With a growing elderly population, especially the “oldest oldâ€, in the United States, new models of care incorporating
nurse practitioners (NPs) such as house calls program have been created to meet the needs of the aging population who
are confi ned to home and are not able to access health care facility. Most of those older adults are over 85 years of age with
multiple illnesses and functional impairments. Limiting to their ability to get to offi ce visits, they frequently call ambulance
and use emergency rooms for their episodic care. House calls health providers include physicians, physician assistants, and
NPs. Among them, NPs are the largest providers delivering primary care to homebound patients over the largest geographical
areas based on a 2013 observational study. Reports from the limited outcomes studies show the reduction of preventable
emergency room visits, hospital readmissions, and prescription medications per patient while patient satisfaction increases.
Th e HouseCalls and Community Palliative program, supported by a community hospital and staff ed by NPs, brings quality and
compassionate care to frail and homebound community-dwelling older adults with the goal of promoting quality of life and
reducing frequent use of emergency room for episodic care. Th e objectives of this presentation are: to describe the HouseCalls
program and its evaluation in general, the role of the NPs, and patient care using a HouseCalls program as an example to
discuss the challenges and successes of caring for frail older adults at home.