Incapacitated adults who may be living away from friends, family, or any type of social safety net face potential risks for abuse and neglect. For those individuals who may lack anyone who can help them make medical decisions and manage other crucial aspects of their lives, a volunteer “surrogate” may become a critical resource, and help maintain an optimum quality of life.

A study led by Robin Bandy, JD, MA, program manager and senior affiliate faculty, Charles Warren Fairbanks Center for Medical Ethics, that was published in the October 30 issue of Journal of the American Geriatrics Society explored the Wishard Volunteer Advocates Program (WVAP). The program is designed to be an intervention for incapacitated, unbefriended, at-risk adults. Some of the most vulnerable members of the community are individuals who fit this description. They are also at risk of receiving medical treatment that is in appropriate.

According to an abstract of the article, WVAP is a guardianship program using trained, supervised volunteers as surrogates for unbefriended, incapacitated individuals.

Study Findings

The research study included 50 subjects described as follows: 20 were female, 39 were Caucasian, and 11 were African American. The subjects’  average age was 67 years, and 19 were insured with Medicare as primary and Medicaid as supplementary insurance.

Among the study subjects, 98% were said to have had four or more comorbid conditions at the time of the index hospitalization. Before program referral, many reportedly lived alone in unsafe conditions. Adult Protective Services was involved in almost half of the cases at the time of the index hospitalization. Furthermore, it was reported that nearly half of the participants required some type of property management.

Healthcare usage data demonstrated that most study subjects were not receiving medical care before WVAP enrollment. The study data indicated a decrease in emergency department visits and hospitalization after WVAP enrollment. According to the study’s abstract 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 authors of the study concluded that the volunteer advocate model provides an efficient and quality mechanism for providing unbefriended individuals with surrogates.

Source: [Wiley Online Library]