This book describes geriatrics practice models that are used to guide the care of older adults, allowing seniors to remain at home, prevent functional disability and preserve quality of life. The models include specific interventions which are performed by health care workers to address the needs of older persons and their caregivers. These models respect patient values, consider patient safety and appreciate psychosocial needs as well. Divided into six parts that discuss hospital-based models of care, transitions from hospital to home, outpatient-based models of care and emergency department models of care, this text addresses the needs of vulnerable patients and the community. Geriatric Models of Care is an excellent resource for health care leaders who must translate these programs to address the needs of the patients in their communities.

Acute Care for Elders (ACE) is a model of care designed to improve functional outcomes and to improve the processes for the care of older patients. This model includes: an environment of care designed to promote improved function for older patients; an interdisciplinary team that works together to identify/address the vulnerabilities of the older patients; nursing care plans for prevention of disability; early planning to help prepare the patient to return home and a review of medical care to prevent iatrogenic illness. Acute Care for Elders: A Model for Interdisciplinary Care is an essential new resource aimed at assisting providers in developing and sustaining an ACE program. The interdisciplinary approach provides an introduction to the key vulnerabilities of older adults and defines the lessons learned from the Acute Care for Elders model. Expertly written chapters describe critical aspects of ACE: the interdisciplinary approach and the focus on function. The fundamental principles of ACE described in this book will further assist hospital leaders to develop, implement, sustain and disseminate the Acute Care for Elders model of care. Acute Care for Elders: A Model for Interdisciplinary Care is of great value to geriatricians, hospitalists, advance practice nurses, social workers and all others who provide high quality care to older patients.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

This book provides a comprehensive and systematic state-of-the science review of major primary care delivery models, how they address specific needs of older adults, and available evidence for their efficacy. Written by experts in the field, this book explores the patient-centered medical home model (PCMH) in depth and dives into the complexities of the “medical neighborhood”. It describes and analyzes primary care specifically directed toward special, complex populations, such as the Health Home for safety net patients with mental health needs, and intensive primary care for older adults. It reviews an array of primary care models related to dual eligible patients including the GRACE primary care consultation model and PACE models. It describes primary care with Advanced Practice Nurses and Physician Assistants and explores in-depth the massive effort within the VA to develop the Patient Activated Care Team (PACT), a VA form of the PCMH that also has several offshoots that address complex older veterans and veterans with severe mental illness. Finally, it illuminates rarely discussed primary care that occurs within the home and within long-term care. Throughout the entire book, experts navigate the workforce, care quality, and financing challenges of primary care for older adults. Primary Care for Older Adults is a valuable resource for clinicians, researchers, patients, caregivers and their advocates, and policy makers who have an interest in designing, promoting, and implementing high quality primary care for older adults.

As the population of older adults in the U.S. continues to grow, medical house calls are increasingly part of a system of comprehensive home-based care for patients who have difficulty accessing office-.based care. Clinicians who have been trained mostly in office and hospital settings must adapt their usual approaches to accommodate a wide range of environmental, social, and physical circumstances that impact home-limited patients. Ideally, a comprehensive team of clinicians proficient in multiple domains of functional, social, and medical care can work together to address potential gaps in any one clinician’s expertise. Unfortunately, such teams are still rare. This book aims to equip individual clinicians with the interdisciplinary knowledge, skills, and perspective they need to provide the best care possible with limited formal interdisciplinary support. This book offers 20 patient cases drawn from the collective experience of experts in home-based medical care from highly respected academic and clinical programs across the United States. Each case demonstrates a scenario that is frequently encountered and/or very important in home-based medical care practice. Each scenario frequently proves to be challenging for many professionals because it requires an approach or leverages aspects of care delivery that most are not trained in. Additionally, each scenario reflects an approach to care that is enhanced by interdisciplinary input. Finally, each case lends itself to a practical problem-solving approach that could be accomplished by most home-based medical care providers, even in the absence of an interdisciplinary team. Written by interdisciplinary experts in geriatric home-based care, this book serves as both an educational tool for learners in all related disciplines as well as a quick reference for experienced clinicians looking to augment their existing house call “toolbox.”

At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.