Biomedical subjects

E R Florio

Publications and source records attributed to E R Florio.

5 recordsLinked to original sources

PubMed1998

The gatekeeper model: implications for social policy.

One of the most important needs of an aging population is to insure that older adults are able to live as independently and safely as possible. The question for social policymakers is how to meet this goal in an era of shrinking resources and growing numbers of older adults. The Gatekeeper Model is highlighted as a method to insure that older adults at risk of problems that impact their ability to live independently can be helped by existing systems of care. The model trains employees of community businesses and corporations who work with the public to serve as community gatekeepers by identifying and referring community-dwelling older adults who may be in need of help. A research project was conducted at Spokane Mental Health, Elder Services Division, where the model was developed. The results indicate that community-based gatekeepers found 40% of clients. Gatekeepers find a distinct population of community-dwelling older adults who are not found by more traditional referral sources. The social policy implications of the Gatekeeper Model are discussed.

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PubMed1998

One-year outcomes of older adults referred for aging and mental health services by community gatekeepers.

One-year outcomes of older adults referred for community aging and mental health services through the Gatekeeper Model were examined in this study. Outcomes included level of social, physical, psychological, and economic isolation, physical health problems, service need, and service utilization. Findings indicate that individuals referred by gatekeepers were more likely to live alone and to be socially isolated but less likely to have physical health problems. They were also less likely to have a physician at referral, but at 1 year this difference was not found. Cognitive problems had a significant impact on the lives of clients referred by gatekeepers at referral but not after one year. At referral, those referred by gatekeepers had greater service needs, but after 1 year they did not use more services than those referred by other sources. Implications of these findings are discussed. The findings from this study indicate that the adoption of the Gatekeepers model does not result in high service utilization. The Gatekeeper model is inexpensive to implement and can benefit communities through increased collaboration among service providers.

Activities of Daily Living↗

PubMed1997

A comparison of suicidal and nonsuicidal elders referred to a community mental health center program.

Sociodemographics, clinical characteristics, and life stressors of community-dwelling suicidal risk and nonsuicidal risk elders referred to a community aging and mental health provider were compared in this study. Information was collected through case manager surveys and agency records on 683 older adults referred to the Elder Services Program of Spokane Mental Health in 1994 and the first 6 months of 1995. This sample included 109 individuals who were clinically judged to be at suicide risk by case managers at the time of initial assessment. Comparisons between suicidal risk and nonsuicidal risk elders indicated that suicidal elders were younger, more likely to be separated or divorced, and more likely to report a previous history of suicidal behavior. Results of a logistic regression analysis indicated that living alone, depression or anxiety disorder, and higher levels of emotional disturbance predicted suicide risk status. In addition, medical problems, family conflict, and relationship loss predicted suicide risk status in this particular sample. Individuals at suicide risk were also more likely to have a family physician than others. Implications of findings for identification and treatment of suicidal elders are discussed.

Age Factors↗

PubMed1996

Pharmaceutical care for home-dwelling elderly persons: a determination of need and program description.

To determine the need for pharmaceutical care services within a community-based, case management program for elders, an assessment of medication, health, and functional status was completed by a pharmacist on 49 home-dwelling older adults. The goal of this assessment was to support the need for pharmacists as members of multidisciplinary teams that provide comprehensive, in-home care for elderly persons. Pharmacists can identify drug misadventures that have the potential to lead to loss of independent living status, hospital admissions, and death. This article describes this program and the results of the assessment that supported the decision to include a pharmacist on the multidisciplinary team.

Activities of Daily Living↗

PubMed1996

A model gatekeeper program to find the at-risk elderly.

This article describes the client characteristics and services needs of community-dwelling older adults found through a unique case-finding model developed at the Spokane Mental health Center. The model trains the employees of community businesses and corporations who work with the public to serve as community gatekeepers by identifying and referring community-dwelling older adults who may be in need of aging and/or mental health services. These community case-finders perform a gatekeeping function for older adults that is similar to that performed by schools and the workplace for younger persons. Information was collected on 777 individuals aged 60 and older referred over an 18-month period (January 1, 1994, to June 30, 1995) to the Spokane Mental Health Clinical Case Management Program in Spokane, Washington, which provides aging and mental health services to older adults residing in the county. Findings indicate that 40% of clients referred were found by community-based gatekeepers. Clients referred by gatekeepers were more frequently socially isolated, economically disadvantaged, and less likely to have a physician. Gatekeeper clients were also more likely to be women and to be younger than others referred to the agency. Gatekeeper clients were receiving fewer services at referral and were identified as needing more services at intake. Gatekeepers find a distinct population of community-dwelling older adults who are not found by more traditional referral sources. The need to integrate this model within a comprehensive clinical case management system is discussed.

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