Sarah Thach Steers Preventative Care for the Elderly

In western North Carolina, the number of adults aged 65 and over is expected to double in the next 40 years, becoming the largest demographic by 2030.

Sarah Thach, a Bernstein Fellow alumni, helps pilot programs aimed at helping primary care doctors prepare for the influx of elderly patients. “We are never going to have enough geriatricians so it falls to the primary care doctor to manage care for older adults.”

Care for the elderly requires a team-based approach. As our population ages, the framework for care delivery will adjust to include communication among a team of professionals including nurses, physician assistants, pharmacists, and behavioral therapists.

One of Thach’s areas of interest is preparing doctors for a team-based approach to care delivery for aging patients. She works for the Center for Healthy Aging, a program of the Mountain Area Health Education Center (MAHEC) in Asheville, North Carolina.

Thach and her colleagues hosted focus groups with primary care physicians in the region about the joys and challenges of working with the elderly. There was a constant theme—doctors need more time with elderly patients.

[box type=”bio”] Care for the elderly requires a team-based approach.[/box]

If an elderly patient visits the doctor because their shoulder hurts, then the doctor will address the shoulder, and may not have time to address the other needs of the patients. And elderly patients tend to have many health complications.

As we age, our illnesses tend to become more chronic and complex. Most of us will need more medication. “The average older adult is on eight medications,” said Thach. It takes time to help a patient manage their medications. To free up time for primary care doctors, Thach, along with her Bernstein Fellowship mentor Dr. Suzanne Landis and colleagues implemented a system of team-based care to increase the number of older adult patients receiving Medicare Annual Wellness Visits, an annual preventative care checkup for older adults. Nationwide, only 14 percent of older adults get this service, but MAHEC’s team has been able to reach 45 percent of older adult patients.  They have accomplished this by having a clinical pharmacist or a licensed practical nurse provide the visits and calling patients to invite them in for the visit. “Medicine is moving from reactive to proactive scheduling to enhance patient care,” said Thach.

These yearly wellness visits address preventive services, screening and vaccinations for the elderly, so that the primary care doctor can focus on acute and chronic needs, like a hurt shoulder.
“Doctors can focus on patients’ priorities, knowing prevention issues are being addressed by their colleagues,” said. Thach The Center for Health Aging also encourages older adult patients to think about and document their end-of-life preferences. “Most people don’t want to be on chemotherapy at the end of their life, and they want to die at home and not in a hospital,” said Thach. “And it’s helpful for families to know their loved one’s wishes, so it’s not all on them when the time comes.”

Thach recently graduated from the Foundation’s Jim Bernstein Community Health Leadership Fellowship, a program that engages emerging health leaders and encourages their work with funding and development training. The Foundation is proud to support innovative leaders like Thach, who champion new ideas and assist communities in cultivating better health outcomes.