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ElderCare Solutions of MI

Archive for 'Prevention'

 

The older we get, the more doctor appointments we seem to need.  It is not uncommon for the average baby boomer or older adult to see a cardiologist, a neurologist, perhaps even a rheumatologist, pulmonologist or gynecologist!  But amidst these many appointments there is one that often gets forgotten…an annual physical with a primary care physician.

Why is it important to keep up with your primary care doctor if you’re seeing all these specialists?  That’s a frequently asked question among our clients.  And the answer is a timeless metaphor…to be sure the right hand knows what the left hand is doing, and vice versa! Most specialists will only diagnose, treat, and prescribe medications for illnesses that fall under their own area of specialization.  So problems that come up may not be addressed outside of a primary care physician’s office.  For example, you’ll routinely have your blood pressure checked as part of an office visit with a pulmonologist, rheumatologist, or gynecologist, but it will not likely be addressed or treated, even if it is elevated. That’s also true if your labs show elevated cholesterol levels.  Instead you’ll be referred to primary care.  Also, routine general preventive care and screening will not be done by specialists, who need to use the appointment time to focus in-depth on the condition they are treating.

So, as much as you would love to eliminate another appointment, call your primary care doc, and schedule your annual appointment.

Getting out my calendar,

Lynn

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The theme for this week is Falls Prevention.  Over the last 2 weeks I fell tripping over power cords, a colleague of mine slipped in her home, and we received several calls from new clients who were asking for help because they are recovering from…you guessed it, falls!

I think most of us think about falls prevention reactively, meaning it becomes really important to prevent another fall, after we’ve fallen at least once.  Prior to that we feel pretty much invincible.   But the truth is, it takes a long time to recover from that first fall if it was a bad one, so the time to think about falls prevention is now!

There are several different reasons people fall.  The most common causes are poor balance, clutter on the floor, inadequate lighting, wet/slippery floors, and neurological causes.  Luckily, the following preventive suggestions are helpful in most cases:  

  • Install grab bars in bathrooms
  • Pick up or tape down all throw rugs
  • Remove clutter from the floor
  • Install additional lighting if necessary
  • Be conscious of where you step on slippery surfaces
  • Work with a physical therapist to improve balance

Whether you put all of these steps in place, or only the one or two critical for you, protecting your quality of life is well worth the investment.

Measuring my bathroom for grab bars,

Lynn

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Almost everyone knows someone who is living with Alzheimer’s.  I will never forget the day when my great-aunt, my oldest living relative, looked me square in the face, and called me by my mother’s name. It was heartbreaking that she didn’t know who I was, and although I wanted to tell her it was me, I knew that even if I corrected her, it would do no good. 

This past spring, the Obama administration took a giant step toward progress by  developing  a National Alzheimer’s Plan, with the hope to prevent and effectively treat Alzheimer’s disease by 2025.   The crux of the plan begins with an investment of $156 million dollars to increase Alzheimer’s disease research,  and support people currently living with Alzheimer’s.

The details of the plan are many, and its mission and goals are specific.  But what it represents to so many of us can be conveyed in one simple word…Hope.

For more information on the details of the plan, visit http://aspe.hhs.gov/daltcp/napa/NatlPlan.shtml#intro

Remembering,

Lynn

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When an older adult is discharged from the hospital, they are often sent home with a recommendation for homecare.  There’s some confusion over what this means, and therefore people don’t always follow through with the recommendation.  Hopefully this will clear up some of that confusion!

There are 2 different types of assistance that are both referred to as “homecare”.  Private Duty homecare, refers to an aide that you pay for out of pocket that can provide companionship, help with showering, dressing, meal preparation as well as light housekeeping and help running personal errands.  Because traditional insurance doesn’t cover this type of care, no prescription is needed.  The average cost in theDetroit area is $20/hour.

Skilled homecare, is something very different.  That is the phrase used to describe agencies that provide nurses, physical therapists, occupational therapists, and speech therapists.  They also have aids that can come once or twice a week for one hour to provide shower assistance.  Their services are covered by Medicare as long as you have a prescription from a doctor. 

Both types of homecare play a critical role for older adults and their families, particularly when first coming home from the hospital or rehabilitation center.  An older adult who lives alone might need the help that private duty can offer in order to avoid overdoing it those first few days at home.  And skilled care can make the difference in terms of helping someone stay out of the hospital. 

Some skilled homecare companies offer a service called Tele Health or Tele Buddies, which automatically sends someone’s blood pressure, weight, pulse and other information to a monitoring station.  If the data is outside of that person’s target range specified by their doctor, a nurse calls them to adjust their medication for the day.  This kind of fine tuning helps people stay at home safely.

Whether you need skilled or private duty, one thing to keep in mind is that all homecare companies are not the same… be sure you use a company that comes highly recommended!

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So many older adults struggle with feelings of loneliness and isolation…even those lucky enough to live in the same city as their family often find their once impossibly busy days suddenly empty, and their nights lonely.  The good news, however is that relief may be only a bark or a meow away!

 At any age pets can provide companionship, and the responsibility of caring for pets can provide a sense of purpose.  But studies have shown that pets can make an even greater impact for older adults. 

Seniors who are pet owners make fewer trips to the doctor’s office, and have a reduced risk of cardiovascular disease when compared to non-pet owners of the same age group.  They are also more likely to exercise (as they walk their dogs), and eat more regularly.  Perhaps those are some of the reasons why caring for a pet is associated with increased longevity. 

But perhaps most important of all, pets fulfill a much needed outlet for touching and cuddling for older adults who live alone.  They offer seniors a source of comfort and affection they may be missing.  One thing to keep in mind though, is the important of making a good match…a very large dog is a lot to handle, so size and personality compatibility are important factors to consider. 

Buying Puppy Chow,

Lynn

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As we get older, many of us begin to develop  chronic medical conditions that can impact our lives. Whether it is diabetes, chronic back pain, depression or a major health condition that is just not going away, it can feel overwhelming at times.  Well, help is on the way!

Personal Action Towards Health or PATH, is a program that helps make disease management and self-care a little less overwhelming.  PATH is a six week program (once a week for six weeks), that covers all the steps, skills and tools people need to begin to manage their disease, rather than feel as it their disease is managing them.

Each class is focused on a specific, concrete step to improve overall health, and includes specific tools to use at home, including medication management and stress management techniques. And, this class is free for people with chronic conditions as well as their caregiver or significant other!  How often do you hear that?

The next PATH class is starting on April 24, 2012 at the Jewish Family Service building in West Bloomfield.  If you would like more information or want to register, contact Becky Eizen at (248) 592-2671.

Signing up right now,

Lynn

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This week has been all about crisis management!  As Geriatric Care Managers we see our clients at least once a month to keep current and look for changes that we can’t pick up on over the phone.  We often look for whether or not they gained or lost weight, if their dementia has worsened, or if it is time to switch from a cane to a walker, to give a few examples. We know how important these monthly visits are, but sometimes a client or family member may question their value when all is stable.  And that value was made clear to families several times this week.

Things can change quickly for all of us, most especially for older adults because their conditions tend to worsen over time.  When a crisis happens, it is much easier to begin to pick up the pieces when someone who knows the client, is familiar with their history, current medications, recent medical procedures, layout of their home, and their support system is there to provide expertise, help and guidance.

So instead of waiting until poor balance gives way to a fall that requires hospitalization, surgery and then rehab, or when progressing dementia gets to the point where someone can’t be alone, start working with a Geriatric Care Manager proactively, so they’ll be there ready to help when you need them. Let us help smooth the way for you the way we did for several of our families this week. 

Waiting for your call,

Lynn

 

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The winter months can be especially difficult for older adults.  I think most of us would agree with that statement, but usually think of outdoor hazards like snowy walkways and ice on the road.  But what we don’t often think about are indoor hazards that lead to falls.  According to The New York Times, falls are the most common cause of non-fatal injury for older adults, and they most often happen at home.

Several factors can contribute to an individual’s fall risk.  Health factors such as vision, balance, medication and cognitive condition play a role, as do environmental factors such as poorly lit walkways, throw rugs on the floor, electrical cords, slick tile or thick pile carpeting.

Here are a few quick ideas to make your home safer:

  • Pick up throw rugs.  While they look beautiful, they are a tripping hazard.
  • Purchase plug-in lighting for dark walkways.
  • Ask your physician for a prescription for balance training.  It is usually covered by  Medicare.
  • Install hand rails or grab bars in bathrooms, as well as front and rear entrances to your home.

While there are many steps we can take to minimize the risk of a fall, the real obstacle in many cases is the fact that we feel invincible.  “Sure, I can climb on that stepstool to clean the top of the cabinet.  That’s not a problem for me’… until suddenly it is. 

It’s time to put the old adage “An ounce of prevention is worth a pound of cure”  into action. 

Take care,

Lynn

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When older adults start to need help it can be very expensive.  Many of the families I speak with are confused about what Medicare does and does not pay for.  The number of supplemental and prescription plans available add to the confusion.  But when an older adult needs help, questions usually fall into 2 areas.

 1. Will Medicare pay for short-term rehab in a skilled nursing facility?

Usually, as long as the older adult:

  • Has a minimum 3 day hospital stay
  • Has a physician order for inpatient rehabilitation
  • Meets Medicare guidelines based on acuity level and potential rehabilitation

If so, Medicare reimbursement is as follows:

  • Day 1-20: 100% covered (max is $400/day)
  • Day 21-100: covered with patient co-pay. Typical 2011 co-pay is $141.50/day
  • Day 101 and beyond: out of pocket charges from $175-$300/day

 2. Will Medicare pay for home care?

That depends.  There are two types of in-home care available, skilled and private duty.  Skilled home care refers to a nurse, physical therapist, occupational therapist or speech therapist that comes to provide treatment at home.  Those services are usually initially covered by Medicare as long as you have a prescription from your doctor, qualify for homebound status, and meet acuity and rehabilitation guidelines.  Qualifying for homebound status doesn’t mean that someone never leaves the house, but that it requires taxing effort and the assistance of someone else for them to do so.  Re-certification is needed to continue to receive services after the initial number of authorized visits are up. While someone is receiving skilled home care, they may also receive services from an aid that can come once or twice a week to assist with bathing, but these visits are short, usually lasting no more than an hour. 

Private duty homecare is not covered by Medicare.  Often called companion services, private duty caregivers help with bathing, dressing, cooking, shopping, running errands and companionship.  Private duty homecare companies usually charge anywhere from $18-$24/hour.   Most private long-term care insurance policies do pay for private duty care.  It’s a vital service that really makes a difference in someone’s quality of life, but the costs do add up.

Looking into long-term care insurance,

 Lynn

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I had so many questions this week about long-term care insurance that I thought I would re-post this blog.  Hope it helps…

More and more often these days I hear people talking about Long-Term Care Insurance…or should I say sharing their confusion about Long-Term Care Insurance!  There’s little doubt that having a plan for long term care is a smart idea, but it is important to be sure that the policy you choose will meet your needs.

Just like homeowners or car insurance, different plans come with different covered benefits, and, of course, different price tags. Here are a few things to keep in mind when choosing a long term care policy:

When will you be eligible for reimbursement?   

Coverage usually begins when someone needs assistance with at least 2 activities of daily living (ADLs).  ADLs include everyday activities like bathing, feeding, toileting, transferring, and dressing.  People with cognitive diagnoses, like Alzheimer’s, may also qualify, depending on the policy. Plans can have a daily or monthly payout.  For example, if you had a daily payout plan that covered $150 per day and you had $200 in services for the week, all incurred on a single day, you would only be reimbursed your daily maximum rate of $150.  Because monthly payout plans don’t limit the amount of service you pay for in a day, they will reimburse you up to your monthly maximum regardless of the amount spent per day.

What is the policy’s elimination or waiting period?

You can usually choose a 30, 60 or 90 day waiting period, but be sure to find out if the policy has a “service day” or “calendar day” elimination period.  Calendar day elimination means that benefits would be covered based solely on the number of calendar days since a diagnosis was made.  Service day elimination refers to the number of days you must receive and pay for services before they are covered.  For example, if you have a 90 service day elimination plan, and you receive services once a week, it would take you 90 weeks to fulfill your 90 service day elimination period before benefits would be covered.   

Should I consider an optional inflation rider?                      

Most plans offer an inflation rider as an option.  The same level of care that currently costs $150/day might cost double that amount by the time you file a claim.

Should I check out exclusions?                                                                                          

This is the equivalent of reading the fine print.  Most policies have broad coverage, but with a few specific exclusions.

Should I ask to have policies quoted from more than one company?

Yes and be sure you’re comparing apples to apples.

 Happy Shopping,

 Lynn

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ElderCare Solutions of Michigan is a division of Jewish Family Service of Metropolitan Detroit, a non-sectarian not-for-profit organization that has served the metro Detroit area for more than 80 years.