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By Ryan J. Foley, the Associated Press
ADEL, The goal of the study,
funded by the Centers for Disease Control and Prevention, is to reduce
hospital admissions from Adel Acres Nursing Home by at least 30 percent in
one year and show others how to do the same. The study, likely to last two
years, will also attempt to determine how much money can be saved in the
process. "The question is: Can
we improve how we take care of folks, decrease their suffering and at the
same time cut costs?" said Dr. Robert Bender, a geriatrician with
Iowa Health System. "If we can do that, that would be magic." The pilot program will
study the care of 50 seniors at Adel Acres. Bender and a physician's
assistant working full time at the home "apply everything we know
about prevention" in caring for the patients, who have long-term
health problems such as dementia, heart disease and diabetes, he said. The program has already
prevented some visits to the hospital. A woman who fell on her head was
treated on site, Bender said, as were others who developed pneumonia that
might otherwise have required hospitalization. Physician's assistant Dave
Michael said his presence will prevent hospital visits and suffering by
detecting health problems before they become a crisis. That's why he spent a
recent Monday telling 86-year-old Edith Reynolds to cut out the sweets in
her diet so her diabetes stays under control; checking Ken Hawbaker's
heart and weight to monitor his congenitive heart failure; and making sure
the medicine he gave to 90-year-old Leona Brown for her sore throat helped
out. "I think it's
wonderful," Reynolds said of the program, even after she admitted to
Michael she ate forbidden chocolate on Valentine's Day. "He takes
good care of us and we can ask him questions and he answers them." Bender said the study will
develop a curriculum for exercise, with prevention in mind. To that end,
Michael plans to give some residents ankle weights to strengthen their
quadriceps in hopes of avoiding falls. Hip pads given to the residents aim
to avoid broken hips if they do fall. After the first year of
the program, Bender said, health care economists will compare the number
of hospital visits from the center to its average for the previous five
years. Based on that information, they will try to estimate how much money
the program saved. A spokesman for the Iowa
Department of Human Services said hospitals spend many thousands of
dollars treating each senior who breaks a hip and giving rehabilitation so
they can walk again. Nancy Whitelaw, the
director of the "People don't need to
decline as rapidly as we generally let them," she said. "But all
of those things take ongoing attention, and thus don't happen in a
traditional medical model." For their part, nurses at
Adel Acres like having Bender and Michael around instead of having to
contact as many as eight to 10 doctors a day for their residents. They say
that frees up time to spend with the residents, who get better care than
they would at a hospital. Bender sees a potentially
big impact of the program not just in Bender said the program
will mean reduced suffering for seniors if in-house doctors can anticipate
and fend off some disease and illness and keep seniors out of the
unfamiliar environment of the hospital. Americans are living far
longer than in the past. By 2014, the population of those 65 and older
will reach 44.6 million - up from 35.6 million in 2002, according to the
2000 Census. "We think that the
system we have imagined is very applicable virtually anywhere in the He said the study is part
of the natural evolution of care from an acute system - in which sick
people are treated - to a system built on preventing disease and illness
among seniors. That is being made possible as doctors accumulate more
knowledge on what illnesses seniors are likely to face as they age. "We're just looking to be a part of that movement," Bender said. Copyright © 2004
Global Action on Aging |
