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!

We hope you have enjoyed the information from our Aging in America conference presentation on “A Better Approach to Eldercare Planning“. An important aspect of that planning process is healthcare planning. With National Healthcare Decisions Day coming up on April 16th, it is a great time to reflect on the importance of healthcare planning and its key components.

To frame the issue, here are a few interesting facts from the National Healthcare Decisions Day website:

• Less than 50 percent of the severely or terminally ill patients studied had an advance directive in their medical record.
• Between 65 and 76 percent of physicians whose patients had an advance directive were not aware that it existed.
• Having a living will was associated with lower probability of dying in a hospital for nursing home residents and people living in the community.
• Patients and families are often not fully informed of the relevant risks and potential benefits of artificial nutrition and hydration.

Did you know? The Federal Patient Self-Determination Act requires all Medicare-participating healthcare facilities inquire about and provide information to patients about advance directives (states also mandate such requirements for various healthcare entities, such as home healthcare and senior care providers, under their regulations). Yet, as we can see from the statistics above (and our anecdotal evidence as patient advocates, working with clients and healthcare providers day in and day out), this is just a small step in the right direction. Many gaps and misunderstandings remain in this complex process of healthcare planning and decision making.

Though this is a complex topic, there are some key steps you and your family can take. Here are some tips from our advocates about both advance care planning and decision making:

• Get the key legal documents in place. Execute advance directives such as a living will and healthcare surrogate (also known as healthcare power of attorney). A durable power of attorney, though it covers finances and other practical decisions, is also a vital part of this planning process as these types of decisions often interrelate. Make sure to keep these documents in a handy place and provide copies to loved ones who are involved in your care. Get copies on the records with your healthcare providers.
• Talk about it. In reality, the conversations should come first. Sharing what you wish with your decision makers is vital to help them do their job should they have to act on your behalf. Talking with others can also help you work through your beliefs and priorities. This is not a single conversation, of course, but an ongoing one. The parameters and the way you feel will likely change. There are some great resources at the National Healthcare Decisions Day website (check “resources for family conversations”). Our geriatric care managers include advance care planning as one component of our comprehensive assessment, to find out the status of client’s legal documents and also offer help with these conversations. However, the patient advocacy extends over time as the client’s health changes. The advocate can not only encourage and mediate conversations, but help ensure clients and families have the information they need to think through the options and consequences.
• As mentioned above, asking the right questions is a vital part of the decision making process. If your family has prepared as mentioned, having the right information at the time of the decisions is the next step. This means asking healthcare providers to explain risks and benefits and asking for help when you don’t feel you really understand the prognosis and realities. When you are ill (or the worried family member), it can be difficult to process the information. The medical terminology is confusing to begin with and the decisions are often made under pressure. This is one reason why hospitals have developed resources like palliative care teams and ethics committees. This is the area where most families find huge benefits to having an independent advocate by their side as well. When you are diagnosed with a chronic disease or even in the initial stages of facing a more acute condition, gathering the right information up front can help you get the right plan in place and anticipate some of the future decisions.
• Know where to turn for resources. The National Healthcare Decisions Day website is a great place to learn more, and the web can also be a good place to research your loved one’s condition or a specific procedure or treatment. However, the web is also full of junk and can be a very scary place when you look up a condition (just try typing in some minor symptoms and see the potential diagnoses the web holds for you!). Seek out the recognized disease-specific organizations and experienced healthcare entities for legitimate information (your healthcare providers can often tell you the sources they’d trust). This also means putting together a healthcare team that is best for you…both in expertise and in personality. You need to have good partners in your care who work cooperatively (this means you too!). Your Aging Wisely care manager can help you build this medical team, as well as serve as a liaison to ensure coordinated care.
• Take a moment to revisit your goals, prognosis and plan. Everything can be so rushed when there is a medical emergency or urgent situation. Sometimes this will just be necessary, but it is also important at some point to pause and think about things (and ask those questions). We hear from adult sons and daughters time and time again who say, “I didn’t realize Mom was having all these tests and treatments. When we talked about what was going on, she didn’t really understand why. It went against everything she wanted.” The elderly parent is often spending most of their time in a doctor’s office, undergoing treatment or tests. Sometimes, this is the reality of fighting a condition, but many times it is because no one stopped to evaluate the situation. Your medical providers generally want to do what is best for you and comply with your wishes, but in this fast-paced system this sometimes requires an “advocacy pause” to think through the plan moving forward.

Need help with patient advocacy in Florida? Our award-winning* team is here to help! Call us at 727-447-5845 or contact us online for SOLUTIONS WHEN YOU NEED THEM!

*Nationwide winner 2011, Patient Advocate Organization, Professional Patient Advocacy Institute

Sally Abrahms at AARP is one of our favorite bloggers. She covers eldercare issues on her blog, often highlighting interesting programs and news related to aging and caregiving. Sally recently shared a post about a new study on end of life issues. Some of the big findings of this end-of-life views survey include:

• 66 percent of respondents think a patient should be allowed to stop treatment and die under some circumstances.
• 31 percent disagree, saying health professionals should do everything possible to save a patient’s life.
• The “do everything” group has increased 9 percent since 2005 and 16 percent since 1990.

The group was fairly evenly divided on physician assisted suicide, with 47 percent in favor and 49 percent disapproving of laws to allow a doctor to prescribe lethal drugs to a terminally ill patient. The survey goes in to a lot of depth on various related topics, and shows the wider divides on these issues when respondents are broken down by ethnicity and religion.

Respondents also have different opinions when looking at what they would want personally, with preferences varying by hypothetical circumstances. The study shows for example, “57% say they would tell their doctors to stop treatment if they had a disease with no hope of improvement and were suffering a great deal of pain. And about half (52%) say they would ask their doctors to stop treatment if they had an incurable disease and were totally dependent on someone else for their care. But about a third of adults (35%) say they would tell their doctors to do everything possible to keep them alive – even in dire circumstances, such as having a disease with no hope of improvement and experiencing a great deal of pain.” The latter percentage has gone up, partly because more people elected to express an opinion on the issue (versus being undecided). At the same time, there’s a growing percentage that say people have a moral right to suicide (particularly when in a great deal of pain with no hope of improvement).

Obviously, these issues are very personal and potentially polarizing. A person’s background can have a big effect on his/her views on this issue, but the decisions are also greatly dependent on the circumstances. Perhaps the uptick in responses also shows that more people have thought about these issues and formed an opinion than in the past. This may be due to increased discussions, awareness and exposure (particularly as more people serve as caregivers, they see these issues played out with loved ones and may have the opportunity to form more crystallized views).

As Florida patient advocates, our team works with many clients facing chronic and terminal illnesses. Many of our clients come to us toward the end of their lives, while we work with others over a number of years throughout different stages of care and illness. This survey further brings to light some important points about end-of-life care and decisions. From this information and our patient advocacy experience, here are some take-away lessons on end of life care:

• These decisions are very personal and often situation-dependent. Therefore, it is important to have continuous conversations about care issues as circumstances change. A patient advocate can help facilitate the conversation and get critical information from providers so that patients and families can make the most informed decision.
• Advanced care planning and end-of-life care decisions are not a “once and done” issue. Completing and advance directive form, appointing a healthcare surrogate or saying you do/do not want certain measures in your living will are all only a small part of this process. Those who have cared for loved ones with chronic illness or served as patient advocates know this well. Multiple trips to the emergency room for small injuries or repeated pneumonia may lead to a discussion about continued treatment versus treating these issues as well as possible at home (or at the ALF or nursing home). When a different illness or injury comes up, this may lead to a different decision. When it comes to technologies, there may be times in a pattern of illness when a surgery or technology makes sense, weather for potential to extend life or for comfort, while at other times the same decision may not seem advisable. Treatment itself may change the process…such as for the cancer patient whose body is depleted by chemotherapy and thus not able to withstand the latest trial or the person who received radiation and is therefore not a good candidate for surgery to that area.
• Understanding the circumstances, in quality of life terms, is the most important information for the patient and family to have. Patients need to understand prognosis…both likelihood of survival as well as what that survival will look like. What side effects are to be expected? What probable complications and long-term changes will occur? What help will the person likely need after treatment? There are often many variables to weigh. A professional patient advocate can often help you get these answers and break it down in to understandable terms (as well as review them with you as often as needed). A doctor’s office or hospital room with attending medical professionals is often the start of this conversation but should not be the end. The patient and family need time, when feasible, to make these tough decisions.
• Practitioners need to take time to understand the patient/family perspective. This means having cultural awareness of different religious beliefs and cultural taboos which may be influencing both the conversation and the decisions. Fortunately, as patient advocates with social work training and a holistic viewpoint, this is an area where the Aging Wisely team shines. We understand the importance of assessment, both as a document and a process that continues. We know that it is important not only to know what diagnoses a person has, but their beliefs, their family situation, their mental health and emotional issues…and much more.

End-of-life decisions are part of a wider spectrum of care decisions that many patients and their caregivers will have to make. The conversations around these decisions are vital and good support from a professional patient advocate can facilitate the process. If your family needs help with patient advocacy…from advance care planning to navigating treatment and setting up a care plan through end of life/palliative care…give Aging Wisely’s award-winning patient advocates a call at 727-447-5845.

*Image courtesy of Vichaya Kiatying-Angsulee/ FreeDigitalPhotos.net

Is your loved one beginning to have difficulty managing all the paperwork, insurance information and day to day financial affairs? Are you concerned that this may leave him or her vulnerable?

Does it seem difficult to find the time to sort through all the medical bills and organize your files as you would like to do?

Aging Wisely offers resources to help seniors, from insurance advocacy and Medicare assistance to referrals to Daily Money Managers, organizers and options to help more easily manage affairs. If your loved one is having difficulty managing paperwork, he or she may be vulnerable to scams and financial problems resulting from unpaid or mispaid bills. For seniors or anyone dealing with major health concerns, the billing and insurance processes can be overwhelming. It may help to have assistance navigating through all of this from an experienced patient advocate.

Aging Wisely’s care managers work closely with a variety of professionals, so we can help locate appropriate services for protecting your loved ones and their financial affairs. If you need resources such as CPAs, elder law attorneys, daily money managers, bookkeepers, and financial advisors, we can offer referrals to help. We also keep updated on senior services and processes that families often have questions about, such as managing mail, reporting scams and getting help when there has been financial exploitation or elder abuse.

Difficulty with paying bills or managing financial affairs is often an early sign of varying eldercare needs. It may be time to get a geriatric care management assessment to put a plan in to place to help keep your loved one as safe and independent as possible.

To learn more about these services and ways we can help call us at 727-447-5845 or click below to schedule a time to talk with our Senior Care Consultant about options and resources.