Providence Panorama Clinic

Our Approach

Adult primary care physicians act as the first point of contact for most adults treating their patients throughout their lifetimes. Should the need arise primary care providers refer their patients to specialists.

The Geriatric Center of Excellence serves as a regional resource for the development of geriatric services and specialized care for older adults. We are here to help you manage your general health, chronic diseases, transitional care, advanced care planning, fall prevention and many more services focused on older adults. Our providers are board certified in internal and family medicine and specialize in adult and geriatric medicine. We are deeply committed to the Providence promise to “know me, care for me, ease my way."

Our new health center offering comprehensive senior care services is opening soon. Be your healthiest by connecting with your doctor on a personal level and accessing an entire team focused on senior health. Learn more about the Providence 65+ Health Center.

What to Bring

In preparation for your first visit, please bring the following with you to your doctor appointment:

• Picture ID
• Insurance cards
• All medications and over-the-counter supplements
• Any previous medical record
• Authorization to release protected health information

Use these forms to request the release of your medical records or health information:

• Request your records from this Providence Medical Group clinic
• Request your records be sent to this Providence Medical Group clinic

Use these forms to request the release of your medical records or health information:

• Request your records from this Providence Medical Group clinic
• Request your records be sent to this Providence Medical Group clinic

Fall Prevention Program

Falls can result in serious injuries and assisted living. Because of the high number of seniors falling, Providence offers programs to screen and educate people on the risks of falling and what can be done to prevent falls. Falls do not just happen because of aging. They are preventable with many different factors playing a role in causing falls.

There are many risk factors that make a person more likely to suffer a fall. Some common risk factors include:

• Taking multiple medications and/or certain classes of medications
• Lack of exercise and activity
• Diseases and conditions that affect balance (ex: inner ear problems, leg injuries, stroke, Parkinson’s disease, diabetes)
• Poor maintenance of general health
• Vision problems
• Improper use of a walker or cane
• Frequent urination, especially at night
• Unsafe environment at home: poor lighting clutter in walking areas telephone/electrical cords that may cause tripping slippery floors/tubs throw rugs 

• Exercise regularly
• Know what medications you are taking and know their side effects
• If you get dizzy, change your position slowly. Talk to your doctor about what may be causing the dizziness
• Keep your home well-lit and use night lights in the bathroom
• Install grab bars in the bathroom
• Use slip-proof mats or strips in the tub or shower
• Practice good nutrition and drink plenty of fluids
• Secure or take up carpets and throw rugs
• Wear shoes that are low-heeled and non-skid
• Speak to someone about the fears of falling
• Consider asking your doctor for a referral to physical or occupational therapy if you have difficulty with any of the following: getting in and out of chairs getting on and off the toilet getting in and
• out of the tub walking outdoors rising up from the floor going up and down stairs
• S.A.I.L. Stay Active and Independent for Life

Balance is the ability to stay upright. The mechanism involves cooperation between your ears, eyes and small muscles around your ankles, knees, hips, shoulders, midsection and even the feeling in the bottom of your feet. Balance is vital to normal everyday life activities. Disruptions to an individual’s sense of stability can increase the risk of falls, the leading cause of injuries in older adults. Talking to your physician about balance problems can lead to testing to determine the reason for your difficulties.

Many things can cause balance issues:

• Inner-ear problems: Swelling from illness or infection, debris in the ear or a blow to the head can damage your ears. When that happens, your balance goes downhill, too.
• Vision problems: The eyes and ears work together to ensure balance. Balance can be thrown off through loss of vision. Cataracts or macular degeneration can cause vision problems that affect balance.
• Loss of sensation: Losing feeling in lower extremities, such as the soles of your feet, can throw off your balance. This is especially prevalent in older people and diabetics with foot problems.
• Disease: Loss of balance is a symptom of any number of diseases or conditions. You name it and balance can be a victim: cardiovascular and neurological disease, colds and flu, a broken leg or an upset stomach.
• Medications: Older people may see more than one doctor, and may find themselves taking many pills every day. Make sure your primary doctor and your pharmacist know which pills you’re taking.
• Alcohol and drug abuse: Intoxication causes balance problems.
• Fear: Many seniors tell their doctors that they fear falling. That fear keeps them in bed, or in a chair, immobile. That can lead to weakened muscles and a self-fulfilling loop: the more sedentary the lifestyle, the more severe the balance problems.
• Muscles: Muscles help keep joints stable. When those muscles weaken, your posture declines, along with your endurance.
• Standing up: When you stand, you experience a drop in blood pressure. That can mean that for a few seconds, your brain loses a big part of its blood supply, resulting in dizziness and making you wobbly.

Balance problems are very common among seniors and may or may not be helped by a regular exercise program. If you are experiencing problems with your balance it is very important that you are evaluated by a physician to determine the cause and appropriate treatment plan.

Leg strength and endurance are two other factors related to fall risk. Increases in both of these areas can reduce your risk for falling. Furthermore, being in good physical condition can decrease the severity of the injury should a fall occur. Again, prior to beginning an exercise program it is very important to be evaluated by a physician to understand any precautions or guidelines which you must consider to be as safe as possible.

Eating well can help to prevent some of the causes of instability and falling.

• Stay alert and energetic. Prevent low blood sugar episodes that can leave you light headed and weak by eating regular meals and snacks. Include some protein with each meal and limit sugary foods to occasional treats.
• Maintain strength and energy. Get adequate iron to prevent anemia be eating at least 4 oz. of meat each day. Beans (legumes), eggs, and soy products can be substituted for some of your meat, but dairy products do not contain much iron. Nuts, dark green vegetables, and fortified cereals and enriched breads can be good sources of iron, as can prunes and raisins.
• Muscle and joint health prevent falls. Vitamin D is receiving a lot of attention for its role in preventing falls by maintaining muscle and bone function. The only dietary source is milk, and it would take 5 cups a day to get adequate amounts. In addition to drinking some milk and taking a multi-vitamin/mineral supplement, most mature adults should be taking a vitamin D supplement, perhaps in combination with calcium and magnesium.
• Getting enough protein in combination with doing strengthening exercise is vital to maintaining muscular strength. Meat and dairy foods are the biggest sources of protein.
• Getting adequate Omega 3 fatty acids by eating fish, walnuts, soy and flax, and possibly be using fish oil or flax supplements can diminish the inflammation that may aggravate joints.
• Maintain healthy bones, blood pressure and muscles. The minerals calcium, magnesium, and potassium are essential for maintaining good blood pressure and also maintaining strong, mineral rich bones. Eat 2-3 dairy products a day and take a multi-vitamin/mineral supplement for calcium. Use additional calcium/vitamin D supplements or calcium/vitamin D fortified drinks and cereals if needed.
• Get magnesium by eating whole grains, legumes, nuts, and meats and dairy products. Pump up your potassium by getting lots of fruits and veggies in your diet…5 or more servings a day. Dark green and orange colored choices, citrus, and potatoes are good sources.
• Drink lots of fluids to prevent dehydration, which can make you weak and less alert. Any liquids will do, but drink a full glass at each meal and several other times during the day.
• Avoid sugary low nutrient drinks like sodas and sweetened teas.