Empowered to flourish

Most people look forward to their golden years as a stress-free time to enjoy life. Too often, however, navigating health care challenges can add strain to the lives of older adults.

This was the experience of Glenn and Joy Walters as they were referred from one medical specialist to another to unravel Glenn’s complex medical concerns. That changed with Glenn’s first appointment with Christian Furman, a geriatrician and medical director at the Republic Bank Foundation Optimal Aging Clinic at the UofL Trager Institute.

“When she was with us, she was present with us,” Joy said of Furman. “She asked very pointed questions about his situation. She also listened to my concerns. We got more out of that one appointment than we have in probably six months with other doctors. She made suggestions right away.”

Within a few days, the clinic’s team approach for Glenn’s care was in motion. A social worker followed up to help them navigate Furman’s suggestions. Treating the whole patient – mind, body and soul – so that older adults can be at their best as they age is the overarching goal of the UofL Trager Institute. The Trager Institute is supported by a gift from Steve Trager ‘85 and the Trager Family Foundation.

[caption id="attachment_52196" align="alignleft" width="300"] The Republic Bank Foundation Optimal Aging Clinic facilities at the UofL Trager Institute[/caption]

The Optimal Aging Clinic, opened in September 2019, enables the UofL Trager Institute to put into practice a model of comprehensive, integrated care for patients as they age. In the customized center, located on Market Street in Louisville, clinicians provide whole health primary care and specialized geriatric care as part of UofL Health - UofL Physicians, as well as behavioral health, wellness lifestyle medicine, yoga, tai chi, fitness classes and acupuncture services.

“Our mission is to provide a one-stop primary care experience for older adults to achieve optimal aging as they progress through their lives,” Furman said. “Annual wellness visits are particularly important for older adults as it is a time to intervene early. The patient and provider have a chance to proactively develop a plan for optimal aging.”

In addition to medical care, clinic providers evaluate medication management, chronic disease management, pain management, palliative care, fall prevention, brain health and dementia care and mental health support.

“Our clinic provides full behavioral health services to help patients when they are experiencing depression, anxiety, trauma, relationship issues or dealing with the losses that occur as one ages,” said Joseph D’Ambrosio, director of wellness and behavioral health therapist for the clinic.

To address the many aspects of health, clinic providers follow FlourishCare™, an evidence-based model of patient care developed at the Trager Institute that addresses functional and quality-of-life factors that affect patients’ ability to flourish in spite of disease.

“We believe that optimal aging is more than treating illness with medication,” said Anna Faul, executive director of the Trager Institute. “Complex cases are evaluated by a full team of providers and professionals from a wide array of disciplines: medicine, nursing, social work, counseling psychology, pharmacy and dentistry. These meetings are then used to develop care plan strategies that are developed into comprehensive whole-health care plans with the patients and their families.”

In addition to treating the patients, providers at the Optimal Aging Clinic offer support for their family members and caregivers.

“When a family member is ill, it affects the whole family,” Faul said. “We keep that in the forefront of our minds and provide resources, support groups and other services to the patient’s friends, families and caregivers.”

For Joy Walters, the support and comprehensive care are a welcome change.

“They don’t leave you out there by yourself. They developed a care plan for Glenn and they made suggestions not only for him but for me,” Joy said.

At a recent appointment, the couple were in the room with Furman and a fourth-year medical student and on videoconference with their counselor and social worker to ensure the whole team knew what was happening. The visit even involved Forest, Glenn’s service dog.

“It was a medical appointment, but it was almost like a family affair,” Joy said.

During the pandemic, the clinic has made adjustments to ensure vulnerable patients continue to have safe access to health care. Whenever possible, patient visits are delivered via telehealth, reducing contact and risk of COVID-19 exposure. Wellness activities and weekly presentations were moved to an online format. For patients in senior living facilities or nursing homes, clinic providers make use of SmartGlasses technology. The glasses, worn by on-site health care workers, include a camera and microphone which allow clinic physicians to see and hear the patient in real time, ask questions and interact with the patient without entering facilities.

The UofL Trager Institute also hosts virtual COVID-19 information sessions focused on needs and concerns of older adults, caregivers and those with chronic conditions during the pandemic.

Since its opening, the Optimal Aging Clinic has served more than 2,500 patients with more than 9,000 patient visits. Plans include an elder law clinic, physical therapy and rehabilitation services and a teaching kitchen for nutritional coaching. Also in development is a survivors’ clinic for those with residual health issues following recovery from COVID-19.

In addition to patient care, the Trager Institute focuses on research and training health care providers in better ways to treat adults as they age.

For Glenn Walters, the most important facets of care at the clinic are that the providers work together and follow up with the patient.

“It is a lot less stressful and not as complicated as a lot of the situations I have been through,” he said. “They are people that care and they are there for me – for us, and they go the extra mile. It is a wonderful organization for the simple fact they are honest and straightforward and they do follow up on things.”