Individualization is key: collaborative care makes all the difference for older adults

[Link]Nina Cox was never a cook - her husband did most of the cooking in their household. That was until she was diagnosed with type 2 diabetes and tasked with lowering her A1C to be cleared for knee surgery. With a clear goal in mind, Cox got serious about her health and found support with The University of North Texas Health Science Center at Fort Worth's HSC Health Center for Older Adults care team.

With Dr. Sarah Ross as her PCP, Dr. Jacob Rogers as her clinical pharmacist and Jessica Copeland as her health coach, Nina has gotten her type 2 diabetes under control and is cleared for surgery.

"I turned 71 last week," Cox said. "I've transitioned from not being a cook at all, to cooking at my age. I bought a program four years ago by a nutritionist with grocery lists and menus and everything. When Dr. Rodgers said we're going to have to get serious about this, I went home and pulled it out and started detoxing from sugar and cooking for the first time."

The Center for Older Adults focuses on the 4Ms of geriatric care, one of which is what matters most to the patient. This is a guiding principle for HSC Health providers which results in individualized treatment plans focused on the patient's desired outcomes.

"At our first meeting, Dr. Rogers asked me what my end goal was," Cox said. "I told him I didn't want any more medicine. I never want any more diabetes medicine or high blood pressure medicine or anything like that, and he was supportive. Dr. Ross is also good about not over-prescribing and will do trials off of medications if possible. I really like that they think like I do."

Rogers also recommended a continuous glucose monitor so Cox could easily monitor blood sugar spikes and see her health data in real time. The ability to share information between all providers and the patient is what sets the HSC Health experience apart for Cox.

"I love that Jessica will take notes on a piece of paper about things and I can take that home to look at them. Then the notes she puts in my chart go automatically to Dr. Rogers and Dr. Ross," Cox said. "I like the way everything here is a community. That's one of the biggest problems in health care - there isn't communication or community between providers."

The inclusion of health coaching has helped Cox to define her goals, identify what motivates her to action, what limiting mindsets stand in her way and how every day stressors impact her overall health. A typical health coaching session involves looking at stressors from the past two weeks and strategizing how to mitigate stress in the weeks ahead, including practical advice around diet.

"I love to eat out, so we've planned around how I can eat out and bring food in that is good for me," Cox said. "For example, I love Saltgrass Steakhouse, but they don't have real butter. I love their bread, but I can't eat it. We talked about how I could get it to go, just the parts that I need, and I can have it at home with real butter and add on any extras we want. That has worked great."

After decades as a nurse working in public hospitals and teaching hospitals, as well as teaching CNA and CPR skills, Cox has a special appreciation for residents and students who are a part of her care at HSC Health.

"I like the fact that this is a teaching facility because I feel like it keeps the providers fresher," Cox said. "When they answer questions from their residents it keeps them centered and focused on the patient. Dr. Rodgers even had some pharmacy students and I love that."

To make an appointment with the HSC Health Center for Older Adults team, call 817-735-2200.

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