Wednesday, 20 August 2003: 09:00-10:30
Sheraton Ballrooms I-V (Sheraton Hotel and Towers)

S057 Fee-for-Service Comprehensive Geriatrics Outside the University Walls

Comprehensive family-centered geriatrics using a multidisciplinary team showed great promise in the 1980's under grants and university sponsors. This presentation team presents a community-based, fee-for service program spanning the continuum of well elderly, home-bound seniors to SNF, subacute, respite and inpatient geropsychiatry.Most medical specialties join with dieticians, social work, PT-OT and pharmacy to care for the multi-ethnic population of this community hospital. No grants built this geriatric program. Routine services include memory clinic, teaching nursing home,Prime-Timers Club, Fitness Center,hospice, home care agency and CHF disease management. Newly offered is a fee-for-service respite service for the community living demented or frail elderly. Conceptually less familiar comes that Parish Nurses (volunteers) care for those unqualified for Medicare home services. Hospital-sponsored ICU nurses do call-backs for weeks after discharge to continue care upon return to the community. Providing a safety net for the frail elderly also aligns with the inpatient geropsychiatic unit. Providing ECT as outpatients requires team support over the treatment intervals. For those without adequate health plan, a church-sponsored psychiatric day-hospital supports outpatient aftercare. The elderly receive most aspects of comprehensive geriatric care under their "socialized" Medicare plan without external funding, allowing this model to be reproduced in other communities, other countries. The platform for all the specialties lies in a strong primary care specialty base which utilizes the specialists in neurology, geropsychitry, cardiology, PMR, etc. productively. Geriatric fellows learn an integrated model of care across professions and disciplines.
Chair:Mary Elizabeth Roth
 S057-001 Continuum of Community-based Geriatric Care
Richar Terrence Martin
 S057-002 Memory and Neurology Clinics as Entree into Care for Dementia
Donald Wills
 S057-003 Role of Inpatient Psycho-geriatrics in a Community Hospital
Farhad Sholevar

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