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Even more so, specific Medicare and Medicaid policies perpetuate this cycle. After experiencing a functional decline at the hospital, the woman, no longer able to live at home safely, was sent to an SNF for post-acute care, covered by Medicare. Older adults frequently utilize such services, often in skilled nursing facilities (SNF).
Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. They’re going to get older, they’re going to struggle with geriatric conditions, and they’re going to need palliative services and eventually end-of-life care.
Alex: And we are delight to welcome Lindsey Yourman, who is a geriatrician, she’s a longtime friend and mentee, and is now a peer and is a key component of the ePrognosis working group and helped originate the ideas that led to ePrognosis and she’s now San Diego County’s Chief Geriatrics Officer. Welcome to GeriPal, Lindsey.
Don’t get me wrong, the evidence points to cost savings, but as Chris Callahan and Kathleen Unroe pointed out in a JAGS editorial in 2020 “in comprehensive dementia care models, savings may accrue to Medicare, but the expenses accrue to a fluid and unstable network of local service providers, patients, and their families.” Diane: Huge.
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