Nazareth Home brings mobile orthopedic care to its campuses

Nazareth Home brings mobile orthopedic care to its campuses

As we continuously seek to provide the best possible care, Nazareth Home recently began working with Louisville-based Live Well Orthopedic Care, a mobile orthopedic practice. Through the partnership, Live Well visits both Nazareth Home campuses on a regular basis to treat the elders who have orthopedic needs such as arthritis management, joint injections, and non-operative fractures.

Live Well seeks to reduce emergency room visits among patients. “If a patient falls and fractures their arm, they can be treated in-house and potentially avoid a trip to the hospital or orthopedic office. Live Well understands orthopedic devices and orthopedic orders so they can work closely with our rehab team to get the patient well,” said Dr. Bonnie Lazor, Nazareth Home’s medical director.

Live Well is also helpful to our nursing team because if a patient needs to leave the facility for an outside medical appointment, and they don’t have a family member to accompany them, then a nursing team member would traditionally do so. Therefore, having in-house care leaves our team members on the floor where they are most needed.

If there is any indication that a patient needs to be sent out to surgery, such as in the case of a fracture or a knee or hip replacement, Live Well maintains relationships with orthopedic surgeons locally and can easily make a referral.

At Nazareth Home, Live Well works closely with Dr. Bonnie Lazor, the nursing teams, and therapy to ensure patients are making progress in their recovery. Family members are also very involved in the care.

“Our practice is known for great communication with families,” said Natalie Jeffries, PA-C, a co-owner of Live Well. “We use a team approach with patients and always include their family members in the care planning.”

Live Well Orthopedic Care was founded in 2019 by surgical orthopedic physician’s assistants Natalie Jeffries and Kirk Fougnie, with a focus on providing mobile care for geriatric patients. When the pandemic began, Jeffries and Fougnie noticed an exceptional need for in-home orthopedic care and arthritis management. So, they began by providing care for patients in the Louisville area who are homebound — including those who are wheelchair and walker-dependent — to eliminate the need for difficult transportation among fragile patients and their families. Their primary focus areas include arthritis management, injection therapies and conservative fracture treatment.

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What is deprescribing and what are the benefits?

What is deprescribing and what are the benefits?

At Nazareth Home, we offer a holistic approach to care, including incorporating healthy diets, appropriate exercise, and therapy to enhance overall well-being. Another piece of this approach is also regularly looking at residents’ medications to reduce inappropriate polypharmacy. 

Polypharmacy, defined as the regular use of at least five medications, can pose serious risks to some patients. Deprescribing aims to combat these risks by reducing or eliminating unnecessary medications for the patient. 

According to a 2019 study published in American Family Physician by Anne D. Halli-Tierney, M.D., Catherine Scarbrough, M.D., M.Sc, and Dana Carroll, PharmD, polypharmacy is most-recognized in older adults because patients with more than one chronic condition often have more extensive medication lists. Because older adults are so often prone to polypharmacy, the effects are commonly seen at nursing homes and assisted living facilities. According to the study, up to 91 percent of patients in long-term care take at least five medications daily. 

Medical professionals at Nazareth Home take the time to examine cases of polypharmacy among elders and communicate with them and their families about deprescribing options. 

“Providing the best care for each elder means that we need to regularly review their medications,” Nazareth Home Medical Director Bonnie Lazor, M.D., said. “Maybe the answer doesn’t lie in medication, but a change to the elder’s dietary regimen may help alleviate their symptoms. These are things we look at.”

These efforts can prove to be very important due to the risk factors associated with polypharmacy. According to the American Family Physician study, negative consequences of polypharmacy can include decreased quality of life, increased mobility issues, increased mortality, financial stress, falls and more. Depending on the patient, deprescribing can help alleviate these issues and sometimes lead to clearer cognition for patients.

According to the American Family Physician study, considerations for deprescribing may include:

      • The patient’s medical history
      • Their full medication list
      • Appropriate dosing
      • Their prescribed drug’s interaction with other drugs, foods and illnesses
      • Their goals/the goals of their caregiver
      • Consumer options for lowering drug costs and more. 

“The goal is to understand which medicines give them quality of life,” Dr. Lazor said. “Those that aren’t really helping the elder should be considered for deprescribing. At the end of the day, we have to look at balance and side effects as well.”

At Nazareth Home, deprescribing efforts are being supported by the medical team’s consultant pharmacist, who assists in identifying potential medications to wean or eliminate. When it comes to approaching deprescribing at Nazareth Home, Dr. Lazor said thorough communication with the families of elders is of utmost importance. 

“We involve the family in the decision,” Dr. Lazor said. “We want to help them understand polypharmacy and the potential benefits of deprescribing.”

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Nazareth Home staff stepping into elders’ shoes with person-centered virtual reality technology

Nazareth Home staff stepping into elders’ shoes with person-centered virtual reality technology

Those of us who have not experienced memory loss can’t understand Alzheimer’s from the perspective of a person living with the disease. It’s also hard to understand end-of-life circumstances without ever being diagnosed with a terminal illness. Yet our caregivers, nurses and staff face these challenges each day. While always compassionate and caring, there has not been a way to truly put our staff in the shoes of the elder faced with these issues, until now.

Recently, the Sisters of Charity of Nazareth awarded a ministry grant to Nazareth Home. This grant funded the purchase of an immersive training platform from Embodied Labs. The software allows our staff to peer into the body and mind of someone confronted with aging issues like cognitive decline such as Alzheimer’s or an elder faced with a terminal prognosis.

Through the platform’s virtual reality experiences, our caregivers are immersed in the elders’ perspectives and conditions, helping them better understand the disease or circumstance. The Alzheimer’s training transports the staff into Beatriz’s life, a middle-aged woman, as she advances through a decade of Alzheimer’s disease. The end-of-life training embodies Clay, a 66-year-old veteran with stage IV terminal lung cancer, as he comes to terms with the reality of his diagnosis.

Through this training, our staff will learn what the elder is feeling and explore the physical, spiritual, and mental changes that may occur. This insight empowers our team to provide more effective and empathetic care. Knowing what to expect, how to relate, and how to respond allows us to communicate more clearly, support more confidently and serve with a greater purpose. Real understanding isn’t just about knowing how to care in certain situations; it’s about feelings. Those feelings are what enhance empathy and compassion.

At Nazareth Home, we focus on achieving outstanding person-centered, innovative and compassionate care. We encompass a holistic approach in our healing ministry, which includes social, spiritual and physical wellness. Our partnership with Embodied Labs’ will enhance our ministry by allowing us to step into someone else’s shoes and understand another person’s experience.

Understanding aging adults’ challenges through a first-person patient perspective builds upon our quality of care. With increased empathy, we will provide better emotional support to our elders and their family members, bringing another layer of excellence to our person-centered approach.

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