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York Hospital Increases Services for Older Adults



YORK — In order to increase services for elders in its coverage area, York Hospital has created the Center for Older Adults with geriatric specialists providing comprehensive care in its new clinic and house calls to those who cannot make the trip to see their primary care physician for a variety of reasons.

The Center for Older Adults opened in February and soon will be increasing clinic hours to two days a week, said Dr. Elizabeth Castillo, a hospitalist and geriatric specialist working with geriatric Nurse Practitioner Barbara Roberge and Nurse Practitioner Erin Morgan, who has been conducting home visits for the Older Adults House Calls Program since November.

“This home visit program is something old that is new again,” said Morgan. “I know in the past doctors often made house calls and it may have been the majority of their work. Now there is a focus on having physicians and nurse practitioners to get back in the home. It’s a bit of a trend.”

There is an important distinction between this program’s house calls and home nursing visits that have existed for decades for those patients being released from the hospital. Morgan, as a nurse practitioner, can diagnose, prescribe, order laboratory tests, similar to the services doctors and nurse practitioners offer in office and clinic settings.

“So, it’s like they are going in to see their physician or nurse practitioner in the office but I’m coming to their home instead,” Morgan said. “I work in collaboration with the primary care physicians, working on the same medical record and working together on a plan of care for the patients.”

Patients are referred to Morgan by their primary care physicians when they have some acute medical concern, but it is difficult to physically get into the doctor’s office due to a fall, trouble walking or mental or memory challenges.

“We do not handle urgent care situations because patients need to wait 24 to 48 hours to be seen. If it’s an emergency, they need to go to the ER,” said Morgan, who has been doing home visits in Massachusetts as a geriatric nurse practitioner and is thrilled to work in York, where she grew up.

The focus on elder care is new to York Hospital and is a result of Dr. Castillo’s arrival last fall. She moved to York from North Carolina with extensive training and experience in geriatric medicine, said Jody Merrill, York Hospital’s lead of marketing.

“Leadership recognized that there is a significant need in the area for specialists in geriatric care,” Merrill said.

The Center for Older Adults provides comprehensive outpatient consultations for older adults who need more time or more frequent visits than a regular primary care visit. Castillo and Roberge stay in close contact with the patient’s primary care provider while an interdisciplinary team of medical, nursing, rehabilitation, nutrition, pharmacy and behavioral medicine is available for those older adults who have experienced some decline in the past year and have been referred for this service.  Read the full article