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At EmpowerMe, we believe in a proactive, team-based approach to care. Recently, one of our residents began showing signs of paranoia and cognitive decline. She often chose to remain in her room, avoiding community activities and social interactions.

Recognizing these changes, EmpowerMe’s Nurse Practitioner took immediate action, reaching out to the resident’s Primary Care Physician (PCP). The PCP conducted an in-person visit, ordered labs, and made adjustments to the resident’s medication. However, in the days following this visit, the community’s nursing staff noticed her symptoms worsening.

To address these concerns, a follow-up telehealth appointment was arranged between the EmpowerMe Nurse Practitioner, the resident, and her Power of Attorney (POA). During this encounter, it was revealed that the labs ordered during the initial visit had not been completed due to transportation challenges. The Nurse Practitioner quickly collaborated with the resident’s PCP, who agreed to have the labs drawn on-site at the Assisted Living Community. The results were promptly reviewed and shared with the PCP.

In response to the resident’s ongoing paranoia, the Nurse Practitioner consulted with EmpowerMe’s Pharmacist. Together, they made recommendations for further medication adjustments. The resident’s PCP, appreciative of the collaboration, immediately implemented these changes.

Throughout this process, communication remained key. The Nurse Practitioner informed the Clinic Director, who relayed updates to the community’s Resident Services Director. The resident’s son, also her POA, was kept informed every step of the way and fully supported the care plan.

After just a month and a half, the results have been transformative. Thanks to the EmpowerMe360 program’s comprehensive, multidisciplinary approach, the nursing staff has observed significant improvements in the resident’s mood, with decreased anxiety and depression. She has become more engaged in community activities, attends social outings, and enjoys spending time outdoors, soaking in the sunshine on the front porch. This success story exemplifies how EmpowerMe360’s commitment to personalized, proactive care can help residents regain their sense of joy and connection within the community.