Recently, Care Answered Director Nicole Christensen appeared on Project Independence, a radio program dedicated to the needs of older adults. Hear the shocking statistics she shared with hosts John Ryan and Ann Hirsch about preventable medical errors and how to be your own healthcare advocate.
Earlier this month, I had the opportunity to participate as a panelist in a discussion on diversity, women’s issues, and entrepreneurship. The panel was part of a Women’s History Month presentation to the Health & Business Alliance, a trade and networking group to which I belong. My co-panelists, Lauren Tanen and Susan Ganz, each brought their own unique perspective on the challenges that confront many women as well as people of color as they navigate their workplaces, healthcare and educational institutions, and other parts of their lives.
My own contribution to the panel centered on healthcare disparities. African Americans have a 40% greater risk than whites of getting high blood pressure, which can lead to heart disease, heart failure, kidney disease and stroke. African Americans are also twice as likely as whites to be diabetic, which leads to a host of serious medical complications.
Last year, the New York Times ran a feature report called “Why America’s Black Mothers and Babies are in a Life-and-Death Crisis.” In an article full of shocking statistics, this one stands out: Black infants in America are more than twice as likely to die as white infants. But what’s even more shocking is the fact that this disparity has actually increased in the past century and a half, since statistics like this were first recorded in 1850, 15 years before the end of slavery.
And these disparities extend to other minority groups as well. The Centers for Disease Control (CDC) reports that compared to whites, Hispanics are about 50% more likely to die of diabetes or liver disease.
These ongoing inequities are part of what drives me to continue my professional quest as a healthcare advocate. A significant part of what I do is to advocate for patients, whoever they are, whenever and wherever they interact with the healthcare system.
It is essential that every person fully understands the information presented by medical professionals and is able to carry out the doctors’ recommendations. Our American healthcare system is complex, involving interactions with insurance companies, government payers, employers, healthcare providers, pharmacies, medical device companies, long term care providers, assisted living centers, rehabilitation facilities, home care agencies, and more. I specialize in helping clients cut through the clutter so that they are armed with clear, understandable information and are empowered to make the healthcare decisions that are best for them and their families.
I’d love to hear about your experiences. Whether you are a man or a woman, member of a minority group or not, what has it been like for you when dealing with a doctor, hospital, school, workplace, government agency or other institution? Did you feel heard, respected, and understood, or marginalized? By sharing our stories, as I and my fellow panelists did, and speaking up for one another, I believe we will begin to make a much needed change.
Six in ten adults live with at least one chronic disease, such as cancer, heart disease, asthma, stroke and diabetes, while four in ten have multiple chronic conditions, according to the Centers for Disease Control and Prevention.
While many adults are able to manage their own chronic medical conditions, as they age this can become a challenging juggling act, especially when there are multiple medical conditions being treated.
Knowing When to Help
Some people with chronic medical conditions develop tricks and habits to help them cope. These techniques may make it appear that they are managing fine, when in reality they are just barely getting by. A seemingly inconsequential issue – a minor cold, a missed trip to the pharmacy, or a skipped meal – may be all that it takes for disaster to strike. The trick for loved ones is to know when to step in with assistance.
Get Involved Early
Don’t be afraid to ask questions. Offer to accompany your loved one to doctor’s appointments if your schedule permits. This will enable you to assess whether your loved one appears to understand the doctor’s instructions and is following his or her medication regimen and dietary recommendations.
Try to encourage frank discussions about your loved one’s condition. Encourage them to be honest about their symptoms, pain, and ability to function. Listen without judgment.
When More Help is Needed
If you feel that your loved one may need more help as their disease progresses, explore all of your options. The areas in which assistance may be needed include:
Personal care – bathing, dressing, washing hair. A family member may be able to assist with this, or a personal care aide can be brought in to help with these types of tasks.
Household chores – cooking, cleaning, laundry, minor household repairs. Again, a friend or family member may be able to visit the home to help with cooking and housework. Another option is for someone to deliver pre-cooked meals or for your loved one to travel to a senior center or local club for a hot meal. Often minor repairs can be outsourced to a local handyman; ask neighbors and friends for a trustworthy referral. If more help is needed, a personal care aide may be able to pitch in.
Medication compliance – pill boxes, alarms, phone calls and other technological devices can help remind your loved one about which medication to take and when to take it.
An Advocate can Help
When the juggling act of trying to coordinate the multiple aspects of a loved one’s care becomes overwhelming, it might be time to consider hiring an advocate. A healthcare advocate can help you determine what care options are available and put those services into place, accompany your loved one to doctor’s appointments, make sense of complex medical information and untangle medical bills and insurance documents, arrange for in-home care or nursing home placement as needed. To learn more about what an advocate can do, call us at 516-584-2007.
You can be in love with your sweetheart, suffer heartbreak, wear your heart on your sleeve, or hear a heartwarming story. Yet for all the references to the heart in language, poetry, music and popular culture, there is a great deal of misunderstanding about how the heart actually functions and nature of heart disease.
Sitting just off-center in your chest cavity, your heart is a fist-sized organ that beats roughly 70 times a minute, pumping oxygen-rich blood to vital organs throughout your body. If you think of the body as a building, your heart contains elements of both the plumbing and electrical systems. An electrical impulse stimulates the heart to beat in a normal, steady rhythm. Any disruption to that electrical system will result in an arrhythmia, which can range from a harmless mis-fire to a life-threatening inability to effectively pump.
With arteries carrying oxygen-rich blood from the heart to the rest of the body, and veins transporting oxygen-depleted blood back to the heart, any interference with those vessels can result in serious problems. Just like a clogged pipe can spell disaster in your home, coronary artery blockages can lead to a heart attack because they prevent oxygenated blood from nourishing the heart itself, resulting in damage to the heart muscle.
With those basics out of the way, let’s see if you can separate fact from fiction when it comes to heart disease.
True or False? Men are more likely to have a heart attack than women.
It is true that men are more likely to have a heart attack than women. But there are variables. When the statistics are broken down by age and ethnicity as well as gender, it turns out that at every age, the rate of heart attacks in black women meets or exceeds that in white men. The Centers for Disease Control (CDC) says that the rate of heart attacks in all women increases dramatically, nearly doubling after the age of 65.
True or False? Breast cancer is the #1 killer of woman in America.
This is false. More women die of cardiovascular disease than breast cancer in America. More than a third of deaths of American women over the age of 20 are due to cardiovascular disease, and heart attacks kill 200,000 American women each year. This is five times as many as are killed by breast cancer, according to the American College of Cardiology.
True or False? Heart disease is genetic. There’s nothing you can do to prevent it.
The good news is that heart disease is considered preventable. In fact, there has been a 60% decline in heart disease from the 1950s to the beginning of the 21st century, according to the CDC. This is mostly due to changes in lifestyle that reduced risk factors, including a decline in cigarette smoking, greater control over high blood pressure, dietary changes emphasizing low fat foods, and improved diagnosis and treatment options.
What Does this Mean for You?
Despite the advances, heart disease remains a serious health threat for both men and women. It is important to have regular physical exams and to have your blood pressure and cholesterol levels checked. Be sure that you manage chronic conditions like diabetes that could contribute to heart disease. And adjust your lifestyle to make healthier choices: don’t smoke, avoid excessive alcohol, get some exercise every day, and stay away from fatty, fried foods. Adjusting your lifestyle is often easier said than done but YOU are worth it.
Your doctor may have suggested you take a medical test, while your friend suggested you take another test that helped save her life, and your brother stated that you shouldn’t take any medical tests because they’re all a scam to get your money. Who is right?
I don’t have the answer to that question. But you do!
Here are some questions to ask your clinician so you can make an informed decision:
-What will the results of the test you are suggesting tell us?
-Are you suggesting these tests based on my family history, symptoms I’m showing, or for another reason?
-I have a friend who had very similar symptoms as I have. Could “x” test be appropriate for me to rule out “y” condition?
-Would you please list for me the pros and cons of having this test (i.e. does it generally have a number of false positives. If so, can it lead to unnecessary procedures that can cause more harm than good?)
-When can I call back for those test results?
Remember no news is not good news. If you decide to have a screening or test done, ask when the results should be expected and who will provide you with the results. If you don’t hear from them, it could mean that they forgot or your file got lost. This lack of knowledge is putting your health in jeopardy. Make sure you contact them and get the results.
Information is power so I want to share with you some information from leading healthcare professionals. Consumer Reports published an article assessing the benefits and risks of medical screenings. They did all the work combing through research, speaking with healthcare experts and coming up with the findings. Below are a few of the key take-aways from their report.*
Abdominal Aortic Aneurysm (AAA) Screening AAAs can cause life-threatening bleeding. This screening is an ultrasound recommended for men 65-75 who were or are current smokers, as well as men and women in that same age group who have a family history of AAA. If an AAA is found the doctor may suggest monitoring or surgical repair.
Bone Density Screening This is a screening test to detect low bone density (osteopenia) and weak, brittle bones (osteoporosis). Generally recommended for women aged 65 but also for women around the age of menopause if they are at risk (i.e. history of smoking or family history of osteoporosis). Men can consider screening at around age 80. If osteopenia is detected, a diet rich in vitamin D, exercise and calcium are often advised. If osteoporosis is detected the clinician may suggest medication to prevent fractures.
Electrocardiogram (EKG) and exercise stress tests These are done to check for signs of heart disease or arrhythmias. They are recommended for those at high risk for heart disease or those with suspected heart disease or symptoms (i.e. shortness of breath or chest pain) as a diagnostic tool. But for other low-risk people with no symptoms, these tests may lead to inaccurate results and unnecessary procedures.
Lung Cancer Scan This low-dose CT scan images the lungs. It is recommended for adults 55-80 with a “30 pack-year history” (smoking a pack a day for 30 years or two packs a day for 15 years) who currently smoke or quit within the last 15 years. It has been found to detect lung cancer early and prevent death for those at highest risk.
Remember, it is always advised that you speak with your doctor for specific recommendations on the screenings and medical tests that are indicated for your unique situation. If you need help selecting a healthcare provider or need an advocate to ask these questions and coordinate care, we can assist you. Give us a call at (516) 584-2007.
*For information and more in-depth information on these screening see Consumer Reports’ January 2019 article “Too Many Tests?”
Think vaccines are only for kids? Think again. The
development of vaccines revolutionized preventive medical care and virtually
eradicated disease like smallpox and polio. And they remain an important part
of the preventive health regimen for adults as well as children.
Which vaccines do you need as an adult? The answer will be
influenced by your age, underlying medical conditions, risk factors, travel
plans and the environment in which you live and work. Here is a rundown of some
of the vaccines that are commonly recommended for adults:
Influenza (Flu Shot)
Generally, everyone over the age of 6 months should receive
a flu vaccine annually. The best time to receive your flu shot is before flu
becomes prevalent in your area, usually in the early fall. However, it is not
too late to get a flu shot for this year. And it is important to do so; last
year, the flu was responsible for 80,000 deaths in America, and it has already
killed 13 children in the US this year. A flu shot will help protect you and
those you love.
The pneumococcal vaccine can help prevent serious infections
in the lungs, blood or brain. The vaccine is recommended for those over 65, as
well as individuals with chronic health conditions such as heart disease,
cancer, lung disease, kidney disease, liver disease, diabetes or sickle cell
Tetanus or Tdap
A tetanus booster is required every 10 years. Tetanus is a
serious illness that leads to severe muscle contractions. It is also known as
lockjaw. It is preventable in individuals who are up-to-date on their vaccines
but can occur in unvaccinated people. The bacteria typically enter the body
through a wound.
Those who have not received the Tdap vaccine as children
should consider getting the Tdap booster, which protects against tetanus,
diphtheria and pertussis, also known as whooping cough, which is making a
resurgence in children and adults.
If you have ever had shingles, or know someone who has, you
know how agonizing the condition can be. Caused by the same virus that causes
chicken pox, shingles results in a painful blistering rash that often wraps
around the torso. The shingles vaccine is recommended for adults 50 and over,
including those who have already had shingles.
If you plan to travel
If foreign travel is in your future, you should speak to
your doctor about which vaccines are recommended for the areas you plan to
visit. Hepatitis A, Hepatitis B, and the meningococcal vaccine may be among
those recommended for you.
Live in a Nursing
If you live or work in a nursing home, or work with patients
in a doctor’s office or hospital, you may need to receive the
measles-mumps-rubella vaccine, especially if you were born after 1957 and do
not show signs of immunity in a blood test.
For every rule, there is an exception. Your general health,
lifestyle and the presence of any underlying medical conditions might preclude
you from receiving certain vaccines or require you to receive others. It is
important to have an open conversation with your doctor or healthcare provider
about which vaccines are appropriate for your specific situation.
Nobody likes getting shots; it brings back childhood
anxieties and phobias for many. But when you consider the benefit of avoiding
painful, debilitating illness, getting your recommended vaccines is worth a
You or your loved one
is ready to be discharged from the hospital. That’s great!
Unfortunately, this may not mean an immediate return home. Although you (or your loved one) may no longer need the amount of care provided in the hospital, your healthcare provider may decide that you need more care than can be provided at home.*
In this case, the hospital may give you a list of short-term physical rehabilitation facilities where you or your loved one can work on getting back to normal daily activities. But how do you select the best facility? And what, exactly, are these facilities supposed to provide?
Before returning home from the hospital, one should be able to:
Safely use a cane, walker, crutches, or wheelchair;
Get in and out of a chair or bed without needing much help;
Move safely between sleeping area, bathroom, and kitchen;
Go up and down stairs, if there is no other way to avoid them within the home.
Other factors may also prevent a person from going directly home from the hospital, such as:
There is not enough help at home;
Because of the home’s features, the patient may need to be stronger or more mobile before returning home;
The patient has medical problems such as diabetes, lung problems, and heart problems, that are not well controlled;
The patient needs medicines that cannot safely be given at home;
The patient has surgical wounds that need frequent care.
Many short-term physical rehabilitation facilities have a full medical staff which includes doctors, nurses, and physical, occupational, and speech therapists, as well as nursing assistants, social workers, and more.
Yet, even with a full complement of clinical staff, the focus of these facilities of often strictly on physical rehabilitation. They want to get their patients moving so that they return home as soon as possible. That’s your goal too, right? While everyone would love to see your loved one back home safe and sound, not all rehabilitation centers are created equally. Here are nine things to consider in order to select a rehabilitation facility that is the best fit for you or your loved one:
Visit the facility and take note of smell, activity, and interactions between patients, between staff, and between staff and patients.
Ask how many days a week each type of rehab (physical, occupational, and speech therapy) is offered.
After receiving the list of medications from the hospital, ask if they are going to be able to access these medications in order to make sure the medications will be available upon arrival. This is especially important for prescriptions that are unusual, expensive or being used for a purpose other than normally intended (off-label).
If your loved one is a fall risk, ask what precautions the facility takes to avoid falls.
Ask about visiting hours.
If your loved one has a condition that will impact their ability to actively partake in rehab (i.e. pain,confusion, dizziness, or other conditions that may make it more challenging for them to cooperate with movement needed for therapy), make sure these conditions are being treated at the hospital. Bring this situation to the attention of the rehabilitation facility immediately, and ask if they have a specialist who can treat your loved one if needed.
If there are other medical concerns, make sure the facility has the necessary equipment and personnel (i.e.ventilator or dialysis).
Review the PRI (Patient Review Instrument) to make sure it has accurate information because this the document that potential rehabilitation sites will review to determine if your loved one is a good fit. If something seems inaccurate, alert the nurse and ask them to make corrections before it is sent out.
Hire a patient advocate before hospital discharge to make things easier for you and your loved one. We make this process easier for you and provide peace of mind.
Last summer, Sandy’s mother was placed in an assisted living facility’s Memory Care Unit. After years of paying for a long-term care insurance policy, the time had come for her to begin collecting benefits.
Yet Sandy found that the process of accessing the long-term care benefits that had been paid for was extremely complex. And while she had been handling details of her mother’s care for some time, she knew she would need outside help dealing with the assisted living facility and the insurance company.
“I needed someone who had the expertise to be able to present herself on behalf of the family and to be on equal ground, to be able to use the same language as the doctor, the assisted living facility and the insurance company,” Sandy said. Fortunately, she found Nicole Christensen of Care Answered to help navigate the maze of paperwork.
“The LTC insurance company that my mom had spent so much money on for the past few years was giving us push back regarding the terms of coverage,” Sandy explained. “Nicole spent countless hours on the phone with me as well as with the assisted living facility and the insurance company making sure all the paperwork was correct.”
But Nicole’s help didn’t end there. “Nicole has also been the liaison with my mother’s doctors’ offices, who also have to file certain paperwork within certain time limits as per insurance company,” Sandy said. “Nicole has been on top of this process from day one. She continues to monitor all paperwork with all parties in this process.”
The impact on Sandy’s life has been immeasurable.
“Having had Nicole as our liaison now for more than a year has enabled me to be able to actually be a little calmer in regard to sharing the responsibility for paperwork and payments” Sandy said. “Nobody can fully appreciate the service that she provides until they have the need for her help, but nobody should ever even consider navigating through the system without someone like her.”
Today, Sandy wholeheartedly recommends Nicole and Care Answered to anyone dealing with a similar situation.
“I would encourage any family in any long-term care or life-changing situation to immediately contact Nicole to have her mediate for your loved one and be the advocate that you will need,” Sandy stated. “She is a wonderful listener and can put a plan into action to achieve the outcome that the family needs. Nicole is an invaluable asset every family should avail themselves of.
To learn more, give Care Answered a call at 516-584-2007.
Living with a chronic illness or as a caregiver to a loved one with a serious health issue can be stressful on a day-to-day basis. When additional activities associated with the holidays – shopping, cooking, entertaining, visiting and more – are added, it is easy to feel overwhelmed. However, careful planning and simple strategies can help you avoid exhaustion, flare-ups and stress. Here are a few tips:
Plan ahead. Try to avoid last-minute parties, visits and obligations. Having a clear idea of holiday events well ahead of time can help you plan in advance. Schedule preparation time as well as rest time in order to conserve your energy so that you can be fully present.
Don’t be afraid to say no. Self-awareness and self-care are essential during the busy holiday season. You know what you will be able to accomplish and how much you can handle. Give yourself permission to turn down invitations and avoid situations that will drain your energy.
Remember to prioritize your health. Important routines – medication, therapy, diet, and doctors’ appointments – must be maintained, regardless of your holiday plans. Try as much as possible to maintain those schedules. In addition, be sure that caregivers are taking care of their own health. Only by remaining well can a caregiver continue to be there for their loved ones.
Scale back your expectations. It’s OK to host a smaller holiday gathering, to contribute a store-bought dessert rather than a home-baked treat, or to give gift cards instead of personal gifts this holiday season. Remember that the true meaning of the holidays lies in being with friends and loved ones. Trying to live up to holidays past or your own image of the perfect celebration may not be realistic or even necessary.
Do a little at a time. Whether you are addressing cards, wrapping gifts, or cooking a meal, break the task down into smaller chunks. Start early, and schedule time to rest and unwind between chores.
Ask for help. How often have you heard the words, “Is there anything I can do to help?” People truly do want to lend a hand, but often they don’t know exactly what you need. Don’t hesitate to ask those around you to pitch in. If you are financially able, hire someone to help with chores such as shopping, cooking and cleaning.
Take time for you. Schedule time to do things that provide you with a sense of peace and pleasure. Read a book, watch your favorite TV show, talk to a friend, meditate or just breathe. These mini-breaks will help you to recharge your batteries so that you can keep going!