Allina Health

Personalized health care support

When you or a loved one has many medical needs, trying to determine how to get help and what services exist can be difficult.

Allina Care Navigation Help Desk is committed to going beyond your medical needs - making it easier to stay in control.

Our care navigators can identify and directly coordinate a wide variety of resources to meet your needs and wishes, including: Advanced illnesses Help with understanding illness and treatment choices, addressing financial and community resource options Advance care planning: Information others need to know if you become unable to make decisions Palliative care for those in any stage of chronic or advanced illness Complex chronic care management Specialty heart failure program Home oxygen and medical equipment Professional staff provides oxygen, respiratory, rehabilitation and mobility equipment, specialty beds as well as other equipment and supplies. 24-hour emergency services     Life care management Professional nurse or social worker provides initial and ongoing assessment and planning for: health and wellness cognition social support purpose, passion, identity home and safety finances Hospice Hospice is for anyone with a life-limiting illness and whose life expectancy is determined to be 6 months or less. Hospice care is provided at the patient's place of residence and is coordinated by an interdisciplinary team of nurses, social workers, home health aides, spiritual care coordinators, doctors and volunteers. Bereavement support is provided to family members. Home health care Professional at-home services including assessment, teaching, medication management and skilled procedures, as well as: skilled nursing care occupational, physical and speech therapy medical social work infusion therapy wound and ostomy dietitians Housing referral and placement Housing experts help seniors and their loved ones research, evaluate and choose from the more than 400 local options, including: independent living assisted living residential care homes skilled nursing facilities memory care adult day care Private care giving Home health aides, homemakers and companions. Insured, bonded and background tested. 4- to 24-hour and live-in options. Guaranteed staffing and satisfaction.

People call Allina's Care Navigation Help Desk with many different needs and health care situations. A care navigator, one patient's daughter and another patient's sister share how we made a difference in their lives and the lives of their loved ones. Patient names have been changed to protect their privacy.

Laura's story

Laura, one of our social workers, provides these examples of how she and her colleagues help you navigate the complexities of care:

• A patient with lung cancer was concerned that his children didn't understand his health care goals and long-term wishes. The Care Navigation Help Desk arranged for an advance care planning session and involved the patient's family so everyone would be clear about the patient's wishes.
• A daughter called the Care Navigation Help Desk because her mom was having trouble remembering to take her medications. The Care Navigator explained that a medication dispensing machine might be helpful and connected the family to a place they could purchase the device.
• A patient who had multiple wounds that were not healing was reluctant to be admitted to a transitional care unit for treatment. The Care Navigator was able to coordinate care with an Allina hospital outpatient wound center and Allina's home care services so the patient could remain at his home.
• A social worker contacted the Care Navigation Help Desk on behalf of a patient who needed help with housing issues. A licensed care manager did a face-to-face assessment with the patient and helped connect him to services to complete paperwork, tour housing options, get on some housing waiting lists and prepare him to move in the near future.

Ann's story

Although Ann would describe her mother's overall health as basically good, her mother does suffer from the occasional age-related medical concern—the periodic health issues considered typical of someone in her upper 80s.

Recently, Ann's mother was brought to Abbott Northwestern Hospital's Emergency Department. While she spent time there for observation, Ann mentioned to the nurses that she thought her mother needed more care and support in order to continue to live independently in her senior apartment facility in Edina. A nurse gave Ann a brochure describing Allina's Care Navigation Help Desk, which Ann quickly reviewed and tucked away in her belongings.

Two weeks later, Ann received a call from her mother's personal care attendant, who assists her mother in her apartment for a couple of hours each day. "My mother's personal care assistant explained that she was so weak, she couldn't get off the couch," said Ann. "It was clear that she was not going to be able to stay in her apartment in that condition."

Although she and her husband both work in the health care industry, Ann found it complicated, overwhelming and frustrating to navigate the social services options for seniors in the Twin Cities. She knew that her mother needed additional care — and fast.

Ann was preparing to leave town for an important trip to celebrate her grandson's birthday in another state. It was a Friday morning, and she was concerned that the weekend would complicate the situation of getting her mother the help she needed.

At 10:30 a.m., Ann called the Care Navigation Help Desk and spoke with a care navigator. "She was just phenomenal," explained Ann. "She understood the problem quickly, knew exactly the type of help we needed and facilitated the entire process."

By 2:30 p.m. that same day, Ann's mother was admitted to a facility where she received extensive physical therapy and rehabilitation services. "Fortunately, I was able to transport my mother for care, but they assured me that if that had not been possible, they would have helped me to arrange for transportation, too."

Allina's care navigators offer a valuable service to people trying to navigate the often complex world of housing placement and referrals. Experts help seniors and their loved ones research, evaluate and choose from hundreds of local options including independent living, assisted living, residential care homes, skilled nursing facilities, memory care and adult day care options.

Today, Ann's mother is back in her apartment in Edina.

"This service was a lifesaver," said Ann. "My care navigator was polite, efficient and the entire experience was just amazing for me and my mother. She even helped to facilitate the referral with my mother's primary care physician at Allina Medical Clinic – Edina."

Jane's story

When Julie was diagnosed with stage 3 lung cancer last December, she and her sister Jane weren't sure what the future would hold.

In subsequent months, Julie's health continued to decline and her doctor recommended she quit chemotherapy due to the side effects she had from the treatment. Jane thought Julie seemed depressed and that they both needed help figuring out what to do next.

That's when Jane went online to look for help. She found information about Allina's Care Navigation Help Desk, a place patients and their families can call when they need help finding health care resources and services. Jane called and talked to a registered nurse care navigator, who offered to work with Julie's doctor to get a referral for palliative care.

Palliative care is for patients living with a chronic illness who are not ready for hospice care (end-of-life care). Members of the palliative care team, including chaplains, nurses and social workers, focus on symptom management, education about disease progression, goals, concerns and nutrition.

Julie's palliative care nurse visited Julie at home three times over the summer to care for her and talk to her about her condition. When the time was right, the palliative care nurse recommended Julie begin hospice care.

"Every since Julie went into the hospital, we've been glad we're hooked up with Allina," said Jane. "They've been able to help with home oxygen, palliative care and now hospice care. Not every health system has all those services."

Julie is still at home, receiving care from Jane and her nephew, in addition to many members of the Allina hospice care team. A hospice nurse visits twice a week and a social worker visits weekly.

"She's been really helpful with information for the family," Jane said.

Julie receives massage therapy once per week. Julie and her family also talk to the hospice chaplain on the phone many times. "It's really comforting to me to talk with the chaplain," Jane said. "She and I had a nice long chat the other day."

Jane hopes that sometime soon Julie will invite the chaplain to visit. "Julie is a person of great faith, but she kind of likes to keep her faith to herself," Jane explained.

Jane said that the hospice nurse said she saw a big change in Julie last week. The nurse visited over the weekend to check on Julie.

"We had a lot of family members over last time, and the nurse spent time with us to explain what was happening and what to expect," Jane said. "Having everything taken care of through Allina has just made things so much smoother for us, and better for Julie."

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