We are exploring a volunteer program to help patients stay out of hospitals

There are some encouraging signs that the health-care system is finally embracing the kinds of at-home care that can focus on the patient’s needs and keep the individual out of the hospital.

Local insurance companies are working with a new provider, Landmark Services, which sends doctors to the home on a regular basis to make sure those at-risk patients who have recently been in the hospital get the follow-up care and monitoring they need.

Doctors making house calls returns us to the kind of person-centered care that we remember in our younger days. These changes are being driven by health-care policies that seek to cut down on re-admissions to the hospital within 30 days of discharge.

Hospitals in our area as well as around the state and country are also embracing community supports.  In addition to in-home medical care provided by doctors and nurses, it is also clear that community services and social support are essential to successfully remaining at home.

“Community Supports Patient Navigators” are being used successfully in some areas to assist patients, their families, and caregivers navigate the complex medical and social-services systems following hospital discharge. Community Caregivers participated in one such program a few years ago and is now exploring re-establishing a volunteer-based community supports navigator program to work with local health providers.

What does a community supports navigator do?

Once the patient returns home from the hospital, the navigator’s primary tasks would include assistance in arranging follow-up appointments, transportation, and medication self-support.  Support would also include health literacy by providing information to support the patient’s self-care and linking to health promotion, chronic disease self-management programs, health care proxy forms and support groups.

Referral to community services through the Albany County Department for the Aging’s NY Connects program and other services would also be a role of the navigator.

Secondary tasks might include grocery shopping assistance, sorting mail, arranging for needed durable medical equipment, home companionship, caregiver support, and advance planning for emergency situations.

Community Caregivers Inc. is a not-for-profit organization that provides non-medical services including transportation and caregiver support at no charge to residents of Guilderland, Bethlehem, Altamont, New  Scotland, Berne, Knox and the city of Albany thorough a strong volunteer pool of dedicated individuals with a desire to assist their neighbors.

To find out more about our services as well as volunteer opportunities, please visit www.communitycaregivers.org or call us at(518) 456-2898.

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