The practice of geriatrics: specialized geriatric programs and home visits

Area of Science:

• Geriatric Medicine
• Psychiatry
• Home Healthcare

Background:

• Home visits have a historical presence in geriatric care.
• Specialized geriatric programs and physician home visits are established models of care.
• Evidence for the effectiveness of these programs requires further investigation.

Purpose of the Study:

• To review the literature on home visits conducted by geriatric medicine or psychiatry specialists and specialized programs.
• To identify lessons learned from existing research on geriatric home visits.
• To propose draft recommendations for specialized geriatric home visiting programs in Canada.

Main Methods:

• A narrative review of literature published between January 1988 and December 2008.
• Focus on studies involving home visits by geriatric medicine or psychiatry specialists or specialized programs.
• Synthesis of findings to inform recommendations.

Main Results:

• The reviewed literature on geriatric home visits was sparse and presented inconsistent findings.
• Limited conclusions could be drawn due to the nature and quality of the available studies.
• The existing evidence base for specialized geriatric home visiting programs is not robust.

Conclusions:

• The current body of evidence on specialized geriatric home visits is insufficient to draw firm conclusions.
• Further research is needed to establish the efficacy and optimal implementation of these programs.
• Draft recommendations are presented for the future development of specialized geriatric home visiting programs in Canada.