It is that time of year… Medicare health and drug coverage open enrollment begins on Nov 15 and ends on Dec 31.  With all the news on revamping America’s health care, you may have missed the announcement from The Centers for Medicare and Medicaid Services (CMS) that seniors or other people with Medicare (and their caregivers and/or family members) can begin to review their 2010 coverage options through  Medicare’s improved online tools.  Medicare Health Options Compare and Prescription Drug Plan Finder is located at www.medicare.gov. 

Remember, caregivers, if your loved one is a Medicare beneficiary, they are eligible for Medicare prescription drug coverage, regardless of income, health status, or current prescription expenses.

There are two types of Medicare plans that provide prescription drug coverage:

1) Medicare Prescription Drug Plans - These plans add prescription drug coverage to Original Medicare, and certain types of Medicare Health Plans.
2) Medicare Health Plans  - Some of these plans cover both health care and prescription drugs.

For caregivers and seniors that prefer to get information over the phone,

• Contact a Medicare customer service representative at toll free 1-800-MEDICARE (1-800-633-4227)
• OR contact your local State health insurance Assistance Program office (find the number online at http://www.medicare.gov/Contacts/staticpages/ships.aspx) or other health advocacy agencies for free personalized counseling.

Medicare's customer service is available 24-hours a day and 7 days a week. English and Spanish-language customer service representatives are available.

A 2010 Medicare & You handbook for seniors and their caregivers, also available on www.Medicare.gov, will be mailed to the homes of all eligible beneficiaries this month.

Medicare can be complicated, and a qualified geriatric care professional can help you figure it out if you're a caregiver.  If you're a veteran (or a caregiver for a veteran) you can also see my previous blogs, which include Information on Veterans Benefits and Part 2: Additional Information on Veterans Benefits.
 

Have you ever went to a doctor and they told you something about your treatment
option(s) that you were unsure with or didn't agree on?  If you ever feel this way, you are entitled to and should get a second opinion.  A second opinion is when a physician other than your regular physician gives their view about your health condition and how it should be treated.  Part of healthy aging is knowing and understanding your health care and treatment options and a second opinion will allow you be more informed about your health care. 

When should I get a second opinion?
You should consider getting a second opinion if  your physician tells you that you need surgery to make a diagnosis or treat a health problem that is not an emergency.  It is always up to you, the patient, to decide if and when you will have surgery.  However, if you need surgery immediately, do not wait for a second opinion.  This would include appendicitis, accidental injuries, blood clots, aneurysms, etc.  

Preparing your visit for a second opinion:
Before your appointment with the second physician, you should:

1. Have your medical records sent to the second physician.  This will inform the physician of what has been discussed and any tests that have been performed.
2. Call the second physician's office before your appointment to make sure they received your records
3. Have a list of questions on paper you want to ask and take them with you to your appointment.
4. Ask somebody close to you to come to the appointment with you. 

What should I do if the first and second opinions are different?
If the second physician does not agree with your regular physician you may want to discuss your condition more with your first physician.  Getting a second opinion does not mean you have to change doctors, it is up to you which physician you choose to see.  The final decision is up to you and should be made with all the facts. 

Falls are a serious danger for seniors, as they can lead to broken or fractured bones, and hospital stays.  As we age, mobility often becomes an issue, and our balance can deteriorate.  Many older adults rely on the help of assistive devices such as canes.

If your doctor or therapist has ordered a cane for you, this Veteran’s Day (November 11, 2009), Sam’s Club is giving away 25,000 canes to veterans.  To find out more, please visit http://www.hugosalutes.com/.  If you’re a caregiver who is providing care for a senior, you should work with their health care providers to make sure that your loved one has the assistance he/she needs.  In addition, you can take actions to prevent falls and help ensure their safety in the home, such as removing throw rugs.  For more on fall prevention, please see my previous blog (http://myhealthcaremanager.compendiumblog.com/blog/immobility/0/0/fall-prevention-). 

Make sure to check with your health care provider before using a cane or other assistive device.

November is Alzheimer’s awareness month.  It is time to catch up with discussions about dementia and redefining dementia.  Dementia is often thought of as simply memory loss and/or a memory disorder.  While memory loss is the “hallmark” of dementia in its early stages, most caregivers treat it as illness and do not think of dementia as fatal. According to Catherine Elton at   time.com, “Experts in the field say dementia is more accurately defined as fatal brain failure: a terminal disease, like cancer, that physically kills patients, not simply a mental ailment that accompanies older age.”  Unlike other terminal diseases, as the older adult with dementia approaches the end of their life, they are often treated aggressively rather than with palliative care.  Read more about what experts are saying in Catherine Elton’s report: Experts Redefine Dementia as a Terminal Disease. 

if you're a caregiver, remember, when caring for an older adult with dementia always ask if the treatments are causing more distress AND if their pain being managed.  Check to see if the older adult has made their wishes clear regarding aggressive treatments, feeding tubes and CPR. Then advocate that their wishes are carried out. As a caregiver, if your parent or loved one is in the early stages of dementia and have not made their wishes clear, now is the time to talk to them and complete their advance directives/living will.  A geriatric care manager can help caregivers and their aging loved ones address these issues.

For more information on treating advanced dementia as a terminal illness requiring palliative care go to Catherine Elton’s report: Experts Redefine Dementia as a Terminal Disease.

We’re pleased that Alliance Care Advisors is My Health Care Manager’s new licensee for the Indianapolis and surrounding counties area.  Like our other licensees, Alliance Care Advisors will use our systems, training, and processes, including SCANS(TM) - our Senior Care Navigation System - a best-in-class knowledge management and decision support system, to provide geriatric care management by their Health Care Managers to seniors and caregivers.  To learn more about SCANS and how it’s helping seniors and caregivers nationwide, please visit our CTO Eric Tinsley’s blog.  If you are searching for geriatric care management services in the Indianapolis area you should visit their website or view their press release to learn more.  Alliance Care Advisors’ sister organization, Alliance Home Health Care, already provides complementary home health services.

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