HAVING recently taken charge of the Korumburra Medical Centre as its sole director, Dr Floyd Gomes is determined to help elderly people remain in their homes, where possible, through integration of their healthcare and social care.
He explained that approach is becoming increasingly popular in a number of countries and is supported by the World Health Organisation.
Dr Gomes stressed the aim is to bring as many services as possible to the home.
Telehealth is one way to connect with elderly medical clinic patients and what happens in their home, helping form a link with carers and other service providers.
While many elderly people would be unable to use telehealth services on their own, the assistance of carers allows that to happen.
Making that connection between social and medical care services is a key ingredient in helping older people remain at home, accessing medical services through the GP clinic and staying out of hospital unless necessary.
“The government’s supporting home care but that needs to link with their healthcare,” Dr Gomes said.
He detailed how involving carers in medical discussions is beneficial.
“If that person who comes to your home as a carer is linked in to those conversations, with your consent, that’s very helpful and at that point they become a patient advocate.”
If a carer is aware of an elderly person’s chronic disease care plan, that carer is well positioned to help when needed, knowing what to do.
The connection between those providing in-home services and GPs also increases the chances of elderly people receiving prompt treatment when required without being hospitalised unnecessarily.
Dr Gomes said the relationship gives carers “a point of escalation” when an urgent situation arises, encouraging carers to take the elderly person to the medical clinic if an ambulance is not needed.
That contrasts with alternatives such as simply reporting the situation or the patient having to go to hospital for issues that can be addressed by a GP.
Dr Gomes gave the example of a patient in Hastings, where he still practises as a GP, having a fall at home, with her carer bringing her to the clinic that morning, enabling her to get prompt medical attention.
The doctor then discussed the patient’s needs with the carer, such as the requirement for a higher commode chair, with the carer also taking her for an X-ray and blood tests.
Another carer brought her in the next day for a follow-up appointment.
With the patient having no injuries requiring hospitalisation, the connection between social carers and medical clinic practitioners allowed the elderly person to remain in her home.
That approach reduces anxiety for the elderly person and prevents a hospital bed being occupied unnecessarily.
Building trust in a person’s life around a service is the key to success.
“If you fail that, in the heat of the moment in the middle of the night when someone falls over or whatever it may be, you lose everything at that moment,” Dr Gomes said.
He explained that without the patient’s trust in available support services, an ambulance would be called.
The paramedics being unaware of those support services would likely take the person to hospital when their condition wouldn’t otherwise warrant that.
Dr Gomes said close association with carers, physios and other in-home service providers also enables GPs to learn more about patients and their needs.
Mark & Sylvie’s Home Care has been brought to Korumburra Medical Centre and is an approved provider of government home care packages.
Dr Gomes explained that whereas he used to do in-home visits as a GP, the system in Australia is not designed to support that, requiring GPs to make such visits in their own time, such as when they are on their way home.
With many older patients unable to get to a medical clinic on their own, that boosts the importance of medical practitioners being integrated with other service providers.
There will be a public talk about the integrated health approach on October 22 at the Korumburra Community Hub.