Wishard Volunteer Advocates Program: An Intervention for At-Risk, Incapacitated, Unbefriended Adults

Robin Bandy, Greg Sachs, Kianna Montz, Lev Inger, Robert W. Bandy, Alexia Torke

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Unbefriended, incapacitated individuals who lack surrogates to make medical decisions present a complex problem to the healthcare providers who treat them. Adults without surrogates are among the most vulnerable in the community and are often alone and estranged from family, neglected and abused, and at risk of receiving inappropriate medical treatment. This article describes the program model and outcomes for the first 2 years of the Wishard Volunteer Advocates Program (WVAP), a guardianship program using trained, supervised volunteers as surrogates for unbefriended, incapacitated individuals. Of the 50 individuals enrolled during the study period, 20 were female, and 39 were Caucasian and 11 African American. Their average age was 67. Nineteen were insured with Medicare as primary and Medicaid as supplementary insurance. Ninety-eight percent had four or more comorbid conditions at the time of the index hospitalization. Before program referral, many lived alone in unsafe conditions. Adult Protective Services was involved in almost half of the cases at the time of the index hospitalization. Approximately half of the participants required some type of property management. Healthcare usage data demonstrated that most were not receiving medical care before WVAP enrollment; the data indicated a decrease in emergency department visits and hospitalization after WVAP enrollment. The WVAP completed Medicaid applications for 12 participants, resulting in $297,481.62 in reimbursement for the index hospitalization and a payer source for subsequent hospitalization and long-term care. The volunteer advocate model provides an efficient and quality mechanism for providing unbefriended individuals with surrogates.

Original languageEnglish
Pages (from-to)2171-2179
Number of pages9
JournalJournal of the American Geriatrics Society
Volume62
Issue number11
DOIs
StatePublished - Nov 1 2014

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Volunteers
Hospitalization
Medicaid
Long-Term Care
Medicare
Insurance
African Americans
Health Personnel
Hospital Emergency Service
Referral and Consultation
Delivery of Health Care
Therapeutics

Keywords

  • guardian
  • incapacitated
  • unbefriended

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Wishard Volunteer Advocates Program : An Intervention for At-Risk, Incapacitated, Unbefriended Adults. / Bandy, Robin; Sachs, Greg; Montz, Kianna; Inger, Lev; Bandy, Robert W.; Torke, Alexia.

In: Journal of the American Geriatrics Society, Vol. 62, No. 11, 01.11.2014, p. 2171-2179.

Research output: Contribution to journalArticle

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