I’m pleased to welcome Jane Niederberger as My Health Care Manager’s new President.  With over 25 years of experience in the health care industry, Jane is a great addition to our team.  Most recently, Jane founded Niederberger Ventures LLC and has been active in HALO, an Indiana angel investment group.  From 2004 – 2006, Jane was Vice President and General Manager of Operations for Anthem Blue Cross and Blue Shield’s Central Region, a $16 billion subsidiary of WellPoint.  Prior to leading the consolidation of operations, Jane was Anthem’s Senior Vice President and Chief Information Officer (1997-2004). 

To read the Indy Star article 'Ex-WellPoint exec to lead elder-care services startup' visit the Star's website:   www.indystar.com/apps/pbcs.dll/article?AID=2009910050305

To learn more about Jane, please visit our website: www.myhealthcaremanager.com/aboutUs_manageteam.asp.

Congratulations to Jim Kerr, My Health Care Manager’s Vice President of Business Development and Marketing.  He was recently honored as a finalist of Indianapolis’ Best and Brightest Award in the Health & Life Sciences category.  To learn more about the Best and Brightest Award, visit www.indysbestandbrightest.com.  To learn more about Jim, visit www.myhealthcaremanager.com/aboutUs_manageteam.asp.

I already covered the everyday precautions individuals, including caregivers, should take to prevent flu infection, such as washing your hands and avoiding close contact with those who are sick or exhibiting flu-like symptoms.  Read my previous post to find out more.

Here are some other important actions that you can take:

• Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
• Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs,* tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.  Caregivers should know the signs and symptoms of flu and contact their aging loved one's health care provider with questions.

According to the CDC, emergency warning signs that need urgent medical attention for adults include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough

Caregivers can find out more from the CDC Flu site: www.cdc.gov/flu.

My last post covered some general vaccination information for seniors and caregivers.  Today, I’m going to provide you with some eldercare resources for flu season.  The best advice during this flu season is to talk to your health care provider about the seasonal flu vaccination and the “novel” H1N1 (Swine Flu) vaccination.

According to the Center for Disease Control (CDC), “One thing that appears to be different from seasonal influenza is that adults older than 64 years do not yet appear to be at increased risk of novel H1N1-related complications thus far.”  To keep up with the latest information, visit the CDC (http://www.cdc.gov/h1n1flu/).

Remember to take everyday flu-prevention and well-being precautions such as:

• Wash your hands often with soap and water   You can also use alcohol based hand cleaners
• Throw away your tissue after use
• Avoid touching your eyes, nose or mouth
• Avoid close contact with people who have flu type symptoms if at all possible
• Listen for your local public health advice especially regarding closing and crowds
• When you are sick (or have flu symptoms), stay at home and have the supplies in need in your home for a week or so. 

If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.  If you have additional questions, please speak with your health care provider.  Your physician can also advise you on prevention measures, such as the flu vaccination.

For seniors and caregivers: if you would like to locate a flu center by zip code, visit http://www.lungusa.org/site/pp.aspx?c=aqKGLXOAIlH&b=1015035.

According the America Geriatrics Society,  a person is expected to live another 16 years after turning 65, a person who is 75 can be expected to live another 10 years and person 85 can expect to live another 6 years.  So even though vaccinations are focused more toward children, it is important to prevent disease as you age and practice prevention.    A recent post contained information about special vaccinations that you may need to travel to certain areas of the world, but vaccines are also an important consideration for everyday life.  Caregivers and seniors should make sure to stay on top of their preventative health plans.

A great eldercare resource is the American Geriatrics Society.  Through their site and publications you can know the latest recommendations not only for flu shots and the older adult, but also the recommendations for vaccinations and prevention tests.  Medicare does pay for some of vaccinations such as the costs of flu, pneumonia, and tetanus immunizations.


Some vaccine recommendations for seniors are:

• Influenza Vaccine - yearly
• Pneumococcal Vaccine - 1 dose at age 65
• Tetanus Vaccine - 1 booster dose every 10 years
• Shingles Vaccine - 1 dose in immunocompetent people

Always remember to discuss a preventative health plan with your health care provider.   
 

My last blog focused on a great eldercare resource for travel planning, the CDC travel site (www.cdc.gov/travel), where you can get information on recommended vaccinations and precautions.  I also gave you some preparation to do with your health care provider, including creating lists of your medical conditions and obtaining documentation of any special conditions for airport security (e.g. pacemakers, steel plates, etc).  Now you’re ready to pack – what do you need to take in terms of health care information?

Don’t forget

• a complete medication list
• enough of your medications for the duration of your trip
• a list of medical conditions (and treatments) created by your health care provider
• documentation of any conditions that airport security needs to be aware of
• alcohol-based hand sanitizer (for times when you can’t wash your hands

The medication list (including any over the counter drugs you’re taking) should include the drug names, doses, when you take them, any special instructions, and the amount of each drug you should take on the trip. 

Having all your medical information on paper (including the medication list described above) will assist you on getting through customs easier and help you if you need emergency medications.  Keep a copy on your person and copy in your luggage.

As always, protect yourself from infection by washing your hands and/or using an alcohol-based hand sanitizer prior to eating or after spending time in crowds such as on plane, bus or train.  Watch what you drink and eat.  

Plan ahead and enjoy!

We’re pleased to announce an agreement with Anthem and Wellpoint, which was covered in the August 24 – 30 issue of the Indianapolis Business Journal.  My Health Care Manager’s Eldercare benefit (which provides senior care management and caregiver support services to covered employees) will be offered in Indiana through the Anthem 360 Health program.  After the Indiana pilot, My Health Care Manager’s benefit will be rolled out by Wellpoint to all 14 states in which they operate. 

The benefit will help working caregivers balance the challenge of providing care to a loved one with work responsibilities, and also help improve the care and quality of life for the senior.  Employers assisting their employees by offering the Eldercare benefit look to reduced costs associated with working caregivers such as absenteeism, workday distractions, and time taken off to provide care.  My Health Care Manager provides an experienced nurse, a Health Care Manager, to guide the caregiver through their personal situation – and can assess a senior in the home anywhere in the U.S.

To learn more about Eldercare benefits for your business, or geriatric care management services for your family, please contact us at (800) 499-8020.

 

My Health Care Manager was honored as one of the Indiana Companies to Watch for 2009.  To see the full list of 2009 winners or to learn more about the honor, please visit their website at http://indiana.companiestowatch.org.  To learn more about us and the eldercare services that we provide, visit us on the web at www.MyHealthCareManager.com or call us at (800) 499-8020.

Fall is a great time of year to travel for the older adult - with school in session, fares drop and popular vacation sites are less crowded.  When planning a trip, an important step is to always check for health and vaccination information for your destination.  A great resource for this is the Center for Disease Control (CDC), where you can access health and vaccination information.  For caregivers and seniors, travel may require a bit more preparation.

Certain vaccines are required 6 weeks before departure, so schedule an appointment with your health care provider to discuss any travel plans and any precautions you should take.
Also, ask your physician to write down any medical problem(s) that you have - and how they should be treated. 

If you have pacemaker, steel plates, total joint or any condition that airport security needs to be aware of, have your physician provide you with the appropriate documentation. This should help you avoid unnecessary hassle or delays with airport security.

Visit the CDC travel site (www.cdc.gov/travel/) for the latest updates and information.

Caregivers should explore eligibility for Veterans benefits.  Veteran health benefits are open to all Veterans. Family members may also be eligible to receive benefits. There is no monthly premium for VA care, but there may be a co-pay. For more information, visit the VA Health Care Eligibility & Enrollment www.va.gov/healtheligibility .

Additions resources are available at:

• Your local VA health care facility’s Enrollment Office
• www.va.gov/healtheligibility
• www.myhealth.va.gov
• Veterans Health Benefits Service Center 1-877-222-VETS (8387)
• Family member benefits www.va.gov/healtheligibility/familymembers

Veteran or Surviving Spouse Benefits Information

Veterans Financial, Inc. is a national company (not a part of the Veterans Administration) that provides free financial advice to veterans and their families who may now or in the future need assistance in their home, assisted living, or long term care facility.  Veterans Financial helps veterans and their surviving spouses apply for the VA’s Aid and Attendance benefit to ensure they are getting the benefits they are eligible for.  Aid and Attendance
The Aid and Attendance benefit is a benefit paid in addition to a monthly pension. 

You may be eligible for the Aid and Attendance benefit if the veteran or the surviving spouse:

• Requires the ongoing aid of another person in order to perform basic personal functions required in everyday living (i.e. bathing, eating, dressing, etc.) -OR-
• Is bedridden -OR-
• Is a resident in a long term care facility due to cognitive or physical incapacity -OR-
• Is blind, or nearly blind

Once Veterans Financial has an idea of your specific situation, they will advise seniors and/caregivers on options you have and help with the application process to help obtain the Aid and Attendance Benefit.

For more information on Veterans Financial, Inc. please visit: www.veteransfinancial.com or contact them at 800-835-1541.

Long term care insurance is separate from Medicare, and may be a good option depending on your situation and that of your loved one.  Senior and caregivers should thoroughly investigate the long term care insurance policies available, and consider finances, health, long term wishes and goals, and other factors.

Long Term Care Insurance

• Long term care is not covered by Medicare
• Long term care insurance can be purchased to cover the expense of long-term care
• Policies protect assets should you need extended care, such as a house for your spouse
• Many are standardized and may be purchased through authorized insurance brokers through the state.  Policies differ from state to state.  Each state must honor the policy from another state
• To find out more information about long term care insurance go to: www.medicare.gov then go to ‘search tools’ then go to ‘plan your long term care needs’

An experienced geriatric care manager can help you identify local resources.

My previous posts have dealt with Medicare, Medicaid, and Medigap.  Here are some of the other insurance options for seniors:

Other Government and Private Insurance Policies

1. Veterans Benefits
2. Employer Benefits
3. Union Benefits

Things to know about insurance:

• If you currently have health insurance benefits through another policy, it is important to know that if you cancel it, you may not be able to re-enroll in this policy
• There are several situations in which the other benefits may pay bills before Medicare benefits will be used
• Often Medicare pays second when you are covered by insurance through a place of current employment or liability claims
• Make sure to give all insurance documents when receiving care

Veterans health benefits, available to all veterans, are something caregivers and seniors should be aware of.  My next post will cover veterans benefits in more depth.  A geriatric care manager can also help you identify your options and identify local resources.

My previous two blogs have explored Medicare eligibility and the 4 types of Medicare policies.  Caregivers and seniors also need to know about Medigap, which can supplement your aging loved one’s regular Medicare coverage.  In addition, caregivers should also know about Medicaid in case their aging loved one qualifies.

Medigap
Medigap policies are health insurance policies sold by private insurances to supplement costs that may not be covered under the Original Medicare Plan - this may include coverage for co pays and deductibles, some policies may cover emergency health care outside the United States. You pay a monthly premium to the private health insurance company that sells you the policy. Medicare and the Medigap policy both pay their shares of covered health care costs.

Medicaid
Medicaid covers health care expenses for people with limited income or resources- this definition varies from state to state.  Medicaid will cover long term care and home care services for services that are not covered by Medicare.
A list of state Medicaid requirements is available at http://www.cms.gov/medicaid/statemap.asp and may be accessed by finding your state on a map of the United States.

Insurance is complicated and seniors have many options.  Look for my next post, as it will cover other insurance options.  Caregivers are often tasked with evaluating insurance options for their loved ones, and it’s important to know all of the options.  If you desire more assistance, a geriatric care manager can help you identify local resources for Medicare, Medigap, and Medicaid information.

We all hear day in and day out how beneficial exercise is to our overall health.  But what about for older adults?  Is it beneficial for them too? The answer is ABSOLUTELY!  Exercise is one of the healthiest things you can do for yourself, young AND old.  Staying active and exercising regulary can prevent or delay many disabilties and diseases.  This is one healthy aging topic that keeps getting discussed within the health care world.  Some older adults are afraid that exercise will be too strenuous or that physical activity will harm them.  Older adults actually hurt their health by not exercising.  Before beginning any exercise program, it is important to discuss the details with your physician and especially if you begin a program and you notice any symptoms or changes that were not there before. 
So, what are some examples of exercises for older adults?

Strengthening Exercise:  Build muscles as well as increase metabolism
Balance Exercise:  Build leg muscles and prevent falls
Stretching Exercise: Gives you more freedom of movement to do the things you like to do
Endurance Exercise:  Any activity such as walking, jogging, swimming, raking, which all increase your heart rate

Taking your pet for a walk in the neighborhood or parking further from the grocery store are just a few of the examples to incorporate in your daily routine.  Increasing your physical activity for 30 days can be significant to your health. 

Happy Exercising!

Source:  National Institute on Aging

The final installment of the SCANS 1.3 rolling release is complete.  The July release includes some 22 new and revised tools and resources.  The list includes:

• Medicare Summary
• Medicare A Information
• Medicare B
• Insurance Resource
• SHIP
• Medigap
• Medicare C and Advantage Plans
• Earwax
• Visual Impairment Websites
• Hearing Impairment Websites
• Visual Impairment Devices
• Optometrist vs. Ophthalmologist
• Bladder Training
• Foley Catheter Care
• Urinary Continence Education
• Incontinence Supplies
• Catheter Education and Support
• Brain vs. Bladder
• Incontinence – Foods to Avoid
• Tips to manage Incontinence with dementia
• Continence Bladder Diary
• Modify Environment to Assist with Continence

Thanks to the SCANS research team for this successful (and popular) release which included some 74 new tools!  You can read more about these topics from a caregiver's perspective directly from one of our researchers Karen Witt Kelsey.  Click here to read more in her Caregiver Support blog.  Karen is a key member of the research team as well a caregiver for her own mother.  You'll enjoy her unique perspective on senior health care.

No sooner than I posted my observations about the emphasis on aging and senior health care at the HCI International conference then one of the My Health Care Manager team sent along this article on the global impact of aging.

http://www.foxbusiness.com/story/globe-soon-geezer-central/

The article highlights a report commissioned by the National Institute on Aging and just released by the U.S. Census Bureau titled An Aging World: 2008.  It identifies the global problems of doubling the aging population in the next generation.  How will people get help with aging parents?  Can the current system of care support the change? 

As we stand today, the answers are - don't expect much help and don't plan on the current system being up to the challenge.

The good news is that this all means opportunity.  Opportunity for new approaches, new technologies, new innovation, new public policy... everything is on the table.

Last week I had the opportunity to present a paper at the Human-Computer Interaction International Conference.  This was the 13th occurrence of the conference and the event was well attended by key researchers and companies concerned about how computers interact with people. 

Jean Bandos co-authored the paper titled "Impacting the Continuum of Caregiving through Innovation in Informatics: Senior Care Navigation System (SCANS)".  Other members of the SCANS team contributed, as well.  You won't find the paper in the conference proceedings however, due to Intellectual Property concerns with the conference publisher's copyright requirements.  In spite of those restrictions the paper and the presentation were well received.

What struck me about the conference on a general level was the amount of attention being given internationally to the challenges of older adults and senior health care.  Conference attendees came from China, Japan, UK, Germany, India, Spain, and many other places - representing some 49 countries in all.  Support for seniors living independently and dealing with challenges like immobility, well-being, and cognitive decline surfaced as a major sub-theme to the conference.  World wide researchers are examining how computers can help with aging parents.  

The specifics were wide ranging from topics like augmented navigation for assistive mobility devices to ontologies for adaptive user interfaces to cope with the specific needs of the elderly. 

I was genuinely encouraged that so many top brains are looking for ways to improve eldercare services.

A colleague handed me a flyer today from a local cardiac physician group for cool little wallet sized CD they provide their patients with key medical information on it. 

The idea is that you carry this card in your wallet and in an emergency situation you can hand the card to a provider who can then view it on a computer capable of reading a data CD.  Even if you are unconscious, medical personnel can find the card style CD and view it.

The CD contains things like:

• medication lists
• current diagnosis
• current allergies
• discharge summaries
• diagnostic test results
• and even educational materials

All in all this is a good thing.  It also points out some of problems with "high tech" solutions to emergency information. 

• First, not all emergencies will allow time for medical staff to leave the patient in order to find a PC with a CD drive and review a set of unfamiliar computer documents.   
• Second, in order for this information to be easily read in an emergency situation, it is also easily read by anyone who steals or even simply has access to a person's wallet.  Because it's a CD, it's also not clear exactly what data is on the record; leaving seniors and families caring for aging parents to wonder what information is potentially disclosed.
• Additionally, the currency of the data may be questionable.  Frequent health and medication changes are common in older adults and this approach requires notification back to the provider, payment of an update fee, and the reissuing of the wallet CD.  Allowing reasonable times for such activity, it could be very difficult to keep this up to date.
• Even small scratches from "wallet wear" on the CD can render it unreadable.  Something that wouldn't be readily apparent until the CD was checked in a computer drive.  Often, I fear, at the time the information is most needed. 
• Lastly, the completeness of the data may be in question as it relies on the patient, often a senior with depression or memory loss, to report the activities of the disjoint senior health care system.

My Health Care Manager approaches this problem differently.  Our geriatric care managers collect, review, and update information across all of a client's health providers.  This Personal Health information (PHI) is then used to inform all providers engaged in the client's health.  For example, each of the client's physicians receives the medication list initially and then again for every medication update. 

For emergency situations, clients are given a Ready Reference Card which contains all the key medical information and alerts.  This PHI easily folds to the size of credit card for wallet use and multiple copies can be kept in other key areas, for example in a specially identified pocket on the client's refrigerator where emergency personnel are trained to look. 

Because the Ready Reference is a paper record it is immediately available to emergency personnel in settings where a CD reader may not be at hand such as the senior's home, as shopping center, and so on.  It is also quick and very inexpensive to reprint when updates are needed.

The point here is not that technology is bad.  On the contrary, technology enables both of these solutions.  We should put it to work in the most effective ways we can devise for seniors and their families.

Not to be out done by the Navigator development team, the SCANS team is continuing their "rolling release" of V1.3.  SCANS is the Senior Care Navigation System that provides geriatric care managers with expert advice, best practices, and practical tools to help families with the well-being or their parents.

The June edition of V1.3 includes 26 new resources, process, or tools.  The list includes items like these:

• Death in the Home – Information for Caregivers
• Tips for Alzheimer Caregivers
• Delirium vs. Dementia
• Transitioning an Individual with Dementia into a Facility
• Member Portal Instructions
• Continence Education – Constipation
• Urinary Incontinence – When to Seek Immediate Medical Attention
• Crime Prevention Education for Older Adults
• IADL (Independent Activities of Daily Living) Education
• Physical Therapy and Occupational Therapy
• My Medicare Matters
• Advance Directives for Mental Health Treatment
• Drug Review and Side Effects
• Geriatric Friendly Pharmacy
• Medicine Reconciliation:  Brown Bag Consultation
• Feeding Tube Education
• Special Diet Needs Education
• Defibrillator Education
• Diabetes Education
• Fibromyalgia Education
• Pacemaker Education
• Physician Planner Case Note
• Alternative Living Options Education
• Speech Therapy Education
• Social Participation Barriers
• Social Support Plan

These tools are available to the clients of My Health Care Manager and our affiliates.  Some of the content is also discussed in our blogs and can be accessed for free.  Check out Natalie Langley's blog titled "Healthy Aging".  Natalie is one of the principle researchers and authors of the tools in SCANS.  Her blog covers a holistic look at healthy aging and senior well-being.

My Health Care Manager's care management system (Navigator) has just been updated to version 1.9.  This is the core system that geriatric care managers use to assist families caring for aging parents.  From past blogs you may know that this includes the assessment, care planning, implementation, and tracking support for seniors and their families.

Navigator 1.9 includes:

• Key changes for work flow
• Assessment and tracking improvements in the following dimensions:
  • Client Designees
  • Financial
  • Advance Directives
  • Engagement – Social Support
  • Provider Information
  • Medication History
  • Family Medical Health History
  • Functional Status
  • Assistive & DME Devices
  • Sensory Status
  • Nutritional Status
  • Anxiety
  • Environmental
• Reporting enhancements in areas like legal and Insurance, personal health record outputs, services listing, and more

This system is available to our clients and clients of our affiliates and partners.  We also provide much of this information in our Guide for Senior Well-being and Eldercare.  This is a self help guide is available at http://www.myhealthcaremanager.com/guide/product.asp.