Longevity Program
Carilion Clinic Home Care Launches Program to Manage Chronic Disease
Carilion Clinic Home Care has launched a new program, Longevity, to help patients manage chronic illnesses. Statistics show one out of every two people in the United States has a chronic disease. Most patients feel overwhelmed, helpless, and lack the confidence to manage their illness successfully.
Longevity aims at empowering patients to make positive life changes. Tracy Stewart, R.N., BSN, manager for Home Health in Radford says, “Our program focuses a lot on behavioral change readiness, adult learning principles and health literacy. We also try to ‘stack the deck for success’ for our patients by working on goals that are important to them and truly putting the patient in the driver’s seat.”
A main focus of Longevity is to make a smooth transition between care at the hospital and care at home. Stewart says half of chronic disease patients have three or more doctors, and 88 percent will not manage their disease successfully. For many patients, when they return home keeping up with treatment can be hard and confusing. “For patients with a chronic disease, hospital to home is a dangerous area in transition where a lot of patients can fall through the cracks.”
After a patient enters the program, they will receive visits from a home health nurse three days in a row. This helps to ensure the patients not only understand their medications, but also have access to them. Gin McCabe, R.N., Home Care coordinator says, “We don’t press the patient, and we avoid preaching. We wait for the patient to come around.” Each patient is given a “red flag action plan” that is reviewed each visit and teaches the patient and their caregiver to recognize danger zones of their disease and when they may need to call for help.
Longevity is also designed to help reduce patients’ chances of re-hospitalization, provide the support to improve quality of life, and surround patients with a team of health professionals who know exactly what their specific health needs are.
McCabe says the ability to make change is related to confidence. If patients have the tools and encouragement to make changes, they will have a better chance at success. Longevity is designed to provide those tools. “The goal we have for our patients is that they will become better at managing their disease.”
