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Homebound Adults: A Medical Care Option

Homebound AdultWhat do you do when a senior family member or friend are so ill or disabled, that they cannot leave their place of residence to see a doctor?  How can they receive medical care?  I recently learned about Portland, Oregon based Housecall Providers.  I had no idea there were services like this available.  Whether you’re from Portland or not, I encourage you to read on to see what they provide.  It’s very possible that this type of service is also found in other areas of the country as well.  You could check with your local Area Agency on Aging, local hospital, home health, or family doctor.  But if this service isn’t available, maybe you can be the one to help make it happen.

My sincere appreciation goes to Kirk Porter, the Social Worker with Housecall Providers, who provided me with some of the information for this article.  I also added some pertinent facts from their website.  I am very impressed with the “much-needed primary care they are providing to a severely underserved population.”

The Need for Housecall Services

“Throughout the Portland metropolitan area, there are thousands of people who are homebound because of illness, disability or age. Many of these medically fragile individuals go without medical care simply because they cannot get out of their home to see a doctor. Even those with complex medical needs may go years without primary medical care.  Without access to medical care, their health often declines further until a crisis leads to hospitalization that might have been prevented.

Established in 1995, Housecall Providers, a 501(c)(3) Oregon nonprofit, offers two interrelated services:  A primary care unit that makes medical home visits to homebound, medically fragile elders and adults with disabilities; and hospice care for patients that have been receiving their primary care through Housecall Providers. They serve the most underserved in their community; no one is turned away due to an inability to pay for their services.  The house call providers help people remain in the residence of their choice surrounded by comfort and care.

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What’s unique about their service is that they function like a doctor’s office, even though they come to you.  They have the range of support personnel you’d expect at any clinic.  What you wouldn’t see in their office, however, are the clinicians (physicians, nurse practitioners, or physicians assistants).  The reason?  They spend most of their days traveling from one patient’s residence to the next.  Their offices are in their homes and cars.

What I find so important is that they see patients where they live.  They meet with caregivers and family to learn as much about the patient as possible.  They evaluate the circumstances in which they live and take that into consideration in managing their conditions.

How the Service Works 

• To qualify for services, patients must be homebound – unable to leave home without considerable and taxing effort.

• The patient intake nurse coordinator reviews patient information to determine if a patient qualifies for the services.  (They are unable to take emergent referrals).

• If a patient is accepted, he or she is assigned to a clinician for ongoing primary care.

• Patients are seen at home by a member of the clinical team at least every six weeks, or more often if necessary.  Clinicians are available by phone 24 hours a day, seven days a week.

• Patients who are in their primary care system can choose their hospice, if that need arises.

• Referrals are by phone or fax from physicians, hospitals, home health and hospice programs, Aging and Disability Services, family members and patients. They accept Medicare, Medicaid, CareOregon  and most other forms of insurance; although no one is turned away because of inability to pay.

In Summary

From what I have learned about Housecall Providers, “they are dedicated to providing a holistic approach to each patient, while at the same time treating the patient with dignity and respect.  As I read on their website, they tailor their care plans to fit the life circumstances and treatment wishes of the patient; and in doing so, prevent many medical crises.”

As a nurse who has such a keen interest in the care of seniors, I am very glad to have had the opportunity to present this information to you.  And remember, even if you don’t live in the Portland area, as mentioned above in this article, check your own locale for those who may provide a similar service.   Thank you for your interest.  Until next time…..

“Life is tons of discipline”  Robert Frost

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