Mi Casa O Su Casa? Addressing Function and Values in the Home
University of Rochester School of Medicine and Dentistry
Described is a longitudinal home visit experience for medical students to increase knowledge of geriatric syndromes, functional assessment, end-of-life care, and home care. Materials include a student guidebook to direct a series of three house calls, a description of the write-up assignment, and a home visit pocket card.
Knowledge and experience in providing care to chronically or terminally ill homebound patients. Learners should be able to: 1) Identify appropriate patients for house calls 2) Perform in home functional assessments 3) Obtain a values and end-of-life care history 4) Gain knowledge and experience in providing care to chronically or terminally ill homebound patients.
Ideal patients are those with significant chronic or terminal illness, yet who are able to maintain an ability to articulate their "story" and values. Used with 360 second year medical students in the classroom and patients' homes.
Comments
This is an excellent guide to history taking in the home setting, and a sensitive introduction to functional assessment, symptom assessment, and interviewing about social/functional history in the older adult. Particularly in pre-clinical students who are learning "the full H&P", this could serve as a focusing exercise, affording the students the time to learn more about elderly patients, the importance of function, and means of providing for their functional deficits. This does not provide instruction in skills necessary for the functional assessment, nor does it touch on physical exam, but the knowledge/attitudinal focus would be terrific for pre-clerks or clerks early in the year.