The Alzheimer's Digest: Improving Geriatric Quality of Care

Improving the quality of care provided to the geriatric population may be a multiple-step process. There are a number of aspects to consider. In addition to evident physical issues and chronic pain, many elderly patients have underlying mental health issues that affect their physical well-being. For example, a patient may feel as if his family has abandoned him or he may feel a general sense of helplessness. Improving the quality of care for this population requires an assessment of treatment options and help in developing quality lifestyles.

Latest patient survey results
Individual care plans

Suggestions

Review pain management options for people with chronic pain. Elderly patients often are elderly suffer from ongoing pain. This may hinder their participation in activities that would improve their quality of life and quality of care. The American Geriatrics Society now recommends persistent pain should be reduced through the use of opioid drugs instead of non-steroidal anti-inflammatory drugs (NSAIDS) including aspirin, ibuprofen, naproxen and Cox-2 drugs such as Celebrex, Vioxx and Bextra. Opiods cause fewer side effects among the elderly and are generally better at relieving pain.
Review the latest patient survey results from the geriatric population. The survey result you utilize should be one that asks questions about the patient's perceptions on the quality of care disaggregated by the service segment (i.e. admittance routine, doctor accessibility, pain management, nursing staff).
Select patients randomly to answer questions about how you can improve the quality of care they receive. Write these answers down and consider each one carefully. Even if the answer is vague or seems unimportant you should give it consideration. If it is important to one patient, it may be important to many patients.
Write overall care guidelines for each group of people you serve. These guidelines should be modified and customized for each patient for whom you provide care. The guidelines should serve as a checklist or jump-off point to begin a treatment plan.
Customize the geriatric care plan to each patient in your care. The plan should center around the patient and their specific needs. It should be developed by the patient with assistance from you. Let the patient know what their options are and elicit other choices from them. A quality care plan will address issues of continued engagement in life activities and relationships as well as providing for a healthy environment.
Ask the patient if the goals of their care plan are being reached. Ask how you can improve the effectiveness of their treatment. Continue supporting the patient in developing relationships with other people and exploring recreational opportunities. Treat each patient as an individual when they come into your office or when assessing quality of care issues.

Tips

Solicit patient input as an ongoing activity rather than once a year.
Allow each patient to be the designer of their care plan; never pressure a patient to request something different from they want.