Table 4.

Sample Case of Patient Whom the Patient Navigator Helped

Patient characteristics and background• Indigent, disabled, 61-year-old single woman
• Has diabetes, coronary artery disease, congestive heart failure requiring implantable defibrillator, severe arthritis, and severe dental problems
• Subsisted on cereal because that was all she could eat and afford
• Window air conditioning unit broke and she was having difficulty breathing in the summer heat
Patient barriers• Financial: could not afford food, dental work, psychiatric counseling, installation of donated central air conditioning unit
• Psychosocial: lacked social support, had fear and mistrust of dentists, depressed (“All I was doing was waiting to die.”)
• Transportation: had difficulty driving the long distance to see a psychiatrist and could not afford gas
Services provided by patient navigator• Obtained Meals on Wheels, resolving a catchment area dispute between 2 offices
• Provided an application for charity care for dental work
• Identified a psychiatrist that accepted Medicare for treatment of anxiety and depression and arranged an appointment
• Obtained application for interest-free loan for air conditioner installation and coordinated a letter of necessity from patient's physician
• Provided emotional support and encouragement to see the dentist
• Negotiated counseling at a nearby church when the patient declined treatment from a psychiatrist and had difficulty driving to the appointment