Yes, geriatricians make house calls—for eligible patients
While not every geriatrician offers house calls, this practice has seen a modern resurgence, particularly among specialized medical programs and hospital systems. These programs are specifically designed to serve older adults who are homebound, frail, or have complex medical needs that make traditional office visits challenging. The primary goal is to deliver high-quality, continuous medical care in the patient's most comfortable and familiar environment.
This is a departure from the historical house call model, which was the norm for general practitioners. Modern geriatric house calls are often part of a more extensive, coordinated care plan involving a team of providers, including doctors, nurse practitioners, social workers, and other specialists.
Benefits of geriatric house calls
For eligible seniors and their families, the advantages of in-home geriatric care are significant and far-reaching. The benefits extend beyond simple convenience and can lead to genuinely improved health outcomes.
Improved health outcomes
- Comprehensive Assessments: Seeing a patient in their home provides valuable insights not available in a clinical setting. A geriatrician can assess the patient's environment for safety hazards, evaluate their nutrition by checking the pantry, and observe their daily functioning. This leads to more accurate and personalized care plans.
- Reduced Hospitalizations: By proactively managing chronic conditions and addressing potential issues like falls or medication errors, house call programs help keep patients out of the hospital and the emergency room, saving significant time, stress, and expense.
- Better Medication Management: With the ability to review all medications, supplements, and over-the-counter drugs in one place, providers can prevent potentially dangerous drug interactions and simplify complex medication regimens.
Convenience and quality of life
- Stress Reduction: Eliminating the logistical challenge of transporting a frail senior to a doctor's office removes a major source of stress for both the patient and their caregiver.
- Extended Visits: Geriatric house calls often last longer than a typical 15-minute office visit. This allows the medical team to conduct more thorough assessments, answer questions, and spend more time with the patient and their family.
- Person-Centered Care: Care is tailored to the patient's specific environment, routines, and goals. This approach supports the goal of aging in place and promotes independence.
What services are offered during a house call?
Geriatric home visits provide a wide range of medical services comparable to what a patient would receive in a traditional office setting. The specific services can vary by program but generally include:
- Annual/As-Needed Physicals: Comprehensive exams to monitor overall health.
- Chronic Disease Management: Treatment plans and monitoring for conditions like heart failure, diabetes, and COPD.
- Coordination of Care: Working with hospitals, home health agencies, and other specialists to ensure seamless transitions in care.
- Laboratory Diagnostic Testing: Drawing blood and collecting other samples for testing in the home.
- Medication Management and Refills: Reviewing and adjusting medications and processing refills.
- Vaccinations: Administering routine immunizations.
- Wound Care: Addressing bed sores and other wounds.
- Caregiver Support and Education: Providing guidance and resources to family caregivers who are crucial to the patient's well-being.
Finding a geriatrician who makes house calls
Finding a suitable program requires research, but several avenues can lead you to the right fit for your loved one.
- Contact Local Hospitals: Major hospital systems often have dedicated geriatric medicine departments that run home visit programs. Health systems like UCLA Health, Northwestern Medicine, and Stanford Health Care are examples of providers with such services.
- Use the Eldercare Locator: This public service connects older Americans and their caregivers with local community resources, including in-home care services. You can visit the Eldercare Locator online or call them directly for assistance.
- Consult an Aging Life Care Professional: Also known as a geriatric care manager, this professional can assess your loved one's needs and provide recommendations for in-home care options in your area. Contact the Aging Life Care Association for referrals.
- Ask for a Referral: Your loved one's primary care doctor or other health care professionals may be able to recommend geriatric house call services in your community.
Understanding Medicare coverage for house calls
Medicare often plays a role in covering geriatric house calls, but the rules are specific and require careful consideration. Coverage is typically provided for medically necessary, intermittent skilled services for homebound patients.
- Eligibility: To qualify, a patient must be certified as homebound by a doctor, meaning leaving home is a major effort. The patient must also require skilled nursing care or therapy services on a part-time basis.
- Coverage vs. Custodial Care: Medicare generally covers the services provided by a medical professional but does not cover long-term, non-medical services like housekeeping or personal care assistance when those are the only services required.
- Private Pay: For services not covered by insurance or for patients who do not meet the homebound criteria, private payment is often an option. The cost can vary significantly by location and service provider.
Comparing house calls with traditional care
| Feature | Geriatric House Call | Traditional Office Visit |
|---|---|---|
| Patient Comfort | High; in familiar surroundings. | Low; can be stressful due to travel. |
| Convenience | Excellent; no travel required. | Requires transportation and travel time. |
| Environmental Assessment | Possible; allows for fall risk and safety checks. | Not possible; relies on patient/caregiver report. |
| Visit Length | Often extended (45-60 minutes). | Typically brief (15-20 minutes). |
| Coordination of Care | Excellent; often part of a team-based model. | Varies; requires patient/family to coordinate. |
| Cost | Can be higher, but often covered by Medicare for eligible patients. | Lower per visit, but total cost can rise with hospitalizations. |
| Best For | Homebound or frail seniors with complex needs. | Mobile seniors with routine medical needs. |
Conclusion
The days of a general practitioner casually dropping by for a visit are largely gone, but specialized geriatric house calls have emerged as a vital component of modern senior care. By addressing the unique needs of homebound and frail older adults, these programs offer personalized, comprehensive care that not only improves health outcomes but also greatly enhances a senior's quality of life. For families weighing their options, exploring reputable geriatric house call services from local hospitals or dedicated agencies can provide a path to ensuring their loved ones receive the compassionate, high-quality care they deserve in the comfort of their own home. To learn more about Medicare's role in home care, see the official guidelines published by the U.S. government on Medicare.gov.
