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Old-fashioned house calls make a comeback to give frail seniors, seriously ill, access to care

 

JourneyCare physicians pack their bags to deliver medical care for the homebound

On a recent Wednesday afternoon, Dr. Mark Grzeskowiak knocks on the door of Betty Wito’s second-floor independent living apartment in Arlington Heights. The hallway is alive with the sounds of the seniors singing, spreading cheer during this cold winter month for residents gathered in the atrium below.

As he enters her apartment at Church Creek Senior Living Care, “Dr. Mark” (as she greets him), sits down at the foot of Wito’s La-Z-Boy in the living room surrounded by her candies and photographs of Betty’s family.

Decked out in a suit and tie (no white coat), he begins conducting a medical checkup.

“It’s been two months since I saw you, so how are you feeling Betty?” “Any migraines, light-headedness, dizziness?” he asks.

Dr. Grzeskowiak, Chief Medical Officer for JourneyCare, an Illinois nonprofit offering care for patients and their families facing serious illness, is one of a growing number of providers in the United States who conducts regular house calls to elderly patients and others with chronic conditions who are mostly homebound.

It’s an old idea that is becoming new again, and one that Grzeskowiak says he believes is the most efficient way to provide more compassionate and thorough care to patients, especially the elderly – and to keep them out of the revolving door of emergency room visits and hospitalizations.

“The hospital emergency room and the inpatient ward aren’t the best way to solve the problems of the elderly homebound who have complex conditions and who can’t get around within their own house very easily, never mind getting out of the house,” he says.

His visit is part of an 18-month pilot House Calls program, launched by JourneyCare and supported by the Home Centered Care Institute in Schaumburg, a nonprofit organization dedicated to expanding home-based primary care nationally. Launched last August, the program is geared to provide service for up to 200 patients. It underscores the personalization and convenience that are poised to drive the patient experience of the future.

By 2030, the number of Americans age 65 and older will account for 20 percent of the U.S. population, according to the U.S. Census Bureau. And by 2035, the nation’s elderly population is expected to double to 78 million — or roughly the current population of California, Florida and Illinois combined. Two-thirds of the people in this age group have multiple chronic conditions and likely would need regular health care visits, which they may have difficulty accessing.

For patients like 86-year-old Betty, the goal is to keep them out of emergency rooms and hospitals. Betty suffers from chronic obstructive pulmonary disease (COPD) and during the last several years, was in and out of hospitals after suffering a heart attack and a series of serious urological infections.

“House Calls has improved her health significantly,” says Betty’s niece Sheryl Walter of Hoffman Estates, who is her aunt’s primary caregiver.

“It’s brought peace of mind,” says Sheryl, who moved her aunt to Church Creek in Arlington Heights after the illnesses landed her in Northwest Community Heathcare and rehab. “She was always having to undergo so much testing and getting to and from the different doctors’ offices was just too much.”

Now, like other JourneyCare House Calls patients, Betty receives physical examinations, chronic disease and symptom management, and medication evaluation in the comfort of her own apartment. The program also offers depression screenings and mental status evaluations, wound evaluation and treatment, routine blood work and labs, and discussions about goals of care.

What’s unique about JourneyCare’s House Calls program, says Grzeskowiak, is that it includes a coordinated team approach with primary care physicians, advanced practice nurses, nurses, social workers, care navigators and connections to community resources.

Home-based medical care for frail older adults makes a lot of sense, according to Thomas Cornwell, M.D. founder and CEO of the Home Centered Care Institute in Schaumburg. This nonprofit organization is dedicated to expanding home-based primary care nationally.

“The sickest patients in society should get the most primary care, but because they can’t easily access it, they end up in the hospital, in crisis, costing much more than care management provided at home.”

For Betty, the best part of the experience is having her doctor see her at home and not in a clinical setting.

“I rarely go out and so getting to the doctor was really hard, plus he is so nice,” she says.

As Dr. Mark prepares to say goodbye, he asks her one more question: “Is there anything else I can do for you?” Betty responds with a giggle: “Marry me.”

About JourneyCare

With 40 years of healthcare leadership and expertise, JourneyCare has achieved national recognition for growth, innovation, community partnerships and best practices in caring for adults and children with serious illness. JourneyCare serves 10 counties in the Chicago region and is the largest nonprofit provider of hospice and palliative care in Illinois. The agency also provides services that include JourneyCare House Calls, Chronic Care Management and JourneyCare Choices – serving patients at all stages of serious illness. JourneyCare is dedicated to enriching lives through expert, compassionate care and empowering patients and families to live with dignity, on their own terms. For more information, visit journeycare.org.