Ching-eng H. Wang
North Park University, USA
Title: Housecalls: nurse practitioners care for frail older adults at home
Biography
Biography: Ching-eng H. Wang
Abstract
With a growing elderly population, especially the “oldest old”, 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 confined 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 office 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.
The HouseCalls and Community Palliative program, supported by a community hospital and staffed 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. The 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.