Healthcare options for Seniors

Navigating the sea of health care options can be daunting for any person. It can be even more uncertain for senior adults who often balance the need for high quality health services with the regulatory framework of Medicare and private insurance. Further complicating the landscape is the myriad of health options that exist for senior adults which can be difficult to understand, especially when aging care and services have been uncoordinated and prone to highly variable use and costs.

Integrated Senior Care Medical Practices

With an exponentially increasing aging population, health care providers are shifting their strategic focus and exploring new ways to coordinate care, lower cost, and improve outcomes. From acute and primary care to senior living and ancillaries, health care organizations nationally, and yes, even in Polk County, are shifting their emphasis to highly coordinated senior care. What is unique about this model? Simple, it is not episodic in nature but rather takes into account the whole person. The focus moves from standard, immediate care to long-term vitality and wellbeing, and from periodic intervention to tailored integrated services. In this complex maze of services, what presently exists in Polk County? The World Health Organization or WHO defines integrated care as “A concept bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion. Integration is a means to improve services in relation to access, quality, user satisfaction and efficiency.” These services as not just primary care, but involve anything and everything from health care to nutrition, wellness clinics and more. The idea is to create an “one stop shop” for senior adults to manage not only their health, but also their wellness and quality of life. These clinics focus on highly coordinated care intent on all of the health care needs. Locally, Polk County has a few, fully integrated clinics which offer a variety of services including spa services with theraputic massage, weight management, health navigators to assist with insurance and Medicare issues, and social workers who can assist senior adults with state benefit programs such as food stamps, Medicaid and Medicare applications, prescription drug programs, transportation programs and Part D plans.

Geriatric Medicine

Geriatric Medicine is a specialty that focuses on medical issues and diseases of aging, and of old age. Often referred to as a Geriatrician, these specialized physicians treat people over the age of 60, who may be healthy or experiencing multiple medical issues. Geriatricians serve as subject matter experts specializing in how medical conditions can impact one another, how medications interact with one another and the unique affect medications and medical issues have as you age. A unique qualifier for a Geriatrician is that they must be certified by two separate medical boards- internal or family medicine as a foundation and then specialized training in geriatrics. Geriatricians will have the designation of “Board Certified” in Geriatrics.

 

Internal and General Medicine / Family Medicine

According to the American College of Physicians, understanding the differences between these practices is, “…perhaps one of the most confusing questions for many students (and patients alike).” While the practices are generally similar, they do share some fundamental differences.

Internal medicine typically focus only on adults. These physicians train in mostly common general medical conditions but also include experience in each of the internal medicine subspecialties – endocrinology, rheumatology, and infectious diseases, and neurology. Internal medicine doctors will also train in and/or gain experience in such specialities as psychiatry, dermatology, ophthalmology, office gynecology, otorhinolaryngology, non-operative orthopedics, palliative medicine, sleep medicine, geriatrics, and rehabilitation medicine. While internal medicine physicians will treat patients over the age of 18, they do not always carry the board designation of a geriatrician. Internal medicine physicians can commonly be found in large clinics and in private practice. 

While internal medicine will focus primarily on adults, family medicine will work through the continuum of care from child to adult. Family medicine physicians often train in general medicine but are required to obtain specialized training in an in-patient facility and in emergency care. Family medicine education is broader in nature than internal medicine since it involves training in the care of children. Family medicine physicians can often handle a myriad of medical issues. Family medicine physicians may commonly be found in clinics, private practice, urgent and walk-in clinics, and emergency rooms. 

Walk-In Clinics / Urgent Care

As with internal medicine and family medicine, there are a few differences between walk-in clinics and urgent care. A walk-in clinic, normally found near retailers and in/or around pharmacies, provide a fast and affordable option for basic medical needs. Nurse practitioners and physician assistants typically staff a walk-in clinic and provide convenient services for insured and non-insured patients. Typical services will entail any common, non-threatening conditions such as minor injuries and illnesses like flu or cold treatment, strep throat, cuts, or skin conditions, as well as services like immunizations, physicals, and health screenings. Most locations are open seven days a week, with extended hours for convenience and affordability. Urgent care clinics are also a convenient and affordable alternative to the emergency room. Urgent care clinics are usually staffed with a physician and nurses and can provide additional capabilities not commonly available at a walk-in clinic such as radiology and lab work. Urgent care clinics are also open seven days a week with extended hours. Most clinics are available for insured and non-insured patients.

Specialty Care

The American Psychological Association (“APA”) notes, “As America’s population ages, the need for mental and behavioral health services continues to increase. Psychologists are playing a critical role in addressing these needs.”
According to the APA, mental health is a growing concern for the aging population. Specifically,

  •  Older Americans underutilize mental health services because of inadequate funding for mental health services; lack of collaboration and coordination among primary care, mental health and aging service providers; access barriers; stigma surrounding mental illness and treatment; denial of problems; and lack of trained professionals in the provision of geriatric mental health services.
  • Fear, distress, anger, stress, social support and relaxation have been shown to influence immune and cardiac functions, susceptibility to infection, pain, asthma and recovery from surgery. Mental health is a critical component in ensuring a high quality of life for older adults. In Polk County, several organizations exist to curb some of the influences that can affect a senior adult’s mental health. Several organizations help with companionship, food, and transportation, while others focus on deeper issues such as depression and anxiety disorders. Counselors, churches, and mental health providers have many programs available for senior adults.

Questions to Ask

Polk County has a plethora of services available to the aging population. From health care clinics offering convenient and comprehensive services to non-profit organizations aimed at helping you navigate, there is a right place for you. When looking for the best health care option in your community, think about these questions when exploring your options:

  • Where is the practice located?
  • Will it be easy for you to get there?
  • Is it accessible by public transportation?
  • Is there ample parking?
  • Which hospital(s) does the doctor use?
  • Are you comfortable with the possibility of being treated at one of these institutions should the need arise?
  • Where are routine x-rays and laboratory studies performed?
  • Can these be done in-office, or will you have to go to an outside laboratory?
  • How long must you wait for an appointment after you call?
  • Can you be seen on the same day if you have an urgent need?
  • Is the office staff friendly and courteous?
  • If you call with a question about your care, does a doctor or nurse return your call promptly?
  • Who covers for the physician when he/she is away?
  • Whom should you call if you have a problem after-hours?
  • If the doctor works in a group, are you comfortable with being seen by one of the practice partners?
  • Does the physician frequently refer patients to specialists or does he/she prefer to manage the majority of your care themselves?
  • Does the office have specialists in-house or contracted through another clinic?
  • Does the office process insurance claims, or must you pay up-front for services and file the claims yourself?