Adult Day Services, Addressing and Treating Multimorbidity
Amanda Graham Sillars, MSW, LCSW
ADULT DAY SERVICES, treating patients through the utilization of a multidisciplinary team and multiple daily interactions, is perfectly poised to address the numerous health needs of those in the community who suffer from multimorbidity. Ultimately not only saving lives but potentially billions in health care dollars.
Multimorbidity is defined as the co-existence of two or more long-term health conditions. In the past ten years researchers and physicians have begun to realize that the modern western medical approach, which tends to focus on a single disease, is not an adequate model to use to treat patients. In attempting to treat each problem as separate from another while ignoring (or further treating) the exponential effect two or more chronic conditions have on one another has both a detrimental effect on an individual’s physical health and utilizes an enormous amount of our health care dollars. Multimorbidity is significantly associated with higher mortality, increased disability and functional decline, in fact 68% of Medicare spending goes to people who have five or more chronic diseases.
When considering the complex number of interactions that occur in co-existing diseases, it is obvious that a medical approach that is focused on a single disease, will not suffice. Many elderly are being treated by multiple physicians and take over ten medications per day, prescribed by different doctors who may be unaware of other medications patients are taking. Despite the complexity of care that those with multimorbidity require, few health care providers have or take the time to look at the big picture to help ensure that the elderly are provided the most cost effective and best care.
“As our population ages, we need some kind of overseer to juggle all the diagnosis and prescriptions and look for conflicts and duplications.” stated a multimorbidity sufferer who takes almost a dozen pills a day, as ordered by six physicians. Adult Day Services provides that oversight. Each health care center employs at a minimum an RN who reviews medications for conflicts and duplications. Some state’s regulations require a pharmacist to review each participant’s medication list for duplications and negative interactions as well.
Adult Day Services, offering a multidisciplinary, “whole person” approach to care is the perfect antidote to overworked physicians and an overtaxed health care system, providing daily observation and care for those suffering from multimorbidity, including medications, health complications and emotional conditions, not just one individual diagnosis at a time.
In this series of blog entries, I will address some of the more common co-existing diagnosis in the elderly and those seen in Adult Day Services, discuss possible multi-disciplinary treatments in order to shine the light on the extreme health and fiscal benefits that Adult Day Services offer to the communities and the States in which they operate.