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The number of people providing assistance to an older relative or friend recently topped 21 million in the United States. Experts expect the burden on these caregivers to intensify as health systems shift more care to the outpatient setting and growing numbers of older adults strive to maintain their independence.
Researchers recently found that the outpatient geriatric evaluation and management (GEM) model, a new model of care delivery designed to reduce caregiver burden and nursing home admissions, does successfully deliver on its promises. In fact, only 17% of caregivers of older adults who received GEM care reported an increasing caregiving burden during the 12-month follow-up compared to 39% of caregivers of adults receiving usual care.
GEM begins with an intensive assessment of a frail older adult’s medical, psychosocial, and functional capabilities by an interdisciplinary health care team. The team provides ongoing care tailored to the needs identified during the assessment.
In this study, the GEM team included a geriatrician, a nurse, a social worker, and a gerontological nurse practitioner. Researchers studied 568 high-risk, community-dwelling older adults and randomly assigned them to receive either GEM or usual care for six months.
The GEM team met with its assigned patients once a month and provided medical treatment, care management, educational information, counseling, assistance with advance directives, and referral to agencies and other professionals as needed. The team discharged the patient back to the primary care physician when the patient was adhering to the comprehensive plan of care or GEM team treatment goals were met.
In telephone interviews, researchers assessed at baseline and again at 12 months the burden experienced by the patients’ informal caregivers. Questions included the overall time spent on caregiving and the extent to which caregiving disrupted their own lives.
[See: Weuve JL, Boult C, Morishita L. "The effects of outpatient geriatric evaluation and management on caregiver burden." The Gerontologist, 2000; 40(4):429-436.]