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What Are My Health Care Resources?

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What types of services are available to you already that may help you navigate the health care system? Many people are unaware of what is available to help you meet your health care needs. At Your Nurse Advocate Consulting we look at your needs, decide what type of service to provide and then put together a plan to achieve the intended outcome.

According to the December 15th 2020 issue of the American Society of Registered Nurses for the 19th consecutive year the annual Gallup Poll has identified that “most Americans rated nurses as the most honest and ethical professionals in America.” We at Your Nurse Advocate Consulting highly value that trust and look forward to both serving and advocating for you on your health care journey.

In this blog post we wanted to share some resources that may be valuable in addressing common questions regarding health care.

Many clinics provide a service free of charge called Case Management, Transitional Care, or Care Coordination. These services are designed to help those patients that may be at risk for a negative outcome due to complex health conditions and or having several providers involved in their care and may be at high risk for missing appointments or keeping things organized and on track.

You may be thinking what do I get for these services? These positions were created to help the patient manage illness, try to keep you out of the hospital, and coordinate the many services and providers you already have. For example, if you have several upcoming appointments for specialists or other providers you may have to travel a distance to get to, a care coordination task might be to try and get all your appointments scheduled on the same day or as few of days as possible.

Another task that may be completed would be some follow up phone calls made to your home to check on you after being hospitalized or after medication changes that have been done in the clinic.

A care coordination nurse or transitional care nurse may accompany you to your doctor’s appointment to make sure you have someone to help you understand your treatment plan and can better explain your options. This clinic nurse may also help you manage your medication list and help you keep that straight.

If you feel any of these services may be of benefit to you or your loved one, all you need to do is ask your clinic. You can ask your clinic receptionist or scheduler if your clinic provides these services and if so, how can you go about accessing them.

The problem that we see for these services is that there are more people that can benefit from using them than they can accommodate. They just don’t have the staff to provide these services to everyone. We see their criteria change regularly on how they will determine who they can or cannot admit into this program based on availability of this resource. Your Nurse Advocate Consulting can provide our services to fill this gap.

If you end up being hospitalized you have access to a couple different resources. First the Social Workers, they can assist you with such things as financial issues, placement issues such as a nursing home or assisted living arrangements or any other social concern you may have. They are a wonderful resource so take full advantage of them while you are in the hospital. Many hospitals will also allow access to the social workers after you discharge home if needs arise later on. Often times the social worker can initiate a referral to a local Aging and Disability Resource Center, if appropriate and desired, which gets the ball rolling before you go home.

A second resource that you may find in the hospital is a Nurse Case Manager. Their role is to compliment the social worker and work to address any medical issues regarding your discharge home. Often times you will see both the nurse case manager and the social worker work together tohelp plan for a successful discharge back home. Some things that will be addressed by one or both of these may include arranging outpatient wound care, home health services, or IV or Infusion services either at home or as an outpatient. This team or individual can work closely with the hospital pharmacist in making sure your medication list is correct before you go home. If these services are not readily offered upon admission to the hospital please ask!

A third resource you may have access to while in the hospital is a Utilization Review staff member that may or may not be a nurse. This person can answer questions about your insurance or hospital bill and help you determine what will be or will not be covered during your hospital stay. Another name for a similar person in the hospital may come under the heading of Patient Financial Services or ask for the department that handles patient billing.

A community service organization called the Aging and Disability Resource Center or ADRC is run by your county and is a nationwide program to help identify needs of the aging population as well as people of any age that may need help, resources, and education in planning for their long-term care needs and services. This is always a great place to start as these organizations are full of local as well as national resources and can put you in contact with organizations that may help you answer questions. This organization can help identify services in your area such as “Life Line” or “Life Alert” a warning system that can be activated by pushing a button on a wrist or pendant device. Your Nurse Advocate Consulting can assist you in identifying what services may be of benefit to you or your loved one based on your specific circumstances.

A phone call is all it takes to begin this process. A representative can answer questions and see if a “needs assessment” may be appropriate. Depending on income levels, they can assist you in identifying what programs you or your loved one may qualify for. As a patient advocate, we can also assist you in looking at what programs the ADRC can offer and

help you make an informed decision based on your situation.

If you are looking for specific resources that may give you information on a certain disease or illness such as Alzheimer’s Disease you can access information on the web. Here you will find things like the Alzheimer’s Association, American Cancer Society, etc. By using your local ADRC, they may be able to share what type of resources also are available locally to you regarding your specific topic of concern.

These are the most common resources that are available to you but certainly not the entire list. Your insurance provider may have other resources available to you so make sure you are clear on what “extras” or what services they provide or pay for.

Thanks for stopping by and spending a few minutes with us. We hope we have provided some value and given you some ideas of where you can get help.