We have all heard the phrase presented to us in millions of scenarios “Change is the only constant”. Through my life I have found that idea to be as solid as the sun rising every morning. It is not a matter of choice. So embracing this fact and being a student of this unfolding life is the easier road. Life is an adventure. 35 years ago I had no idea of what my life would look like today. I was fresh out of nursing school. Wide-eyed and ready to help my patients back to a life of better health. I lived in a world of no cell phones. Nor could I imagine that a fictitious device used by Captain Kirk would become a reality. Now I am a slave to my ever-present cell phone. As a floor nurse on an oncology unit I was limited by the luxury of the technology at my fingertips. My predecessors did not have an intercom system, lab results within an hour, or sterile needles. Today these concepts seem fictitious and undoubtedly archaic, although they were the reality of that time.
I now am privileged to work at a company that is helping to bridge health care gaps, brings the patient into the center of focus and increases the outreach of the provider. This is all done with high tech equipment. But there is so much more… I work at Optimized Care Network. A phrase that describes this company is that it is a high tech, high touch way to deliver healthcare. At OCN, the RN brings the patient into the room. There is a conversation with the patient about pertinent data, billing, history of present problem and any underlying issues, lifestyle, vital signs. This information is entered into the Electronic Health Record –EMR and the provider can see this information before they join the encounter. Then the provider enters the room on a 55-inch screen. This special technology allows the provider to be displayed in a 3D lifesize image in real time. Initially our patients may be wowed by this experience, however as the conversation with the provider continues the magic of the technology falls away. This screen allows for eye-to-eye contact. This is the building block of all relationships. The provider guides the nurse through performing the physical assessment. There are cameras in the room that can further advance the exam. The image is brought onto the screen where the provider and the patient can see it enlarged to about the size of a basketball. This assists the provider with objective data and empowers the patient with knowledge of there own body. We also use a stethoscope with Bluetooth technology. So the provider can hear in real time all body sounds, heart, lungs, bowels and carotids. More objective data. As the conversation and plan between the patient and provider continues the nurse enters the assessment data into the chart. They can capture any of the relevant photos from the camera and enter them into the chart to be compared at a later date. The provider is able to give the patient their full attention and help educate them towards better health. All these very cool tools and the process that is used can be an impactful, submersive experience for our patients. The nurse/ care coordinator in the room provides not only health related skills, but is a warm human presence. When the encounter ends the nurse is still present in the room and adds an extra layer of reinforcement. A dear coworker of mine had an elderly patient state. “ This experience has been all about me!” Hooray!! As it should always be! So as much as I know that the sun will set this evening, I know that the digitally enhanced Doctors visit will be commonplace. I am excited to see how it unfolds and helps patients on the road to better and more educated wellness.
Read more into this exciting evolution on our website.
Consider these few statistics from the Alzheimer’s Association at http://alz.org/facts/overview.asp – “More than 5 million Americans are living with Alzheimer’s disease. In 2015, more than 15 million caregivers provided an estimated 18.1 billion hours of unpaid caregiving, which had an estimated economic value of $221.3 billion.”
These startling statistics relate to just one disease that strikes older adults and their families across our country. What about the number of caregivers who are caring for older adults with diabetes, those who may have had a stroke, those recovering from falls, younger family members, and so on?
A more comprehensive picture is painted by statistics from the National Alliance for Caregiving (2015): Caregiving in the US – “Approximately 43.5 million caregivers have provided unpaid care to an adult or child in the last 12 months.” Further, the AARP Public Policy Institute reported in the Valuing the Invaluable 2015 Update, “The value of services provided by informal caregivers has steadily increased over the last decade, with an estimated economic value of $470 billion in 2013, up from $450 billion in 2009 and $375 billion in 2007.”
But caregiving is about much more than statistics. It’s about people caring for others they care about – a spouse, parent, sibling, grandparent, friend, or a newer acquaintance who has no one else to turn to. It’s about making appointments, remembering medications, preparing meals, cleaning the house, visiting, consoling, dressing, bathing, running errands, patching up relationships, reminiscing, sleepless nights, time away from work and family, and so much more.
Caregivers truly are our everyday heroes. But they can’t do it alone. There’s help out there, through resources such as:
Along with accessing a wide array of resources, it is so important to establish communications and relationships with your loved one’s healthcare team, which will help the caregiver understand the disease more fully, establish their presence as the primary caregiver which should include an opportunity for caregiver support, and open the door to discussions about their involvement in decision making and helping their loved one comply with medical orders.
And let’s not forget about the important assistance technology can provide for caregivers. Much work is being done in this area. Aging in Place Technology Watch provides a listing of announcements of the latest technology advances that could be helpful to caregivers and families at https://www.ageinplacetech.com/category/category-tags/family-caregivers. And Caregivers and Technology: What They Want and Need (2016) from AARP Project Catalyst, offers a guide for innovators through research from a nationally representative sample of America’s 40 million family caregivers.
So, look around your neighborhood. How many of your neighbors are involved in raising their families, working one or two jobs, and providing care for a loved one today? Chances are they could use some help – understanding what resources are available to them in the community, having access to a home-cooked meal, or maybe just receiving a pleasant “Hi, how are you?” greeting that could change their day! You may just be in the right place at the right time to offer a bit of help to the hero next door!
Dispelling a commonly held belief among some physicians that NPs and PAs provide inferior patient care, a new study published this month in the, Annals of Internal Medicine, showed that care provided by advanced practice clinicians was not inferior to physician care. The study, which evaluated treatment of patients with upper respiratory infections, back pain, and headaches across thousands of patient encounters, showed the advanced practice clinicians were not any more likely than their physician colleagues to order expensive and inappropriate tests or medications. This study adds to the volume of data showing that advanced practice clinicians are capable of providing high quality, evidence based healthcare to patients across the lifespan while controlling healthcare costs. NPs and PAs have the education and training to provide safe, competent, and compassionate care to patients with a variety of health concerns. With primary care physician shortages predicted to continue and more patients accessing primary care services, expanding the scope of care of advanced practice clinicians is one important piece of solving the healthcare puzzle.
You can find the full text of the study here: http://annals.org/article.aspx?articleid=2529481
Further commentary from Forbes here: http://www.forbes.com/sites/brucejapsen/2016/06/20/nurse-practitioners-pas-no-more-wasteful-than-physicians/#4b010677a3e1
Pause for a moment to “think forward.” Do you have a mental image of yourself at age 85? Are you living in your current home when you’re 85? Are you independently going to the grocery store, fixing your own meals, participating in your weekly bridge games and dinner with friends, maybe taking care of your spouse, navigating throughout your home, and so on? It’s reasonable to believe that your answer is “yes” to most or all of these questions. The great majority of those who have reached the age of 85 are living in their homes and communities – not in nursing homes, assisted living or other alternative housing locations. However, with time, some support may be needed.
When is the right time? And what is the right care? Most often these decisions are dictated by health conditions which are often unforeseen. When you’re 85, might you have some hearing loss, some difficulty with mobility and stairs, high blood pressure, another chronic disease such as arthritis or heart disease? It wouldn’t be uncommon for you to have 2-3 of these “co-existing” conditions while living independently in your home.
And who will provide your care? According to an article in the AAMC Report, April 2015, by Aliyah Baruchin, “The statistics tell the story. By 2025 the number of Americans over the age of 65 will nearly double, making them the fastest growing age group in the country. Providing quality medical care for these seniors will require a certified geriatrician population of 25,000 according to The American Geriatrics Society, but as of 2014, there were fewer than 7,500 geriatricians in the United States. Only eight of the country’s 145 academic medical centers have full geriatrics departments, and only 44 percent of the nation’s 353 geriatric fellowship positions are filled.”
When access to responsive care at the right time and in the right place is the most important – in our later years – it can be the most difficult to accomplish. Could one solution to the challenges of geriatric care be the adoption of telemedicine to bridge-the-gap and bring medical care closer to the patient? There’s no better time than the present to talk with your health care provider(s) about your expectations for care as you age. Do they have special training in geriatric care? Do they understand your goals for independent living? Are they aware of supportive resources in the community? Are they accepting of technological approaches to support health care delivery?
Plan ahead to achieve your individual expectations for successful aging -- you are your own best advocate! View informative videos and learn more about telemedicine at: http://www.americantelemed.org/about-telemedicine/what-is-telemedicine#.V1sFmY-cGM8.
Or check out Optimized Care Network's answer here: http://www.optimizedcare.net