1. Caring for Aging Parents “Children, obey your parents in the Lord: for this is right. Honor your father and mother; which is the first commandment with promise; that it may be well with you, and that you may live long on the earth.” (Ephesians 6:1-3) Week 4 | Negotiation the Healthcare System, Part 2 | March 29, 2015

2. Negotiating the Healthcare System, part 2 MARCH 29, 2015  Coordination of care across multiple doctors (primary care physician, allergist, audiologist, cardiologist, cardiothoracic surgeon, cardiothoracic vascular surgeon, chiropractor, dentist, dermatologist, electro physiologist, gastroenterologist, general surgeon, bariatric surgeon, gerontologist, ob-gyn, hematologist, internist, nephrologist, neurologist, neurosurgeon, oncologist, ophthalmologist, orthopedist, otolaryngologist, pain management specialist, sleep specialist, physiatrist, reconstructive surgeon, podiatrist, psychiatrist, psychologist, radiation oncologist, rheumatologist, urologist, vascular surgeon, wound care specialist)  Managing prescriptions  Emergencies (when/who to call, transportation, hospital emergency departments)  Hospitalization, Rehabilitation, Transitions (to home, to long-term care) 2015-03-29 Caring for Aging Parents 2

3. Meet today’s panelists 2015-03-29 Caring for Aging Parents 3

4. Mike Norwood Mike Norwood : Mike Norwood retired from 12 years with TN Dept. of Health after being in retail 4 years and in ministry 32 years. He currently acts as Conservator and Guardian for his mother-in-law who resides at Claiborne Hughes in Franklin. She suffers from vascular dementia and has been in residential care for over 6 years. 2015-03-29 Caring for Aging Parents 4

5. Travis Johnson Travis has attended Berry's Chapel for 30 of his 33 years of existence. He has been in EMS for 12 years. Worked for Dekalb EMS for 5 years as an EMT. Moved to Smithville for 3 of them and attended Paramedic school at Tennessee Tech. Moved back home to Franklin in 2008, and have been employed through Williamson Medical Center EMS since as a Paramedic / Field Training Officer. Teaches various classes for CPR Nashville. When not working assists in the wrangling of his 4 kids. 2015-03-29 Caring for Aging Parents 5

6. Rhonda Wood Rhonda Wood - Rhonda has been a Registered Nurse for 35 years, and currently works as a health coach with CareHere in Brentwood since 2006. Rhonda's introduction to caregiving began in 2006 when her father was diagnosed with Alzheimer's and once again when her mother-in-law was diagnosed with Alzheimer's disease in 2008. Logistically, both parents were cared for remotely with coordinated efforts from family, friends, and loved ones. 2015-03-29 Caring for Aging Parents 6

7. Our Faith Lament over Judah “Is there no balm in Gilead? Is there no physician there? So why has the healing of my dear people not come about?” (Jeremiah 8:22, HCSB) 2015-03-29 Caring for Aging Parents 7

8. Our Prayer today  Patience  Persistence  Perspective 2015-03-29 Caring for Aging Parents 8

9. Patient-Centered Medical Home (PCMH) 2015-03-29 Caring for Aging Parents 9

10. Accountable Care Organization (ACO) 2015-03-29 Caring for Aging Parents 10

11. Comments from our panelists… 2015-03-29 Caring for Aging Parents 11

12. Mike Norwood “Will you please promise me that I won’t have to go to a nursing home?” 2015-03-29 Caring for Aging Parents 12

13. Travis Johnson 2015-03-29 Caring for Aging Parents 13

14. Rhonda Wood “In today’s world, navigating the healthcare system can be very intimidating. It requires organization, knowledge, and appropriate resources to advocate for yourself or your loved one, resulting in desired continuity of care.” 2015-03-29 Caring for Aging Parents 14

15. How do I advocate for myself or others? 2015-03-29 Caring for Aging Parents 15

16. The Team  Patient  Professional Care Providers  Family  Friends/Neighbors  Clergy  Legal/Financial Counselors 2015-03-29 Caring for Aging Parents 16

17. Get Organized! Notebook:  Forms of Personal ID -Copies of Social Security Card, Driver’s License, Passport, Birth Certificates, Marriage Licenses, Death Certificates, Military Discharge Papers  Medication Record  Contact info of every doctor (provider)  Health/Pharmacy care Coverage information  Copies of Healthcare Records from all providers  Notes from Doctor, Lawyer, Accountant, Banker meetings 2015-03-29 Caring for Aging Parents 17

18. All those Dr. appt…..  Establish care with a Primary Care doctor who understands older adult care concerns and will work with the patient and family to establish a “medical home”  Geriatric Specialist  Care Manager  In time, simplify!!! 2015-03-29 Caring for Aging Parents 18

19. Your Guide to Medicare’s Preventive Services http://www.medicare.gov/Publications/Pubs/pdf/10110.pdf 2015-03-29 Caring for Aging Parents 19

20. According to Consumer Reports on Health… “Any new health problem in an older person should be considered drug induced until proven otherwise”. 2015-03-29 Caring for Aging Parents 20

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22. Healthinaging.org In 2012 The American Geriatrics Society updated the BEERS Criteria: Medications that older adults should avoid or use with caution Healthcare providers use the AGS Beers criteria when whether and what to prescribe for older adults The criteria does not take into account all of the unique circumstances of older people getting palliative or hospice care. 2015-03-29 Caring for Aging Parents 22

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25. Next week 2015-03-29 Caring for Aging Parents 25

26. Financial and Legal Issues April 5, 2015  Wills  Power of Attorney  Estate Planning  Protecting and preserving assets  Reverse mortgages?  Investment options appropriate for aging parents  Family members financial responsibilities (or potential responsibilities)  What should be considered when multiple children are involved 2015-03-29 Caring for Aging Parents 26

27. Resources Available 2015-03-29 Caring for Aging Parents 27

28. Everything in One Place 2015-03-29 Caring for Aging Parents 28 http://berryschapel.org/ministries/caring-for-aging-parents