Community-Based Case Management as a Method of Accessing Services for Residents of Intermediate Care Facilities. Geriatric Assessment and Resource Center Model Project

摘要

The Geriatric Assessment and Resource Center designed and implemented a model system of human services for the frail elders within the Massachusetts Mental Health Center catchment area in order to achieve an improved level of self - sustained community living for that population. The project created a mechanism through which community services and programs could become available to elders in nursing homes. The catchment area includes 41 nursing homes with 3,200 beds and a total population of 212,000 people, with 35,000 of these individuals over age 65. Ten nursing homes were selected to participate, half as study sites and half as controls. Assessment procedures were part of either a research effort evaluating patient impact issues or a management process evaluating the effectiveness of interagency procedures in achieving common goals. Project objectives included decreasing the isolation of frail elders by increasing the availability of community resources, increasing the participation of nursing home residents' family and friends in service provision, developing a geriatric day treatment strategy, and expanding rehabilitation service programs. Final assessments of the population revealed that all study home residents were more mobile, all study home residents were more belligerent than those in control homes, and all study home residents were prescribed more drugs than controls. The mortality rate in study homes was half of that in controls. Implications of the results are discussed, and policy recommendations are offered. Case management forms and study products are appended. (Author abstract modified).