Welcome to the Geriatric Home Visit
During your training, you will complete multiple home visits in order to develop the skillset necessary to perform home visits independently following graduation. Home visits provide you an opportunity to observe the patient in their home environment and better understand the challenges they may face.
Pre-work:
- Review as needed: House Calls Tip Sheet
- Review as needed: AFP House Calls Review Article
- Read the attached article based on PGY Level
- PGY2: “Physical and Mental Health of the Homebound Elderly: An Overlooked Population”
- PGY3: Read either: "The Invisible Homebound: Setting Quality-Of-Care Standards For Home-Based Primary And Palliative Care” or "Two-Year Mortality in Homebound Older Adults: An Analysis of the National Health and Aging Trends Study”
- Complete a pre-visit planning chart review and open a progress note or pre-visit planning to document using the dotphrase: “homevisitchartpreview”
During Home Visit
- Identify and explore one social determinant of health that is particularly impacting the patient and include this in your reflection
- Should we include a link to the evaluation?
Post-Work
Submit a 1-2 page thoughtful personal reflection of the experience. You may want to reflect on what surprised you, what could be done differently and how it will impact your future care, or anything else meaningful from the experience. Use this Personal Reflection Link to submit your reflection.
Log every home visit in New Innovations in the procedure log. If this is a continuity visit for you, log it as “home visit - continuity.”
Objectives
Demonstrate care for complex homebound patients in their home environments.
- Describe challenges and opportunities unique to patient care in the home environment.
- Review medication use and adherence while identifying medications that are no longer effective, are duplicative or carry greater burden than benefit. Identify medications that you would recommend stopping and create a schedule for stopping these medications.
- Practice culturally sensitive shared decision making with patients and families/caregivers in the context of their goals of care, health literacy and methods of communication such as tele-health and e-technologies.
- Develop and implement a safety plan to make the patient’s home environment safer.
- Collaborate with patients, caregivers, interprofessional health care team and community service providers to develop a care plan for a home visit patient maximizing skill sets of each team member to address the social determinants of health impacting the patient.
- Develop a personal plan to integrate home visits into your future practice.