A Step Forward: Speak Up When You Feel Tired

Signs of heart disease can be very subtle. One thing Ms. Diane, age 93, noticed was that she had been feeling a little more tired lately. So, she spoke up and told Bonnie Coker, RN, her virtual care nurse about the fatigue.

Ms. Diane lives with chronic obstructive pulmonary disease, congestive heart failure and atrial fibrillation. Managing these conditions requires a careful balance of medication and lifestyle changes. To stay balanced and healthy, minor adjustments may be needed to stay on course.

Ms. Diane is not alone. 1.4 million or 31% of Humana members live with diagnosed heart disease in an equal number of men and women. About 272,000 Humana Medicare Advantage members are women living with congestive heart failure.* Heart disease is often thought of as a man’s disease, however it is the leading cause of death in women in the U.S. Treatment of heart disease is essential to maintaining health and requires specialized care.

After being hospitalized eight times in eight months, Ms. Diane needed extra help when she came home from the hospital. Due to her severe heart disease, she was referred to a Home Health program in her Humana Chronic Special Needs Plan network, CenterWell Home Health’s specialized cardiopulmonary program called Keeping Hearts at Home.

The cardiopulmonary program focuses solely on treating patients with heart and lung diseases. Clinicians within the program complete comprehensive training in the identification, treatment and causes of cardiopulmonary conditions, as well as the use of medications and advanced devices in patients with severe heart disease. More than 10,500 Humana members participate in the Keeping Hearts at Home program each year.

Common tools used in the program include virtual visits with a registered nurse, telemonitoring and NICaS, a non-invasive cardiac output monitoring system that provides physicians with a way to remotely measure blood flow in a patient’s body.

As Ms. Diane’s virtual care nurse, Bonnie had noticed recent changes in Ms. Diane’s heart rate via daily telemonitoring of her vitals. Ms Diane’s heart rate was becoming very slow, beating at less than 50 beats per minute. The nurse had also noticed changes to Ms. Diane’s NICaS test earlier in the week.

Bonnie scheduled a home visit with Ms. Diane and reviewed her medication list. The nurse considered that the lower heart rate may be due to a medication Ms. Diane was taking for congestive heart failure that helps the heart pump blood through the body by lowering blood pressure and slowing down the heart rate.

Bonnie reached out to the cardiologist who prescribed a lower dose of metoprolol. Then she reviewed the change with Ms. Diane, educating her about the medication and providing her with instructions on how to take it as prescribed.

“Within a day or so we began to see the patient’s heart rate and other vitals trend in a positive direction,” said Chris Smith, RN, Area Director of Cardiopulmonary for CenterWell Home Health. “The patient reported feeling much better and her energy was back.”

The combination of the Keeping Hearts at Home program along with telemonitoring and virtual visits allowed CenterWell Home Health to catch a potentially dangerous situation involving a patient with serious heart disease. Specialized cardiac care in the home helped Ms. Diane stay safe, feel better and avoid another hospital visit.

All of this was possible because Ms. Diane spoke up and reported how she had been feeling. Open communication with healthcare providers is essential to taking charge of your own health and well-being.

Beneficiaries living with certain chronic conditions, including congestive heart failure, may be eligible for  Humana Medicare Advantage Special Needs Plans (SNP) that provide extra coverage and benefits to help them better manage their health. To learn more about managing heart failure, visit the Neighborhood Center video archive.

*Statistics regarding heart disease in Humana Medicare Advantage population are accurate as of September 2022. Data provided by Humana Clinical AI Integrated Health Solutions.

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