Access to Care for Older Adults

1. Access to Care for Older Adults

2. I need help…..where do I go? Amarillo Resources Marge Dean, RN,CS-BC,GNP-BC,MSN West Texas A&M Nursing Program mdean@wtamu.edu

3. We will look at the following… • Finding a health care provider • Mental health assistance • Nursing home • Home health/Hospice • Other helpful resources

4. Navigating the Health Care System Health care reform may help….. Meanwhile?????

5. If you are lucky enough to have insurance…… • Know what your policy covers • What are your individual health care benefits • Save all of your healthcare bills and insurance records • Does this really cover all of your usual expenditures?

6. You or a designated other must be your healthcare advocate…. • Look into the hospitals and labs that you are referred to for procedures • Are they OK? Ask around…. • Did you get your test results back? • Did a healthcare professional talk to you about what the results mean? • Don’t be afraid to get a second opinion

7. Keep a medical record • We currently don’t have a national system of medical health records • You can keep a running record of what has happened to your health Immunizations illnesses Surgeries CT scan, MRI’s, DEXA Mammograms pap smear prostate exam lab tests

8. If you move…. • Get a copy of your medical record • HIPPA does not prevent you from getting a copy of your own record • Make a copy of these records for your own files

9. Communicate… • Talk to your healthcare team • The better they know you….the better your care will be • Write down questions and ask them • Take ALL your medications with you to the visit • Be honest about your “bad habits”

10. Best way….is the to stay out of the healthcare system STAY HEALTHY!

11. How? • Regular screenings Pap, mammogram, PSA, DRE, colonoscopy • Healthy diet • Regular exercise • Wash your hands • Take your prescribed meds as directed

12. How do I find a healthcare provider? Much easier if you have Medicare plus a supplemental insurance More difficult when only Medicare assignment

13. Finding a primary care provider? Why is this so difficult? Fewer available today Many don’t take Medicare Phone Book????

14. Who is taking Medicare? • Texas Tech Clinics • NW Senior Health Services/j O Wyatt Clinic • WTAMU Health Partners Clinic • BSA Family Clinic • Regence Health Network,Inc

15. Clinics with no appointment • BSA Urgent Care • Amarillo Urgent Care • United Bell and 45th Clinic (cash only)

16. Psychiatric Help…Day Programs covered by Medicare TPMHMR Adult Day Program NWTH Pavilion Day Program Jan Werner Adult Day Care (Alzheimer’s)

17. Psychiatric Help…In House covered by Medicare NWTH Pavilion Golden Phoenix (Pampa Hospital) Covenant Hospital (Plainview)

18. Pysch Care in the Home Accolade Home Health has RN’s with psych experience that provide in home care for elders living in the community

19. What other ways are there to find a Medicare provider? • Call: • Medical Society 355-6854 • NWTH Physician Referral 1-800-887-1114 • Medicare Physician Referral 1-800-633-4227 • Questions on Medicare file 1-800-999-1118 Internet: www.medicare.gov

20. What if you need a specialist? Usually you see the primary care provider first

21. OK….still not sureWho else can I check with? • You can ask trusted friends, family and neighbors • Call the Area Agency on Aging 331-2227

22. Served in the military? Amarillo VAMC life support (ER) primary care and specialty clinics hospital psych clinic/in house treatment Thomas Creek Nursing Home Ussery Roan Texas State Veterans Home

23. Who Else? Contact a Geriatric Care Manager Leticia Goodrich MA Goodrich Care Management Services 352-9956 lagoodrich@yourtexan.net La Rita Mason, MS,CCCSP 376-6200 http://www.caremanager.org for more information

24. Other types of health care providers…… To find a nurse practitioner http://www.npfinder.com/ To find a physician assistant http://www.steadyhealth.com/find_doctor/ physician_assistant/

25. I need an overall check up…. Texas Tech has a Senior Clinic that will do a complete health check up Physical exam Nutrition screen Dementia screen Depression evaluation Evaluate your medications Look at how you walk and move Then discuss the findings with you

26. What do they do with that information? You can have the information sent to the provider of your choice Or You can become a patient with Texas Tech

27. Home Health • One time when the phone book might help • http://medicare.gov has a list by city and state to help you find a home health agency Usually the provider will recommend an agency that deals with the type of medical need that you have

28. Hospice/Palliative Care • Again the phone book might help • Provider will usually suggest a group • National hospice & palliative care organization http://www.nhpco.org

29. How to find a Nursing Home… Visit and look around Talk to the residents, staff and visitors Talk to the Omsbudsman

30. Perform the “Sniff Test”

31. Find out about the state survey • For explanation of Quality Improvement Program: http://aspe.hhs.gov/daltcp/reports/statenhB.htm#Texas Enter Your county to find out a nursing home’s quality rating: http://facilityquality.dhs.state.tx.us/ltcqrs_public/nq1/jsp3/qrsHome1en.jsp?MODE=P&LANGCD=en

32. Respite Care • ER not the place to take Mom and Pop! • Not paid by Medicare or Medicaid • Private pay only

33. Call Ahead…. Call ahead to see what is available and if you meet qualifications Contact local nursing home or home care agency Check with Area Agency on Aging for resources 331-2227

34. Access to care issues will always be present…. Knowing where to look for the information is half of the battle….