IKOR® provided an elderly couple and their 9 children a nutral solution. IKOR® ’s care plan addressed the medical issues with the senior couple. IKOR® helped them get the medicaid benefits. IKOR® also made a long term living arrangement for the couple according to their wishes. IKOR® RN Patient Advocate enhanced the quality of these two lives, saved the family long term out of pocket expenses, and gave back to Mr. and Mrs. C more of their disposable income.
Issues and Challenges
Mr. and Mrs. C reside in a blue collar suburban neighborhood where they raised their 9 children. 4 children still remain geographically close to their parents, with the remaining 5 children scattered throughout the United States. IKOR® was initially contacted by the eldest son who found IKOR® via the internet.
The children sought IKOR® 's help because they were concerned about the needs of the parents. They felt that the parents would benefit from moving to a facility, but were uncertain and divided upon the decision. In addition to the families identified concerns, during the referral process IKOR® discovered that Mr. and Mrs. C had $1600.00 per month in total accessible income, less than half of what they would need to pay for facility living. The couple also had $600.00 per month bills for medication expenses alone. The couple was Medicaid eligible but application for Medicaid had not been initiated. The children had never considered a Power of Attorney for either parent.
IKOR® Approach
The IKOR® RN assessment uncovered multiple medical issues. Mrs. C tested extremely high for depression. She had been diagnosed by her Family Doctor with diabetes, but had been performing the necessary home blood testing and was not following any formal diet. The medical history revealed that the medications she had been prescribed were either inadequate or inappropriate, exposing her to serious health complications.
Amazingly, Mr. C had 12 Doctors providing care at the time of the assessment. All had ordered medication. The eldest son confirmed that the Doctors were not aware of each other or the treatment they had prescribed. Mr. C was receiving multiple medications for high blood pressure and fluid retention. Mr. C had also been formally diagnosed with Gout, but had not been provided medication or diet to address the disorder. The weekend before the assessment Mr. C had been hospitalized for an acute flare up of this condition. Mr. C's children were concerned about his memory, and assessment testing confirmed a well- hidden, borderline cognitive loss with hostile tendencies. If the family delayed a decision regarding transition to a facility, acceptance to a facility would be highly doubtful. It was the conclusion of IKOR® , based upon review of the assessment information, including current living conditions, that Mr. and Mrs. C would benefit from Assisted Living. Assisted Living would mediate the medication problem by providing immediate oversight
IKOR® then assisted the family in selecting a new family Doctor who specialized in geriatric care. This change further addressed the medication issues by centralizing the prescription process and in general enhancing Mr. and Mrs. C's overall medical care. The IKOR® RN provided the remaining treatment providers with records regarding all of the care currently being given, thereby enabling safe, focused ongoing care. IKOR® recommended an Attorney who specialized in elder law to address the Power of Attorney, and obtained the necessary applications for Medicaid. The RN care manager educated the family to recent changes in Delaware (State) policy regarding Medicaid which would enable the parents to enter Assisted Living using Medicaid as the pay source. IKOR® identified an Assisted Living center in close proximity to the 4 local children, with an apartment living layout, who would accept Medicaid. To address the ongoing medication expenses, IKOR® located a pharmacy supplemental plan. This prescription plan would pay 75% of all prescription costs for both parents at no cost to them or their children.
Case Outcome
As a result of IKOR® intervention, Mr. and Mrs. C now reside in a comfortable apartment, eat fresh and medically appropriate meals in a restaurant style dining room, and enjoy an new social life. Through attendance in the many social functions of the center, Mr. C is enhancing his mental function, and Mrs. C is no longer shows signs of depression. IKOR® RN Patient Advocate enhanced the quality of these two lives, saved the family long term out of pocket expenses, and gave back to Mr. and Mrs. C more of their disposable income.
