A new programme has been devised to prolong older adults' ability to live independently.
The programme looks at seniors' abilities to carry out essential daily functions after enrolling in the PACE program, a large-scale managed-care project with 15,000 U.S. participants.
"The objective of PACE is to enable individuals to live independently in the community and with a high quality of life," said Dana Mukamel, Ph.D., lead study author and a senior fellow at the Center for Health Policy Research, University of California.
"Maintaining or improving function is important in enabling frail elderly individuals to do so," Dr. Mukamel added.
The average programme participant is 80 years old. Study data showed that at three months, 61 percent of participants reported no decline in functional skills and by 12 months, 43.3 percent still reported no decline.
Although these statistics might not seem like progress to a casual observer, study authors consider the slower rate of decline an important factor in the ability to prolong independent living.
PACE participants must already be eligible for a nursing home, as the organization provides services in day centres.
In the centres, the participants receive therapy, personal and medical services, and supportive care. An interdisciplinary team of doctors provides both acute and long-term care. Therapy also includes help with functional skills such as bathing, dressing, grooming, walking and feeding.
"This allows the program to be more flexible financially. Such flexibility can make it easier to deal with the whole patient and not just the patients' health problems," Dr. Mukamel said.
"There's a bias in Medicare to provide acute care. If we can use Medicaid funds to deal with minor problems, we can sometimes prevent them from becoming acute," said Lynda Burton, Sc.D, associate professor at the Johns Hopkins Bloomberg School of Public Health.
Despite the programme's overall success, the study showed that there is room for improvement. According to Dr. Mukamel, PACE's medical teams are most efficient when a medical director who is also a geriatrician leads them.
Patients seem to respond better to aides from a similar cultural background, Dr. Mukamel said.
The study appears in the latest issue of The Milbank Quarterly.