Key to at-home geriatric care lies in reliability

By Sarah Guy, medwireNews Reporter

Older individuals who live at home but are dependent on healthcare services perceive their care delivery system to be effective when it involves supportive and reliable services, indicate UK study results.

These services should include care continuity and a relationship style that supports patients, have an ongoing shared provider-patient view and functioning links to primary care, and show evidence that the healthcare system could respond to escalating problems or crises, report the researchers.

"Healthcare professionals try hard to work together as an integrated team to provide a good standard of care," said lead author Claire Goodman (University of Hertfordshire, Hatfield) in a press statement.

"But, with different approaches to inter-professional working, we are beginning to understand more about the impact on the health and well-being from the patient's perspective and which approach achieves the best outcomes," she added.

Goodman and colleagues reviewed existing research into the effectiveness of interprofessional working for home-dwelling individuals aged 65 years and older, including interviews with carers, professionals, and older individuals living at home, and a national survey on current standards.

The team also assessed 9 months of care, support, and treatment data for 62 older people living at home who received either integrated team-based models of care, case management models, or collaborative models.

While data on the mechanisms and delivery of interprofessional working for older people are not well documented, note Goodman et al, older people and their representatives were able to differentiate between different approaches to care. They indicated that the process of service delivery during key crises was as important as the ultimate agreed outcomes of care.

After the 9-month case study, the authors identified several key mechanisms that changed older people's experiences of interprofessional working - irrespective of the model of care received.

These mechanisms were continuity of care via a recognized care worker, a style of working that supported co-production with the older person, an ongoing shared view, functioning links with the primary care network, and evidence that the system would respond appropriately during crises.

Goodman highlighted that the presence of a key professional to speak to about their healthcare means "the older person and their family can be more involved in reviews and decisions."

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