Settlement Proposed To Broaden Medicare Coverage

Click Here for the article

While this article is timely for political "points", the bottom line is that Medicare still only pays for "rehabilitative" or purely "skilled" services in a nursing home.  

Only a small percentage of people ultimately qualify for the full Medicare benefit (up to 120 days maximum).  It's true that a large number of people fall through the cracks -- and always have-- when they have a condition that could be stabilized by additional care and therapy.  The system is far from perfect.  I hope this doesn't trigger a class action lawsuit and deplete Medicare further!   

While it would be great if they could cover more bases in the program, I'm not sure if it is realistic right now.  In the meantime it is important to consult with a Geriatric Care Manager to implement any and all services that might be available to you -- under Medicare and otherwise.  

Many people qualify for additional Home Care services (PT, OT, Speech, Social Work and nursing) and they don't even know it.   

Obama Care and Health Policy: CH-CH-CH-CH-CHANGING!

Lately there are so many changes on the healthcare front that our heads are spinning! From having a laptop computer between you and your practitioner --- to finding out that the policies have changed dramatically since the last time you visited your hospital or clinic. How to keep track of the changes? I'm not sure you can. The most important thing you can do is to try to stay aware of current trends.

Like this one which poses hope for better hospital care the First Time Around:

Click HERE for the article.

There is nothing perfect about Obama Care and its coverage. Up until now I have been looking at it primarily from a recipient's point of view. However, I've been doing some work for a Medicare-based home health agency here in Yavapai County and the ObamaCare changes have been affecting policies and procedures on a corporate level already. Some of those changes are positive ones. There are patients receiving care who really should have been discharged long ago. Taxpayer dollars pay dearly for the daily care they receive from a multi-level, comprehensive care team. The new rules are forcing their discharges at an appropriate time -- not too early, no. And no longer too late.

I don't know how this will pan out over time, but thus far from the systemic level, there will be significant taxpayer relief coming down the pike. A drop in the bucket compared to our national defense plan and national debt, perhaps, but nonetheless an improvement for the national budget. It may be a big player in the survival of Social Security and Medicare.

The most important thing -- as I see it - is that the patients who are being discharged from hospitals, hospices and home care programs are to be treated with compassion and receive the very best information they can to help themselves once they are on their own again.

Make the best use of the discharge planner at the hospital, the social worker in the hospice or home care agency or hire yourself a geriatric care manager to get an effective long term plan in place!

I Needed A New Individual Health Plan

 Happy Fourth of July, Independence Day.   My latest story is timely.  Those of you who know me well, know that I was quite ill last Fall and Winter.  One thing led to another and I ended up leaving my MSW position at Hospice Compassus to strike out on my own again.   

Leaving the job meant leaving my benefit package behind.  I was aware that this would cause some increased "insecurity" if I allowed it to. Overall the transition has been a good one and I am back in control of my own work life and schedule and I am happy to report that it is going very well!  

A few days ago I called a friend of mine, Susie Clarke, in Prescott.  Susie and her husband Dennis have been selling health insurance for years.  They do more than just sell insurance.  They do for people who need health insurance what I do for seniors --- they teach them, they guide them, they help them to navigate the system; to make the system work for them.   I told Susie my situation.  I knew she would give me the right answer.

Upon my resignation from hospice, I planned to remain covered with my BC/BS of Arizona policy under COBRA.   COBRA allows you to keep a health insurance policy for a period of 18 months.  What I didn't plan on was the increased premium based on my "unwell" status.   I may have left my Unwell status behind me but I find that now it keeps following me!  

When I contacted Susie to assist me in finding a good policy at a better price, she suggested waiting --- she suggested I establish a Track Record of WELLNESS before I apply for a new insurance plan.  Insurance companies review our health status much like they review a Financial Credit Report.  I will be better off improving my "score" by improving my health over the next 6-12 months.  

The real reason I write this post is because it may be Independence Day here in America, but we need to wonder how independent we really are.  Privacy laws and HIPAA, the Patriot Act are all supposed to protect our privacy, our identity.  But did you know this:  

There is a website you can log on to -- Go ahead, log onto it now.  It is www.mib.com  
You can apply for a full report on yourself -- and at no charge.  All you need to do is fill out a digital online disclosure form and you will have your own copy of your personal medical history report within 15 days.

The MIB database is a program that -- with your permission of course -- can access any and all of your medical records.  Much like a credit report, it shows your entire medical history from the day you were born until the present.  Insurance underwriters typically use this information to assign premiums and policies.   Physicians, hospitals and health care agencies are being required to be computerized, which helps MIB have timely and (hopefully) accurate digital information.  

The MIB Group has been in existence since 1902. 

Pain Doesn't Last Forever

"...Yet pain is part of being alive, and we need to learn that.  Pain does not last forever, nor is it necessarily unbearable, and we need to be taught that. 

Adolescents need to accept the fact that broken hearts, like broken bones, hurt dreadfully but ultimately they heal, and that there is life beyond the hurting.  People whose shameful secret is about to be revealed need to be assured that there is forgiveness as well as condemnation, that there are people in the world and a God in the world capable of forgiving and loving even the most flawed and imperfect of us.  The terminally ill need to be reassured that we will cherish them and spend time with them and take them as seriously as we did when they were healthy. 

Most of all, we have to learn to trust our own capacities to endure pain.   We can endure much more than we think we can; all human experience testifies to that.  All we need to do is learn not to be afraid of pain.  Grit your teeth and let it hurt.  Don't deny it, don't be overwhelmed by it.  It will not last forever,   One day, the pain will be gone and you will still be there."  

~Harold S. Kushner

Losing a Parent, Losing An Identity

Mourning is prolonged when guilt is involved.
 Some adults are inconsolable at the death of their elderly parents because 
they recognize that their childhood has also died. 

 ...There is no grief which time does not lessen and soften.

From "Love, Hate, Fear, Anger" by June Callwood

Forgiving Our Families

A woman asked me for help in placing her father in a nursing home. He was 89 years old and had never been sick a day in his life; had worked construction until he was 81.

One day he had a massive stroke that rendered him incapable of caring for himself. It also made him incapable of controlling his emotions and he was crying most of the time.

The day we got him settled into his nursing home room; him with his huge hands and furrowed brow! The smiling courteous polite daughter asked me to step outside of his room. When we did she sputtered, with tears in her own eyes: "That SON OF A BITCH! He was a miserable ___ ___ bastard all of his life and now he's vulnerable. How DARE HE?! NOW he needs us to be kind to him?? It's just not fair."

This was her lesson in forgiveness. And actually.... the story turned out quite nicely. Forgiveness works. We are given opportunities to learn its power.

Chivalry is not Dead

Today I heard a story about a man and a woman who had been married 73 years.  She had cared for him for nearly a decade; he had Parkinson's Disease and complications.  One night they both went to the hospital by ambulance.  She had had a stroke that left her with significant impairment, but overall she was in much better condition than her husband.  In the morning the young doctor went in to check on his patients and the wife had died during the early morning hours.  The doctor was quite surprised, as her vital signs had been stable throughout the night.  "What happened?"  he asked the husband, who seemed amazingly calm and accepting.  "A gentleman always lets the lady go first."  The husband passed that night.  This was a true story.