The Center for Successful Aging at MedStar Montgomery is the topic of Episode 6 of The Senior Soup Podcast.
The spotlight guest is Deanna Cho, a licensed clinical social worker assigned to MedStar Montgomery’s Center for Successful Aging in Olney, Md.
She joined Raquel and Ryan at MedStar Montgomery to discuss the hospital’s individualized older adult care programs delivered by an abundance of healthcare professionals at the Center for Successful Aging.
The Senior Soup provides a summary of its podcast recording with Deanna and a full transcript below.
The Center For Successful Aging at Medstar Montgomery Medical Center Podcast Show Notes
- What is The Center for Successful Aging at MedStar Montgomery Medical Center?
- What is CSA’s high-intensity outpatient center?
- What specialized care services are offered at the Medstar Montgomery Medical Center to address the needs of older adults?
- What are the foundational concepts behind successful aging?
- How and where do people learn about successful aging at MedStar Montgomery Medical Center for Successful Aging in Montgomery County?
- The Center for Successful Aging’s Caregiver Support Program
- Deanna’s three takeaways
Contact The Center for Successful Aging at MedStar Montgomery (301) 570-7400 to set up your in-patient appointment.
What Is The Center For Successful Aging?
Raquel Micit 0:00
Welcome to The Senior Soup Podcast.
My name is Raquel Micit
Ryan Miner 0:03
And I’m Ryan Miner.
Raquel Micit 0:04
Today’s soup of the day is MedStar Health: The Center for Successful Aging in Olney, Maryland.
Raquel Micit 0:10
Our spotlight guest is Deanna Cho.
Raquel Micit 0:13
Deanna is a licensed social worker.
I’d say she’s the licensed social worker over here.
And Deanna, welcome to The Senior Soup!
We are excited to have you here this morning.
Raquel Micit 0:22
We’re going to dive right in.
Can you tell us what is the Center For Successful Aging?
Deanna Cho 0:27
The Center for Successful Aging is a geriatric primary care clinic and it’s an interdisciplinary care center.
Deanna Cho 0:34
So we (CSA) care specifically for sixty-five-plus, and we provide that care with an interdisciplinary care team, meaning we have the geriatrician and nurse practitioner.
Still, we also have a physical therapist, pharmacist, and social worker on our care team.
Visiting The Center for Successful Aging At MedStar Montgomery For The First Time
Ryan Miner 0:47
Do you know when a patient visits the Center for Successful Aging for the very first time, what should they expect?
Deanna Cho 0:53
Our (CSA) first visit is very different from your typical primary care visit.
Deanna Cho 0:58
So I want to start and say that they (patients) can come to us as a consultation, or they can come to us as if they’re establishing care with us.
Deanna Cho 1:05
So the difference is that much like you would see a specialist, a cardiologist, a gastro, a neurologist, whatever specialty it is, we specialize in geriatrics.
And you can come to see us as you would see a specialist referred by a physician.
Deanna Cho 1:20
You can also come to see us as if you’re going come and establish care, and we are your primary care physician (and assume care of your healthcare ship is what I like to say).
Ryan Miner 1:30
I like that: healthcare ship.
Raquel Micit 1:32
That’s a new hashtag.
Ryan Miner 1:33
Hashtag: healthcare ship.
Deanna Cho 1:34
There are a lot of people on your healthcare ship.
Deanna Cho 1:36
And if we were your primary care provider, we would be the ones who are there, guiding you where you’re going.
What waters are we heading for, so to speak?
The High-Intensity Outpatient Center
I’m most interested in understanding and learning more about the high-intensity outpatient clinic.
Deanna Cho 1:54
I’m really glad you asked about that.
That’s a totally separate side of the Center for Successful Aging here at [MedStar] Montgomery [Medical Center].
Deanna Cho 2:01
The difference is that the high-intensity outpatient program is the first of its kind here on the East Coast, where all we do is again specialize in caring for sixty-five plus.
But that care is provided through skilled nursing interventions that are meant to prevent ED admissions and ED visits.
Deanna Cho 2:19
The reason why we set that up is that we’ve noticed a lot of our older adults have interventions – skilled nursing interventions – that they absolutely need.
And if someone was able just to schedule that earlier, they wouldn’t need to go to the ED, or the crisis event would not occur.
So we have provided this for the community, and it’s a growing program where people can come for their skilled intervention; they leave and go home.
It’s something where you’re not going to the ED and sitting for hours on end and then getting your assessment and then hopefully getting treatment. You go in there scheduled and receive the intervention that you need – that is, it’s a clinic, where it’s a referral basis only.
So a provider – a medical provider – must provide a referral to the [Medstar Montgomery Medical] Center for you to be able to use the services there, whereas with the primary care center, you can self-refer, or you can have your provider refer you to us.
Raquel Micit 3:08
So, to break it down, that’s great!
Raquel Micit 3:10
You guys have two sides:
- You have your primary care side, where you really help personalize a life plan for your patients; that is self-referred.
- And then you have your other high-intensity outpatient clinic side, where they do need a referral, correct?
Deanna Cho 3:24
Acute Care Services For Older Adults At Medstar Montgomery Medical Center
Raquel Micit 3:24
Can you review some examples of services you offer in that high-intensity outpatient clinic?
Deanna Cho 3:30
Some of the services that we provide in our high-intensity outpatient program, those skilled nursing interventions are:
- IV Lasix
- IV steroids
- IV antibiotics
- Wound dressing changes
- Blood transfusions (that’s something that we [MedStar Health] really specialize in that is not easy to get in the community, otherwise.)
- Prolia injections
- Foley Catheter exchange & assertions
- RBC transfusions.
There are a lot of things that we can do.
And again, I don’t expect a lay person, much less myself, to remember all of these little words and letters.
I expect our provider to know what infusion or what treatment I need and to reach out to the Center (CSA) and ask, ‘Is that something that we can provide and provide them the referral?’
Deanna Cho 4:13
So that’s not something I want you to worry about.
It’s more a question for you to ask your provider, ‘Hey, is this a service that I could take advantage of so that I don’t have to do XYZ, like going to the ED for it?’
Ryan Miner 4:23
A provider is typically someone they (seniors) would see at a hospital or a doctor’s office.
Ennoble Care, of course, we can go to them and see them (seniors) inside the home.
Call Ryan Miner (Ennoble Care) at (301) 991-4220 to learn more about the top Maryland doctors who make house calls.
Ryan Miner 4:34
Do providers in Montgomery County (or in the DMV area) have a direct relationship with and know about the Center for Successful Aging?
Deanna Cho 4:43
That’s a growing knowledge.
So we’re brand new; we just opened a little over a year ago in (October) 2021, I believe – in August 2021.
So, again, we’re just a little bit over a year.
So we [MedStar Health] love the opportunity to share with the community and our providers because how we support our current primary care physicians is by saying, ‘If you have a 65-year-old patient that is experiencing changes with cognition, mobility, there are multiple hospitalizations, there’s many psychosocial issues or concerns, please feel free to refer them to us.’
Aging at MedStar Montgomery – Coordinated Care – A Holistic Approach
Deanna Cho 5:16
And what happens is we’ll then complete a comprehensive geriatric assessment, which is not your typical twenty-minute visit.
Deanna Cho 5:22
Our initial visits [at Medstar Montgomery Medical Center Hospital] are, typically speaking, ninety minutes to two hours long.
We can break those down, of course, because we understand that for our older adults, that can just be a very long visit.
Having said that, the typical length is ninety minutes.
And then, we send the report from our visit to the referring providers so that they’re aware of what we found.
And we rely on that primary care provider to continue maintaining their day-to-day care and take in our recommendations as much as they would in another specialist’s recommendations. And those are for our consultation visits.
Deanna Cho 5:54
Again, for a consultation visit, just as if you’re going to establish primary care with us, you’re going to see the entire care team – and that’s why it’s ninety minutes long.
CSA Highly Specialized Care Team
[During the initial visit to the Center, older adults have an opportunity to visit with a comprehensive care team, including a:]
- Physical Therapist
- Social workers
So it’s a lot of people that get to see you who will examine you from head to toe.
Raquel Micit 6:14
My next question was going to be, you know, what does a specialized care team consist of – but it sounds like you really answered it.
Raquel Micit 6:20
You guys not only go through, you know, with nurse practitioners, geriatric physicians, pharmacists, physical therapists, your social worker, can you talk through the patient journey a little bit more?
We have an idea of how it started – and I’m sure it’s different across the board – but can you walk us through a little bit more of an example of what to expect throughout their patient journey?
Deanna Cho 6:40
I think in Montgomery County, especially, we (CSA) get the joy of seeing a lot of older adults who are aging for a lot longer than we’ve ever seen in society.
We’re living well into our 90s and early hundreds.
And it’s not always that happens – but there can be chronic illnesses or comorbidities (this is what we call it) multiple chronic illnesses – that can occur.
And managing those as you grow older is like managing a maze.
You get a lot of information from your specialists on what to do regarding a particular diagnosis or a particular symptom you’re exhibiting.
And then you’ll get something a little different from the other specialists regarding another illness or another symptom you’re exhibiting.
And it can be really confusing and hard to manage all of that.
Deanna Cho 7:25
So what we (CSA) see with our patients who come in for the first time – and their family member or caregiver is [feeling] overwhelmed:
- ‘Do I need to be on all these medications?
- Do I need to see all these specialists?
- What is important?’
Deanna Cho 7:36
We had a patient the other day with several dietary recommendations that were all over the place.
‘I just want to eat food, whatever, you know, how do I, how do I navigate all of that?’ So there are a lot of questions around navigation and coordinating the care.
And that’s, I think, unique to growing older and aging for so much longer. And that’s where we [the Center for Successful Aging] specialize in just answering those questions and sitting with our older adult and saying:
‘Well, what’s important to you?’
That’s the first question.
Discovering The Center For Successful Aging At MedStar In Olney, Md.
Ryan Miner 7:36
I’m interested in how people first discover this outstanding resource [successful aging at MedStar] in our community.
It just started last year (October 2021).
It’s a first-of-a-kind area resource that you and the rest of your team are promoting and shouting about and explaining what it does and how it does it.
And that is why the seniors who listen to our podcast… Raquel and I were so fascinated with this concept because it is so unique.
How To Find The MedStar Montgomery Successful Aging Center Using Google
Ryan Miner 8:29
If a senior citizen, or if my parents, who are in their late 50s – I won’t tell you how old they are because that would give away how young they had me – if they were to visit a Google search bar and begin to type in a few keywords, how would they begin to find the Center for Successful Aging?
Deanna Cho 8:49
Google is hands-down the easiest way to find this, in a sense.
Just search ‘Center For Successful Aging‘ or ‘MedStar aging services,’ and they’ll be able to find this online.
[You can also Google ‘Aging at Medstar Montgomery‘ or “MedStar hospital aging.”]
Montgomery County Resources Older Adult Resources
Deanna Cho 8:52
The other piece, too, is that many of our area older adult services are growing aware of us.
So if there’s a service that you feel comfortable with or familiar with, I would just ask them directly who would you go to for health care for an older adult.
That journey is one where again, Google helps a lot by asking the people in your community because we are growing and are a source of growing awareness with our community members, too.
Raquel Micit 9:22
I love it because you guys really help navigate the senior care maze.
That’s essentially what you guys are helping our community do – and that’s so important because there are so many dots that need to be connected, and people don’t really know how to do all of that.
It’s too much; it’s really overwhelming.
The MedStar Montgomery Caregiver Support Program
Raquel Micit 9:37
One other thing you guys do great that I feel very passionate about, too, is caregiver support.
I own a home care agency: Amada Senior Care.
Amada Senior Care offers the best personalized care in Silver Spring, Md, and the surrounding areas.
Raquel Micit 9:45
I can’t tell you how many families come to me with caregiver burnout.
During the pandemic, they decided to work from home and be their family member or good friends’ caregivers.
And they’ve come to a point where they’re burnt out.
They want to be able to enjoy more time with their loved ones. They need some help and support and resources [and support and encouragement].
So can you talk to us a little bit about the caregiver support program you guys have here at the Center for Successful Aging?
The Center Offers Caregiver Support Programs
Deanna Cho 10:12
As you’ve already indicated, sometimes our caregiver is the only backbone supporting our older adults.
Recognizing that, we spend time with our caregivers if they want, and we ask them, ‘How are you doing?’
Deanna Cho 10:25
I think a lot of times, it’s how your loved one [is] doing. And we always want to know how our caregiver is doing.
‘What’s going on with you? How is this journey for you?’
When we ask that question, we invite them to have a private conversation because sometimes it’s just easier to say certain things in private – or we offer they have that with their loved one present, too.
That’s totally up to their choice.
But we offer the conversation; we offer a space in our center: the console room, where the social worker, me, and the caregiver can really sit and have more conversation.
We can also speak with them over the phone and make tele-video appointments with the caregiver specifically to have those deeper conversations, to answer those deeper questions – because the journey is long and it can be hard as well joyful.
Most Insurances Pay For Healthcare Services At MedStar Montgomery Medical Center
Ryan Miner 11:09
Seniors who are looking for this type of resource [geriatricians, chronic condition management, memory programs, and Dementia education], how do they pay for this service?
Deanna Cho 11:15
Because we’re a part of the MedStar Health Network, we’re able to accept many insurances:
- Medicare Advantage plans (a few)
Deanna Cho 11:23
We [MedStar] always run a check on your insurance before we accept a visit or schedule a visit.
Having said that, we really haven’t run into many issues with reimbursement because we cover or accept, I should say, many plans that older adults (seniors) have.
Raquel Micit 11:39
The Center for Successful Aging: It really is a golden nugget that not enough people know about.
The Three Takeaways From This Podcast
Raquel Micit 11:43
If you could give three takeaways that people could really take from this podcast and learn about the Center, what would you want them to get from this?
Deanna Cho 11:52
1) Find A Doctor Who Specializes In Geriatrics
It doesn’t have to be us, but I always say to consider having one of those on your care team when you turn 65.
The reason is: When we’re young, we have a pediatrician.
When we grow into an adult, we have a primary care physician.
Our body changes, and it’s very important for us to have a provider that understands those changes and the complexity of those changes. You can age with that provider.
So I always recommend getting a geriatric provider or someone who specializes in geriatrics.
For example, our physician is a board-certified geriatrician, and many of our providers on the care team have ample experience with older adults.
2) Consider Interdisciplinary Care
I think it’s really nice to come to one place and know that your medication(s) can be reconciled, that you can check in with the physical therapist if there are any mobility concerns, that if there are all the other things in our lives, besides our health, you have a social worker that you can just touch base with – and that’s both for patients and caregivers.
3) Consider The Center for Successful Aging At MedStar Montgomery Medical Center As You Age
We want to look at the whole person, and that’s what I encourage you to think about as you age.
As a whole person, what are the things that I want to make sure are balanced and in place, where I can get support around when they get unbalanced?
Deanna Cho 13:09
So those are the takeaways for the Center for Successful Aging.
And I think generally speaking for growing older and health care concerns.