Posts Tagged ‘coordinated care’

Foot Care for Seniors: 10 Important Tips

Proper foot care is essential for older adults to help prevent injuries, falls and complications from chronic conditions like diabetes.Proper foot care is essential for older adults because it can help prevent injuries, falls and complications from chronic diseases like diabetes. Learn how to properly care for your feet so they can continue to take you wherever you need to go.

1. Be good to your soles. As you age, the muscle tissue in your feet can thin and your nerves may not work effectively. This can lead to loss of feeling in your feet (neuropathy). Use a long-handled mirror – it will extend your reach several inches – to see what you may not feel. Examine the soles of your feet and in-between your toes every day for cuts, blisters, sores or any areas of skin breakdown from moisture. This is especially important if you have diabetes.

2. Choose the right footwear. Wearing the right footwear can help you keep your balance, prevent falls and reduce the risk of blisters and other injuries. Never purchase shoes that rub or slide around on your heel as you walk – this is a common way to develop blisters that can become more serious sores. Also avoid shoes that are too tight, slick on the bottom, have high heels or pointy toes.

If you have diabetes or neuropathy, talk with your doctor about prescription orthodics (supports or devices worn in your shoes). You may be eligible for custom othodics partially covered by Medicare.

3. Get the right fit. Here are a few suggestions:
• Visit the shoe store in the afternoon when your feet are slightly swollen from daily activities.
• Have a sales associate measure your feet so you can select the correct size. It’s normal for your feet to change sizes slightly as you age.
• Choose the shoe size that fits your larger foot (it’s common to have one foot that’s bigger than the other).
• Always try on shoes before you buy them to make sure they fit. A good rule of thumb: your toes should be half an inch from the tips of your shoes when you are standing.

4. Barefoot isn’t better. When going outdoors, always wear shoes (preferably closed-toe shoes) to prevent cuts, scrapes and falls. It’s also best to wear shoes as much as possible while indoors to protect your feet.

5. Keep your toenails in tip-top shape. Trimming your toenails correctly (straight across and no shorter than the tip of your toe) is key for preventing ingrown toenails. If you have diabetes or trouble reaching your feet, see a podiatrist (a physician who specializes in foot care), not a nail salon technician, for regular medical pedicures and nail trimming.

6. Get the blood flowing. As you age, you may have decreased blood circulation to your feet. To promote healthy circulation:
• Prop up your feet on a stool or couch when sitting down
• Wiggle your toes when you sit for long periods of time
• Stretch daily
• Give yourself regular foot massages
And, if you smoke, now’s the time to quit. Smoking can affect good circulation in the body.

7. Keep your feet dry. Change your socks regularly and make sure your feet aren’t damp from sweat or a shower before putting on your shoes.

8. …But not too dry. Keep your feet moisturized to prevent cracking, itching and calluses. Stick with gentle soap and apply cream or lotion daily after your shower or bath.

9. Fight fungal infections. Prevent athlete’s foot by wearing shoes that fit properly, changing your socks or stockings daily (or whenever they become damp) and applying foot powder each day. If you experience itching or burning, see your podiatrist for treatment.

10. Visit your podiatrist regularly for foot checks. Your podiatrist can catch problems like bone spurs, hammertoe, neuromas, bunions, warts, ingrown toenails or wounds before they cause more serious problems.

Would you like to find a podiatrist near you? Yes, I’d like to find one now. 

Top 10 Things Care Coordinators Do For You

Care coordinators are there to help you navigate the sometimes confusing world of health care so you can get and stay healthy, or manage chronic disease. Whether you are juggling multiple doctors’ appointments or returning to daily life after a hospital admission, staying on top of your health can seem like a full-time job. That’s where care coordinators come in. Care coordinators are registered nurses, social workers, health educators and case managers who help you manage your chronic health condition and stay in touch with you after a hospital stay or doctor’s appointment to ensure you have the resources you need to get and stay healthy.

Emory Healthcare provides care coordination services through the Emory Coordinated Care Center and Emory Healthcare Network Care Coordination.

Keep reading to learn the top 10 things care coordinators can do for you.

1. Help you set and meet healthy lifestyle goals. Care coordinators can work with you to set achievable health goals and prevent chronic disease, such as diabetes and heart disease.

“We use motivational interviewing skills, health education and lifestyle modification discussions to help patients to improve our patients’ knowledge and get them more engaged in their healthcare,” says Misty Landor, RN, MSN, CNS, ANP-C, manager of Emory Healthcare Network Care Coordination.

2. Keep you accountable to your goals. Your care coordinator may reach out to you on a weekly, monthly or quarterly basis depending on your health needs.

“We have a multidisciplinary team of that helps patients get the care they need in the time they have,” explains Landor. This team includes:

  • A registered nurse who serves as care coordinator or case manager to oversee chronic disease management
  • Licensed social workers who support patients with psychosocial needs, like transportation, caregiver support or mental health care
  • Health educators who work with people to develop healthy lifestyle goals
  • Care coordination associates who help patients schedule appointments, get prescriptions filled and complete referral forms

3. Connect you with a primary care provider. Care coordinators can help you find a primary care physician so you can see him or her when you have a health need, rather than visit the emergency department.

4. Help you manage chronic disease. “We bring patients with chronic diseases into our disease management program, which is run by a nurse practitioner,” says Varnette Robinson, RN, BSN, lead case manager at Emory Coordinator Care Center. “The disease management program covers diabetes, hypertension, chronic obstructive pulmonary disease (COPD), heart failure and chronic kidney disease (CKD). We also assist patients if they need wound care.”

5. Get your prescriptions filled. Care coordinators can help you get your prescriptions filled and will follow up to ensure you are taking your medications correctly.

“Many times, patients come back to the hospital because they were unable to get their prescriptions filled, perhaps because they didn’t have a caregiver or transportation,” says Robinson.

6. Schedule doctor’s appointments. A care coordinator can help you schedule doctor’s appointments at a time convenient for you.

7. Provide access to mental health care. Care coordinators are trained to identify patients with depression and anxiety, and connect them to mental health resources.

8. Find caregiver or home health services. “We follow patients after they go home and make sure they are connected to appropriate community resources as needed,” says Robinson. “We make sure they have good social support, transportation, food and medication. We go the extra mile to figure out what the patient needs.”

For example, if a patient is discharged from the hospital and does not have anyone to care for her once she is home, the care coordinator will connect her to a community resource that can provide in-home care until she is well again.

9. Prevent hospital readmission. “If the patient is in pain or having recurring issues, we can bring them in to the Emory Coordinated Care Center so they aren’t going to the emergency department. This prevents unnecessary hospital readmission. If we identify any issues during our calls, we bring them to the Center.”

10. Be a source of support. “We are there to support patients 100 percent,” says Robinson. “Getting them what they need when they need it is going to improve their quality of life. We are part of a support system to facilitate them living well.”

To learn more about care coordination at Emory, click here.

Aging Parents and Multiple Health Problems – Live Chat Takeaways

aging-parents-emailAs we age, the likelihood of developing multiple ongoing conditions increases. These problems can include high blood pressure, heart disease, diabetes, chronic obstructive pulmonary disease (COPD) and congestive heart failure, to name a few. On Tuesday, August 2nd many joined Anthony Nguyen, MD, Emory Healthcare Regional Medical Officer for the Emory Coordinated Care Centers, part of the Emory Healthcare Network Advantage program, to learn more about care coordination for aging adults, health management and how caregivers – and patients themselves- can  best communicate with their doctors.

Thanks to such a great turnout, we were able to answer quite a few questions that were submitted both prior to and during the chat. Below are some highlights from the live chat. View the full chat transcript here.

 

Question: Are there doctors in the metro area who offer comprehensive care for older adults?

Dr. Nguyen: All patients should have a primary care physician to help manage one’s overall care. A general internist or family practice physician may see a wide array of patients, including older adults. However, a geriatrician specializes in older adults who have multiple ongoing medical conditions and medications. Emory Healthcare has numerous geriatricians and primary care physicians in its network. It also has developed a new care model to assist its providers in delivering comprehensive care for older adults.

Visit emoryhealthcare.org/ccc to learn more about the Emory Coordinated Care Centers and the specific services available for aging adults.

 

Question: How do you work with in home care providers to assist with following your care plans?

Dr. Nguyen: There are many different types of in-home care providers. Home health providers are assigned by orders from a physician. In order to continue home healthcare services, there is communication between the home health agency and the primary care physician. Communication may come in the form of fax, letters, or direct phone calls. Here, the Emory Coordinated Care Center offers registered nurse case management to assist in carrying out patient care plans.

 

Question: A friend’s mom recently fell, and after the initial injury, it seemed like her health deteriorated rapidly. Why is that? How can I help my own parent avoid that?

Dr. Nguyen: It is more difficult for an older person to recover because of other possible underlying conditions they had prior to the fall. Immobility after a fall can also lead to slower recovery. The best ways to prevent a fall are to stay active. Depending on your health conditions, you may require balance exercises, appropriate assistive devices and making sure your environment is safe. Having your hearing and vision checked regularly could also help prevent falls.

 

Thank you to everyone who participated in our live chat. You can read the full chat transcript here and learn more about Emory Coordinated Care Centers below.

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Aging Parents and Multiple Health Problems – What Adult Children Can Do to Help

aging-parents-emailAs we age, the likelihood of developing multiple ongoing conditions increases. These problems can include high blood pressure, heart disease, diabetes, chronic obstructive pulmonary disease (COPD) and congestive heart failure, to name a few.

Multiple medical conditions also means multiple prescriptions, therapies and physicians, all of which can become confusing. Sometimes, they might seem at cross purposes as well.

Join us July 27, 2016, from noon to 1 p.m. to chat online with Anthony Nguyen, MD, Emory Healthcare Regional Medical Officer for the Emory Coordinated Care Centers, part of the Emory Healthcare Network Advantage program. Dr. Nguyen works with Emory primary care physicians and Coordinated Care Center staff to deliver continuous coordinated care to older patients.

He will discuss how caregivers – and patients themselves- can communicate with their doctors to help manage health conditions like

  • High Blood Pressure
  • Diabetes
  • Anticoagulation Therapy Program
  • Congestive Heart Failure
  • COPD

He will also explain the therapies, services and treatments offered at the Coordinated Care Centers that can help with this more intensive health management, including:

  • HealthStart assessments
  • Fall prevention
  • Medication management
  • Nutrition advice
  • Smoking cessation programs
  • Behavioral health support

During this chat, you’ll be able to ask questions and get real-time answers from Dr. Nguyen. Register now for our July 27 chat at emoryhealthcare.org/mdchats.

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Coordinated Care Centers: A New Care Model for Older Adults

Emory Coordinated Care Centers promote wellness in older adults. The goal of the care center model is to educate patients and promote quality of life.Leaders from Emory Healthcare and California-based Caremore published an article in NEJM (New England Journal of Medicine) Catalyst presenting early results and highlights from the coordinated care program both company’s worked to launch in August 2014.

So what is a coordinated care program?

Coordinated care programs seek to streamline healthcare for older adults. As people age, they may find themselves juggling multiple doctors’ visits, chronic disease treatment plans and a number of daily medications.

To simplify this process, the Emory Healthcare Network opened two Emory Coordinated Care Centers, as well as several satellite locations, which use multi-disciplinary health care teams to improve quality of life for its patients. These centers are part of Emory Healthcare Network Advantage, a program that focuses on high-risk Medicare Advantage patients who either have, or are at risk for, chronic health problems such as diabetes, congestive heart failure and chronic obstructive pulmonary disease (COPD).

“The goal of the Emory Coordinated Care Centers is to promote wellness in the older patient population,” says Anthony Nguyen, M.D., regional medical officer at Emory Healthcare. “Many older patients have multiple chronic diseases that affect their health over time. With many different medical problems, medications and providers, it may become difficult for a patient to understand everything that is happening with their health.”

A New Approach to Health Care

“Often times, patients have many medical conditions and require care from multiple physicians,” says Dr. Nguyen. “Unfortunately, it’s common that patient care becomes fragmented. The Care Center team works to bring all of the patient’s information together.”

He adds, “The coordinated care center approach is different from the standard model of care because it focuses on the continuum of care. Our goal is to educate patients to be active in their own wellbeing to promote quality of life.”

Many of the services in the Care Centers are provided at low or no cost to patients to remove barriers to care. The model promotes preventive and proactive care rather than sick or reactive care.

Nearly a dozen programs are offered at the centers, including Healthy Start , a comprehensive assessment that identifies a patient’s health risks. Each of the programs supplement care patients receive from their PCPs and specialists.

The Coordinated Care Teams

The coordinated care teams include medical professionals who educate patients and help them manage conditions such as diabetes, hypertension or heart failure. This team includes:

  • A physician
  • A registered nurse outpatient case manager
  • A social worker
  • Advanced care providers, such as nurse practitioners and physician assistants
    Staff at Emory Coordinated Care Centers get nearly two months of comprehensive, interdisciplinary training.

“To provide the best patient experience and great clinical outcomes, everyone must work together,” explains Dr. Nguyen.

“The care center works very closely with a patient’s primary care physician to ensure we have the same goals for their care,” he says. “The coordinated care center model works collaboratively with the primary care physician and everything we do in the Care Center is communicated back to them. We don’t replace the primary care physician, but rather supplement their care.”

Once patients are part of an Emory Coordinated Care Center program, the team follows up with them on a regular basis by phone and schedules Care Center appointments as needed.

“If the chronic diseases are managed well, the rate of disease progression may be slowed, leading to a higher quality of life,” says Dr. Nguyen.

How do people become patients

Patients who already see a primary care doctor in the Emory Healthcare Network and are members of a participating Medicare Advantage plan can talk to their physicians about the program or simply call to make an appointment for a HealthyStart.

In addition, Emory Healthcare Network patients may be referred to an Emory Coordinated Care Center by a physician who cared for them during a hospital stay

Read about the early results of this model at the Emory News Center.