Physician home visits for persons with dementia: Is there a need?

Abstract

This study explores the potential role ofphysician home visits in the care of persons with dementia. Family caregivers (n = 182) of relatives with irreversible dementia were surveyed about their use of physician home visits, perceptions of the availability of home visits and anticipatedfuture need for this service. Persons with dementia who had used home visits had higher functional and mobility deficits, were more likely to have used other types of in-home assistance and were more likely to require catheter or decubitus care. Over half of the sample intends to use physician home visits in the future, but mostfamilies have not investigated the availability of the service. Barriers to the use of physician home visits are presented and policy implications are discussed.

Get full access to this article

View all access options for this article.

References

1. Congressional summary : Losing a million minds: Confronting the tragedy of Alzheimer's disease and other dementias. U.S. Office of Technology Assessment (OTA-BA-323), Washington, DC, 1987

2. Congressional summary : Confused minds, burdened families: Finding help for persons with Alzheimer's and other dementias. U.S. Office of Technology Assessment (OTA-BA-403), Washington, DC, 1990

3. Comments of the American Academy of Home Care Physicians re : Medicare payment schedule for physicians' services. American Academy of Home Care Physicians Newsletter, 1991;3(3): 1-6

4. Greico A : Physician's guide to managing home care of older patients. Geriatrics, 1991;46(5):49-60

5. Goldberg A : What is a home care physician? American Academy of Home Care Physicians Newsletter, 1991;3(3):1-14

6. Goldstein M , Gwyther L , Lazaroff A , Thal L : Managing early Alzheimer's disease. Patient Care, 1991;25(18):44-72

7. Ogle K , Given C , Given B : Physician home visits from the viewpoint of the disabled elderly and their caregivers. Home Health Care Services Quarterly, 1989:;10(3/4):67-75

8. Gwyther L : Clinician and family: A partnership for support. In Mace N (ed.): Dementia Care: Patient, family and community. Baltimore, The Johns Hopkins University Press, 1990

9. Katzman R , Jackson E : Alzheimer's disease: Basic and clinical advances. J Am Geriatr Soc, 1991;39(5):817-826

10.

10. Patterson C , LeClair J : Acute decompensation in dementia: Recognition and management. Geriatrics. 1989;44(8):20-32

11.

11. Besdine R , Jarvik L , Tangalos E : Managing advanced Alzheimer's disease. Patient Care, 1991;25(18):75-108

12.

12. Cassel C , Hays J , Lynn J : Alzheimer's: Decisions in terminal care. Patient Care, 1991;25(18):125-137

13.

13. Winograd C , Jarvik L : Physician management of the demented patient. J Am Geriatr Soc, 1986;34:295-308

14.

14. Volicer L : Need for hospice approach to treatment of patients with advanced progressive dementia. J Am Geriatr Soc, 1986;34:65-658

15.

15. Maslow K : Issues in late stage care. In Mace N (ed.): Dementia care: Patient, family and community. Baltimore, The Johns Hopkins University Press, 1990

16.

16. Rossman I : The geriatrician and the home bound patient. J Am Geriatr Soc, 1988;36:348-354

17.

17. Barker W : The house call. J Am Geriatr Soc. 1985;33:877-877

18.

18. Burton J : The house call: An important service for the frail elderly. J Am Geriatr Soc. 1985;33:291-293

19.

19. National Center for Health Statistics : National Health Interview Survey. Physician visits: Volume and interval since last visit. U.S. Govt. Printing Office: Washington, DC, 1980

20.

20. Collins C , Stommel M : Out of pocket expenditures by family caregivers of patients with dementia residing in the community. Home Health Care Services Quarterly, 1991;12(4)