Overlake Senior Health Clinic Guards Against Patient OvermedicationApril 24, 2014
Reducing 92-year-old patient’s medications from 20 to five prescription medications serves as stark reminder of risks of overmedication and severe side-effects
Our providers emphasize prevention and wellness and are specially trained to meet the health and psychosocial needs of seniors.
The core team is comprised of:
The initial visit is a very important step in establishing care at the Senior Health Clinic. Patients undergo a comprehensive 90-minute evaluation addressing all aspects of their care. The visit establishes a solid foundation for a successful partnership with the medical team.
The first 30 minutes is spent with the geriatric pharmacist, who will obtain an accurate medication list and counsel patients regarding their medication regimen. The patient is encouraged to bring all of their medications to the first visit, including any over-the-counter medications and supplements.
The pharmacist then discusses the patient’s care directly with the geriatrician, who will be updated on the current medication regimen. The pharmacist and geriatrician then discuss potential areas for change and optimization of the medication regimen.
The patient then undergoes a 60-minute evaluation by the geriatrician. This is a wonderful opportunity for the physician to get to know their patient. In addition to obtaining a thorough medical history, there is an emphasis on getting to know patients personally. By understanding someone’s background, family situation and culture, an individualized approach to the patient’s care can be formulated, which respects their wishes and values.
Subsequent visits are 30 minutes with the geriatrician. Any acute medical problems are addressed, as well as follow-up of chronic conditions. These visits offer an opportunity to check in with the geriatrician to maintain health, function and well-being. Visits are two to three times longer than a typical primary care visit, as many of the issues facing seniors take time to evaluate and address appropriately.
Hospitalization is often a traumatic and stressful event in seniors’ lives. The transition from hospital to home can be a period fraught with uncertainty, fear and confusion. The Senior Health Clinic provides Transitional Case Management Services to assist seniors and their families during this difficult period.
Patients will receive a call from a registered nurse specializing in seniors within two business days of discharge from the hospital. During this call, the nurse will check to see how the patient is doing, ensure there is proper follow up arranged and answer any questions that have arisen since discharge.
Within 10 business days of discharge, a Transitional Case Management visit will be arranged at the office. As medications often change during a hospitalization, the pharmacist conducts a thorough medication reconciliation and updates the patient’s medical records. Potential problem medications are identified.
The geriatrician then conducts a comprehensive post-hospitalization evaluation to ensure that there is a good plan to optimize recovery. Any issues that have come up since discharge are addressed, including arranging rehabilitation, social services, and home health.
This is an introductory visit available to new Medicare patients within 12 months of obtaining Part B coverage.
During the visit:
This is a visit covered by Medicare to discuss preventive care. Eligible patients are beyond their first year in Medicare. The visit cannot be within the same year as the Welcome to Medicare exam.
During the visit:
Your provider will:
This is a visit covered by Medicare annually and is similar to the initial Medicare Annual Wellness Visit.
During the visit:
Registered nurses who specialize in senior care are available throughout the week to patients and families to provide advice and guidance over the phone.
The registered nurses can help order medical equipment, refer to home health agencies and provide information on community resources.
Geriatricians can help facilitate difficult end-of-life discussions with sensitivity and compassion. The utmost effort is made to document and honor patients’ wishes for the last part of their lives. It is strongly recommended to initiate these discussions when patients are feeling well, rather than wait until an emergent situation occurs.
Patients of the Senior Health Clinic have access to a medical professional 24/7, 365 days a year. A registered nurse who specializes in seniors is available by phone to patients and their families during regular clinic hours. The nurse coordinates the care closely with the patient’s geriatrician to ensure the medical team is updated with any new issues or concerns. After hours, the patient’s geriatrician is available by phone for urgent issues. On weekends and holidays, there is always a geriatrician on call to provide advice by phone. Patients with urgent or emergent issues will be referred to the emergency room.
In addition to the comprehensive initial medication evaluation and transitional case management, patients enrolled in the Senior Health Clinic get unparalleled medication management.
Four pharmacists specializing in geriatrics evaluate every request for medication refills for safety and appropriateness. Important parameters that can affect medication effectiveness and safety, such as kidney and liver function, are monitored by the pharmacists. Any appropriate changes to medication choices or dosages are referred directly to the patient’s geriatrician for consideration.
Patients who require blood thinning with Coumadin (warfarin) can have their Coumadin dosages monitored and adjusted by the pharmacists at Senior Health. This is very beneficial, as the care can be coordinated closely with the patients’ geriatrician.
Patients and their families who have specific questions about medications can discuss them with a geriatric pharmacist during regular business hours.
Open to anyone 65 and older, the clinic accepts the following major insurances and most supplemental insurances including:
*Please Note: This is a hospital-based clinic and if you are treated here you will receive a bill from Overlake Medical Center.
Overlake's Senior Health Clinic is accepting patients for geriatric consultation for complex geriatric issues like falls, memory loss and complex medication reconciliations. All our Geriatric consults include a 30 minute medication management appointment with a licensed pharmacist, followed by a 60 minute appointment with the physician. We are happy to make recommendations to the primary care provider regarding these issues and work in conjunction with the primary care provider for management of these issues.