|Author: Teddy Durgin|
|RN Gets to the Core of Families’ Problems at IKOR|
|Patricia A. Maisano, RN, CCM, FAACM, RG, ABDA, is a classic example of someone who saw a need and is now trying to fill that need. Maisano is president and CEO of IKOR USA, Inc., a Pennsylvania-based patient advocacy and professional guardianship firm focused on the elderly and disabled.
Maisano recalls the early days of IKOR's formation. "Originally, I was doing case management work for corporations and insurance companies and disability management. I had a very thriving business at the time, but I really wanted to do something different. One day, I received a phone call from a woman who was very emotional. She asked if we could help her with her mother. Her story at that time was one that I now hear every day. But then it was very new to me, and I told her that I thought we could help her. But I would have to do it in a different way than what we had been doing. I found out from my staff that we had had other people call us for the same issue. I asked the woman who had called how she had found out about me and my company at the time, because we didn't advertise. She said her sister found my name in a research book at the library. That really told me how desperate people were to get answers, and it started me designing the prototype of what is now the IKOR approach. I left the world of disability management and started over again in this field. I only wish I could remember the lady's name so I could find her and tell her what her call precipitated."
Maisano is a Registered Nurse by training, having been taught at St. Francis in Wilmington, Delaware. She also attended Our Lady of Angels College, which is now known as Newman College. Her national certifications include: Case Manager (CCM), Fellowship in Case Management (FAACM), Registered Guardian (RG), and Disability Analyst (ABDA).
She remarks, "The design of the IKOR Approach began in 1998, with services beginning in 2000. The implementation of Datikor [a proprietary software system] rounded out our process in 2006, with the introduction of telemedicine becoming the final phase of the process this year. The franchising of IKOR, through IKOR USA, began in July 2008."
Among the services offered by IKOR are telemedicine solutions for dispensing of medications, blood pressures, blood sugars, weights and pulse ox. Maisano adds, "We also provide, through on-site visits or telemedicine remote camera observation, oversight of the care our client's receive. IKOR also provides simple bill pay services to help a person remain at home but not worry if bills are being paid in time…At the core of IKOR advocacy is educating and informing. We work to educate and inform our clients, so that they understand their medical choices and how those choices impact their wishes with respect to quality of life. We educate family members who are involved with their loved one's care, especially those who are in the position to make the decisions for the person."
As both president and chief executive of IKOR USA, Maisano oversees the day-to-day business operations of the development of the franchise. She also regularly appears in court in Guardianship cases and as an expert witness. "I also do all of the public presentations and educational programs for the general public and professional organizations such as the Pennsylvania Bar Institute."
Maisano says the biggest challenge she faces on the job is working with what she calls "the fractured family." Such households may have had some challenges in working together in other situations and find their relationships severely tested when forced to make decisions about the care and living arrangements for elderly family members, most notably one parent or both.
Maisano states, "When I talk about a ‘fractured family,' it can come from many realms. As an example, there may be multiple adult children. The son lives nearby to the mother, the daughter lives at a distance. Parents often want to stay where they are living, which doesn't happen to be in the area of either child. The mother and father want to remain independent. So, the sister and the brother get together because they are concerned about the mom and dad. The mom and dad are giving the son and daughter only partial answers. They're telling them, ‘Everything is fine.' And the kids know that it is not fine, but maybe the sister and the brother haven't gotten along in their lifetime, and they are clearly not in agreement for what needs to be done for their parents now. Part of it is because they don't know what needs to be done, and part of it is because they have opposing opinions. The daughter may feel that mom and dad need to be in a nursing home, while the son may feel that they can stay home."
She continues, "When IKOR comes in, we bring an objective point of view to the whole problem. We are able to tell these children that here are the issues we have found. They are objective issues. They are not things we think are a problem, but things we know are a problem. The parents are more likely to tell us about those issues because we are nurses, and people inherently feel comfortable talking to a nurse. So, we find out more than the kids knew, and we bring to the kids an objective plan of action that may not reflect either of their opinions. Our opinion is just what is in the best interest of this person or people and how do we enhance the quality of their life. If you have made the decision to bring IKOR in, what you are going to get from us is the bottom line. It is what is in your parents' best interests."
Maisano says she is motivated by the same thing that motivates many people to become nurses: the desire to help others and make a real difference. "I believe that all of my experiences and education in the nursing industry have led me to where I am today and have helped to prepare me for creating IKOR, where we truly add to the quality of life for our clients, providing life-altering solutions on a daily basis. What I am most proud of are the responses families have had to our work. The profound effect we have had on the lives of our elderly and disabled clients has been so rewarding. I also have found that my education grows deeper on a daily basis because of the diversity of the people and cases we work with. While my formal education has taken place in the classroom, it is the practical learning and everyday interaction with my clients and staff that teaches me the most."
On the disabled end, IKOR has worked with children as young as two years old and their families. The young are always tough cases to deal with from an emotional standpoint. But, in turn, those are often some of the greatest triumphs. One case in particular still sticks out for Maisano.
"There was a young man who was disabled from a head injury," she recalls. "His mother died and his father was only partly involved in his life. There were other family members around, but things were very fractured and fragmented from the time his mom died. She died in the early 2000s. We got involved in the case, and there have been a series of years where this young man had not had any direct care that was focused toward improving him and his quality of life. What we did for him was got him into a special program that would give him intensive therapies and training. We also went about the process of selling the house he was living in, a house he didn't really have full access to. Working with a homebuilder, we took an existing model and modified it as a new home from the beginning so that it would be fully handicapped-accessible. This young man was not able to walk at 22 and his ability to communicate limited. He now has a job, he now can communicate, and he lives in a home that is completely accessible to him in every way. He will be able to live there the rest of his life with complete mobility. For me, that case always stands out. I was there the day he walked into that house with his walker, and he was just giggling and so happy about this house and the ability to do things like turn on lights by himself and go upstairs because he had an elevator. We made a real difference."
Maisano invites others to make a real difference via IKOR's burgeoning franchise program. She and her staff have just begun franchising IKOR, and their goal is to have the program all over the country. "We are starting first on the East Coast," she states, "building fairly close to home from our perspective. Some states, the demographics on the elderly are higher than other states. But the elderly are now living everywhere, and the problem exists everywhere. Right now, we function in the state of Delaware and the eastern half of Pennsylvania. That will be branching out more as we add franchises."
Maisano describes the launch of Datikor as IKOR's most involved project, due to the fact that it continues to be improved and enhanced. The proprietary technology program is the core of the IKOR Approach, enhancing communication of real-time information to all involved family members worldwide. More importantly, the technology gives the organization's clients the opportunity host all of their medical records, legal information and real estate-related documents on a portable and secure database. She remarks, "Wherever our clients may travel, whatever their medical conditions may be, with IKOR involved, their most up-to-date records on medication, treatment and testing is accessible to medical personnel located anywhere in the world, through this system."
Not surprisingly, Maisano is very excited about IKOR's future prospects. She credits nursing with giving her the strong foundation for the success she now enjoys helping those families and individuals in need. She concludes, "Our goal is to exceed the expectations of the person's quality of life. We aim to enhance the quality of life and act in their best interests. What are their wishes? What are their thoughts? And what answers can we give to them that are best for them in making life decisions? We have never lost sight of those objectives. In not losing sight, I think it gives us a really objective focus in what we are doing. There is so much out there in medicine and communities and resources, but they all aren't a perfect fit with every person."
Maisano adds, "If IKOR is something that interests you [as a potential franchisee], I would say go to our Web site, www.ikorusa.com, read more on what we do. What we are looking for in the people who are going to be franchisees for us, it's really about a passion for helping these people and bringing their abilities to task in that effort. Go to the Web site and learn if this is something that matches up with your abilities. We have looked at several groups of people—doctors, estate attorneys, elder-law attorneys, nurses—as potentially great franchisees for this model. Those are some of the people who have contacted us already. But a businessperson could also handle this if they had a nurse working with them. The business is set up with the use of Datikor, which is our proprietary software system, to make this a virtually paperless business. The oversight and help that franchisees are going to get from IKOR USA is going to be really in-depth. We will all be interlinked with Datikor. Our franchisees are going to have answers there. They are going to be able to communicate with each other and with the home office. They are not going to be alone, and the process will be uniform throughout the country. Those are the types we are hoping will look at this program."
Patricia Maisano is president and CEO of IKOR USA, Inc., a Pennsylvania-based patient advocacy and professional guardianship firm focused on the elderly and disabled. Maisano is a Registered Nurse by training, whose national certifications include: CCM, FAACM, RG, ABDA.
Teddy Durgin is a Baltimore-based freelance journalist who writes frequently for NEWS-Line for Nurses.