What it involves
A continuous-care programme for older people living at home. The medical team knows their history, the family sees what the team sees, and decisions are made before problems grow.
What's included
- Quarterly home doctor visit, emergency or not
- Medication review every 6 months to remove what's unnecessary
- Nurse on demand: wound care, injections, catheters
- Alert button with an on-call doctor who already knows their history
- Panel shared with up to 4 family members
After the visit
The family follows everything from the panel: vitals, visits, care diary and alerts. The doctor and nurse write in the same place.