We recently encountered two gerontologists that are getting senior care right. By doing so, they are driving down hospital admissions and costs for the facilities where they work.

In this model the facility has hired the gerontologist, who works with all the residents as needed to support them.  The residents are encouraged to learn how to cope with issues, and to communicate with each other and stay active. Families are educated as to the process of aging and important issues to address at each stage.

Dr. Dennis McCullough, at Dartmouth has outlined these principles:

• Understanding fully the aging person and their complex, ever evolving needs
•  Emphasizing the dignity of the person and the right to make informed decisions
• Encouraging clear and open communication and greater coordination of care between families, an elder's Circle of Concern, and myriad health professionals
• Encouraging more reflective, thoughtful, slowed decision-making in all non-emergency situations as a means for expanding choices for elders
• Limiting the human and financial costs and maximizing the rewards of different levels of medical intervention.
• Questioning systematically the overuse of hospitalizations, extensive testing and specialists' care.
• Encouraging individual, informed wishes, including declining medical interventions
• Offering compassionate covenantal care to declining elders.

From Dr. Dennis McCullough's book, My Mother, Your Mother: Embracing "Slow Medicine," The Compassionate Approach to Caring For Your Aging Loved Ones, 2008.

Dr. Mark Agronin takes a similar approach outlined recently in the New York Times http://www.nytimes.com/2011/05/01/us/01elderly.html?pagewanted=1

Both understand the need for the gentle chronic approach to this stage of life that is needed to optimize all it's aspects. They reject approaching old age as a disease. They also reject the episodic treatment model of payment.

Although their work is being done in large continuing care communities, we believe it is applicable to seniors living independently and their families. Home Instead Senior Care is starting to develop teaching materials for families to help them address the issues that will emerge. We will be pursuing these ideas in our work with seniors and in future articles.

For more information about this and other senior issues related to health and well being please visit our website:

                  www.hearthside-homeinstead.com

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