Remember ME - You Me and Dementia

July 11, 2006

USA: Doctors' House Calls Return to Serve Elderly

Tucson, Arizona (Arizona Daily Star), July 11, 2006: The little black bag is back in style. The tradition of doctors providing house calls is coming back, and health-care experts say the practice will increase as the population ages. Evan Kligman, former co-director at the Arizona Center for Aging, said a growing number of physicians are specializing in home care, especially as the cost of running a practice rises sharply. Dr. Kevin Jackson greets Hazel Register, an asthma sufferer, during the physician's recent visit to an assisted-living home in Scottsdale. Joining them is Kristi Conlan, Register's granddaughter. Photo: Julio Jimenez /East Valley Tribune The need for home care and geriatric physicians will grow in the next few years, and the baby-boom generation will be looking for ways to receive better health care, Kligman said. "There needs to be more options as people get older and more incentives for home-based care," he said. Relatively few Arizona doctors make house calls, but at least one of them is planning to serve more patients. "The most rapidly growing demographic is 85-plus," said Phoenix home-care physician Kevin Jackson. "A large segment are frail and fragile, and they want their symptoms treated. . . . They want to be as mobile and flexible as they can, in the most independent place they can." According to a study in the Journal of the American Medical Association (November edition), the annual number of house calls increased 43 percent from 1998 to 2004. The study attributes the increase to factors such as the aging of the American population, advances in portable medical devices, improved information technology and a 1998 change in Medicare that increased reimbursement for house calls. The American Academy of Home Care Physicians has reported an increase of about 60 members a year since 2000. Jackson said most of his patients find travel very painful. Those with dementia easily become upset or confused when they have to leave the house. Hazel Register, who is seen by Jackson at a Scottsdale assisted-living facility, said she struggles with asthma, and the summer heat makes it worse. Jackson said Register loses her breath after 10 or 12 steps. Jackson visits his patients about once a month, traveling around the sprawling Phoenix area. Like many house-call doctors, he serves private residences, assisted-living facilities and nursing homes. He said he sees about 12 patients a day. Jackson usually will check blood pressure, heartbeat, temperature, diet and whether the patient is experiencing pain. "With most of these people, anything real awful or unusual would have happened already," Jackson said. "They don't want to see a zillion specialists." By Lindsay Butler EAST VALLEY TRIBUNE All content copyright © 1999-2006 Arizona Daily Star

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