Introduction

In this video we interview health care advisor Nan Wetherhorn, RN who provides thought-provoking and practical tips to be a better advocate for your loved one. Caring for a family member can be daunting, learn where to go for help and resources.

Video

Transcript

Jason Neufeld (00:10):

Hello everyone. I’m Jason Neufeld with Elder Needs Law and welcome back to the YouTube show. And as I state time and time again, I’d like to tell people I’m just an elder law attorney. That doesn’t mean I can do everything related to what a senior citizen or disabled individual might need. I have to rely on other experts to supplement what it is that I do. I like to think of myself as quarterback, but again, when we need help for the family, my goal is to provide a holistic experience. And if that involves bringing in other experts, then it’s my pleasure to do so. And it is my great pleasure to introduce you to one of those experts. Her name is Nan Weatherhorn. Nan is an RN patient advocate, and rn Nan has been a nurse in the neonatal unit, adult ICU. She’s provided skilled care in home doing feeding tubes and ventilators. And so she knows what the aging process looks like from a crisis perspective, and she knows what it looks like from just a gradual aging perspective. And she sees she knows what people should be expecting to see and can help people and help guide those people along the way. Nan, welcome. Thank you so much for being here. Please tell us a little bit more about yourself and maybe start off by telling us how you got into this.

Nan Wetherhorn (01:28):

First of all, Jason, thank you so much for having me on your YouTube channel. I appreciate it. And yes, I am an RN patient advocate, and I’ll say briefly, I graduated from Vanderbilt School of Nursing in 1976 and have worked, still work as a nurse. But in 2015, I started my business as a patient advocate. And how did I get into this? I’ve worked mostly intensive care, so that communication is the biggest breakdown in our healthcare system. And as a nurse in ICUs, I was communicating with doctors, with family members. And the biggest thing is to speak in as my clients tell me plain English, none of the medical stuff. And I got into this because that’s part of the reason. The other part, my mother was diagnosed with ovarian cancer in 2000 and we’re from Georgia. I was in Boston working as a nurse at Children’s Hospital. And the minute they called me, I said, no, no, you’re not being taken care of there in that town. You’re going to go to another place. Please have your doctor find another teaching hospital. So they did. We went to Emory and my mother was very smart.

(02:41):

She was a pharmacist. She went to pharmacy school during World War ii, and she’s from Macon, Georgia. Went to Columbia University School of Pharmacy when women didn’t do that. So now pharmacy schools are 80%, 85% women. Back then it was 3% women. So yeah, she was very smart, all that to say, the minute the doctor said to her, you have ovarian cancer, she put her hand up and said, you know what? My daughters are here with me. Nan’s a nurse, tell them everything because you said cancer, and I know that means I’m going to die. So that doesn’t mean you’re going to die, but that’s what everybody who hears that word thinks. Sure. So we’re sitting there and we’re getting the information. And my mother lived another six or seven years. Okay. She was 75 when they found it. She passed when she was 81. She went back to work after six rounds of chemo, and she was a pharmacist in an independent drugstore. So I thought, what do people do who don’t have anybody? And what do people do who really don’t understand? So that’s when I thought about doing this, and I didn’t start my business until 2015. I did some research, talked to other people, and it was like, I don’t know. Would anybody pay for this? Would anybody need this? And yes, people need

Jason Neufeld (04:03):

This. Why is it a problem? It’s not intuitive to me. In other words, you go see your primary doctor with a problem, they refer you to a specialist. There’s notes everywhere. There’s medical notes everywhere. Why is communication such a problem? If everyone’s supposed to be putting notes in the chart, it’s also supposed to filter back to your primary doctor who’s ostensibly the quarterback. Where’s the breakdown?

Nan Wetherhorn (04:26):

The breakdown is the system as it’s set up, particularly when people are on there, are on Medicare. The system is set up in two ways. There’s the plan where you must be in network, which is the HMO plan, and that is what an advantage plan is for the most part. And then there’s the one where it’s called the PPO, or which I would say what it really means, but what it really means to me is you can pick your own doctor without a referral. And that is a huge difference that people don’t understand. You can’t just go to any hospital, you can’t just go to any doctor with the H HMO model. You must go where they tell you. So the doctors don’t always communicate with each other, nor do they communicate with the patient as well because they’re talking in medical ease. And the patient, I often find it doesn’t matter the age of the patient that when the doctor talks to them, they look at them very seriously. They go and they’re always nodding their head. And I have learned to now stop and go, Mrs. Jones, could you tell Dr. Smith what he’s really, what we’ve been talking about the last, what he’s been trying to get us to understand and go, Nope. And oh no, they will tell you because they don’t want to look silly.

(05:49):

They will say something that has absolutely nothing to do with what this doctor’s been telling them. And that is where the doctor looks at me. I go, start over. Let’s find another way.

Jason Neufeld (06:01):

So you’re an interpreter, you’re a medical interpreter, right? I am. And I tell people I do the same thing. I try to take complicated legal concepts and explain it in a way that non lawyers can understand. You’re doing the same thing with medical jargon, medicalese, and you’re explaining it in plain English to help people make a more educated decision as to their healthcare.

Nan Wetherhorn (06:22):

Yes.

Jason Neufeld (06:22):

And so I imagine this would involve you reviewing a lot of medical records. Are you doing a lot of that and are you attending appointments? How are you simplifying things for your patient?

Nan Wetherhorn (06:31):

What I do when I meet with my client once they hire me is I look at their medical records first. I ask them, I have a form I go through and I ask them what their health problems are. We go through everything from head to toe, and then I ask them, do you have your medical records? And the next thing I ask is, who are your doctors? Well, that tells me what their diagnoses are from the different types of doctors they’re seeing. And there are some people that have two and three, the same doctor. I’m like, why is this some? And again, slipped through the cracks. So I go through all of that, and then once I’ve reviewed everything, I put my client’s information in a chronologically ordered medical timeline, a short version, like two lines for each date so the doctor knows, refer back to this date, refer back to this date in the medical records. So I do that. And when we go to the doctor, I have that information that I hand to him along with the medication list that I’ve reviewed with the patient. I circle the ones or start them where there’s a little bit of a,

Speaker 3 (07:32):

Why

Nan Wetherhorn (07:32):

Are they on two with ease? Why are they on two with ease kind of thing. And we go through everything with the doctor, and people have asked me before you even ask, I have yet to have a doctor say, why did you do this? Every one of it looks at, I go, do you do this for everybody? And everybody that pays me

Speaker 3 (07:49):

When

Nan Wetherhorn (07:49):

I go into an emergency room with that same information or I fax it during covid, I fax that information to the emergency room. I call to make sure they receive the fax. And the doctor always wants to talk to me and say, this is so helpful. It answers all of my questions. And that is why I do that.

Jason Neufeld (08:06):

Oh, that’s so interesting. So if a client of yours goes to the er, when you’re notified of that, you’re immediately going into their file and sending the er, the pertinent information. So they’re not prescribing something that’s prescribed. They’re not iv something they shouldn’t iv. And wow, that’s incredibly important.

Nan Wetherhorn (08:22):

That’s incredibly, the other thing is when my clients are going into the er, usually because they can’t breathe or they’re in severe pains, they’re not talking too much.

Jason Neufeld (08:29):

Right? Correct.

Nan Wetherhorn (08:30):

So this alleviates that,

Jason Neufeld (08:32):

And it may not be the greatest historian as to what’s been going on with that medically. Exactly. Yeah, absolutely.

Nan Wetherhorn (08:37):

So that’s why I feel that information is incredibly important for a doctor to have. And I’ll be honest, I have doctors who referred me clients because they see all of this detail.

Jason Neufeld (08:48):

I believe it. I believe it. It’s so helpful. While we’re talking about er, I think that’s a really good segue into, you’ve already talked about one important aspect, which is making sure the ER has an accurate medical history. At the very least, prescriptions, because we don’t want anything to interact with what’s already in the client system, but whether it’s the er, whether it’s an inpatient hospitalization, whether it’s a rehab after hospitalization, I think those are special settings where people are, they’re letting things happen to them, and the person in the white coat is in charge. And I think a lot of people, I feel whenever they go to the er, everyone’s frustrated with the process When they’re in the hospital, they’re frustrated with the process, they can’t get someone’s attention. They have a need, and the nurses and the doctors are doing a million different things. Do you have any advice for people, even if they can’t hire you in that setting, how are you a good advocate for yourself or your loved one in these ER rehab inpatient settings?

Nan Wetherhorn (09:47):

Well, I will tell you, I tell people before they go in the ER and I tell people, get a list of your medications and have it with you always. But if you’re going to go into an emergency room, you’re not going to go in and say, give them a whole long history. Well, I didn’t feel good for a month and this has happened. And you want to give them everything in three sentences or less. And then once they get you in the back, in the treatment room, they will start to ask you questions, but always have questions that you have. For example, if you go in and it’s been severe stomach pain for the last two weeks, and today it was so bad, you had to come in and you talked to your doctor and the doctor said, oh, let’s wait and see. Try this, try that. Well have everything that you’ve tried. Tell them what the doctor has said to try. If they said antacids or they said this or that, and say, do you think I need a CAT scan? Do you think I need an MRI? You know what? You know your body better than the doctor

(10:54):

Suggest these things. If they say no, say to them, well, why not? And if anybody that says to you, that’s a silly question or a stupid question, get another doctor. Get another practitioner.

Speaker 3 (11:07):

You

Nan Wetherhorn (11:07):

Are the one in charge of your healthcare or your child’s care. You have no stupid or silly questions. And number one, for emergency rooms, that’s the first thing is no, prepare in advance. Have your medication list, have your allergies

Jason Neufeld (11:26):

Front

Nan Wetherhorn (11:26):

And center. Start with red and remind them, these are my allergies. They should be asking you these questions. But the other thing I tell people is make sure if you’re in the emergency room, that they give you a diagnosis. Especially if they say, we’re going to do tests. We’re going to run this. We’re going to have you for observation. No, no, no, no. I don’t want observation. I want to know what is the problem. And if they say, well, we’re not sure you’re having stomach pains. Okay, that sounds like you could say, I have a gastric problem, doctor. And if I’m having to recommend it, and I’ll tell you why that happens, because insurance doesn’t have to pay if you’re in the emergency room or even admitted to the hospital for under 24 hours, 23 hours and 59 minutes is under 24 hours with the diagnosis of

Jason Neufeld (12:20):

Observation, you

Nan Wetherhorn (12:22):

Do not have to pay that bill.

Jason Neufeld (12:24):

Wow.

Nan Wetherhorn (12:25):

It says it in tiny letters when you’re discharged. But you can also Google medical observation and

Jason Neufeld (12:32):

Insurance. What do you think the doctor’s incentive would be to kick someone out too soon or keep ’em under observation for 23 hours?

Nan Wetherhorn (12:40):

Any thoughts on that? I would say that’s an insurance I’m not going to From an

Jason Neufeld (12:45):

Insurance company.

Nan Wetherhorn (12:46):

Yeah,

Jason Neufeld (12:47):

I’m

Nan Wetherhorn (12:47):

Going to say that that would be insurance.

Jason Neufeld (12:49):

As an aside, I think you’ll be happy to hear that. One of the things when we’re doing just general estate planning for our clients, and we’re doing a healthcare surrogate designation, the front page, we tell our clients, this is optional. There’s nothing legally required based on this one bit that we do, which is we do have on the front page the ability to date and then list the prescriptions they’re taking, their blood type and what they’re allergic to. Because listen, this is not for you, me and my client. This is for your loved one who may not know your blood type off the top of their head, and to have it in writing somewhere. And at least, even if it’s an old set of prescriptions, the doctor can ask, are you still taking X, Y, and Z? And we hope that provides a little bit of extra care and benefit for our clients. But working with someone like you who I see them, and I may not see them for another year or a couple years after we do those documents. If they’re working with someone like you who’s keep it up to date with all of their latest medical history, their latest medications, that’s going to provide all the more value. That’s excellent. That’s excellent.

Nan Wetherhorn (13:51):

Yeah. And I did develop a digital one that they can buy online and they can fill it out themselves. And every time they can hand it to their doctor every time they go to the doctor, that’s great. Any changes that are made, it’s what I call a living document because you update it every time

Speaker 3 (14:06):

And

Nan Wetherhorn (14:06):

Your doctor has a copy. So it becomes part of the medical record.

Speaker 3 (14:09):

Yes,

Nan Wetherhorn (14:09):

Absolutely. And it includes all of your family health history, which I know a lot of people don’t know anything that happened with their parents or they only know how they died. They don’t know any other health problems. And it’s important to know the other health problems. Tell you what led up to that. I push people learning all they can about their own health history.

Jason Neufeld (14:31):

So Nan, tell us a little bit more about your subscription model, where people need to be located to work with you and how if someone wanted to reach out to you directly, what’s the experience? How does it work?

Nan Wetherhorn (14:44):

Okay, I’ve just started a subscription model because people told me, oh, that would be great and really want that because I come in in a crisis, I get you through the crisis. And normally the client says, after a few months or so, I’m good. I can do it myself. And then they come back if they need to. My subscription model is for somebody who wants me to be there, me or my nurses to be there

Speaker 3 (15:06):

Ongoing.

Nan Wetherhorn (15:07):

And it’s a certain number of hours for a flat fee

Speaker 3 (15:11):

As

Nan Wetherhorn (15:11):

Opposed to my regular rate of service, which is a fee of two 50 an hour. This is a little bit easier for people to manage.

Jason Neufeld (15:22):

What region do you serve?

Nan Wetherhorn (15:24):

I serve the entire United States.

Jason Neufeld (15:26):

Entire United States,

Nan Wetherhorn (15:27):

If you want me there. Boots on the ground, as I call it. I’m in Florida and I have nurses in South Miami. I have nurses in Jupiter and I have nurses in Tampa.

Speaker 3 (15:37):

Very

Nan Wetherhorn (15:37):

Good. So we can accommodate you. If you want me to go to you, you can fly me there or I can find you another advocate. I’m connected to most of the advocates, and I would find you an advocate that would take care of you.

Jason Neufeld (15:48):

Very good. Excellent. Nan, if someone wanted to reach out to you directly, what’s the best phone number? What’s the best website?

Nan Wetherhorn (15:56):

The best thing to do is go to my website, it is healthcare advisor nan.com. And on there,

Jason Neufeld (16:03):

We’ll put that in the show notes

Nan Wetherhorn (16:05):

And on there you can email me or there’s a direct line you can call me from there.

Jason Neufeld (16:10):

Very good.

Nan Wetherhorn (16:10):

So that’s going to be the easiest way to actually contact me and on the website it’ll tell you all about the subscription model. I’ve also written two books for people that need to understand the difference in an assisted living, skilled nursing and home care. Very good. That’s on the website. And if they wanted to call a number, (786) 507-5637.

Jason Neufeld (16:37):

Perfect. Nan, thank you so much for lending us your time and your expertise and what you do is just a wonderful compliment to what I do. And I love working with you, and I love the care that the extra level of service that you bring to some of my clients and to your patients throughout the state and throughout the country, and we appreciate you and everything that you do.

Nan Wetherhorn (16:58):

Thank you so much, so much. I appreciate your work too, Jason. I really do.

Jason Neufeld (17:02):

Take care.

Nan Wetherhorn (17:02):

Thank you. Bye-bye.