older people’s health issues
Care of Older People in the Home
Other models of home health care
In the past few years, several new health care models have been developed as a way for people to receive home-based health care. The goal is to provide a higher quality of care and management that keeps older adults out of hospitals and nursing homes and allow older adults to remain in their home and community. Overall, these models involve traditional at-home health services that have been expanded to include other services. Some of these are being tested in various parts of the United States and are known as demonstration projects. TheIndependence at Home Demonstration(IAH) model is sponsored by the Centers for Medicare and Medicaid Services (CMS). In this model, frail older adults who cannot easily leave their home receive care in their home from a doctor or other health care practitioner such as a nurse practitioner or physician assistant. The goal of this model is to keep older adults in their home and out of the hospital. To be eligible for this model of care, older adults must be unable to leave their home and have two or more chronic conditions. The Hospital at Home (HAH) model enables organizations to provide hospital-level care in the person's home. Most of the participants are very ill older adults. The goal of this model is to decrease the number of days a person spends in the hospital, reduce hospital costs, improve patient satisfaction, and improve outcomes. In most cases, these people are generally stable but require extended hospital-level skilled care, such as daily visits from a doctor or nurse practitioner or physician assistant, and daily monitoring of their medical condition. TheEmergency Triage, Treat, and Transport (ET3)model developed by CMS allows ambulance care teams to have greater flexibility in deciding where a person should receive care. Instead of transporting a person to a hospital emergency department, the ambulance care team, often in consultation with a nurse practitioner or physician assistant, can transport the person to an urgent care center or doctor's office or can begin treatment in the person's home as directed by the nurse practitioner or physician assistant. The nurse practitioner or physician assistant may be in the ambulance or accessible via telehealth. 