Everything Relying on a HATS (Healthy Aging Transition Services) Assessment????

rbrammer01 · March 6

I'm new to this group and have found the information very helpful. In January, I moved my 75-year-old sister from Florida, where she had lived for 47 years, to central Indiana. Before the move, I was aware of her memory and vision issues, but now, two months later, her cognitive abilities and vision seem to have declined rapidly. She recently had an eye exam, which resulted in a prescription change, but her overall decline has been significant.

We are now trying to transition her from independent living to assisted living. However, her PCP insists that she either go directly to Memory Care or wait for an assessment by the Healthy Aging Transition Services (HATS) through Community Health Network in central Indiana to determine a care plan. The doctor is refusing to order any diagnostic tests until after the HATS assessment.

From what I understand, the HATS assessment is meant to help develop a care plan, but it doesn’t provide diagnostic testing. Has anyone in this group had experience with the HATS assessment? If so, what was your impression? I feel that her rapid decline warrants more urgent diagnostic testing—am I wrong to push for it?

SusanB-dil · March 6

Hi rbrammer - Welcome to 'here', but sorry for the reason.

sorry - I've never heard of that, but could you get a second opinion? Is the current PCP really familiar with working with a PWD? Seems odd, though, that a doctor would refuse any diagnostics, but that's just my little opinion. Seems any further information would help.

as an aside, is DPOA and HIPAA access in place?

rbrammer01 · March 6

https://alzconnected.org/discussion/comment/237785#Comment_237785

Hi and thank you so much for the reply. Yes, a DPOA is in place. Unfortunately, seems that central Indiana does not have many resources (or I have not been able to locate many) or physicians who focus on these issues so it has been difficult to find one. The PCP we are working with claimed he focuses and is experienced in geriatric medicine and elder issues but his actions conflict with his "Bio" statement. My sister is completely aware of what is happening and just wants to know if she should "just give up" or continue to hold on to hope that her issues can be addressed…..breaks my heart when she says if there is no treatment or positive outcome she may as well just give in to it and give up. :-( She knows that her short term memory no longer exists and that her issues are likely related to Dementia which she believes is a slow death sentence and is terrified. She is not aware of the issues with this PCP and has accepted that a move to Assisted Living where she is can meet new people and make new friends as well as get the social and mental stimulation that is so important is her best option. This is a struggle for her as she was a business owner and managed the books, was very organized and had everything in its place. Now, she is not able to do any of that. She is a sweetheart and does not want to cause any issues/problems and continually says that I should take my frustrations, if any, (due to being her sole caregiver) out on her and no one else….then her sense of humor kicks in and she says that, after all, she likely will not remember anyway. Her vision issues keep her from reading, working puzzles, or anything where vision/focus is needed thus it has been challenging to find things to keep her occupied when she is alone. For anyone reading this post and starting this journey as a caregiver, DO NOT rely on the physician's Bio statement when looking for a PCP to care for your loved PWD or even if Dementia is suspected. Sorry for the long reply but I am so exhausted already and seem to run into roadblocks every step of this journey.

H1235 · March 6

Welcome. If blood tests have been done to rule out another cause, (so sorry) there is probably not much that can be done. I can imagine not having a specific diagnosis would be very frustrating though. The doctor insisting on memory care seems odd. If she is in Al and doing well I don’t really understand how he would have a say. Are there problems in Al? Are they ok with her being there? I believe it is usually Al that steps in and says a pwd needs more care than they can provide and therefore suggests a move. Audio books might be good for her if you could find a way for her to start and stop it independently. The testing my mom had was hours long. Her pcp did an in office evaluation before referring her for the in-depth evaluation. Could it be that this hats assessment is being used to determine if the long neurological examination is necessary? You are a good sister for doing all this for her.

harshedbuzz · March 7

Have you looked into the IU Methodist website for geriatric specialists?

rbrammer01 · March 7

https://alzconnected.org/discussion/comment/237814#Comment_237814

Blood tests have been done and no other cause was found. My LO is in Independent Living and I am trying to get her into Assisted Living and this is where the PCP is causing issues wanting to wait on the assessment before determining if Assisted Living is right for her. There are residents currently in Assisted Living who are clearly much worse than my sister and the director is baffled by the PCPs attitude. Apparently, the PCP listed every symptom possible with dementia on her physician order and, given he had already completed the same form with designation to Memory Care, the facility does not want to move forward with Assisted Living until the assessment is done in April. It is stressful enough caring for someone with dementia and to add this type of attitude by the PCP is harsh.

rbrammer01 · March 7

Yes, I have found someone who claims to specialize in Geriatric Medicine at the IU Carmel location. I will be calling them today to discuss the possibility of bringing my LO in for a visit. Thank you every one for sharing your thoughts.

SDianeL · March 10

HARTS is unique to Indiana. It’s a non profit that takes patients referred by physicians. Not just dementia patients. They bill your insurance. I don’t see how you can be forced to use them. I would place her directly into memory care. They do have activities. They are more secure so as she progresses she will not wander off. If you place her in AL she will have to move again as she progresses. I would either get a new PCP or a referral to a Neurologist. Sadly more testing won’t make a difference. It may give you a better diagnosis but may not. It’s a progressive disease with no treatment and no cure. So sorry.

harshedbuzz · March 10

@rbrammer01

HATS seems really unusual compared to most places with which I am familiar. Is it a requirement for Institutional Medicaid or other government-funded program?

Generally, it is the facility's director of nursing who decides, with family, what is the appropriate level of care for the incoming resident. Care level should be set for the PWD at their least functional level rather than aspirationally for when they're having a "good day".

That said, it's pretty common for families to see their LOs through rose-tinted lenses. There's a say here that by the time family is willing to consider AL, that cruise has already sailed, and MC is appropriate. I'm not saying that's the case here, but I know from experience how hard it is to imagine your LO in a setting where there are folks further along in the disease progression. Finances can drive this decision making as well given that AL is considerably less expensive and assets would last longer. Sometimes, places that offer AL and MC will accept a new resident into AL to appease family knowing the PWD will not do well and need to be moved to MC fairly soon after arrival.

I hope the doc in Carmel can help you.

HB

Everything Relying on a HATS (Healthy Aging Transition Services) Assessment????

Comments

Commonly Used Abbreviations

Community Guidelines

Categories