Access to Care for Older Adults

Access to Care for Older Adults

Amarillo Resources

Marge Dean, RN,CS-BC,GNP-BC,MSN

West Texas A&M Nursing Program mdean@wtamu.edu

I need help…..where do I go?

Finding a health care provider

Mental health assistance

Nursing home

Home health/Hospice

Other helpful resources

We will look at the following…

Navigating the Health Care System

Health care reform may help…..

Meanwhile?????

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?

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

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

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

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”

Best way….is the to stay out of the healthcare system

STAY HEALTHY!

How?

Regular screenings Pap, mammogram, PSA, DRE, colonoscopy

Healthy diet Regular exercise Wash your hands Take your prescribed meds as directed

How do I find a healthcare provider?

Much easier if you have Medicare plus a supplemental insurance

More difficult when only Medicare assignment

Why is this so difficult?

Fewer available today

Many don’t take Medicare

Phone Book????

Finding a primary care provider?

Texas Tech Clinics

NW Senior Health Services/j O Wyatt Clinic

WTAMU Health Partners Clinic

BSA Family Clinic

Regence Health Network,Inc

Who is taking Medicare?

Clinics with no appointment BSA Urgent Care

Amarillo Urgent Care

United Bell and 45th Clinic (cash only)

Psychiatric Help…Day Programs covered by Medicare

TPMHMR Adult Day Program NWTH Pavilion Day Program

Jan Werner Adult Day Care(Alzheimer’s)

NWTH Pavilion

Golden Phoenix (Pampa Hospital)

Covenant Hospital (Plainview)

Psychiatric Help…In House covered by Medicare

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

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

What if you need a specialist?

Usually you see the primary care provider first

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

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

Who Else?

Contact a Geriatric Care Manager

Leticia Goodrich MA Goodrich Care Management Services

352-9956lagoodrich@yourtexan.net

La Rita Mason, MS,CCCSP 376-6200

http://www.caremanager.org for more information

Other types of health care providers……

To find a nurse practitionerhttp://www.npfinder.com/

To find a physician assistanthttp://www.steadyhealth.com/find_doctor/

physician_assistant/

TEXAS TECH HAS A SENIOR CLINIC THAT WILL DO A COMPLETE HEALTH CHECK UP

PHYSICAL EXAMNUTRITION SCREENDEMENTIA SCREENDEPRESSION EVALUATIONEVALUATE YOUR MEDICATIONSLOOK AT HOW YOU WALK AND MOVE

THEN DISCUSS THE FINDINGS WITH YOU

I need an overall check up….

You can have the information sent to the provider of your choice

Or

You can become a patient with Texas Tech

What do they do with that information?

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

Hospice/Palliative Care Again the phone book

might help

Provider will usually suggest a group

National hospice & palliative care organization

http://www.nhpco.org

How to find a Nursing Home…

Visit and look around

Talk to the residents, staff and visitors

Talk to the Omsbudsman

Perform the “Sniff Test”

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

ER not the place to take Mom and Pop!

Not paid by Medicare or Medicaid

Private pay only

Respite Care

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

Access to care issues will always be present….

Knowing where to look for the information is half of the battle….