Jerry is a 77 year-old man who was referred to PrimeCare by his Massachusetts
General Hospital (MGH) primary care physician (doctor). At the time he
was struggling with several medical conditions while living alone in an
apartment in Boston. His close family members believed he was unsafe.
However, as Jerry did not wish to leave his apartment, they had been unsuccessful
in intervening and finding an alternative living situation for him. The
doctor was frustrated because Jerry was not taking his medications as
prescribed, and he often refused care from visiting nurses.
The PrimeCare care manager met with Jerry’s family and doctor to
discuss his living situation and how to best manage his care. The family
and doctor did not agree about where Jerry should live. His doctor believed
a long-term nursing home scenario was inevitable, and therefore likely
most appropriate for his current placement. The family wanted to see if
Jerry would be happier and thrive in a “lower-intensity” assisted
After making a thorough assessment of Jerry’s situation, including
his numerous medical and psychosocial issues, the care manager determined
that Jerry was too medically unstable to transition to an assisted living
environment. However, she also thought that much of his instability might
have resulted from unidentified neurological issues. She convinced Jerry’s
doctor that admission to the MGH for a comprehensive neurological examination
might be helpful. As a result of this admission and subsequent examination/testing,
Jerry was diagnosed with a new but mild stroke and treated at the MGH.
He was then discharged for a short-term stay at a skilled nursing facility,
with the ultimate goal of final discharge to an assisted living facility.
In Jerry’s case, the care manager’s medically focused perspective
and expertise resulted in treatment and care that facilitated his ultimate
transition to an assisted living facility. Her efforts not only met Jerry’s
needs, but also satisfied the caregivers and medical providers that looked
after him on a regular basis. Jerry was successfully transitioned to an
assisted living facility where he receives meals on a regular basis, has
help with taking his medications and perhaps, most importantly, he is
not isolated and alone. In fact, the PrimeCare care manager introduced
him to another of her clients who was living at the same facility. They
are now in regular contact with each other, sharing meals and keeping
an eye out for each other.
Medical conditions often underlie and drive the issues and problems
that elders and their caregivers experience. PrimeCare, with its unique
medical focus and expertise, will help to identify and resolve the medical
conditions contributing to elder decline and frailty. Your care manager
will work directly with the elder’s physicians and other care providers
to ensure the best medical care possible. With the medical conditions
under control, you and your elder can focus on making appropriate life
decisions to ensure the elder’s safety, vitality and happiness.
Dan is a 74 year-old retired gentleman living with his wife in their split-level
home in a community north of Boston. Recently he become increasingly frail
and had experienced a number of falls at home; the last one resulting
in his laying on the floor of his home alone for over 4 hours. His wife,
who has a part-time job, is frequently away from the home for extended
periods of time. After this last fall, she became fearful about leaving
him home alone.
After speaking with a friend about PrimeCare, Dan’s wife contacted
our care manager and discussed the situation. Following this conversation,
a one-hour meeting was planned with Dan, his wife and the care manager
in the PrimeCare office. With the guidance of the care manager, Dan and
his wife were able to have an open and frank discussion about their situation.
After the meeting the care manager designed a report for Dan and his wife
that offered specific recommendations and information about how to best
support both Dan and his wife. These recommendations included:
||enrolling Dan in a formal physical therapy program to
evaluate, assist and strengthen his mobility
||securing Lifeline emergency assistance service
||providing techniques to prevent falls and subsequent injuries
The care manager called Dan and his wife several days later to review
and discuss the care report recommendations, and to answer any questions
they might have, provide additional guidance, etc. Dan and his wife were
extremely happy with the report recommendations and the concrete care
plan provided by PrimeCare. They felt better about their situation and
were now prepared to handle many of the daily living issues they had struggled
A frail elder living or left alone in a home can be of great concern
to those who care for them. PrimeCare can assist you in evaluating your
elder for safety in the home, and in devising a care plan that will allow
your loved one to be safe and supported in their home. As evident above,
such plans may include both medical and home environment strategies. Our
primary concern is always the safety and well being of the elder, and
the peace of mind of their primary caregiver.
The Ambulance Ride
Grace is a 72 year-old woman who lives in southern Massachusetts, but
who receives her medical care in Boston at the Massachusetts General Hospital(MGH).
She had always been able to drive to her doctor’s appointments,
but she recently experienced an illness that left her unable to drive
a car, or even sit up. As her daughter was unable to transport her to
appointments, Grace would need to find some type of alternate transportation
to continue her necessary medical care in Boston.
Initially, Grace’s daughter arranged for ambulance transportation
and paid several thousand dollars for these rides (not covered by Medicare).
As you might imagine, cost was becoming prohibitive, and Grace and her
daughter turned to PrimeCare to determine whether less expensive transportation
might be available. After researching the possible options, and following
three separate discussions with one ambulance company’s director,
PrimeCare was able to convince the company to accept a reduced fee of
$1,200 per transport, this well below the average local rate of $2,000.
Grace has continued with her medical appointments at the MGH and she
is saving $800 on each ambulance transport. In addition, the PrimeCare
care manager coordinated a plan whereby Grace could have her day-to-day
medical care (such as treatment of a cold, routine physicals, etc.) provided
by a local physician, thereby minimizing the ambulance rides to Boston.
In this fashion, Grace would receive cost effective care appropriate to
her medical needs.
One of the many benefits of engaging PrimeCare is that we have the
knowledge and resources to identify and secure effective, low cost care
options for caregivers. This often includes negotiating pricing and other
service agreements that most caregivers would not be aware of. As we are
a medically focused service provider, we work closely with our clients
to ensure they receive the highest quality medical care possible, and
with the least interruption to their daily lives.