Primary Care and Dementia Care Services to patients who live in assisted living communities.
We are a Nurse Practitioner practice that provides convenient and holistic comprehensive home visits with a goal of reducing acute hospitalizations by providing timely management of acute and chronic conditions.
Primary Care and Dementia Care Services are provided by Board Certified Nurse Practitioners with several years of experience in geriatric, palliative, and hospice care.
Services
Primary Care
• Physical Exams
• Evaluate and Treat Acute Illnesses
• Evaluate and Treat Exacerbations of Chronic Conditions
• End of Life Care Management
• Diagnostics in the comfort of your home. This includes blood work, urine sampling to assess for UTI, X-Ray, EKG, and Ultrasound.
• Holistic care and treatment of behavioral disturbances in Alzheimer's disease and other dementias.
• Initial and ongoing cognitive assessments.
• Personalized treatment plans tailored to the patient’s individual needs.
• Treatment is pharmacological and non-pharmacological in approach.
• Physiological, environmental, and communication triggers are identified, if present.
• The Nurse Practitioner educates the care team on strategies to alleviate and avoid triggers that are contributory or causative factors in behavioral disturbances.
• If necessary, with the Health Care Proxy’s permission, the Nurse Practitioner will prescribe and manage medication(s) to treat behavioral disturbances.
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DEMENTIA Care
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PHYSIOLOGICAL TRIGGERS
• Symptoms such as pain, constipation, urine retention, nausea
• Infection (urinary tract infection most common)
• Dehydration, hunger
• Metabolic (vitamin deficiency, abnormal TSH, blood sugar imbalances
• Not wearing glasses or hearing aids
EMOTIONAL TRIGGERS
• Lack of routine/structure in the day to day
• Lack of consistency with caregivers
• Boredom
• Overstimulation (Loud noises, crowds)
• Social isolation
COMMUNICATION TRIGGERS
• Instructions with multiple steps to complete task, or too many choices
• Caregiver not allowing them to be involved in decisions
• Caregiver arguing with them
• Difficulty understanding caregiver when caregiver is speaking
THINGS TO LOOK OUT FOR
BEHAVIORAL DISTURBANCES
• Repetitive vocalization (repeating sentences, questions)
• Resisting help with personal care
• Sleep disturbances (altered sleep cycle, inability to sleep)
• Psychomotor hyperactivity (inappropriate dressing or disrobing, opening/closing cupboards, picking at self)
• Verbal aggression (yelling, screaming, swearing)
• Anxiety/anger/irritability
• Physical aggression (pushing, grabbing, spitting, hitting, kicking, throwing items)
• Psychosis (hallucinations -seeing or hearing things that are not there; delusions - false thoughts; paranoia - unjustified suspicion or mistrust)
• Manic-like behaviors (impulsivity, labile mood, hypersexuality)
• Self-neglect
• Depression
• Pacing or wandering
NON-PHARMACOLOGICAL TREATMENT
PHARMACOLOGICAL TREATMENT
Physiological, environmental, and/or communication triggers are identified, if present. Tina educates the care team on how to alleviate and avoid triggers that are contributory or causative factors in behavioral disturbances.
If it is deemed necessary, Tina will recommend and prescribe medication to treat behavioral disturbances.
Tina Hughes
APRN, FNP, CDP
Tina Hughes, NP is the principal owner of Hughes Health and Wellness. Tina is a board-certified Family Nurse Practitioner and Certified Dementia Practitioner. She has over 15 years’ experience in hospice, palliative, and complex care management of adults. Tina’s holistic approach is unique in that she investigates the root cause of symptoms prior to considering medications. Tina carefully considers a person’s physical, emotional, social, and spiritual needs when developing an individualized treatment plan.
Kimberly Azulay-Williams
FNP
Kimberly is a board-certified Family Nurse Practitioner who has over fifteen years of experience working in both acute and primary care settings. She provides empathetic, compassionate, and quality evaluation and management skills to patients with complex acute and chronic medical needs. Kim ensures treatment of the physical, social, emotional, and spiritual aspects of one’s being.
YOUR CARE TEAM
