Pamela D. Wilson - The Care Navigator

The current state of the economy has everyone concerned. Whether it’s about the banking system, the automobile industry, the price of gasoline or healthcare, the issues are plenty. It’s clear we can’t rely on a healthcare system that needs an overhaul. While the incoming 2009 administration favors leaving “Medicare intact for older and disabled Americans” it also promises “to guarantee affordable, accessible health care coverage for all Americans.” Considering that the current Medicare hospitalization system (Part A) will be out of funding in 2019 and the current Medicaid system is overburdened because Americans have been taught to “rely on the government”, this guaranteed promise is nearly impossible without increasing taxes. And since there is difficulty administering the current government plans while keeping costs in check, how can the government proceed to initiate new plans without fixing the current system? More campaign promises unfulfilled.

We all read stories in the newspaper or see them on the news, but when they become personal they become real. Last week I gained exceptional clarity about the difference between “hearing” a name and talking about a situation versus actually “meeting” a person and learning about the situation. Admittedly I do a significant amount of both in working with my clients, however for some reason this particular case became especially relevant. Perhaps it’s because the individual involved is 25 years old and demonstrated exceptional grace, humor and humility in the midst of an exceptionally difficult situation. The level of involvement and empathy is so much greater when one directly experiences the situation of another. This is how we become advocates for whatever cause we choose to support. What interests you, what are you willing to advocate for?

We can never be too educated. Admittedly it’s difficult to be educated on every subject. That’s why there are experts for certain issues: physicians, attorneys, financial planners, dentists etc. Even at this level of education, questions still arise. It’s always good to ask questions even of the experts. How else to become better educated by someone with a high level of education? Look at this relationship as an opportunity to learn more. As I’ve mentioned previously I recently became the State Policy Liaison for the Patient Advocate Foundation. I’m an expert in aging and healthcare but not in politics. One of my role as SPL is to contact government officials to advocate on behalf of the foundation. I called a colleague I know who knows someone else who spends time working with lobbyists in Washington D.C. We’re having lunch in a couple of weeks so that I can learn from an expert and utilize my expertise in navigating health care to support health care issues in the scope of the larger community.

Trying to change a habit can be difficult and almost impossible. Unless there is significant motivation and determination, the change either rarely occurs or is short lived. I have a client who wants to exercise. This woman has been healthy and active all of her life and she was recently diagnosed with Parkinson’s. This has resulted in a change in mobility that requires her to “work” to remain active. All her life she has gone to the gym to exercise and she currently doesn’t belong to a gym so she is having difficulty exercising. She is also embarrassed about her physical appearance in going to a gym for exercise. While she sees the need to go to the gym for exercise she is embarrassed people will stare at her. After doing research we discovered that many recreation centers have sit and be fit programs, water exercise and other programs for disabled people that would make her comfortable and not feel like someone who had to be watched. She is going to try to make this new habit a routine so that she can maintain her physical mobility and health as long as possible.

People with special needs require special care. For those of you who know an individual with dementia, Alzheimer’s or memory loss you know or have learned that there is a knack to providing care for individuals with this diagnosis. Reasoning and directing usually doesn’t work. Persons with brain injuries also require special care and have different needs especially in the event of a hospitalization or nursing home stay. The majority of staff are taught to work with the general population who is cognitively aware and generally able to describe and care for their own needs. Special populations often cannot express their needs and have needs they cannot describe. If you have a family member in this situation be sure to talk with the staff and if possible request persons who have experience with Alzheimer’s or brain injury. If this cannot be accomplished you’ll want to spend as much time at the hospital or nursing home as possible or relocate your family member to a nursing home with a memory care unit. The difference in the care and treatment your loved one will receive is day and night. There is a knack to providing care.

I recently accepted the position of State Policy Liaison for the National Patient Advocate Foundation. This is a simple way of saying that I’m taking a stand for individuals with insurance and healthcare access. Those of you who know me know that I love to educate and speak in front of groups. Give me an hour and I’ll fill the time. The Patient Advocate Foundation or PAF provides services to patients AT NO COST. Really, at no cost for individuals without the ability to pay. If you have money then you don’t usually have insurance premiums or co-pays that you can’t pay. You probably haven’t lost your job because of health issues. You probably don’t have problems accessing health care. Almost everyone knows someone who is struggling financially with healthcare. Pass this information along to anyone you know and have them call 1-800-532-5274 for additional information or visit http//www.patientadvocate.org

I recently went to a presentation by a local physician about delirium. He discussed the high percentage of persons recovering from surgery who fall into this state, about 40% on average. He also mentioned that the geriatric population and individuals with any type of brain injury are more susceptible to delirium. Probably the most important fact in his speech was that delirium is mainly caused by outside agents i.e. medications and the sooner this fact can be diagnosed and addressed the better the patient will fare. Statistics show indicated a 25% increase in mortality over a 3 month period from a person who suffered from delirium and a 50% increase in mortality over a period of one year. His presentation was so interesting and appropriate that I’m seeing him tomorrow. Not for myself but for one of my clients I suspect is on too many different medications that are wreaking havoc with wake, sleep and activity patterns. This will be my opportunity to see first hand how this doctor treats patients and the outcomes and a great way to determine how many of my other clients might use his services.

If you haven’t already, it’s time for the annual flu shot. I always say a small stick in the arm is better than a night praising the porcelain god. The last time I had the flu, which thank heavens was years ago, I wished I was dead. Anyone who has gone on a recent drinking binge and experienced flu-like symptoms knows what I’m talking about. It’s miserable regardless of the source of the upheaval. By getting vaccinated you’ll not only be doing yourself a favor but a favor to your family and the many others you come in contact with over the coming winter. I’ve gotten vaccinated for at least the past ten years and, knock on wood, remain healthy all winter. It’s an old wives tale that by getting a flu shot you get the flu. If that was true, everyone would be buying a lottery ticket and winning. And remember, wash your hands frequently. Most contagious illnesses are transferred by hand to face or hand to mouth contact. Be healthy not heaving this flu season.

I’ve recently met a few older adults who find themselves in a great deal of pain every day and all day. Their greatest concern is taking and becoming addicted to medication. However many of them can barely get out of bed, walk up and down steps, make breakfast without a great deal of pain that I’m told is a 9 on a scale of one to ten, ten being unbearable. So I ask why? Many don’t know that there are pain management specialists. Sure this involves yet another trip to see yet another specialist. But why, I ask, live in constant pain. I would not only be grumpy, irritable, and angry but my husband would probably throw me out of the house for constantly complaining. Ask your general practitioner to refer you to a pain management specialist. Yes, you’ll likely get a prescription for some type of medication, but only after extensive testing to determine the source of the pain and the best course of action. As always there are better pain management physicians than others, ask for a couple of referrals and then make your choice to be pain – less or pain free.

Due to the recent economic downturn, many individuals are putting off routine medical visits. While this is understandable, buying groceries or making a trip to your doctor for what you only see as “bad news” is a tough choice. If you really sense something is wrong and you haven’t been feeling well, don’t delay the medical trip. Catching an early diagnosis of an illness versus later can be the difference between life and death. And as humans, we usually imagine things to be much worse than they are, so why worry? Worry itself causes additional stress and health problems. Get thee to thy physician!