In her recent article, Reliable and Sustainable Comprehensive Care or Frail Elderly People in the Journal of American Medical Association (JAMA), geriatrician, Joanne Lynn, MD, Director of the Center for Elder Care and Advanced Illness in Washington, DC is able to articulate the missing link in caring for the elderly in the United States.
No surprise… it is not affordable medical care; the missing link in caring for the elderly is affordable non-medical support, like homemakers and personal care assistants, to help them live the rest of their days in an environment that gives them the most joy, peace, and contentment.
Dr. Lynn sums it up very well in this paragraph from her recent article.
The service delivery system should encompass health care and long term services and supports as equal partners. A balanced system would give integrated multidisciplinary teams the tools and authority to match services with each frail person’s priority needs. Food, housing, transportation and direct personal services are often more important than diabetes management or chemotherapy. Today, a physician can order any drug for any Medicare patient at any cost – but that physician cannot order adequate housing, except by perhaps arranging a nursing home admission.
Unlike in the palliative care arena, the patient’s goals for daily living cannot be matched with their preferences for daily living, as the “supports” that they need and prefer are often not available or affordable to them.
What can we do to help these vulnerable patients? How about growing and developing our accountable care organizations? They may be our best hope.