Our Members' Stories
Nelly, a CareFirst employee and member, spent years as her husband’s primary caretaker while he dealt with multiple chronic health issues including high blood pressure, chronic pain and numerous reconstructive and replacement surgeries. For much of this time, her husband was on disability and unable to work, causing the family added financial stress.
Although she had her own health concerns including high cholesterol, unstable blood pressure and debilitating neck pain due to degenerative disc issues, Nelly worked full time and supplemented their income with multiple part-time jobs. Despite her best efforts, eventually Nelly and her husband were forced to declare bankruptcy and move in with her elderly in-laws, who Nelly also looked after. After her mother-in-law passed away, Nelly’s husband became increasingly disheartened, impacting Nelly who recalls, “It was an awful place to be in; I was full of anxiety, depressed, just hating life.”
Nelly’s Care Coordination Experience
It was during a visit with her primary care provider that she learned about CareFirst’s chronic care coordination program. The program provides members who are managing chronic or complex health conditions with one-on-one support and guidance from a registered nurse. Nelly’s doctor thought both she and her husband could benefit from the additional help and they agreed.
Nelly had just begun working with her nurse, Corinne, when her beloved husband of 32 years suddenly passed away. It was at this point Nelly said she felt the true value of the program, “Corinne called nearly every day. She set me up with a behavioral health case manager and every week she’d call to check in on me to see how I was progressing. I felt like she was genuinely concerned.”
Nelly’s behavioral health case manager, Jessica, helped her work through her grief during weekly calls. Nelly remembers, “I was devastated and didn’t know what to do next. Jessica would just listen to me and it helped so much.”
Corinne helped Nelly focus on her own health concerns. To address her chronic neck pain and disc issues, Nelly decided to have surgery. Corinne assisted her with all the pre-operative arrangements for the surgery and scheduled physical therapy sessions afterward. When Nelly experienced a severe allergic rash post-surgery, Corinne contacted home nursing services to deal with both the reaction and post-operative pain. Having the help of a home health nurse saved Nelly a trip to the hospital emergency room and kept her rash from becoming more serious or causing respiratory issues.
A nurse with more than 25 years’ experience, Corinne knows how important it is to get inside a patient’s home. The home health nurses often call the care coordinators from the home to ask questions, to report what they’re seeing and to review additional resources as needed. She says, “It’s good to have that collaboration in the home environment—to be able to see if anything else needs to be addressed. Had the home nurse not acted upon it, Nelly would have gone to the ER— it definitely prevented it.”
Corinne continues to call Nelly weekly as well as keep track of every doctor appointment and follow up with her afterward. She also identified a specialist to help determine the cause of Nelly’s allergic reaction to prevent future issues. When asked her thoughts about CareFirst’s chronic care coordination program, Nelly says, “It’s absolutely a great program. I thought I would never get better or get over everything, but I am making great progress finding my ‘new normal.’ Throughout it all, my care coordinators have been my rock and support.”
"It’s good to have that collaboration in the home environment—to be able to see if anything else needs to be addressed. Had the home nurse not acted upon it, Nelly would have gone to the ER—it definitely prevented it."