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Senior Focus: Education fills need with ever-changing health care system

Going in the home of a patient helps in finding the right kind of care needed for each particular case instead of working over the phone.

Sun Advocate reporter

Over the years health care has undergone many changes and that's a trend that will continue into the future. What many people, especially seniors, may not be informed about is all of the services that are currently available and who is eligible to get those services. These problems are one of the many that people within the health care industry are looking to fix as they attempt to educate the population on what is out there.

Regulations and rules have changed with the health care overhaul. One example of a change that is going into effect this year says that for those under Medicare who are receiving home care, a face-to-face meeting between the patient and the patient's physician or non-physician practitioner is now required 90 days before the care starts or within 30 days after the care has began. Medicare allows for home health services for those who are confined to their homes and are found to be in need of home nursing.

This can include services such as physical therapy, speech-language pathology and a continuing need for occupational therapy. To receive this type of care, a patient must be under the care of a physician who certifies that there is a need for that care and must specify that an individual is confined to their home. There is a long list of provisions that are required before the care is permitted along with the face-to-face meeting.

Linda Beal, area manager with Community Nursing Services, said that this change now provides more control over what kind of care is being given out and also tightens up how much control a doctor has. Beal noted that the new regulation is very complicated and many in the Carbon and Emery County areas will need to be educated about the rules going forward.

Because of a regulation like this one, now more responsibility is being put on the patients and their families. Beal said that CNS is trying to help provide the education for people on what they need to do and that care overall is becoming more teaching-based.

"There is a lot of good that comes with being this," Beal said noting it helps patients understand more about their conditions and what they can do before seeking care.

"It's always worthwhile when people can be self-sufficient and independent in learning and knowing about the care out there," she said.

Nurses who visit the home of a patient say that seeing them in their surroundings is a big help in knowing what kind of care can be provided compared to speaking with a patient over the phone about their ailments.

"It really does make a big difference seeing them in their home," said Megan Burke, patient care coordinator with CNS.

One example of care comes in the form of charitable care. This involves helping those who may not be able to afford certain medical needs and are in need of help. Many organizations are willing to help out, including United Way, as they have provided funding that go towards purchasing things such as medical equipment. The requests for charitable care has risen over the years, Beal said, listing examples such as newborns having surgery and requiring care afterward.

"We don't ever want to deny someone care," Beal stated.

One such example of charitable care, Beal remembers, is a baby that needed a special type of formula. No formula was available in town and ordering over the internet would take more than a day due to the lack of one-day shipping option for the Carbon and Emery County areas. So CNS jumped in and helped out. They ordered the special formula and had it shipped to Salt Lake City, where someone picked it up and brought it to Price.

"We jumped through hoops to get this done and help out," Beal said. "There are so many needs out there for charitable care."

So many in fact that over a five-year period from 2006 to 2010, over $1 million of charitable care in both Carbon and Emery County was used.

Not knowing what services are available for seniors is something CNS and other organizations hear often, Beal said.

"We hear that from patients all of the time," she explained.

It's a problem that can be difficult to tackle. Because the lack of knowledge of what services are available, some seniors may not be quick to act. Beal said that she has seen cases where seniors have not sought out care and instead see themselves saving their money. However, it can cost more in the long run and, in some cases, it can end up with a patient in the hospital.

During the winter season, many agencies, including CNS, deal with a lot more calls from patients seeking help. Lots of people fall and slip on ice and many are not as active compared to other times of the year, Beal stated.

In Carbon and Emery Counties there are seniors who are living with diabetes, heart disease and lung problems, many of whom are former miners who spent years working in the coal industry. But there are agencies that jump in and help out including Veterans Affairs and United Mine Workers Association, according to Angie Fausett, an RN case manger with CNS.

For diabetics, wounds can be a big problem. Those living with a wound from diabetes may have been living with it for so long that they may not know how severe their case may be. Home health can help with a situation like this, Fausett said.

"Getting help can prevent serious problems from occurring," Fausett said. "It may help save a toe or a whole foot."

Being located in smaller communities can play a major role in how well the system can work, Fausett stated.

"It's priceless," Fausett said. "It's a big advantage in a small community. It helps us because we can work to prevent problems, get to know patients more closely and monitor their status over a period of time during care."

Teaching the importance of being independent and being safe is a key point CNS pushes to patients and their families, Fausett said.

"It's not just the patients that need to be involved. Their families need to step in and help out in any way they can," Fausett said.

However some problems arise with that idea, as some seniors do not have families who are able to care for them, Beal pointed out.

To help combat that issue, education and knowledge of health care becomes paramount. Being independent and being safe is important for seniors and others dealing with health conditions. Face-to-face meetings can help in assessing the specific case and what services can benefit that particular person.

Tips for seniors include:

*Take care of yourself.

*Stay as active as you can.

*Be healthy and live healthy.

*Seek out help before a problem becomes more severe.

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