1. By Ann Rhodes RN,FNP, C October 29, 2011

2. Objectives: To learn about one of the many roles of the nurse practitioner in health care To learn about how “peeling the human onion” can lead to the empowerment of your patient, AND YOU. To learn about having a health care proxy and its importance.

3. Aging Statistics The oldest of the 77 million baby boomers approach their 60’s. The elderly and their concerns are moving higher on the national agenda. The older people are getting smarter, richer and healthier as time goes on. Ageism in America 2011

4. Aging Statistics The number of Americans 65 and older is projected to double over the next three decades from 35.9 million to nearly 70 million, comprising 20% of the population in 2030 compared to less than 13 % now.

5. Aging Statistics The 85-and-over population is the FASTEST growing segment- projected to grow from 4 million in 2000 to 19 million in 2050 as part of an unprecedented surge in longevity. Americans now turning 65 will live, on average, an additional 18 years.

6. 2006-2008 Most Frequently Occurring Medical Conditions of the Elderly: Hypertension38% Osteoarthritis 50% Type 2 Diabetes Mellitus 18% All types of Heart Disease 32%

7. The Alliance for Aging Research Reports: The elderly are less likely to receive preventive care and often lack access to doctors.

8. Barriers to Care: A shortage of geriatric specialists for the elderly Lack of transportation to medical offices Poor communication between clinicians with fragmentation of care

9. THE BIG QUESTIONS 1. HOW ARE WE GOING TO GET THE MEDICAL CARE WE NEED AS WE AGE? 2. WHO IS GOING TO PROVIDE IT?

10. A registered nurse with advanced academic and clinical experience who has completed a formal educational program at a Master’s level and is licensed by the State Board of Nursing.

11. Their practice emphasizes health promotion and maintenance, disease prevention, counseling, and patient education.

12.  Obtain health histories and perform physical exams  Diagnose and treat common illnesses and injuries  Recognize complicated medical conditions that require referral  Manage chronic medical conditions such as diabetes, high B/P

13.  Order and interpret diagnostic tests, including lab tests and x rays  Prescribe medications and other treatments  Advise on how to prevent disease  Offer education and counseling to assist in lifestyle changes  Give vaccinations  Refer to community resources and agencies

14. Working in collaboration with a physician or the patient’s physicians, a Nurse Practitioner provides high quality, cost-effective care to you and your family.

15. Chapter 168 On July 20, 2011, Gov. Cuomo passed the bill, Chapter 168, allowing Nurse Practitioners and Physician’s Assistants to complete and sign DOH 3122 forms in nursing homes and assisted living facilities. Patients will be able to have timely, comprehensive exams and episodic visits for medical issues.

16. What does it mean to peel the Human Onion?

17. Peel the Layers of the Person Down LISTEN to the person for whom you are caring Be attuned to his reactions and actions

18. Continue to Peel Allow him to know you are there as his advocate. Ask him what his wishes are for the rest of his life.

19. Nurse Practitioners can: Provide medical care in patient homes. Work with community agencies/ programs to improve quality of care. Collaborate with specialists and act as a case manager. Allow “aging in place.” Assist with transition to palliative care and hospice Allow the patient and their families to have their wish come true. Allow the patient to have dignity in life, and when dying at home.

20. Medical House Calls by Nurse Practitioners can: Reduce hospital admissions by finding small problems before they become big ones. Reduce the expenditures of Medicare and Medicaid Reduce unnecessary ER visits by caring for the patient with medical modalities at home

21. The Health Care Proxy It allows you to appoint someone you trust to make medical decisions for you if you lose the ability to make decisions yourself. Simple instructions included to complete it No lawyer or notary needed Can be completed in less than 15 minutes.

22. Empower Yourself and your loved ones Complete a health care proxy today Go to: www.health.state.ny.us/forms/doh- 1430.pdf · PDF file

23. Thank you