Millwood Nurse Brings Old-Fashioned Senior Care Right to Your Door

By Elaine Clarke

When Julie Mossberg-Kaplan, who lives in California, learned her mother was struggling to leave her Westchester apartment for routine medical appointments, the family felt stuck.

Trips to the doctor became stressful, and coordinating care from across the country was overwhelming, even with her sister living in the local area.

But then they met Diane Pagan, a nurse practitioner with decades of experience who, about two years ago, began bringing personalized care directly to their doorstep.

After nearly 30 years focusing on geriatric health, the Millwood resident founded Senior Moments Care in 2023 to revive the kind of hands-on, compassionate care she felt was disappearing from modern medicine.

“She very much has the same philosophy that we have, in terms of making my mother comfortable,” Mossberg-Kaplan said of Pagan. “She’s made it so most of the things that my mother needs to have done she can bring in to her, rather than my mother having to leave her apartment.”

And for Pagan, her commitment to elderly patients in the region is more than just a job — it’s a calling.

“I’ve had this pull toward geriatrics ever since I was in my 20s,” Pagan explained in a recent interview with The Examiner. “I don’t know where that came from, I just know that it’s there. They provide so much knowledge and they’ve just been around twice as long as I have, so to be able to sit and listen to each one—they’re funny, they’re unique, they’re sad, they’re happy. They’re not afraid to just be who they are.”

Value Over Volume

Pagan, who lived in the Town of Mount Pleasant for 20 years and was an active member of the Pleasantville community through Holy Innocents Church, said her concierge-style business revives an old-fashioned approach to health care—one that puts patients first. 

“Throughout my career I’ve definitely seen a steady decline in the hands-on personalized care that I used to see when I first started,” Pagan said. “Especially after the larger health care organizations began, they really prioritized volume over the value of care.”

Working in health care, Pagan said she became frustrated that she could not focus on what really mattered to her: getting to know her patients, listening to them, and guiding them through complex decisions. 

“Senior Moments Care was born from that frustration,” she explained. 

Pagan is certified as a geriatric care manager, which allows her to address any environmental, social, financial, or even legal issues her patients might face. She is also certified in hospice and palliative care, which ensures she can manage pain or other issues patients confront. 

“They really don’t have to go anyplace else, no matter the need. And that’s something I have not seen,” Pagan said. “I would love to see more advanced practice providers have practices similar to this, where we’re addressing everything with these patients and their families.” 

She made the switch after her role as the director of complex care in a larger health care organization suddenly changed overnight when it was purchased. This change is part of a larger shift in health care, as corporatization alters the way hospitals and other organizations approach patient care. 

Pagan believes her role as a health care provider had changed, especially in regard to leadership not paying attention to her expertise. 

“What turned me off the most was I felt out of control,” Pagan said of her prior work. “And that feeling is horrible, because everything I wanted to do in this large group, I’m doing now in my practice and it is working.”

But now, running her own organization, Pagan can do things her way — and communication is one of her top priorities when meeting new patients.

To find out what matters most to her patients, Pagan emphasizes the Five “M”s of health care: multi-complexity, what matters most, mind, mobility, and medications.

“What I try to do within those first couple of visits is build a care plan that addresses all the needs for those ‘What if?’ situations,” Pagan said. “So that no matter what happens—if the patient falls, if they should get sicker, if something based upon their complexity or their issues occurs—we’ve already talked about it, we know what the plan is.” 

Additionally, Pagan doesn’t have a call service. Instead, she gives patients and families her cell phone number and tells them to reach out at any time of day. So although her services are not 24/7, having a defined care plan and being easy to reach allows Pagan to provide her patients with comprehensive assistance. 

Sandwich Generation

Janice Porphy, whose mother was one of Pagan’s patients during the last year and a half of her life, said the care Pagan provided was exceptional. She especially appreciated the emotional connection Pagan built with her mom, who could be ornery at times.

“She’s also just a super compassionate, caring person, and my mom really took to her,” Porphy said. “I think she really felt like Diane was on her side and was there to help her and be her advocate and meet her goals.”

Porphy believes that Pagan filled a needed gap in the market, especially for the sandwich generation adults who have to balance the care of the parents with that of their children.

“It allowed us to have the luxury of really doing what my mom wanted and also have proper medical care at the same time,” she said. 

Pagan believes shifting health care back to a person-centered model is essential — but says real change will require a broader shift across the system.

“I would love to see health care become more of what’s needed, rather than how much income they can bring in with that patient,” Pagan said. “And it takes a village.” 

Pagan’s own village has grown over the past two years. She now leads a small team of about half a dozen, many of whom are family and friends. Her brother-in-law, William Julian, for instance, helps transport patients to the office.

“A lot of my patients have dementia, so he’s my eyes and ears and appointments,” Pagan remarked. “A lot of times he’ll call me during a visit and I can get on the phone with the doctor, and then he brings me back all the paperwork.”

‘Not Cookie-Cutter’

Alexandra Yacco is a part-time nurse practitioner for Senior Moments Care. She and Pagan met while Yacco interned under her. When Pagan wanted to start her own business, she knew that Yacco was someone she wanted on her team. 

“I was very excited for her,” Yacco said. “We don’t have enough people in the community helping the vulnerable population.” 

Yacco recently completed her doctorate in nursing at Chamberlain University in Chicago. She said the best part of working with Pagan is the flexibility it gives her to balance her responsibilities with her work at Senior Moments Care.

“It is not cookie-cutter, going to an office every day,” Yacco said. “You build relationships with the families and the patients and you feel like you are making more of an impact, now that you are in the homes and watching them and learning about them.”

As for Mossberg-Kaplan, the California resident, she echoes what many families of Senior Moments Care clients seem to say: she can’t imagine managing her mother’s care without Pagan, and the peace of mind she provides.

“I feel like there’s somebody that is comprehensively taking care of my mother in a way that I would not be able to—even in a way with her having a primary doctor wouldn’t be able to,” Mossberg-Kaplan said.