to nursing homes for over 100 days. People in the program were much less likely to require assistance in performing basic activities of life such as bathing, dressing, eating, and moving about the house. However, the program did not affect participants' survival or ability to perform without assistance such tasks such as cooking, shopping, and paying bills. The estimated cost per year of intervention by the nurse practitioners resulting in life without disability was $6,000.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
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House calls to the elderly: a vanishing practice among physicians
Article Abstract:
House calls by physicians have declined among Medicare patients, and are primarily limited to those very old and ill. Using data from 36,350 Medicare housecalls in 1993, researchers found that house calls to Medicare patients fell about 31% from 1988 to 1993, and an additional 12% in 1996. Patients treated at home were older, more likely to die in the year visited, spent more time in the hospital, and were likely to receive other types of home care. House calls were more common in the Northeast, in rural areas, and were more often made by general practitioners and internists.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
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Preventing disability: beyond the black box
Article Abstract:
Research is needed on the most effective methods of preventing disability in elderly Americans. Various projections target the elderly US population at 34.9 million to 40.3 million by the year 2000. Seventy-five percent of elderly Alzheimer's disease patients end up in nursing homes at an annual cost of over $40,000 per patient in 1991. A 1996 study found that a comprehensive counseling service for caregivers of Alzheimer's patients delayed the patient's placement in a nursing home. Several other studies have documented the benefits of such geriatric services.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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