Home Care Visits

What is your Concierge Service?

For home services, I go where the patient is.  This includes home visits for psychiatric care for adults with dementia with behavioral disturbance, cognitive impairment, depression and other lifelong chronic mental illness other than dementia. I visit patients in private homes, memory care units, assisted living, adult family homes, etc.  In addition to the general psychiatric assessment and care planning and implementation, I also assess the environment and the level of nursing care provided to identify adjustments that may decrease symptoms and improve the quality of life for the patient. 

I also offer home visits for adults who are not “older adults” who suffer from mental illness and co-morbid conditions that may impair their ability to leave their home to attend office visits or participate in telepsychiatry sessions.

I offer consultation for systemic assessments of overall care to determine “root causes” during acute crisis, for patients who are not thriving or may be rapidly deteriorating, facing eviction from a care setting because of behavioral disturbance, etc., in spite of what appears to be appropriate treatment plans. I assess the treatment planning and all aspects of implementation of the treatment plan, including medication regimens, nursing care plans, communication between the medical care providers, the care givers, the pharmacy and family members, as well as the overall stimulation of the environment where the patient resides, etc., and offer recommendations for improving the patient’s health and quality of life.

I offer consultation and care management for patients with a history of severe mental illness who are under guardianship and use my years of experience as an attending in inpatient psychiatric crisis intervention settings to help patients avoid crisis and avoid hospitalization.

How long are your home visits?

Initial home visits vary in length based on the patient’s ability to participate in an interview and the time that it takes for me to review available records.  I schedule 150 minutes for initial evaluations. Ideally, a family member or care manager is present to answer questions or has provided history in a pre-visit telephone call about the patient’s history and current condition and symptoms in cases where the patient is unable to provide history.

Follow up home visits vary in length and are initially scheduled for 60 minutes direct care time plus travel time .

Which treatments or services do you provide with your home visits?

Initial home visits include a general adult or geropsychiatric assessment which may take up to 2 and 1/2 hours, after which I offer therapeutic hypotheses and treatment recommendations/options which may include new medication, medication changes, lab requests, environmental adjustments, in some cases psychotherapy and anything from my body/mind/spirit knowledge base that may be relevant and helpful.

In follow up visits, I assess the patient’s response to previous interventions and make any adjustments that are indicated.

I’d love to hear from you. I try to respond to all inquiries within 24-48 hours, often on the same day.