A team approach to geriatric case management.

Providing high-quality, comprehensive care for elderly Americans is becoming increasingly challenging because of the aging of society, the shortage of primary care physicians, and rising health care costs. These trends are encouraging health care delivery systems to adopt alternative models of patient care. This article reports on one such model, the complementary practice model, which incorporates a team approach to geriatric case management. The complementary practice model targets the frail elderly who are near the end of life, or are at highest risk for either hospitalization or cognitive decline. It includes a diverse, multidisciplinary team to provide patient care by involving the patient, family, physician, nurse practitioner, social worker, and registered nurse as core team members. This team approach assesses and identifies patients' problems, utilizes the expertise of multiple health care disciplines, and encourages patients and families to be active participants in developing and implementing the case management plan.