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December 12, 2016 - Lay navigators: A 'priceless' part of cancer care

Wessler-1 resized.jpgSandra Wessler of Fairhope reviews materials with MCI lay navigator Sissy Louise Moore.

FAIRHOPE -- Sandra Wessler remembers the smile.  Newly diagnosed with breast cancer, she had come to USA Mitchell Cancer Institute’s Fairhope office for an introduction to her treatment, what she called “Chemo 101.”

“I was met by a woman named Sissy Louise,” she recalls. “And she had the biggest smile. It was then that I knew everything was going to be OK.”  

Sissy Louise Moore was Wessler’s lay navigator, one of six who work with patients at MCI.  Lay navigators provide support to patients throughout their cancer journey, helping them navigate cancer treatment, survivorship and follow-up.

While lay navigators do not have medical training, they are part of a complex medical team.  Their role is to assist patients and their families with information to help them make decisions regarding their care, to provide emotional support, and assist with problems that inevitably arise.  MCI was an early adopter of the services.

During that first meeting, Moore sat with Wessler and her daughter, and discussed how cancer might impact every area of Wessler’s life, including her job and finances, in order to prepare them for the journey that lay ahead.   

“It was like I was the only appointment she had all day long,” says Wessler. “Sissy Louise took time to go over every aspect of treatment and also to make sure I heard her.”    

That detail was important, because when Wessler was first diagnosed she was so stunned after hearing the word “cancer,” that she didn’t recall anything else the doctor said.  

The lay navigator program at MCI began in 2013 with a Centers for Medicare & Medicaid Services grant through the University of Alabama at Birmingham. The goal was to improve health outcomes and reduce health care costs among patients 65 and older.  

Under the program, patients are followed more closely, which can result in fewer emergency room visits and lower costs, said Cathy Tinnea, manager of Navigation Services at MCI. The same oversight that ensures patients follow their treatment plans, coupled with the removal of barriers such as lack of transportation, is also expected to improve health outcomes, she said.

This year, MCI was selected as one of 195 practices across the country to participate in Medicare’s Oncology Care Model program, which aims to provide higher-quality and more highly coordinated oncology care.  Under this program, MCI’s lay navigation services have been expanded to include all patients.  To date, more than 1,500 patients have received services, Tinnea said.  

“One of the biggest advantages of lay navigators is that they understand from a non-clinical side what the patients are experiencing,” she said. “They are able to understand the patient’s challenges, and the program empowers them to take an active role in the management of their care. “  

Wessler, a vivacious 62-year-old, was diagnosed with cancer in both breasts in July 2016.  After initial appointments at another cancer treatment facility, she sought a second opinion at MCI.  She made an appointment with oncologic surgeon Dr. Lynn Dyess, and during the first visit, knew that MCI was where she belonged.  The patient navigator program was also a plus, she said.

Under the program, all patients are assigned a navigator, but they can rely on him or her as little or as much as needed.  Some patients have plenty of family support and resources, while others struggle with basic needs, including finances, food, housing and transportation.  Lay navigators are able to direct patients who need assistance to a variety of community resources that can help them.  They also assist patients with drug expenses by referring them to foundations that may cover some of the cost.

Moore assisted a patient by finding a qualified builder to help with a home wheelchair ramp.  When a street sign was stolen, making it more difficult for EMS to find a patient’s home, Moore made the call to have a county engineering department install another one.  Navigators have helped homeless patients find shelter and provided cleaning resources for patients too sick to manage housework.  The range of needs varies from patient to patient, but one thing is certain: No patient has to go it alone. 

“The reality is that with every diagnosis of cancer comes fear, anxiety, even confusion,” Moore said. “Some people think they can try to do this by themselves, but I don’t recommend they do.  I think lay navigation empowers the patient to act as their own best advocate in whatever form that might take.”

A title examiner at Gulf Shores Title Co., Wessler has a network of supportive colleagues.  She counts her daughter, Jessica, and Moore as her biggest cheerleaders.  Moore checks on her every time she has an infusion treatment and provides assistance with information and other needs. 

“Sissy has taken a lot of the burden off me, and she’s accepted it willingly,” said Wessler.  “I think it’s vitally important to a patient’s well-being, recovery and treatment to have someone like that in their corner.  I think the program is priceless for every patient.”

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