Return of the house call
Yes, this doctor makes house calls.
Since St. Mary's Innovis Health launched its new Department of Geriatric Medicine, Older Adult Services Program last fall, Dr. Bill Henke has been making regular calls to visit his patients at area nursing homes, assisted living and senior housing facilities.
Henke, a 27-year resident of Detroit Lakes, is a primary care physician with special certification in geriatric care from the American Board of Family Medicine and the American Board of Internal Medicine.
"It gives me an opportunity to look at the patient within their place of residence -- how they interact with their surroundings, and how safe it is," he said. "By meeting them on site, you get a sense for why it might be difficult for them to comply with some of the treatment measures we try to initiate (at home).
"It provides really good insights as to why these treatments sometimes fail," he added.
A lack of available support from friends and family, social isolation and depression and poor nutrition habits are just a few of the contributing factors.
Once Henke has met with the patient, he will work closely with their regular physician to identify problems, and make future clinic visits "more efficient, and thus more effective," he added.
As a specialist in the field of geriatrics, Henke is very aware of the statistics: By the year 2030, roughly 20 to 30 percent of the U.S. population is expected to be over age 65. In Becker County, he said, the ratio is on the higher end of that scale, between 27-30 percent.
By contrast, the number of health care providers specializing in geriatrics is expected to decline over the same period of time from "one geriatrician for every 5,000 people over age 65," Henke said, to one for every 7,000-8,000 people.
"Historically, the elderly have been underserved as they age -- when (medical) needs are significantly increased," Henke said. "Both St. Mary's Innovis Health and myself felt we needed to prepare a response (to those needs)."
Thus, the new Older Adult Services program was born. Henke joined forces with psychologist Dr. Jon Aligada -- a 2009 graduate of the locally-based Minnesota Consortium for Advanced Rural Psychology Training -- to provide a broad range of medical and mental health services aimed specifically at older adults.
The Older Adult Services program is "all-encompassing," and includes such functions as coordinated care, chronic disease management, advance directive planning, psychology services and home safety, Henke noted.
Besides the House Call program, Henke also provides services such as geriatric assessments and consults; chronic disease education and management; home safety assessment and fall screening with ongoing management, in conjunction with therapy professionals; development or updating of health care directives; and medical oversight of the Eldercare program.
Dr. Aligada, meanwhile, focuses on providing services such as early detection of Alzheimer's; ongoing assessments of patients diagnosed with dementia, Alzheimer's and "other concerns"; counseling for depression, anxiety, stress or bereavement; counseling of families related to those with dementia or Alzheimer's disease; and assistance with power of attorney and advanced directive planning.
Dr. Aligada also makes "house calls" to patients living within the SMIH campus, at Winchester on Washington, Lincoln Park and Oak Crossing.
The Eldercare program, Henke noted, specifically focuses on care coordination for the "frail elderly," or those with multiple chronic illnesses and health issues. Patients in this program are all Medicare and medical assistance eligible, he added.
"The goal of the program," Henke said, "is better health."
Ultimately, it is hoped that patients will experience fewer visits to the emergency room, reduced and shorter hospital stays, fewer falls, and general assistance with health care needs.
As medical director at both the Oak Crossing (operated by SMIH) and Emmanuel Community nursing homes, Henke works with their transitional care units to rehabilitate their elderly patients "to the highest level possible," he said.
"People are coming out of the hospital more ill and with greater rehabilitative needs," Henke said, noting that the transitional care units have "picked up the slack" for the hospital in providing for those needs.