Rationale
  • Caregivers are often put at a disadvantage by health care systems that aren’t sensitive to their needs. More recently, there has been an increase in the development of collaborative relationships across disciplines leading to integrated teams. These teams may be more sensitive to caregivers’ concerns and more receptive to their participation in treatment planning.
  • The Institute of Medicine in two recent reports, titled “Retooling for an Aging America: Building the Health Care Workforce (2008) and “The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?” (2012) states that family members should be included as part of the healthcare team.
  • Including caregivers would increase the healthcare team’s knowledge of patients’ backgrounds and living environments. This information would inform team decision-making regarding care.

Reference

Institute of Medicine (2008). Retooling for an Aging America: Building the Health Care Workforce. Retrieved Nov. 1, 2010, from www.iom.edu/agingamerica

Institute of Medicine (2012). The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? Retrieved from www.iom.edu

Model

The figure below illustrates a model including families into an integrated healthcare team and demonstrates the components of the model that are crucial for an effective team.

Interprofessional teams model

Electronic Medical Records and Interdisciplinary Care
  • Increasingly, healthcare settings are using electronic medical records (EMR) with patient and family portals to share health information between family members and healthcare providers.
  • In some settings, family members can access a portion of the electronic medical record (EMR), including a patient’s problem and medication lists and most recent laboratory findings, through the patient and family portal. They can also use the portal to send secure email messages to the healthcare team members that provide ongoing, real-time observations about the patient, as well as share information about what it is like to be a family caregiver. Those secure messages become part of the patient’s permanent medical record.
Resources for Teaching about Interprofessional Care Teams

A fact sheet developed by APA for Graduate Psychology Faculty and Training Directors on integrated healthcare teams for geriatric populations is available online (PDF, 2.58MB).

These suggested topics for teaching about caregiving for interprofessional teams are adapted from the 2008 report of the APA Presidential Taskforce on Integrated Health Care for an Aging Population, entitled “Blueprint for Change: Achieving Integrated Health Care for an Aging Population.”

  • The Broken Healthcare System for Older Adults
  • A Basic Model of Integrated, Interdisciplinary Healthcare
  • Knowledge and Skills that Psychologists Contribute to Integrated Healthcare
  • Principles of Integrated Healthcare
  • Interdisciplinary Collaboration in Diverse Sites of Care
  • The Older Consumer’s Perspective on Healthcare

Competencies have recently been defined to guide training in service delivery on interprofessional teams. The Interprofessional Education Collaborative released a report in May of 2011 that details those competencies: "Core Competencies for Interprofessional Collaborative Practice." (PDF, 1.15MB) 

In addition, the Interprofessional Professionalism Collaborative has a wealth of resources for use by educators across all health professions.

Reference

American Psychological Association (2008). Blueprint for Change: Achieving Integrated Health Care for an Aging Population. Retrieved November 1, 2010, from http://www.apa.org/pi/aging/programs/integrated/integrated-healthcare-report.pdf

Patient-Centered Medical Homes

The rise of the Patient-Centered Medical Home (PCMH) is a primary care model that emphasizes interdisciplinary care. Many organizations and family caregiver advocates are calling for family members to be considered lay members of the PCMH team. Benefits to the care recipient, caregiver, provider and health care system itself result from the incorporation of family members as part of the team.

References:

Wolff, J. L., Clayman, M. L., Rabins, P., Cook, M. A., & Roter, D. L. (2012). An exploration of patient and family engagement in routine primary care visits. Health Expectations, doi:10.1111/hex.12019

Wolff, J. L., Roter, D. L., Barron, J., Boyd, C. M., Leff, B., Finucane, T. E., ... & Gitlin, L. N. (2014). A Tool to Strengthen the Older Patient–Companion Partnership in Primary Care: Results from a Pilot Study. Journal of the American Geriatrics Society, 62, 312-319. doi:10.1111/jgs.12639