Sharp Healthcare has designed a program to give elderly patients the care they want at home and keep them out of the hospital.
This article first appeared March 27, 2017 on Kaiser Health News.
By Anna Gorman
Gerald Chinchar isn't quite at the end of life, but the end is not far away. The 77-year-old fell twice last year, shattering his hip and femur, and now gets around his San Diego home in a wheelchair. His medications fill a dresser drawer, and congestive heart failure puts him at high risk of emergency room visits and long hospital stays.
Chinchar, a Navy veteran who loves TV Westerns, said that's the last thing he wants. He still likes to go watch his grandchildren's sporting events and play blackjack at the casino. "If they told me I had six months to live or go to the hospital and last two years, I'd say leave me home," Chinchar said. "That ain't no trade for me."
Most aging people would choose to stay home in their last years of life. But for many, it doesn't work out: They go in and out of hospitals, getting treated for flare-ups of various chronic illnesses. It's a massive problem that costs the health care system billions of dollars and has galvanized health providers, hospital administrators and policymakers to search for solutions.
Sharp HealthCare, the San Diego health system where Chinchar receives care, has devised a way to fulfill his wishes and reduce costs at the same time. It's a pre-hospice program called Transitions, designed to give elderly patients the care they want at home and keep them out of the hospital.
Social workers and nurses from Sharp regularly visit patients in their homes to explain what they can expect in their final years, help them make end-of-life plans and teach them how to better manage their diseases. Physicians track their health and scrap unnecessary medications. Unlike hospice care, patients don't need to have a prognosis of six months or less, and they can continue getting curative treatment for their illnesses, not just for symptoms.
Before the Transitions program started, the only option for many patients in a health crisis was to call 911 and be rushed to the emergency room. Now, they have round-the-clock access to nurses, one phone call away.
Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.