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by Lynne Mumaw-Black, NP, Geriatric
Nurse Practitioner, Corona Family Medical Group, Corona, CA
With the growth of the older adult
population, community-based elder health services are becoming critical
components of the continuum of care for many health systems. These
specialized health service centers for older adults, called "senior
clinics," may vary widely in mission, scope of available services,
background and skills of providers and overall capacity. The American
Geriatrics Society has developed the following information to help
you evaluate the services of the senior clinics available to you.
Many people still believe old age means sickness, which
is not true.
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Q. What is a senior clinic?
A. It is a group of
health care providers specializing in senior care. The
clinic may be part of a hospital system, a large group
practice, or a smaller private practice. Locations identifying
themselves as a "senior clinic" should offer
a range of services custom-made for older adults.
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Q. Aren't most of my health problems
just part of old age? Why would I need a special clinic?
A.
Many people still believe old age means sickness, which is not true.
The health care providers in a senior clinic should have expertise
and training in diagnosing or recognizing and managing the common
problems that occur with aging. They are focused on treating you
as a whole person, including your physical and mental health, and
your ability to function in your everyday activities.
Q. What
happens at a senior clinic?
A.
The senior clinic should have special programs to diagnose and treat
the most common problems older adults face. Some of these are:
- incontinence
- arthritis
- memory loss
- falls
- depression
- problems managing daily
activities at home
Your care is usually provided by a group of people called a "team."
The team may consist of two or more of these providers:
- physician
- nurse or nurse practitioner
- physician assistant
- social worker or care
manager
- occupational therapist
- physical therapist
- psychologist or psychiatrist
- pharmacist
- dietitian
The team will help you with your mental and social needs, and monitor
your ability to do the things you need to do everyday. They will
meet regularly to check on your progress and give you advice about
your care. For example, a social worker or care manager can help
you and your family connect with local services. In some clinics,
the team will oversee your care while you are in the hospital, a
nursing home, or an assisted living facility. Senior clinics work
best when you can receive care there on a regular basis. This is
called primary care. The clinic may have a service that is a one-time
evaluation of your health problems, but you should be able to go
to the clinic for care after the evaluation. You will likely receive
information and written material about your own health so you can
take charge of it whenever possible.
Q.
What credentials should the providers have?
A.
The physician in a senior clinic should have a certificate of added
qualifications in geriatrics (CAQ). He or she may have completed
a fellowship in geriatric medicine, or have extensive experience
and continuing education in geriatrics in place of the certification.
Nurses should have advanced education in geriatrics, and may be
called nurse practitioners or clinical nurse specialists. Staff
in senior clinics should have senior sensitivity training, which
is usually taught at a community college or by the clinic's sponsor.
Q.
What is special about the office or clinic site?
A.
A well-equipped senior clinic should have:
- adequate parking and
handicapped accessible spaces
- public transportation
access
- enough space for wheelchair
and walker access in the exam rooms, rest rooms and lobbies
- enough lighting to
assist with reading signs and materials
- exam tables low enough
for those with less physical mobility
- areas where you can
talk about private concerns without others hearing you
- telephones for people
with hearing loss
- a library with information
about community resources
Transportation services should be
provided by the clinic or clinic staff may help you find local transportation.
Q.
How will team members know what each is doing for me?
A.
The clinic should have a way of sharing information about your care
with other people caring for you. For example, reports about your
stay in the hospital should be shared with the skilled nursing facility
and the team at the clinic. Ask how the clinic makes your records
available to the rest of the team.
Q. How will I know
the team is doing a good job?
A. The clinic
should give regular reports to the community and to patients about
the effectiveness of the care being given. For example, the clinic
might print information on the immunization rates of the clinic's
patients. You should also be given the chance to tell the clinic
staff how you liked the services they gave you, and the team members
should have enough time to spend with you and your family to address
your concerns.
Q. How will I pay for
the care?
A.
You need to ask about the fees the clinic charges for its services,
and find out whether or not Medicare and/or your other health insurance
will pay for these services. Most clinics offered through managed
care or HMO plans do not charge extra fees for their services-but
again, you need to ask! There may be special financial payment plans
for older adults who have limited financial resources.
Q. How
can I find out if there is a senior clinic near me?
A.
You may call the American Geriatrics Society at (800) 247-4779 for
referral information, or check the AGS website at www.americangeriatrics.org.
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