“Pre-hospice” program called Transitions

Photo by Heidi de Marco/KHN

‘Pre-Hospice’ Saves Money By Keeping People At Home Near The End Of Life

“Gerald Chinchar isn’t quite at the end of life, but the end is not far away. The 77-year-old fell twice last year, shattering his hip and femur, and now gets around his San Diego home in a wheelchair. His medications fill a dresser drawer, and congestive heart failure puts him at high risk of emergency room visits and long hospital stays.

Chinchar, a Navy veteran who loves TV Westerns, said that’s the last thing he wants. He still likes to go watch his grandchildren’s sporting events and play blackjack at the casino. ‘If they told me I had six months to live or go to the hospital and last two years, I’d say leave me home,’ Chinchar said. ‘That ain’t no trade for me.’

Most aging people would choose to stay home in their last years of life. But for many, it doesn’t work out: They go in and out of hospitals, getting treated for flare-ups of various chronic illnesses. It’s a massive problem that costs the health care system billions of dollars and has galvanized health providers, hospital administrators and policymakers to search for solutions.

Sharp HealthCare, the San Diego health system where Chinchar receives care, has devised a way to fulfill his wishes and reduce costs at the same time. It’s a pre-hospice program called Transitions, designed to give elderly patients the care they want at home and keep them out of the hospital.”

Read more about this pre-hospice program

Geriatricians–Would you, or someone you know, benefit from seeing one?


Geriatricians Can Help Aging Patients Navigate Multiple Ailments

“For months, Teresa Christensen’s 87-year-old mother, Genevieve, complained of pain from a nasty sore on her right foot. She stopped going to church. She couldn’t sleep at night. Eventually, she stopped walking except when absolutely necessary.

Her primary care doctor prescribed three antibiotics, one after another. None worked.

“Doctor, can’t we do some further tests?” Teresa Christensen remembered asking. “I felt that he was looking through my mother instead of looking at her.”

Referred to a wound clinic, Genevieve was diagnosed with a venous ulcer, resulting from poor circulation in her legs. A few weeks ago, she had a successful procedure to correct the problem and returned home to the house where she’s lived for more than 50 years in Cottage Grove, Minn., a suburb of St. Paul.

Would her mother benefit from seeing a geriatrician going forward, wondered Christensen, her mother’s primary caregiver, in an email to me? And, if so, how would she go about finding one?

I reached out to several medical experts, and they agreed that a specialist in geriatrics could help a patient like Genevieve, with a history of breast cancer and heart failure, who’d had open heart surgery at age 84 and whose mobility was now compromised.”

Read more about geriatricians

Find a Geriatrics Healthcare Professional

The founder/author of LivingLifeRetired.com is not related to Teresa Christensen.

A second opinion may give you peace of mind

second opinion

When to Get a Second Opinion

by Nellie S. Huang for Kiplinger’s Personal Finance Magazine

December 2016

“Your doctor has just diagnosed you with a serious disease, or recommended a costly procedure, or advised you to have major surgery. Before panicking or following a drastic course of treatment, get a second opinion. Not only can a medical evaluation from a different doctor help you learn more about your illness, the options available to you, and the risks and benefits of each path, but it can also ‘give you the confidence and peace of mind that you’re making a good decision,’ says Robert Nielsen, medical director of PinnacleHealth System in central Pennsylvania.

Most insurance policies will cover the fee for a second opinion as they would cover a regular office visit, but it’s always wise to check with your insurer before you schedule the appointment, especially if you plan to go out of network. ‘In some cases, such as certain elective surgical procedures, a second opinion is mandatory,’ says John Ulatowski, vice president and executive medical director of Johns Hopkins Medicine International, in Baltimore.

Ask for referrals from people you trust—your primary care physician, the doctor who delivered your first opinion, your family and friends. Avoid seeing a colleague at the same practice or medical center as the doctor who gave you the first opinion—the approach to care can vary from place to place. For example, ‘some cancer centers are more aggressive about treatment; others are more concerned about side effects,’ says Jerome Groopman, Recanati Professor of Medicine at Harvard Medical School.

For cases that involve a specific procedure—for example, heart-valve replacement surgery—consult a doctor who frequently performs those surgeries.”   Read more

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