BEHAVIORAL HEALTH AND DELIRIUM

The goals of the Behavioral Health Grand-Aides program are similar to the goals of the Chronic/transitional Grand-Aides program. In addition to completing questions about physical conditions they also ask questions/scales related to mental health symptoms, cognition, social resource needs and caregiver availability. Medication reconciliation, teaching and monitoring medication adherence are also performed at each visit. Visit frequencies are similar to other Grand-Aides programs beginning with 3-4 visits during the first week of program enrollment and decreasing each week based on patient condition which is determined by medical team.

In one program the first twenty-five patients seen in the home were taking medications incorrectly, and other discrepancies were found. Examples of medication related issues identified during home visits include no prescriptions, limited transportation to pharmacy, limited funds to purchase medications and adverse effects. The program has affected patients in unexpected ways, including referring an actively suicidal patient to a psychiatric hospital, identifying a possible gastrointestinal bleed in a patient on an oral anti-coagulate, hyperglycemia on patients taking antipsychotics and elder abuse by families.