Support groups and resources for seniors

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-host Dr. Rajay Seudath and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Rajay Seudath.

CARMENN MILES
Hello everyone and thank you so much for joining us today on the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles and I'm excited to jump into another great conversation today. For those joining us for the first time, every week we delve into health and wellness topics that really matter, especially for our senior community. Our goal always is to share practical health information that helps all of us live healthier, happier lives, and maybe, just maybe, we can adopt some great health tips and practices that will impress our doctors at our next appointments. We're thrilled you're tuning in today. Our regular listeners are likely familiar with our great co-host today, Dr. Brooke Mobley. She's not only been a guest on our show but has shared some pretty amazing health care tips as a co-host as well. A little bit about Dr. Mobley. She graduated from Xavier University of Louisiana in 2003. She went on to obtain her masterÕs in business administration from Saint Joseph's Hobbs School of Business and Doctor of Osteopathy from Philadelphia College of Osteopathic Medicine. During medical school, she was active in the Student National Medical Association. She completed her internal medicine residency and the Nephrology Fellowship at Christiana Care Health Services in Delaware. Dr. Mobley began her nephrology career in Lake City, Florida, where she established a renal disease clinic and served as medical director of a dialysis clinic for DaVita Kidney Care. After the birth of her daughter in 2015, she moved to Tampa, Florida, where she started her hospitalist career with Optum. She later developed a skilled nursing facility program for the Tampa and Orlando areas as a lead physician and later associate medical director. Currently, she is the medical director of Post Acute Care for Optum and WellMed patients for the state of Florida. While Dr. Mobley's experience runs far and wide, as you've heard, my absolute favorite thing about Dr. Mobley is she gives back. She actively mentors medical students and founded a charitable organization called Purple Tears, contributing to the development of minority medical professionals. She frequently speaks at conferences on topics like cancer, medical disparities, domestic violence, and motivational subject matter. Welcome back to Docs in a Pod, Dr. Mobley. How are you today?

DR. BROOKE MOBLEY
I'm great. I like to be on this side of things as a co-host and be able to enlighten and show the support of other physicians being an actual guest. So, I look forward to today's topic. I know we're all going to learn from it, and I look forward to hearing to see what Dr. Juarez has to say.

CARMENN MILES
We are so excited to have you here today. As you mentioned, we do have a special guest today, Dr. Jocelyn Juarez. She's an internal medicine physician and hospitalist with WellMed's medical center pod in San Antonio, Texas. Dr. Juarez was born in Nuevo Laredo, Mexico, moved to San Antonio in high school, and pretty much never slowed down from there. She earned two bachelor's degrees in biology and French from UTSA, then went on to complete medical school at UT Health San Antonio. She later headed down to Harlingen, Texas for her internal medicine residency, which she wrapped up in 2019. She's been practicing as a hospitalist for more than eight years now, and in 2023, she joined WellMed Medical Management, where she first led the downtown San Antonio hospitalist group. Fast forward to today, and she's the physician manager and lead hospitalist for WellMed's medical center team. What I really believe sets Dr. Juarez apart is how she views medicine. For her, it's not just a profession. It's truly a ministry. I knew the moment that I met you late last year that you lead with God's love through service, through humility, and through dedication. It's evident in the way that you care for your patients and lead your team. So, when you're not making patients well, she's all about family time with her husband and their two sons. We're thrilled to have her here with us today. Dr. Juarez, welcome to the show. How are you?

DR. JOCELYN JUAREZ
Thank you very much. I'm doing well. It's great to be here. I'm very grateful for the opportunity.

CARMENN MILES
Very good. We're going to jump right in. On our topic today. Dr. Juarez is going to give us the 411 on all the support and resources that are available to our seniors. If you've ever felt isolated or overwhelmed by a gazillion health care options out there, or maybe you're just unsure where to turn to for resources, today's episode is your road map to support. Support groups aren't just for crisis scenarios. I think that you're going to share with us today, Dr. Juarez. They are a tool for connection to gain confidence and for practical help and guidance. Today we're going to cover resources that are available to seniors, what support groups are, how they help, where to find them and how to choose the right group. Dr. Juarez, what do you wish people understood most when we say support group? Why our support groups so important?

DR. JOCELYN JUAREZ
When I think of support, I think of not being alone. Knowing that even when things are difficult, there is help available. For me, I see patients at their worst because I'm a hospitalist. So, when I see them in the hospital, they're usually in a very sick state. One of the things that I love about WellMed and Optum is all the support and things that are available. And if I can, if it's okay, I wanted to kind of start out by just mentioning some of the things that we have available from the hospitalist perspective.

CARMENN MILES
That's great. I want to jump into that, but I just want to take a moment to welcome those who may have just joined us. You're listening to the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles alongside co-host Dr. Brooke Mobley. Our podcast is available wherever you listen to your podcasts, and we're also available on the radio in several Texas and Florida markets. We're talking with our special guest today, Dr. Jocelyn Juarez, about the benefits of support groups and the great resources that most of us don't know are really available to seniors. Go right ahead, Dr. Juarez.

DR. JOCELYN JUAREZ
One of the support resources, and maybe not everybody would think of this as support, but when a patient discharges from the hospital, they have the ability to follow up with their primary care physician, whether it's virtually through a quality transition clinic or with their own primary care physician. For me, that's a great support that is provided by WellMed/Optum to patients that are in the hospital and will be going home. This is mostly for patients that will be going home. If they're going to a skilled nursing facility that will be set up later, b ut I wanted to highlight this because it's something I educate patients on. Being able to have that follow up within seven days from the discharge is key. This helps to go over medications, any changes to the medications, any hospital course that is needed for the primary care physician to be aware of if there's a new diagnosis, if there's a change in the diagnosis and then even provide further education if something has changed. I think this is extremely important, not only because it helps our patients with their health, but it prevents readmission. So, it helps the patients stay home rather than having to come back to the hospital if something were to come up within those seven days. So, that was one of the things that I wanted to kind of just start out by saying that is available to our patients. IÕve worked for other hospitalist groups and other companies, and unfortunately, I would just discharge patients not knowing if they were going to follow up but knowing that they have this support available and that we make sure they have that appointment set up before they discharge is huge.

DR. BROOKE MOBLEY
Dr. Juarez, I have a question.

DR. JOCELYN JUAREZ
Yes.

DR. BROOKE MOBLEY
With this population there is a subset of patients who fortunately don't go to the hospital often. They take pretty good care of themselves. What kind of support systems are there for the patients who may not be seen in hospitals or skilled nursing facilities but may be dealing with things at home like depression or cognitive decline, and not really knowing what's going on, especially if there are people who live alone or may not have family that they're in touch with. What are some support systems that are available for that patient population who we can't necessarily meet in a hospital or skilled nursing facility situation?

DR. JOCELYN JUAREZ
There are senior centers the patient can go to. I guess this is something if they're able to drive themselves, but there are also virtual options. At these centers there's fitness, nutrition, social activities and education available for them. There are also personal care attendants that I have recently found out about that can have in the case that they do have a caregiver. I know you mentioned specifically not a caregiver, but if somebody does have a caregiver, there's also a caregiver program, which is called Caregiver S.O.S. Let's say it might not be a family member; it might be a neighbor that kind of just checks on the patient. They can be coached through the process. They can be taught about their medications, about their medical issues, and even just the stress that goes into taking care of these patients, particularly for somebody like you said that might be limited for home, there's also the care coach connect program and there are different levels of complexity for those patients. So, they are the very complex patients, such as the ones that I see in the hospital that can have more visits. Then there are also patients that are lower complexity patients that can have and home visits and assessments for them.

DR. BROOKE MOBLEY
I also work with the geriatric population, and I do want to also take some time to note that there are other organizations outside of our clinical providers, like AARP, Triple A, other organizations like that. Sometimes your insurance carriers who will have hotlines available for their population and the members of their organization to sometimes utilize if they don't feel comfortable with their doctors, or maybe they have transitioned to a new place and have an established care with someone. So, there are numerous resources, even outside of the clinical setting where the senior population can get help and possibly even get referred to clinicians who could further any differentiation, diagnosis or treatment.

DR. JOCELYN JUAREZ
That's wonderful.

CARMENN MILES
That's wonderful information. We need to just take a quick break, but please stay with us as we continue this great discussion on support and resources for seniors right here on Docs in a Pod by WellMed.

AD
For over 35 years, WellMed has redefined health care for older adults and people on Medicare. We're physician led and nationally recognized as an Age-Friendly Health System. Our doctors take time to listen and support your unique needs, working with Medicare and select Medicare Advantage plans to keep you healthy and independent. With 24/7 nurse support, telemedicine, in-home, and office visits, care is always within reach. WellMed compassionate care proven results. Visit WellMedhealthcare.com to learn more.

CARMENN MILES
We're back with co-host Dr. Brooke Mobley and our guest, Dr. Jocelyn Juarez. I'm Carmenn Miles, and we're discussing when it's a good idea to seek out support, whether it's through a hospitalist or some type of support group, and how to determine the best fit, and what other great resources are available to seniors. I just want to step back a little bit, Dr. Juarez, and talk about the concept of or the idea of a hospitalist. It was new for me when you and I first met, and you explained what you do for WellMed but talk to me as a patient. How would I know that a hospitalist is available? Is that a conversation that I have with my primary care doctor? How does that work, exactly?

DR. JOCELYN JUAREZ
I would definitely encourage all patients when they go see their primary care physicians ask where WellMed/Optum physicians practice and even which hospitals they recommend. It's important to know what each hospital or area of hospitals might offer. There are some things that are offered at certain hospitals that are not offered at other ones. So, I think that's definitely important to discuss. Once you know which hospital, primary care physicians, for example, in San Antonio have fliers and information of where we cover. We cover Methodist hospitals. We cover Baptist hospitals. So, my education to patients always includes when you show up to the ER, mentioned that you are a WellMed/Optum patient if you're being admitted because they will only see a hospitalist if they're being admitted, if they're discharged, they will likely not have a hospitalist. I tell them to ask for a WellMed/Optum hospitalist. The reason for this is we practice medicine a little bit different compared to other hospitalist groups. We tend to have a lower census, and as I mentioned before, IÕve worked for other companies, so I've kind of seen the difference. I have a lot more time to spend with my patients with this company. I'm able to dig into the chart and review records. I'm able to communicate with the primary care physicians, particularly for the employed clinics. Make sure that I have the matching home medications of what the patients are saying. There are times they might not even remember their medications, but I have access to that. So, I can also avoid a lot of unnecessary testing. I can communicate with their specialist because I get a list of who they see. The way I describe a hospitalist when I see my patients is like a primary care physician but in the hospital. That's how I describe it to them to make it simple because we're in charge of all their care when they're in the hospital, similar to a primary care physician. We're an extension of the primary care physician, but in the hospital.

DR. BROOKE MOBLEY
In the Florida market, we have fliers that are in the PCP offices, and the fliers have the pictures and names of the facilities where we have hospitalist at in their geographical area, as well as a list of the skilled nursing facilities where we have employed skilled nursing facility rounders and their pictures. So, I think that's very important for the Florida market, because one, you have to keep all documentation at a fourth grade reading level just in order to make sure that you're hitting health literacy. But then with the population that we have, a lot of times they have visual issues, sometimes they have cognitive decline, and pictures are a great way for them to see someone on a flier and then go to the hospital and be like, hey, I have this flier, this is the doctor who's supposed to see me. The hospitalist group also works hard with the emergency department to ensure that any patient being admitted or being triaged for admission under the Optum/WellMed PCP name goes directly to our hospitalist groups. In the same way, when our hospitalist discharged patients to our skilled nursing facility, they particularly like to send them to the facilities where we have employed rounders. That's my particular team in Florida. So, we get a heard sign out from the hospitalist so that there is collaborative care. Just Dr. Juarez said, because we're all in the same company, we have access to the PCP electronic records. We have access to the hospital records, and we have case managers or ACTM/s who have access to both hospital and sniff records so that we can have a more holistic approach to the patient. Like Dr. Juarez says, so we're not doing unnecessary tests and we're not doing unnecessary recommendations. We are ensuring, despite the patient's cognitive well-being or cognitive decline, that we have the most accurate information because we're getting it directly from the PCPs. I agree 100%. It's important to let them know that you are an extension of the PCP, whether in the hospital or the skilled nursing facility. We have a team approach, and we collaborate and communicate with the PCP so that they know what's going on with their patient so that they can treat them accordingly upon discharge and upon that up visit that Dr. Juarez let us know was very important to have within seven days of being discharged from a hospital or skilled nursing facility.

CARMENN MILES
Very good. I think that collaborative approach. As a patient in the past, I've not ever dealt with a hospitalist, but I imagine that would make patients feel much more comfort comfortable getting that care at the hospital, knowing that their PCP is speaking to the hospitalist. The hospitalist is also communicating the information back to the primary care physician. What happens again? You've touched on it, but what does the communication look like once they're ready to be released from your care at the hospital, Dr. Juarez.

DR. JOCELYN JUAREZ
First, there's education that we give to patients. We go over all of their discharge medications. Fortunately, I work at some hospitals where there are computers in the room so I can go over all of the medications. If not, I just write it down, and I tell them, it's key to have a good discharge medication list, like what we call medication reconciliation. I think errors and that can lead to readmissions, issues of patients with their medical care. So, educating is extremely important, especially if discontinuing a medication I want them to know or the caregiver to know. So, if a patient is not able to remember, I'll call a family member when I'm in the room so that they're aware, and I'll write things down. That's very key. I do a discharge summary, which is a summary of the hospital course and all the important things that happened. I've read it in the electronic medical record, and I send it to the primary care physician so that they know I saw the patient at this hospital. They're going home. I usually have the follow up appointment by then, so I also tell them this is when they're going to follow up. This is the date. This is the time. These are the things to please follow up on. Check the renal function. Check the electrolytes. Whatever is needed for labs or even referrals consultants that they need to see. I explain all of that information on the discharge. The discharge process takes a lot of time, but it's very important to make sure that you have the correct information when patients are discharging.

CARMENN MILES
Dr. Mobley, did you want to add anything to that?

DR. BROOKE MOBLEY
No. I think what she said is absolutely on par. I think it's what makes Optum/WellMed stand out from other health care organizations. We have a multidisciplinary, collaborative, holistic approach to the patient where we are in constant communication and collaboration with the PCPs, the hospitalist and the skilled nursing facility clinical rounders, so that we are making sure patients are not just getting best practices, but they are getting our time. Something that a lot of physicians and clinical rounders don't have a lot of. The whole point of value based medicine is so that we have the time to have the hard conversations, to have end of care conversations, to tell them about all the different resources that they have, and to make sure that they're following up with their PCPs and that they understand what went on in the hospital and what's expected once they leave.

CARMENN MILES
Very good. Dr. Mobley, you kind of touched on some support things that are out there and resources that are out there. I want to get back to that. Can you talk about the benefits of support groups and different resources that some of our seniors may not know are available to them?

DR. BROOKE MOBLEY
There are a lot of outside organizations such as AARP, Triple A, and I'm not being paid by any of these organizations. This is just information that I have. This is not marketing. It's just informational. Different cities will have specific support groups as well. I live in Tampa, and the city of Tampa has a program called Aging Friendly Tampa. So, they also supply different resources for patients. They also do referrals and recommendations to clinical people, as well as adult daycares or adult programs to keep people engaged. Because what we learned is if you don't use it, you lose it. So, if you're not using your brain, you lose a little bit of it. If you're not using your body, you lose a little bit of it. Programs like this are an adjunct or sometimes an extension to what our clinical professionals and insurance companies can provide. You can just search in Google Òsenior hotlines in my cityÓ, and you will get a list of things that could be beneficial.

CARMENN MILES
Very good. Dr. Juarez, what about you? What's the easiest way to connect someone to some local services in your area in the San Antonio market?

DR. JOCELYN JUAREZ
I definitely would agree with Dr. Mobley about searching. The other thing that I actually was not aware of this before, but I have found out is there, and this was more I guess through WellMed, there are senior centers available. So, physical places where patients can go to. They provide things such as fitness, nutrition and social activities for people who are age 60 and older, but there are also virtual centers. So, there's a QR code that patients can use and they can join classes, working out, building their muscles. That is available to them. If they choose to go in person, they're able to meet other patients, other people who are around their age that they're able to communicate with, share information with. I thought that was very wonderful that this is available to them and to the community. So, for instance, in San Antonio, there are three of those available. Other community resources that I was able to learn more about is that there are different phone numbers that through WellMed/Optum patients and again, this is probably more particular for the San Antonio area. but there are legal services. So, help for seniors if needed. Help with advanced care planning and Medicaid applications.

CARMENN MILES
Very good. Well, we are out of time. I want to thank you, Dr. Juarez and Dr. Mobley, for sharing with us the role of a hospitalist and all the great support and resources that are available to our seniors. Thank you again for our listeners who have joined us today. Make sure that you are sharing this information with people who may benefit from this these great health care tips. Remember, you can listen to Docs in a Pod wherever you get your podcasts. Don't forget, you can also catch us on the radio and several Texas and Florida markets. Until next time, stay well.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by. WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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