This month we are celebrating our healthcare providers by sharing with you some of the great team members that contribute to our clients’ excellent care. Today, we have the pleasure of talking about Dr. Michael O’Neal, a groundbreaking doctor with a different approach to patient care. He founded Cooperative Med, a concierge medicine practice serving Tampa Bay.

Background: Dr. Michael O’Neal

Dr. O’Neal received his undergraduate degree from the University of South Florida (USF) and attended medical school at the Kansas City University of Medicine and Biosciences. He completed residency training at USF College of Medicine, where he was elected the Chief Resident. Dr. O’Neal has published numerous articles in peer-reviewed scientific journals and received awards for his scholarly achievements, research, and contributions. He was 1 of only 15 national physicians to receive the American Medical Association (AMA) Young Physician Leadership Award.

About Cooperative Med, Concierge Medicine in Tampa Bay

CooperativeMed, founded in 2002 by Dr. Michael O’Neal, is a pioneer in the development of concierge (also known as membership/boutique) medical practices. Dr. O’Neal is credited with developing the first concierge medical practice in the U.S. created from scratch (non-transitioned). Concierge medicine offers a low volume practice setting which allows the physician to devote more time and energy to each patient, individualizing care.

Dr. O’Neal wanted to create a different option for those dissatisfied with today’s high-volume, managed-care health care system, where physicians are compelled to care for upwards of 3,000 patients. In contrast, CooperativeMed limits the number of patient members, providing a higher level of service to fewer patients, while focusing on disease prevention, health maintenance, nutrition, lifestyle changes, patient advocacy, and high-quality care. In order to sustain a practice of only 350 patients, each member pays an annual membership fee.

The Benefits of Working with Dr. O’Neal

The Aging Wisely team appreciates Dr. O’Neal’s collaborative approach to healthcare. Each patient is encouraged to be a proactive participant, targeting health care goals in partnership with the physician and other involved professionals.

Dr. O’Neal prides himself on developing nurturing relationships with patients and fulfilling their previously unmet health care needs. Cooperative Med’s concept blends modern medical technology (micronutrient and genetic testing, sophisticated cholesterol profiling, use of technology to extend care such as virtual visits via your iPad or iPhone) with traditional philosophies (home visits, advocacy, more face time with the physician and less wait time).

We’ve had the pleasure of working with Dr. O’Neal for a number of our Aging Wisely and EasyLiving clients. As Care Manager Julie Scott shares, “I, as well as my clients, feel he goes beyond the scope of medical treatment to remain in tune with the whole patient, which makes the difference between compliance and non-compliance, treatment or no treatment and feeling good about whatever decision is made…”. Julie explains that Dr. O’Neal not only respects patient wishes but takes the time to discuss options with them and weigh pros and cons, not only medically but socially, emotionally and with regards to potential outcomes. By making home visits to elder patients, Dr. O’Neal adds a level of convenience to their lives, but is also better able to assess their situation and get to know them.

Looking to The Future of Healthcare and Eldercare

To learn more, check out Dr. Michael O’Neal and Cooperative Med concierge medicine online or contact us for more information and ways our Aging Wisely team can put the best care team in place for you!

Aging Wisely and EasyLiving, your family’s advocates: ensuring quality of life and supporting you with:

• Patient advocacy and coordination
• Assessments and personalized care plans
• Professional in-home care, personalized for you
• Transition assistance, help navigating choices and more

Call us at 727-447-5845 for answers, resources and all the ways we can help!

You realize Mom needs some help at home or you are planning for the recovery period after an upcoming surgery. You know you need help that can come to the home…but beyond that it all seems quite confusing. What qualifications should you be looking for? Where do you find someone? How do you know about the quality of the home caregiver or home health agency? Will your Medicare or health insurance cover the costs (and that are the average costs)? We’ll help clear up the confusion to these and other questions, with this straightforward guide to home health care and in-home eldercare.

First of all…understanding what you need…

The first step in hiring in-home care is understanding the type of assistance you will need. A geriatric care management assessment is a great first step, because a professional can help you identify all the possible needs as well as anticipate things you may not have thought about. The care manager can also build a care plan for you, make recommendations and even carry out the process of getting the in-home caregivers in place and monitoring ongoing care.

In examining home care needs, think about the kind of tasks needed and particularly whether you need all household “hands off” help (in other words, only someone to assist with cooking, light housekeeping, and errands but no physical assistance) or whether you may need help, for example, getting in and out of bed or completing hygiene tasks. As a care manager will often suggest, it is better to err on the side of caution. If you are having surgery, you may think you’ll be able to handle all our own physical needs but you may find yourself in a weakened state or drowsy from medications. In Florida, a companion is only allowed to do household tasks and therefore could not help you if you found yourself needing assistance to get up from a chair or needing help in the bathroom.

There are certain medical tasks which require a nurse (R.N. or LPN) such as giving treatments/injections and changing surgical dressings. Usually these are intermittent tasks which can be handled by a visiting nurse and may be covered by your insurance/Medicare for short-term needs. Medication management also requires a nurse’s oversight and this help is often available through home care agencies on a set basis for long-term needs.

Now…where do I go to get help?

Many elders and families think about hiring someone themselves by putting an ad in the paper or asking friends for references. This is one option, but comes with a lot of extra work and liability for your family. You are solely responsible for the hiring, training and supervising as the employer. You also need to handle any tax and employment responsibilities. Additionally, you should consider the coverage (or lack thereof) should the employee have an accident, get sick or some other liability issue arise. You should also make a backup plan.

If you do not wish to serve as the employer and take on all these responsibilities, you can hire in-home care through an agency. In Florida, home health agencies and other medical/eldercare providers are regulated by the state. There are three basic types of companies providing in-home care to seniors and others: a fully-licensed home health agency (with medical and non-medical agencies in this category), homemaker companion services and nurse registries. You can read more about these categories of Florida Home Care on our EasyLiving home care website.

There are many benefits to hiring a licensed agency, including liability protection and assistance with all aspects of the process. The agency takes on the hiring, screening, training, supervising and can assist you with troubleshooting any concerns. A quality home health agency like our EasyLiving Home Care agency will take extra steps to ensure their caregivers are prepared for their work and continually improving. You can review state inspection reports online for most states, but you should also have a list of questions prepared to understand how the agency operates and handles quality improvement. Getting a referral from a trusted source may be your best bet for beginning this process.

What about costs and insurance coverage?

Medicare (other insurers tend to follow suit with similar rules) covers certain in-home care under limited circumstances. Most likely, the type of in-home care you are primarily seeking is what is sometimes termed “private duty home care”. Long-term care or even day-to-day care that is temporary (i.e. help during the recovery period) is usually not covered under Medicare or other medical insurance. However, long-term care insurance will often cover ongoing in-home care.

We outlined the requirements for Medicare to cover home health care in our blog post, “Paying for Home Care: What Home Health Services Does Medicare Cover?“. In order to receive Medicare home care, your doctor will need to write an order (additional visit requirements were added in recent years). Doctors often prescribe this type of care after surgery, hospitalization or a major change in functioning. Skilled home health care often includes therapy services, to increase strength or resolve specific issues. Many clients also have “private duty” services while receiving skilled care as the skilled care is only intermittent and does not fulfill many of the day-to-day/safety needs clients have in the home.

If you have a long-term care policy, your Aging Wisely care manager or EasyLiving home care representative can work with you to navigate the claims process and help get the insurance company the information needed. Most long-term care policies do cover in-home care if you meet the assessment requirements (demonstrating you need help in certain areas) after any elimination period (kind of like a deductible…you pay for so many days of care before the policy kicks in).

For those who do not have long-term care insurance and need private duty home care services, costs vary by geographic region of the country. In Tampa Bay, Florida home health agency care averages about $17-23/hour. The costs depend on whether the caregiver is a home health aide (i.e. is trained to provide hands-on care) and the amount of care needed (costs may be higher for very short periods of care, such as having a home health aide visit for 1-2 hours to help with bathing versus 6 hours in a day).

When it comes to costs, work closely with your provider or care manager on the most efficient care plan. Again, this circles back to what type of care you need. Your care plan can be built around: what times of day you have difficulties, what duties you need help with, your typical schedule and preferences. Your care plan should then be coordinated with any other care being provided (such as skilled home health care and assistance from family and friends). Because home care is usually a per hour charge, there is a great deal of flexibility to create an individualized care plan and budget.

Have questions about in-home care? Our Senior Care Consultant, Sue Talbott, can offer sage advice and will even come out to your home to complete a needs analysis for you. Call Sue at 727-447-5845 for help with in-home eldercare, Medicare and insurance issues, geriatric assessments and much more!

Our previous blog posts have covered the Challenges of Hospital Discharge for Elders and Ways You Can Help an Aging Loved One Have a Safe Hospital Discharge. Now we will share some important questions you should ask (a checklist of sorts) in the hospital discharge process.

Did I get written discharge instructions explained to me with time to ask questions and clarify any concerns? Items that should be included:

o Reason for admission, procedures done, outcome
o Do we know who to contact if we have a problem after discharge?
o What symptoms should we be watching for and what do we do if we have a concern?
o Medication list (and how will I make sure all my doctors & providers are updated with the new list)
o Follow up appointments

Get information about follow up treatment and therapy that might be essential to recuperation. Find out:

o Will I be receiving therapy services at home, inpatient or outpatient? You will need to select a provider and the hospital will generally provide a list of options if you ask, but you should do your research so that you can make an educated choice. There is information online about provider outcomes and you may wish to check with your loved one’s doctor or geriatric care manager for recommendations.
o Does insurance cover these services (your insurance may impact the choice of provider)?
o How long can they be expected to last? What outcome is expected? (Share your goals and concerns as well.)

Find out about the patient’s home care needs and what assistance may be needed in the weeks following the hospitalization. Issues to consider:

o Patient’s functional status: strength, ability to transfer safely, bathing, dressing, weakness, physical limitations.
o Household needs: can the patient take care of the household? Do laundry, clean? Help preparing meals (in compliance with nutritional needs/medical orders)?
o Transportation: will the patient need rides to appointments or help with errands?
o Medication management: consider how the patient will get new medications and discard old ones properly, manage following a new medication routine, communicate changes to all doctors/providers?

*Most times, if a patient is returning home after a hospital stay, they will receive some Skilled Home Care services, covered under Medicare or insurance. These services often do not begin on the day of discharge and are not intended to cover custodial needs such as most of those listed above. Medicare may cover support from a home health aide, but only as long as the patient requires skilled services such as physical therapy or a R.N. (for example for dressing changes/wound care). If you have concerns about any of the areas above, you should talk to a licensed, private duty home care provider, such as our sister company EasyLiving, about affordable home care and transitional packages to fill any gaps.

Ensure the home environment will accommodate post-hospital needs:

o Is any special medical equipment needed? Have arrangements been made? Will equipment be delivered and when? Do I need to pick up equipment and where can I do so? Cost/insurance coverage?
o How safe is the home environment? Have we completed a home safety, falls prevention assessment?
o Does the patient have a Personal Emergency Response System in case he/she falls or needs to call for help?

If you would like professional advice on how to prepare for a hospital discharge, what resources are available and how to get the best after-care, Aging Wisely’s geriatric care managers provide caregiver consultations, in-hospital and home safety assessments and patient advocacy.

Our professional patient advocates are here to help-contact us today!