The Mount Sinai (New York) Visiting Doctors Program: Meeting the Needs of the Urban Homebound Population

2011 ◽  
Vol 12 (4) ◽  
pp. 139-143 ◽  
Author(s):  
Katherine Ornstein ◽  
Cameron R. Hernandez ◽  
Linda V. DeCherrie ◽  
Theresa A. Soriano
Keyword(s):  
New York ◽  
Social Work ◽  
Clinical Care ◽  
Older Individuals ◽  
Social Service Agencies ◽  
Complex Needs ◽  
Home Based ◽  
Major Teaching ◽  
Mount Sinai ◽  
Physician Availability

The Mount Sinai Visiting Doctors program, a joint program of Mount Sinai Medical Center’s Departments of Medicine and Geriatrics, is a large multidisciplinary teaching, research, and clinical care initiative serving homebound adults in Manhattan since 1995. Caring for more than 1,000 patients annually, the physicians of Visiting Doctors make more than 6,000 urgent and routine visits each year, making it the largest program of its kind in the country. Services include 24–hour physician availability, palliative care, social work case management, collaboration with nursing agencies, and in-home specialty consultation. The program serves many individuals who have previously received inadequate and inconsistent medical care. Patients are referred by social service agencies, local physicians, and hospitals and are primarily frail older individuals with complex needs. Funded by Mount Sinai and private support, the program serves as a major teaching site for medical, nursing, and social work trainees interested in home-based primary care.

A QUALITATIVE INVESTIGATION OF THE IMPACT OF HOME-BASED PRIMARY CARE ON FAMILY CAREGIVERS

2019 ◽  
pp. 1-4
Author(s):  
E. Wool ◽  
J.L. Shotwell ◽  
J. Slaboda ◽  
A. Kozikowski ◽  
K.L. Smith ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Family Caregivers ◽  
Emotional Support ◽  
Positive Impact ◽  
Clinical Care ◽  
Family Members ◽  
Home Based Primary Care ◽  
Home Based ◽  
The Impact

Background: Home-based primary care (HBPC) provides team-based clinical care for homebound patients who have difficulty accessing typical outpatient care. Interdisciplinary team members also provide social and emotional support and serve as a resource for family caregivers, who often experience significant emotional stress. Objectives: This qualitative study explores the impact of HBPC on family caregivers to identify aspects of the program that caregivers find most helpful and meaningful as well as areas for improvement. Design: Semi structured recorded interviews were conducted with family caregivers of frail, elderly homebound patients. Interviews included the following topics: overall program satisfaction and suggestions for improvement. Setting: A HBPC program serving patients in Queens, Nassau and Suffolk counties in New York. Participants: Nineteen family caregivers: 13 women, 6 men; 10 were adult children; 6 were spouses, and 3 were other family members of patients in a HBPC program. Measurements: Thematic coding of all recorded transcribed interviews was prepared by 3 qualitative coders. Interrater reliability was conducted to ensure reliability across coders before themes were disseminated and discussed until consensus was achieved with the larger group of investigators. Results: Three main themes were identified: the importance of staff emotional support; the burden of caring for homebound patients; and the need for a broader range of home-based services. Multiple family members noted that the program not only had saved their loved one’s life, but had also metaphorically saved their own. Conclusions: Family caregivers value the communication and accessibility of HBPC and report that the program has a positive impact on their stress and mental health. Results can inform key aspects that need to be retained or enhanced with the expansion in HBPC programs.

scholarly journals Covid-19 Pandemic Era: Is It Time To Promote Home Dialysis And Peritoneal Dialysis?

2021 ◽  
Author(s):  
Mario Cozzolino ◽  
Ferruccio Conte ◽  
Fulvia Zappulo ◽  
Paola Ciceri ◽  
Andrea Galassi ◽  
...  
Keyword(s):  
Severe Infection ◽  
Human Interaction ◽  
World Health ◽  
Older Individuals ◽  
Home Dialysis ◽  
Renal Replacement Therapies ◽  
Home Based ◽  
Immunologic Diseases ◽  
Novel Coronavirus ◽  
Health Organization

ABSTRACT The novel coronavirus, called SARS-CoV-2 has been declared a pandemic on March 2020, by the World Health Organization. Older individuals and patients with comorbid conditions such as hypertension, heart disease, diabetes, lung disease, chronic kidney disease (CKD), and immunologic diseases are at higher risk of contracting this severe infection. In particular, patients with advanced CKD constitute a vulnerable population and a challenge in the prevention and control of the disease. Home-based renal replacement therapies offer opportunity to manage patients remotely, thus reducing the likelihood of infection due to direct human interaction. Patients are seen less frequently, limiting the close interaction between patients and healthcare workers who may contract and spread the disease. On the other hand, while home dialysis is reasonable selection at his time due to the advantage of isolation of patients, measures must be assured to implement the program. Despite its logistical benefits, outpatient hemodialysis also presents certain challenges during times of crises such as COVID 19 pandemic and potentially future ones.

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