Nurse Practitioner Home-Based Primary Care: A Model for the Care of Frail Elders

Abstract

Growing numbers of frail older adults fi nd it increasingly diffi cult to leave their homes in order to access health care. Primary care providers in the home-based setting must have expertise in chronic illness management, illness and injury prevention, and quality-of-life care. Th e doctor of nursing practice brings specifi c competencies and nursing background to the role of primary care provider and is therefore the ideal health professional to provide primary care to frail elders in this setting. Further research is needed to determine the cost-eff ectiveness of home-based primary care and its eff ect on caregiver stress. Keywords: frail elderly; doctor of nursing practice; homebound persons; primary health care in the home setting Th e health care needs of the frail elderly continue to increase as the population of older people grows. Th e number of Americans over the age of 85 will grow from 4.6 million in 2002 to 9.6 million in 2030. Today, less than 20% of these octogenarians live in nursing homes. Even so, over half of people over 80 report having at least one severe disability (Administration on Aging, 2003). Th is population has its own unique health care needs, and the current system of offi ce-based care does not adequately address the needs of the frailest group of patients, a group that promises to grow as the baby boomers age. Homebased primary care off ers one solution to this gap in health care. Th e doctor of nursing practice (DNP) brings specifi c competencies and nursing background to the role of primary care provider and is therefore uniquely qualifi ed to assume this role in the home setting. Th is article explores the evidence that a diff erent approach from offi ce-based care is needed, what particular skills are necessary to provide quality care to this population, and how the DNP is the ideal health care professional to fi ll this role.

Characteristics of Homebound and Patients with Disability Who Use Home-Based Primary Care in Korea: A Retrospective Study for 2018–2022

“…Nevertheless, the outcomes of the service showed that it is difficult to operate with only a physician visit and that a nurse visit is also necessary for HBPC for homebound patients. In Japan, nurses provide HBPC services at nursing stations [ 14 ] and in the US HBPC model, nurse’s role is pivotal [ 9 , 33 ]. It is difficult to apply the model of the US to Korea, which does not have nurse practitioners [ 9 ].…”

Ganhos das intervenções de enfermagem individualizadas: revisão sistemática da literatura

“…Providenciar à pessoa uma intervenção de intensidade da dor, nas pessoas em residências para idosos, acompanhadas por enfermeiros (28)(29)(30)31) .…”