The Use and Mis-Use of Antibiotics

When Healthcare Costs Rise, Dont Put Your Health on HoldBy Jamie Ulmer, President & CEO, Healthcare NetworkWhen the cost of everyday life goes up, most of us look for places to cut back. We may eat out less often, postpone a purchase or reconsider a trip.Healthcare shouldnt be one of those things.Yet rising insurance costs, deductibles, prescription expenses and other household costs can make even routine healthcare feel difficult to afford. For older adults living on a fixed income, an unexpected medical expense can be particularly concerning.It can be tempting to put off an appointment when youre feeling relatively well. Maybe that lingering cough can wait. Perhaps the pain in your knee isnt quite bad enough to call the doctor. Or that annual checkup can be pushed back a few months.The problem is that delaying care can allow a manageable health concern to become a more serious one. Establishing a relationship with a primary care provider and receiving regular preventive care can help identify health concerns earlier and provide ongoing support for conditions that require monitoring.Community Health Centers Are an Option for Seniors, TooOne healthcare resource older adults may overlook is their local community health center.There is a common misconception that community health centers are free clinics or that they serve only people without insurance. In fact, community health centers provide care to people with a variety of insurance coverage. Healthcare Network accepts Medicare, Medicaid, commercial insurance and Affordable Care Act Marketplace plans. For those who qualify, care is also available on a sliding fee discount scale based on household income.For older adults, having access to primary care is particularly important. Regular visits give you and your provider an opportunity to monitor changes in your health, discuss medications, keep up with preventive care and address concerns before they become more serious.Community health centers can also make it easier to address multiple healthcare needs within one organization. At Healthcare Network, patients have access to primary care, dental care, behavioral health and other services.Getting to Care MattersCost isnt the only reason people delay healthcare. Sometimes the challenge is simply getting there.Transportation, distance and convenience can all become barriers, particularly for older adults who no longer drive, have mobility challenges or depend on family members or caregivers for transportation.Thats why access isnt only about having healthcare services available. Its also about making those services easier to use.Healthcare Network offers telehealth appointments for certain services, giving patients the option to connect with a provider from home when appropriate. For older adults, telehealth can help reduce some of the transportation and scheduling challenges that might otherwise lead them to postpone care.Access to medications is another important part of staying healthy. Healthcare Networks pharmacies offer prescription mail delivery, allowing patients to have eligible medications sent directly to their homes. This can be especially helpful for older adults managing ongoing prescriptions or those who find frequent trips to the pharmacy difficult.Of course, there are times when an in-person visit is necessary. Having healthcare closer to home can make those appointments easier, too.Here in Collier County, Healthcare Network recently opened the Van Domelen Community Health Center in Orangetree. The center brings primary care, dental care, behavioral health, pharmacy services and more to an area where rapid population growth had previously left many residents traveling significant distances for basic healthcare.Options such as care closer to home, telehealth and prescription mail delivery can remove some of the everyday obstacles that make it harder to stay on top of your health.Think of Primary Care as an Investment in IndependenceFor many of us, one of the greatest priorities as we get older is maintaining our independence.Healthcare plays an important role in that.Routine care isnt only about treating an illness after it occurs. Its an opportunity to monitor your health over time, manage ongoing health conditions, keep up with recommended preventive care and talk with your provider about changes you may be experiencing.Having a healthcare provider you know and trust can become especially valuable as you age.If cost, transportation or uncertainty about where to go has caused you to postpone care, ask what resources are available in your community. Having Medicare or Medicaid doesnt prevent you from receiving care at a community health center, and depending on your circumstances, other assistance may be available as well.Last year, Healthcare Network cared for more than 55,000 patients, including nearly half of Collier Countys children, and provided more than $19 million in uncompensated care. Behind those numbers are people at every stage of life who needed a place to turn for healthcare.Growing older brings plenty of changes. Accessing healthcare shouldnt have to become one more challenge.Taking care of your health today can help protect something that becomes increasingly valuable with every passing year: your ability to continue living life on your own terms.About the AuthorJamie Ulmer is President and CEO of Healthcare Network, a nonprofit healthcare organization that has served Collier County for nearly 50 years. He is passionate about improving access to care and strengthening community health so all residents have the opportunity to live healthy, productive lives.  

Substance-use problems do not disappear with age.Alcohol, prescription medications, and other substances can become difficult to manage at any stage of life. For older adults, substance use may develop alongside chronic pain, grief, loneliness, anxiety, depression, retirement, sleep problems, or major changes in independence.Families may also find it difficult to recognize a problem because symptoms can resemble other health concerns.In Port Charlotte, Twin Rivers Pathways provides outpatient substance-use and behavioral health treatment, including an Intensive Outpatient Program and integrated care for people experiencing both substance use and mental health conditions.What Is a Substance Abuse Program?The clinical term substance use disorder describes a pattern of alcohol or drug use that causes meaningful problems with health, relationships, responsibilities, or daily life.Treatment programs may address concerns involving: Alcohol Prescription medications Illicit drugs Other addictive substances Different levels of treatment exist.They may include: Outpatient counseling Intensive outpatient treatment Residential treatment Medical detoxification Inpatient rehabilitation Not every provider offers every level of care.Twin Rivers Pathways focuses on outpatient behavioral health and substance-use treatment, including Intensive Outpatient Program services.Twin Rivers Pathways4161 Tamiami Trail, Unit 302, Port Charlotte, FL 33952 Phone: 941-766-0171Twin Rivers Pathways is operated through DeSoto Memorial Hospital Behavioral Health and serves adults throughout Charlotte County and surrounding Southwest Florida communities.Outpatient Substance-Use TreatmentTwin Rivers Pathways identifies substance-abuse treatment and addiction treatment among its Port Charlotte services.The provider describes its approach as helping people address substance-use disorders while developing tools intended to support long-term recovery.Because the program is outpatient, participants can continue living at home while attending treatment.That can make outpatient care suitable for individuals who are medically stable and do not require inpatient monitoring.Intensive Outpatient ProgramTwin Rivers Pathways offers an Intensive Outpatient Program, or IOP.An IOP provides more structure than occasional outpatient counseling without requiring a person to live at a treatment facility.Twin Rivers' program combines structured therapy with behavioral health treatment while allowing participants to maintain many of their normal responsibilities. An evaluation helps determine whether this level of care is appropriate.Group Therapy in Substance-Use RecoveryGroup therapy is commonly used in substance-use treatment because it gives participants a structured place to develop recovery skills and hear from others experiencing related challenges.Twin Rivers Pathways provides clinician-led group therapy within its outpatient treatment continuum. The exact content and schedule depend on the individual's treatment program.Co-Occurring Mental Health and Substance-Use ConditionsSubstance use and mental health conditions frequently overlap.Someone may drink heavily while experiencing depression or anxiety. Another person may misuse medication while coping with trauma, grief, or another behavioral health condition.Twin Rivers Pathways provides dual-diagnosis care, meaning mental health and substance-use concerns can be treated together rather than as unrelated problems.The provider's current services specifically identify integrated treatment for co-occurring mental health and substance-use conditions.Why Substance-Use Treatment Matters in Port CharlottePort Charlotte has a large senior population, with 33.1% of residents age 65 or older.This makes later-life behavioral health and substance-use services especially relevant locally.Retirement can bring positive changes, but it may also bring: Loss of routine Reduced social contact Health concerns Chronic pain Grief Isolation When alcohol or medications become a way of coping with these changes, professional support can help address both the substance use and the underlying emotional needs.Having an outpatient program in Port Charlotte allows appropriate participants to seek structured treatment while remaining connected to home and family.How to Get Started With Substance-Use TreatmentStep 1: Describe What Is Happening Honestly Step 2: Call Twin Rivers PathwaysStep 3: Complete an Assessment Step 4: Verify InsuranceStep 5: Ask About Family InvolvementStep 6: Ask Whether Another Level of Care Is NeededRelated CategoriesMental Health & CounselingBehavioral HealthSupport Groups & Services

Preventing Setbacks, Falls & Avoidable Hospital Readmissions: Helping Someone With Parkinsons Stay Safely at Home Part 4 of the PennDYNAMIC Care at Home Parkinsons Recovery & Wellness Series For a person living with Parkinsons disease, returning home after a hospital or rehabilitation stay can feel like a major victory. But families often have another concern: How do we keep Mom or Dad from going back to the hospital? This is an especially important question for someone with Parkinsons. Changes in mobility, balance, medications, nutrition, hydration, cognition and the ability to manage everyday activities can make an already complex condition even more challenging after a health setback. A fall, missed medication, poor nutrition, increasing weakness or an unnoticed change in condition can disrupt recovery and potentially lead to another emergency room visit or hospitalization. At PennDYNAMIC Care at Home, our post-hospital and post-rehabilitation approach is designed to help bridge the transition home, support continued recovery and help families recognize concerns before they become bigger problems. The goal is not simply to get someone home. The goal is to help them stay safely at home. --------------------------------------------------------------------------------The Revolving Door Families Want to Avoid Hospitalization can be particularly difficult for an older adult with Parkinsons. A person may return home weaker than before, less steady on their feet or with changes to their medications and daily routine. They may also be receiving instructions from several healthcare professionals. There may be follow-up appointments to schedule. Therapy recommendations to continue. New medications to understand. Dietary instructions to follow. Mobility equipment to use. Symptoms to monitor. Families are often expected to coordinate all of this while simultaneously helping their loved one adjust to being home. It can be overwhelming. This is where structured, coordinated support can make a meaningful difference. -------------------------------------------------------------------------------- PennDYNAMIC's LifeCARE Pathway is built around proactive, evolving care, while DYNAMIC NeuroWELL at Home provides specialty support for individuals with neurological conditions such as Parkinsons. Together, these approaches help families focus on an important objective: Protect the recovery and reduce preventable setbacks. -------------------------------------------------------------------------------- 1. Make Fall Prevention a Daily Priority Falls can be a significant concern for people with Parkinsons because the disease can affect balance, walking and movement. After a hospitalization or rehabilitation stay, weakness and reduced confidence can add to the risk. Fall prevention begins with understanding how the person functions in the actual home environment. Are pathways clear? Is there adequate lighting? Are there loose rugs or clutter? Does the person have difficulty getting to the bathroom? Are recommended mobility devices within reach? Is the individual trying to move too quickly when getting up? Does the person require assistance with transfers or walking? A caregiver can help maintain a safer environment and provide the level of mobility assistance identified in the client's care plan. But fall prevention should not mean eliminating movement. As we discussed in Part 3, unnecessary inactivity can contribute to further loss of function. The goal is: Safe movementnot no movement. -------------------------------------------------------------------------------- 2. Pay Attention to Changes in Function Families sometimes assume that every new difficulty is simply another symptom of Parkinsons. But a noticeable change from someone's usual level of function deserves attention. Perhaps Dad suddenly needs much more assistance getting out of his chair. Mom is walking differently than she did several days ago. A normally engaged client is suddenly sleeping most of the day. Someone who was eating independently is now struggling at meals. The caregiver does not diagnose the cause. Instead, the caregiver can play an important role by observing, documenting and communicating changes to the family and appropriate healthcare professionals. Knowing someone's normal routine makes it easier to recognize when something is different. That is one of the advantages of consistent care at home. 3. Support Medication Adherence Parkinsons medication routines can be important to a person's daily functioning. After a hospitalization, medications may have been added, discontinued or changed. Families should make sure they understand the discharge medication instructions and direct medication questions to the appropriate physician, pharmacist or other healthcare professional. PennDYNAMIC caregivers can provide medication reminders consistent with the client's care plan. They can also observe whether the person is having difficulty following established routines and communicate concerns appropriately. For complex clients, medication support is not about independently changing medications or making clinical decisions. It is about helping the established plan work in everyday life. -------------------------------------------------------------------------------- 4. Don't Overlook Nutrition and Hydration Eating and drinking may seem unrelated to preventing hospitalization, but they are important components of overall health and recovery. Someone returning from a hospital or rehabilitation facility may have a reduced appetite, fatigue or difficulty managing meals independently. Parkinsons may create additional challenges around mealtimes. PennDYNAMIC caregivers can support meal preparation, hydration and established dietary recommendations. Just as importantly, caregivers can pay attention to changes. Is the person eating significantly less? Are meals being skipped? Is drinking becoming more difficult? Has something changed about the person's ability to manage meals? Concerns can then be communicated to the family and appropriate healthcare professional. 5. Keep the Person Moving Safely Following a hospitalization, it can be tempting to encourage someone to take it easy for an extended period. Rest may certainly be necessary. But when healthcare and rehabilitation professionals have recommended movement, exercises or daily activities, consistency matters. PennDYNAMIC caregivers can help clients follow established recommendations from physical therapists, occupational therapists and other members of the rehabilitation team. That might mean helping the person safely participate in everyday activities or supporting completion of exercises that have been prescribed or recommended by the appropriate professional. -------------------------------------------------------------------------------- We do not replace rehabilitation. We help reinforce the recovery plan at home. The objective is to help protect the progress already made while supporting continued function. 6. Make Follow-Up Care Part of the Recovery Plan Discharge from the hospital does not mean medical care is finished. There may be follow-up appointments with a primary care physician, neurologist or other specialists. There may be therapy appointments. There may be changes in the care plan based on how the individual is progressing at home. For families already balancing careers, children and other responsibilities, coordinating all these moving pieces can become difficult. This is why care navigation and progress monitoring are important components of the PennDYNAMIC approach. The goal is greater continuity between what healthcare professionals recommend and what actually happens at home. -------------------------------------------------------------------------------- 7. Watch the Caregiver Too There is another potential crisis families sometimes overlook: Caregiver exhaustion. A spouse may be trying to provide around-the-clock assistance. An adult daughter may be working all day and then spending evenings managing medications, meals and personal care. A son living out of town may be trying to coordinate everything by telephone. Families can continue like this until something happens. The spouse becomes exhausted. The adult child misses too much work. Someone gets injured trying to transfer the person. Or the family reaches a point where it simply cannot continue. Professional caregiving is not only about supporting the person with Parkinsons. It can also provide critical support to the family system. A family that has appropriate help may be better positioned to make thoughtful decisions instead of waiting until exhaustion creates the next crisis. -------------------------------------------------------------------------------- Create a Parkinsons Stay-at-Home Plan Families can make their care plan more proactive by asking several questions: What usually causes problems for our loved one? What changes should we watch for? Who should be contacted when we notice a change? Are medications and follow-up appointments organized? Is the home environment as safe as possible? Are rehabilitation recommendations being followed? Is our loved one eating and drinking adequately? Is the family caregiver becoming overwhelmed? Do we have enough help at home? These questions move the family from reacting to problems toward anticipating them. -------------------------------------------------------------------------------- Know What Is Normal for Your Loved One One of the most useful things families and caregivers can understand is the person's baseline. What does a normal day look like? How does Mom usually walk? How much assistance does Dad normally need getting dressed? How much does he typically eat? How alert and conversational is she? What activities can the person normally complete? Once you understand the person's usual pattern, changes can become easier to recognize. A good care plan should therefore be dynamic. As needs change, support may need to change too. That principle is central to PennDYNAMIC's LifeCARE Pathway. -------------------------------------------------------------------------------- How DYNAMIC NeuroWELL at Home Supports Parkinsons Families PennDYNAMIC's DYNAMIC NeuroWELL at Home was created to provide coordinated, disease-informed support for people living with Parkinsons and other neurological conditions. Depending upon the individual's needs and established care plan, support may include: Personalized, disease-informed in-home caregivingFunctional fitness, movement and restorative supportMedication adherence and chronic symptom observationNutrition and mealtime supportNeurocognitive stimulation and memory supportEmotional well-being and family educationCare navigation and progress monitoringCommunication and collaboration with the healthcare team For families, this means having support that looks beyond individual caregiving tasks. The focus is on the whole person and the many factors that can influence the ability to remain safely at home. -------------------------------------------------------------------------------- The Best Hospital Readmission Is the One That May Be Prevented Not every hospitalization canor shouldbe prevented. Parkinsons is a complex condition, and medical emergencies sometimes occur despite excellent care. Home care should never replace necessary medical attention. But families can take proactive steps to reduce preventable setbacks. Support safe movement. Follow the established medication plan. Encourage adequate nutrition and hydration. Continue rehabilitation recommendations. Attend follow-up appointments. Watch for meaningful changes. Communicate concerns. And make sure the family has enough support. These actions may seem simple individually. Together, they create something powerful: A safer and more coordinated environment for recovery. -------------------------------------------------------------------------------- Home Should Be More Than the Place Someone Returns To For a person living with Parkinsons, home represents familiarity. Routine. Family. Memories. Dignity. Independence. And often, the place where the person most wants to remain. At PennDYNAMIC Care at Home, our goal is to help families protect that possibility. Through personalized care, proactive communication, disease-informed support and coordination with the individual's healthcare team, we help make home a place where recovery can continue and quality of life remains the priority. Because getting someone home is only the first step. Helping them stay safer, stronger and supported at home is the next. -------------------------------------------------------------------------------- Love Is Not Enough When You Are Dealing With Parkinsons Disease When someone you love is living with Parkinsons, you may find yourself constantly wondering whether you are doing enough, watching closely for the next fall or worrying about another trip to the hospital. You do not have to carry all of that responsibility alone. The right support can help your loved one remain safer at home while giving your family greater confidence and peace of mind. When someone you love is challenged with Parkinsons and you need assistance, please call PennDYNAMIC Care at Home at 610-467-7827. We would be honored to listen to your concerns, learn about your loved one's needs and discuss how PennDYNAMIC Care at Home may be able to support your family. PennDYNAMIC Care at Home Personalized. Coordinated. Expert-Led Care at Home. www.DynamicCareAtHome.com