Nicole Taylor believes in making personal connections. When she first meets a new member, the Aetna nurse case manager breaks the ice with a personal tidbit: She has twin 7-year-old boys and seven chickens at her Toms River, N.J., home. Helping members get to know her allows them to feel more comfortable talking about their health so Nicole can create a personalized health care plan based on their likes, abilities, living situation, and more.
Nicole’s approach was effective with Marshall Cummings, an Aetna member with diabetes, heart disease and liver cancer. Marshall, 67, lives alone in Elizabeth, NJ and didn’t want to burden his family and friends as he struggled to manage his health. Nicole became his lifeline, going to doctors appointments with him, educating him on the right foods to eat, getting him active again and lifting his spirits. “She was the right person at the right time,” says Marshall. “Nicole helped me get my strength back.” (Read more about Marshall’s journey here).
Nicole says visiting members in their homes gives her better insight into what’s truly going on in their lives, so she can offer them the best care. “You can’t pick up on verbal cues, postural cues and different things like that on the phone,” she says. “They may say they have their diet under control. But you walk into their home and there are doughnuts and bagels sitting right out on the counter.”
It’s a bittersweet moment when Nicole’s members don’t need her anymore. “The goal is for them to feel empowered,” she says. “It feels good to see people make good decisions and move forward with their health on their own.”
Q. When did you realize how critical your role as a nurse can be?
A. My first job was at a subacute rehab center as a floor nurse. I was just passing out medications and providing general care. But when you start working directly with patients and families and seeing them in that vulnerable moment you think, “Wow, this could be my mom, my dad, my sister.” It changed my view on life knowing that I could really make an impact.
Text Overlay: About 80% of older adults have one chronic disease, and 77% have at least two.
Marshall: I have been living with diabetes for years.
I had triple-bypass surgery in 2014.
In 2016, I was diagnosed with liver cancer.
Nicole: Marshall and I met just a little over a year ago in his doctor’s office. He’s the type of member that just tugs at your heartstrings. For one reason or another, he’s gotten into my heart. It’s very important for chronic conditions to manage them and make sure they’ve having coordination with care between their doctors and their medications.
Marshall: She made me at ease because she would ask questions that I didn't know how to answer, and she would be break it down so you could really understand what the doctors are saying to you.
She became a best friend.
Nicole: The amount of impact we can give to a member by giving this personalized support and being in their home, it’s just priceless.
Marshall: You have seen me at the lowest point of life, and you helped me to go through it.
Nicole: The little steps that you take to the bigger picture are greater, actually, than trying to attack it all at the same time.
You can go anywhere. Small steps. The sky's the limit.
Marshall: I’m 67. I hope to live to be 107.
Marshall Cummings is a real member who’s given us permission to use his story.
Q. How can the community-based care model make a difference for patients who have chronic illnesses?
A. Each person has different social determinants we have to deal with — different jobs, different lifestyles. One size doesn't fit all. When I first met Marshall in his doctor’s office, he wasn't as health literate as he is now. His doctor pulled me aside and said, “Hey, listen, there’s a lapse in what’s going on. I don't know if he's understanding or not.” After that, I went to doctor appointments with him. I sat with him after surgeries. I made sure he was asking the right questions and getting the right answers so he could get everything he needed.
Q. Marshall calls you his guardian angel. How important is it for older adults to have that support system in place?
A. It is very important for older adults to have support in place, as there are many things that they may need help with due to memory deficits, new technologies and other issues. Marshall got a new glucometer through Aetna and we worked on tracking his blood sugar, but also on helping him understand what those numbers mean. Sometimes it’s holding his hand a little bit more, sometimes holding his hand a little bit less, but overall we were in it together.
Q. What is your strategy when someone’s physical health impacts their mental health?
A. It's about giving them positive reinforcement and encouragement. I try to help the member put things into perspective so they don’t get discouraged — so they say, "I'm not going to be able to do everything today, but if I do one thing today, or half of one thing today, it's an accomplishment." For Marshall, he had lost a dramatic amount of weight from surgery and looked frail. He wasn’t himself, he wasn't shaving. Every time I would see him, I would say, "Where's your razor? Come on, we have to shave." The next time I saw him, he said to me, "Look, I shaved for you." Now, he gets pride out of doing the things that he's supposed to do.
Q. What has been your most fulfilling professional moment so far?
A. When I was working in end-of-life care. I was taking care of patients and making sure all their wishes and needs were being met, watching them be at peace and their family be at peace as well. That was very fulfilling for me.
Q. What do you like to do in your free time?
A. I like to be outside. I love the beach. I like to walk. We have a garden outside that everyone in the family works in and grows food. And we try to take bike rides and do things so we are active together.
Q. What’s your health ambition, and how are you achieving it?
A. It has always been mindfulness. I tend to be the kind of person who wants to do it all and be involved. I think it's the woman and the mother in me. But I need to be more mindful and in the moment and stop thinking about what's going to be next, and next and next. I want to take a more mindful approach to my life and balance between work, my kids and my social life.
Q. What’s the best piece of health advice you’ve been given?
A. Your mental health is just as important as your physical health. It’s important to make sure that you're equipped to deal mentally with the struggles life can bring. Physically you can be healthy, but if you're not mentally there and in a good space, you're going to do a disservice to yourself and everyone else. Being healthy in body, mind and spirit is going to bring you closer to your goals.
Christina Joseph Robinson is a veteran editor and writer from New Jersey who still loves to read the old-fashioned newspaper. She’s raising two fruit-and-veggie loving daughters to balance all the treats Grandma sends their way. Christina’s health goal is to resume her workout routine after being sidelined by injuries.
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