Explain how care should be facilitated for the patient in the case you selected based on the model used for the interdisciplinary geriatric teams at your practicum site.

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Care should be facilitated for the patient selected based on the model used by the interdisciplinary geriatric teams at my practicum site by first developing a comprehensive care plan, identifying goals and objectives relevant to the patient’s medical, functional, and psychosocial needs. A team consisting of a physician, nurse practitioner, social worker, physical therapist and other healthcare professionals should collaborate to assess the individual’s condition and develop an individualized care plan that is tailored to his or her unique needs.

The team approach ensures that all aspects of health are addressed including complex medical issues, mental health issues such as depression or anxiety, mobility challenges due to physical impairments or frailty as well as social determinants of health like access to adequate nutrition and housing. After this initial assessment is completed it is important for teamwork members to come together on a regular basis during case conferences in order for them to stay updated about any changes in patient condition , review progress towards identified goals and make any necessary adjustments in their care plan accordingly. Other measures such as providing family education about disease process , medications , safety precautions etc can also help facilitate effective care .

Lastly providers must ensure that families have access to resources needed complete their daily activities ie transportation services which may enable them participate in follow up visits with their providers or attend community events which can improve quality of life.