Wednesday, the primary care team came from NaviCare, Kathy’s new health plan. (See my previous post about it). It was day one of coverage. Miguel is our Navigator (commercial pun intended). He will be the main contact: getting any approvals for this and that, and he will make Kathy’s first appointment with her new doctor. He will get any needed authorizations for ambulance rides to her doctor and dentist appointments. And he is ordering supplies for her like incontinence briefs, creams and pads.
The nurse manager’s name is Robin. I started to fill her in on Kathy’s health history. I was in such a panic to get Kathy’s team going on this first day that they had no records and no real health information about Kathy. It’s another by-product of the patient privacy thing called HIPPPPPAAA (Note to Peter: look up correct abbreviation. It doesn’t look right.) Basically NaviCare couldn’t get information until they were in charge on October 1. It was pretty hectic anyway. Three people talking to me with Kathy asleep a few feet away. Marty was penned up in the bedroom whining for attention. He has had an upset stomach and was puking with regularity. I had a hard time remembering when this and that happened. I could tell Robin that she had Huntington’s Disease. They didn’t even have that yet. I guessed at a bunch of stuff: last visit to the doctor; last flu shot; last pneumonia shot; and when and why she was in the hospital. I need to create one file with a summary or time-line of what her story is. I did have her med-list all printed out.
Angella is our new case-manager from Greater Springfield Seniors (GSSSI). I think she coordinates all the home health aides for this type of comprehensive insurance plan. I made certain before switching, that the aides we have would be covered. I feel fortunate to have the amount of help I am getting now. Angella asked if it was enough. They want to get me as much help as I can use. I asked if I could think about it and get back to her. The only thing I think of was trying to go to my Huntington’s Disease Caregiver support group at UConn once a month. That didn’t seem to be a problem. But I brought up “suctioning.” Robin nodded at the suction machine and asked if I need to use it often. I said there are periods each day and evening. Whoever is here needs to be willing and able to suction Kathy’s throat if she starts to choke on saliva or throat gunk. That’s one of the reasons I have to keep within a 15 or 20 minute drive of the house. I’ve never been sure whether aides are allowed to do it. There are whole lists of what different health care workers can do and should not do. They can’t cut fingernails and aren’t supposed to move furniture. There are things that need to be done by skilled nursing or medical specialists. One of Kathy’s aides was dismissed from an assisted living home where she worked because she wasn’t authorized to do the Heimlich Maneuver and CPR. The nurse who didn’t want to do the Heimlich turned her in. The nurse and the aide were both let go – one for doing what the other didn’t do. But that is the kind of aide I want.
At any rate, I need to do some planning and figure out when and where to plug the help in. It might be just adding some time to the help Kathy is already getting and filling in some of the afternoons. Kathy could be changed by an aide instead of by me. My back might appreciate the break, I suppose, and Pat and the girls do a much better job at it. They are so familiar with different tricks and getting the best leverage that Kathy gets rolled around less. My method is a cross between high school wrestling and rodeo calf-tying. So, we’ll see what happens.