Choosing a health care option
One of the most important and challenging aspects of being a caregiver is determining when an older adult may need medical attention from a clinical expert. The decision is not always obvious, and there are a range of options available. This article outlines the main types of health care options available and offers some examples of the types of care provided.
Challenges in deciding care type
One of the most important and challenging aspects of being a caregiver is determining when an older adult may need medical attention from a clinical expert. A second challenge is deciding where to go for help. It’s important not to overreact or to fail to act when it’s necessary.
Caregivers must often consider many factors when deciding which care option is best. Ultimately, decisions about care and treatment are the shared responsibility of the older adult, caregivers, and medical team. However, knowing what types of care are available and the services offered can help.
General health care options include:
Emergency departments and trauma centers are equipped to deal with virtually all life-threatening health conditions. If you think a condition could be life-threatening, you should call 911 or arrange for ambulance transport to an emergency department or trauma center.
Emergency care examples may include:
- Heavy bleeding
- Heart attack symptoms
- Inability to speak or see
- Inability to move
- Injury to neck or spine with loss of feeling
- Loss of consciousness
- Pain in the arm or jaw
- Potentially broken bone
- Prolonged diarrhea
- Prolonged dizziness
- Prolonged high fever
- Severe burn
- Severe chest pain
- Severe headache
- Severe pain
- Stroke symptoms
- Sudden confusion
- Suicidal thoughts
- Trouble breathing
If you call 911, they can send emergency personnel and the appropriate ambulance, rescue squad, or non-emergency transport. If the situation does not appear to be life-threatening, and moving the person does not appear to create additional risk, it is advisable to have a another person in the vehicle—in addition to the driver and the person in need of care.
There are over 6,000 urgent care clinics in the United States. They are staffed with doctors and other medical health professionals and are often associated with health systems. They also accept walk-in patients, and can help with a wide range of non-life-threatening conditions. It is advisable to have someone accompany the person in need of care to the center to help with safe transport and with plans for care and follow-up.
Urgent care examples may include:
- Ear pain and infections
- Eye irritations
- Food poisoning
- Hives and rashes
- Sinus infections
- Sprains and broken bones
- Stomach flu
- Strep throat
- Urinary tract infections
- Wound repair
A primary care physician (PCP) is sometimes also referred to as a general practitioner (GP) or simply a person’s “doctor.” Often, and unless it’s an emergency, the PCP should be the first health care provider to contact anytime “something is wrong” but you are not sure what it is, or for follow-up and ongoing conditions. PCPs are trained to handle most non-emergency conditions. They can handle preventative care, screenings, and can diagnose and treat many common conditions like colds, flu, bronchitis, asthma, rashes, and minor wounds. Most importantly, a PCP can refer you to the most appropriate specialist.
Specialty care is a broad category of healthcare that covers the many body systems and disease-specific branches of medicine. In many instances, primary care physicians, or clinicians at urgent care centers or ERs will make referrals to specialists for care. In addition, seeing a specialist may be beneficial if you are confident of the type of care that is needed or have an existing relationship with a specialist.
Specialist care may include:
- Cancer care
- Ear, nose, and throat
- Kidney disease and dialysis
- Ophthalmology and optometry
- Psychiatry and psychology
Home health care
Clinical care at home is typically delivered by nurses or therapists, sometimes assisted by medical technicians. The visits are usually initiated by clinical teams for follow-up or on-going care for chronic conditions. If this is an option available to you, it can be convenient. Services can include checkups, changing of wound dressings, IVs, and portable imaging and other diagnostic tests. Custodial services such as personal hygiene, house cleaning, laundry, and meal preparation are generally NOT considered to be home health care and are not likely to be covered by health insurance plans.
Retail clinic care
Retail clinics are medical facilities inside drugstores, pharmacies, and big-box stores, such as Walmart, Walgreens, and CVS. They can be convenient sources of medical care for non-urgent issues. Retail clinics are usually staffed by nurse practitioners or physician assistants (medical professionals with fewer years of training than doctors) and may be used on a walk-in basis or by appointment.
Retail clinic care examples may include:
- Colds, coughs, and flu symptoms
- Preventative care such as shots and physical exams
- Sinus and ear infections
- Urinary tract infections
Care delivered by a health care provider using communication technology has become commonplace and efficient for certain situations. It is often a good first contact with a medical professional, with triage (initial assessment) and treatment handled by a medical assistant, nurse, nurse practitioner, or physician’s assistant trained to deal with virtual care conditions. You will need to verify with your plan, but many health plans often encourage and completely cover virtual care as a benefit.
Virtual care may include:
- Behavioral health therapy session
- Follow-up video conference or phone call in lieu of an office visit
- Prescription refill
- Remote monitoring using in-home and personal health tracking devices
- Urgent care
Self-care in a medical sense refers to a person taking care of their own medical and health care needs without explicit direction from a medical professional. This care can be preventative in nature (keeping the problem from occurring) or curative (treating a problem that already exists).
Self-care may include:
- Taking over-the-counter (OTC) medicines for coughs, headaches, cold, fevers, etc.
- Prescribed treatment for chronic conditions such as diabetes, asthma, COPD, and even dialysis
- Treatment of cuts, bruises, and inflammation
Admission to a hospital is generally determined by medical professionals. The two most common paths to hospital admission are from the emergency room or as a result of scheduled procedures.
Hospital care examples may include:
- Heart failure
- Serious conditions and injuries requiring additional and on-going care
- Surgical procedures
In addition to general hospitals that provide in-patient and out-patient diagnosis, treatment, and short-term care, there are specialty hospitals that provide a range of rehabilitative, long-term and palliative care options. Those facilities are typically recommended by medical teams, and should be investigated to understand insurance coverage and out-of-pocket obligations.
Making the home safe for older adults
Overview of home health assistance
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