Fort Defiance Indian Health Home Based Care Program
Program Type: Promising Practice -Programs not formally evaluated (or formal evaluation is not yet complete) but identified by experts as programs with results suggesting efficacy and worthy of further study in broader pilot implementation efforts.
The FDIH Home Based Care Program reports on their recent progress. It is a well organized and well staffed program that provides coordinated, interdisciplinary care for elders and their families. Case studies have been purposeful in that they have reminded us to open up to new possibilities, highlight key elements for elder care, i.e., care coordination, support for the family caregiver, importance of quality of life as perceived by the elder, etc. These case studies have an additional value in that they prompt the question “How do we ensure that every elder in our health system has access to the care they need?” Dr. Finke, who spent the last 10 years promoting the development of geriatric specific services in the IHS system, has come to understand that this is not the way to ensure reliably high quality care for every elder. The solution to ensuring reliably high quality care of elders is in ensuring reliably high quality care for everyone. The principles that drive good care of chronic conditions in patients of every age are the same as the principles of good elder care. The only reasonable way to reliably identify and address depression in every affected elder or to identify and support the vulnerable caregivers of elders with dementia is to systematically integrate behavioral health into primary care. This does not mean that improvements are not still needed. This is still a large task. Broadening our focus to look at the prevention and care of chronic conditions across all ages is where the solution lies to improve care of the elderly. Design features that support the delivery of care within relationships and across time, that really, truly support patient driven health care, and that allow providers to tailor the services provided to the care needed should be build into our primary care design. A health system that is designed to provide quality care, reliably, across the age span and across conditions will achieve reliably high quality care for our elders. We will all walk down the same road let’s build it together.
Infants, Toddlers, Children, Adolescents, Adults, Elderly
Community, Clinic/Health Center, Hospital, Home
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