Elderly Get Medical Aid Streamlined

              The Times
Sunday, Nov. 30, 1980 *« Classified Oil and gas .MetroNews Shreveport-Bossier
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Elderly get medical aid streamlined
By SALLY REESE
Times Medical Writer
At a coffee break one day, the chief of
surgery asked the acting chief of family
medicine if he would, as a favor to him,
look in on a former patient, a woman in
a nursing home.
Dr. Arthur T. Fort said Dr. John C.
McDonald had treated her at LSU Hos-pital.
He was concerned about how she
was getting along.
Fort said he would check on her, and
notified the nursing home he was com-ing.
When he arrived he found not one but
14 patients waiting to see him. The
nursing home staff had collected them
together, hoping the doctor would see
them while he was there.
Fort was examining them when the
director of a nearby nursing home
dropped in. He had heard a doctor was
in the neighborhood. Would the doctor
stop by and see his people, too, when he
finished there?
Before returning to the medical school
that day, Fort saw or checked the charts
of about 30 people in the two nursing
homes.
He told his colleagues about the ex-perience.
"It seemed to us there was a large
number of patients in the community
who must rely on LSU Medical Center
for their care," he said. "We are their
doctor. We must take care of them.
"Some of us were talking about it ....
Could we respond? We went to the
administration about it."
Subsequently, administrators of other
Shreveport hospitals sat down with
Dean Ike Muslow of LSU Medical School
and Associate Administrator Robert C.
Hall of LSU Hospital and members of
the faculty and staff to air the problems
of the sick elderly.
What are these problems?
• Not enough doctors willing to see
patients in the nursing homes, said Fort.
("Some homes have a problem get-ting
doctors to come to their patients,"
said Alvin T. Birkelbach, manager of
the Guest House. "Some have a consult-ing
doctor who will come at least once a
week, but not all do.")
("We live in horror of something
happening to Dr. Hawkins," said Ralph
Balentine of Shreveport Manor. Dr. I.L.
Hawkins, a general practitioner, re-sponds
when called, said Balentine.)
• When nursing home residents re-quire
laboratory tests or hospitalization,
they must go to LSU Hospital because
most are on Medicare or Medicaid.
Some cannot go to a doctor's office for
lab tests because they don't have the
money, said Fort.
• "When they get to LSU, they have
long waits because of administrative
delay — the paperwork processing," he
said.
It became evident, then, that LSU
provides most of the lab, emergency
and hospital services to nursing home
residents.
"So we decided that, though LSU
doesn't have enough doctors to send to
the nursing homes, we could at least
make it simpler, faster for these people
to get treated," said Fort.
LSU then set up a meeting with man-agers
of the nursing homes. Out of that
September meeting (hailed by nursing
homes for opening sorely needed lines of
communications) came a proposal and
a partnership.
Now LSU Hospital and the nursing
homes are testing a plan they hope will
expedite the hospitalization of patients
from the nursing homes.
Both seek to eliminate prolonged wait-ing
for the sick elderly. Together they
are trying to ease the admission process
by pre-registering these patients.
A questionnaire is getting a trial run
in two nursing homes chosen by the
liaison group, a committee of nursing
home managers.
At Roseview Nursing Center and Mid-way
Manor, the pink form is being filled
out in advance so it can go with a patient
to the hospital. It provides information
the hospital needs for admitting these
patients. Its color distinguishes them
from other patients.
"The patient forms will come in with
the patients and we'll send it back with
them," said Fort.
He said LSU Hospital and the nursing
home committee want to "iron out any
bugs" before placing the questionnaire
in other nursing homes. The aim is to
pre-register nursing home residents
throughout the hospital's patient shed
area.
The physician said they also plan to
spare the elderly the exhausting
transfers from nursing home to the
hospital for laboratory tests. These are
particularly hard on nursing home resi-dents
in outlying towns, he said.
"Why should they have to come to the
hospital for blood tests when blood could
be drawn in the nursing home and
brought to the hospital?"
"Obviously, we want to recruit prima-ry
physicians who will be available to
see these patients — in the nursing
homes," he added. "LSU will provide
doctors, too."
Meanwhile, the medical center is look-ing
into the possibility of obtaining re-search
funds for a demonstration pro-gram
wherein strategies for more com-prehensive
care of the sick elderly could
be developed. Fort said a pilot program
could address some of their special
needs, such as medication, physical
therapy, occupational therapy and psy-chological
support.
"We don't want to raise the expecta-tions
of the nursing homes that we are
going to solve their problems im-mediately,
but we can work together to
alleviate them."
In the meantime, the joint effort
seems to be drawing them closer togeth-er
in solving some of the misundertand-ings
which have plagued both.
Although one nursing home com-plained
of a "hassle to get a patient in
LSU," others were saying relations with
the hospital are better than ever.
"There has been fault on both sides,"
said Birkelbach, regional vice president
of the Nursing Home Association. "I'd
be the first to admit that.
"There's been a lack of communica-tions
that has interferred with unity of
care. We know their problems now, and
they know ours."
Said Balentine, "I feel real good about
LSU right now."