In 2009, there was an estimated number of 246 million people affected worldwide. In the USA alone, it is predicted that 48.3 million people will be affected by 2050. This is an astonishing number considering that in 2012 the number was estimated at 29.1 million with an average of 1.7 million new cases per year. Even more staggering, 1 in 4 US residents aged 65 and older have diabetes. If not held in check, diabetes can cause kidney failure, heart disease, stroke, and blindness. The key to managing diabetes is through a careful combination of self-managed with the utilization of team-based care programs @HomeCore Solutions™ Disease Management Clinical Pathways Diabetic Care.
Assure’s Clinical Supervisor leads a team of Case Managers, Certified Nursing Assistants and Home Health Aides all specially trained in diabetes to provide condition-specific, patient-centered care.
Assure’s @HomeCore Solutions™ Disease Management Clinical Pathways for Diabetic care employs an evidence-based approach that focuses on the key aspects of managing diabetes with Teach Back Methodology on daily foot inspections, healthy eating habits, and blood sugar tracking – to make sure people with diabetes and their families gain the knowledge and coping skills needed to successfully manage the disease and its related conditions.
Our @HomeCore Solutions™ Disease Management Clinical Pathways for Diabetes ensures:
• Patient clearly understands the plan of care from the physician and the steps needed to take to optimize their wellness
• Family feels confident their loved one can self-manage their condition
• Physician is kept up to date on the patient’s condition and made aware of any circumstances that may require attention
What to expect during a @HomeCore Solutions™ Disease Management for Diabetes Visit?
- Comprehensive head to toe assessment focuses on Medical, Functional and Environmental needs with special attention spent on education of signs symptoms like checking the lower extremities for swelling and open areas, safe needle disposal, daily foot inspection
- Reviews physician orders, secures PCP follow-up appointment dates, and items to bring
- Listens to the client’s and family’s concerns and evaluates how well the client and family are coping with the diagnosis, medication management, and related lifestyle changes
- Understand that the person’s choices may conflict with the plan of care and discuss the pros and cons of that personal choices is and is the advocate for the client
Assure’s Field Case Manager's, CNA's and HHA's
• Checks vital signs, blood glucose levels, feet for cracks and sores, weight, home safety, and food and medication supply
• Assist in activities of daily living (ADL) and encourage pacing of person-centered leisure activities with rest in between
• Reviews the plan for the visit with the client and family
• Exit after ensuring the client’s safety and noting any changes of condition. Before leaving ask, “Is there anything more we can do for you?”
• Education Provides a comprehensive educational patient booklet on the disease process (Teach Back Mythology)
Exclusive @HomeCore Solution™ Zone Management Resources for Diabetes Patients and their Families
• Patient and Family Education Material – Informative, illustrated packet that provides useful information on how to stay healthy.
• Knowledge Guidebook – Think of this as the story of the condition that the individual, caregiver, physician, and family can reference to track progress.
• Client and family education material – Informative, illustrated packet provides useful information on how to stay healthy.
ZONE MANAGEMENT UTILIZATION
• Symptom Alert – Easy-to-read reference card helps monitor symptoms for early detection.
•• Green = I am doing well
•• Yellow = I should notify Assure Case Manager (CALL ME FIRST CAMPAIGN)
•• Red = Time to call 911