Making a Fragmented Healthcare System Work

The Fragmentation of Healthcare

Thanks to modern medicine we are living longer and sustaining the body long into old age. Also thanks to modern medicine, more and more doctors are specializing which has contributed to a fragmentation of the healthcare system. This trend has a huge impact on how aging adults receive care. The average older adult sees 11 doctors a year, according to Dr. Neil Resnick in an ABC news interview. For example, it would not be uncommon for an aging adult to see a primary care physician along with a collection of specialists from podiatrists to cardiologists to nephrologists.

This dividing up of care has also left a rift in communication. As consumers, we might assume that all of these doctors are connecting with one another especially when prescribing new medications. Here in lies the problem with assumptions: they’re often not. While many doctors are responsible for the care of a particular part or illness, no one person seems to be responsible for the care of the whole person except for the individual patient themselves. Families are often serving as the missing link between doctors. In fact, much of the coordination of healthcare and private services is falling to the loved ones and adult children of aging parents. Many families find themselves lost in the healthcare maze unclear of how to find their way to the solutions they need. 

Medications: Too Many Cooks

Where we see the danger of this trend of increasing doctors and decreasing communication is around the management of medications for aging adults. “The average person over 65 now uses seven different medications per day, four prescribed and three over-the-counter,” says Andrew Duxbury, MD, associate professor of geriatrics at the University of Alabama Birmingham. In a WebMD article, he also stated that about one in every three people over 65 will have some sort of adverse medication event that requires a hospital visit, and some 10-15% of all emergency room visits are related to medication reactions and drug interaction problems in seniors. As the old saying goes, too many cooks in the kitchen spoil the broth.

Bridging the Gap: Integrative Care

Chances are you’ve never heard of Care Management. Most Americans don’t know what the professional service involves, let alone how it could dramatically change the way they think about and receive elder care services. A Certified Geriatric Care Manager is a Registered Nurse or Masters of Social Work who specializes in elder care. While it might seem counter-intuitive to add another professional to the mix, Care Managers are filling in the communication gaps between doctors and relieving family members from taking on the part-time job of managing the healthcare of an aging loved one.   

Finding the Missing Link

Take Art Jenson, for example, a 75 year old from Gig Harbor, WA. He was taking 12 medications every day and complaining of multiple symptoms that interfered with his quality of life. He was seeing 2 doctors for each of his chronic illnesses, but was declining in the last year. Art’s family contacted Sound Options and a Care Manager went to be his advocate. Jane, a RN Care Manager, was able to attend the next doctor’s appointment with a medication list in hand. She had taken stock of all of Art’s prescription medications and over-the-counter supplements along with dosages and reviewed it with the primary physician. They were able to reconcile their medication lists, adjust dosages, eliminate unnecessary medications, and take away some of the supplements that were interacting with daily medications. Jane also noticed the disarray of Art’s medications throughout the house. She was able to help Art purge expired medications and set up a schedule with the family so she could visit every week to set up Art’s mediset to make sure he was following the updated instructions from the doctor. She introduced simplicity to his routine, and dramatically increased his safety and quality of life.  Because Jane built trust with Art through this process, he would also candidly speak to her about health issues that arose over the following years. Her care coordination between his doctors and medication management in the home allowed Art’s family to have their own lives, to just be family, and to enjoy time with Art that wasn’t over-burdened with tasks and care. Jane found solutions to his needs as they arose and Art was able to age well in his own home into his late 80s with Sound Options providing care and everyday assistance in his home overlooking Puget Sound.

By integrating the professional voices involved in care, Certified Care Managers are making a fragmented healthcare system work for aging adults and their families. When it comes to getting care, you need simple. You need narrowed quality choices. You need Sound Options.  





Published on February 26, 2014.