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 |