The key to reducing health related attrition in a Retirement Community (and therefore stabilizing the census) is early identification and physician intervention in a resident’s declining health. This is illustrated in the following diagram that we call The Illness Model. It shows the pathway frequently taken by an elderly person who experiences an illness.
Let’s walk through this illustration, beginning at the green line on the left side, and discuss what can happen when Jane, a resident of a Retirement Community, experiences an illness.
The green baseline that’s shown is meant to indicate a low risk level where Jane functions very independently in the Community. She has a stable medical status and adequate support with family and friends, and she tolerates the little ups and downs of daily living just fine.
But when an illness begins to set in and her health starts to decline, Jane transitions from low risk (green) to medium risk (yellow). This very early point of declining health is called the “Inflection Point” and is usually identified by family or fellow residents or especially employees of the Retirement Community (“Jane just doesn’t seem to be doing well and seems more confused,” or “Jane’s been falling a lot recently,” or “Jane seems to be losing her appetite,” or “Jane has missed a few meals.”). If healthcare is offered proactively to Jane at the Inflection Point with physician attention and possibly additional support services (home health, personal care services, etc.), then there is a high likelihood of stopping the decline and of Jane returning back to baseline and remaining in the Retirement Community.
But without early intervention, Jane’s health may continue to decline and force her to go to the emergency room or even be hospitalized. If this happens, her overall risk level now becomes high (red). And then, if she is too weak or has too many needs to recover from her illness back in the Retirement Community, she may lose her home and need to transition to a higher level of care, and the Community loses a resident.
But if Jane hasn’t been too weakened by her illness and has good physician-directed support at home, she may be discharged from the hospital and continue her recovery in the comfort of her own apartment in the Retirement Community. In the illustration, she leaves the red, high risk areas and begins climbing the yellow recovery line on the right side of the diagram where her risk level is now about medium. With continued physician-directed support in her home, her goal is to reach the stable baseline health she had before her illness and become low risk again.
This model illustrates the advantage enjoyed by Retirement Communities that partner with House Calls who offers on-site physician services and leadership in the healthcare of any or all of their residents. Physician visibility and easy on-site healthcare access are essential elements in maintaining the health and independence of community residents and stabilizing the census.
Physicians bringing healthcare to Retirement Communities…EVERYBODY WINS!