Caregiver Tip of the Month
What you need to know when your loved one
is a Medicare hospital patient
If you are looking for assisted living, home health care, skilled nursing or a nursing home, it's usually because of a medical crisis involving a loved one. You're probably in a time crunch – decisions have to be made quickly. The hospital may have said that your loved one will be discharged tomorrow. They've given you a list of rehab facilities, and it's up to you to pick one. But, how do you know which one is best? Are some better than others?
If you are in this situation – take a deep breath – relax a little – and read the next paragraph. You might make a better decision as a result.
Medicare has special rules to keep patients from being discharged from the hospital too soon. In spite of what the hospital may have said, your loved one cannot be discharged until 3 days after the hospital gives you a form called a Notice of Noncoverage. If they have not given you the Notice, insist that they do. (You won't get into trouble by insisting, and neither will your loved one.) This will give you additional time to find the rehab facility that's best for your loved one.
Hospitals discharge their Medicare patients quicker and sicker that ever before. In 1968, patients age 65 and older stayed in the hospital an average of 14.2 days. By 1982, that was down to 10.1 days. Now it only 6.4 days.
Why? Medicare is under constant pressure from Congress to cut expenses. Now, Medicare benefits pay a hospital the same fixed fee for each patient with a particular medical condition – even if one patient's condition is more severe than another's. If a patient stays too long, the hospital has to pay the extra costs out of its own pocket. But, the shorter a patient stays, the more money the hospital gets to keep.
How bad has the situation become? According to The Wall Street Journal, "Nearly one in five people admitted to hospitals with broken hips are discharged before all of their vital signs are stable ... . Those patients are far more likely to die or be readmitted to the hospital within two months."
To protect you, Medicare guarantees you certain rights if you think you are being asked to leave the hospital too soon. Unfortunately, these rights are given to you along with all the other papers a hospital makes you sign when you are admitted. So, they are usually lost in the shuffle, with most people never realizing how important they are. Hospitals sometimes take advantage of that fact. ...
... to read our complete article, click on Hospitals
Our visitors ask ...
Q. Please give me some information on how to get my parents on Medicaid. My father really needs help. He had a stroke in Dec. 99. My Mom and I take care of him and both of us are really unable to lift and take care of him.
A. Eligibility for Medicaid varies by state. Contact your State Health Insurance Assistance Program (SHIP) or your state's Medicaid office for more information. The telephone number(s) should be in the blue pages of your phone book.
Depending on your parent's financial situation, it may not be necessary for your mother to go on Medicaid even if your father does. Discuss their situation with an attorney who specializes in elder law. There's a link to the National Academy of Elder Law Attorneys in the Legal Issues page in our Website. Once at their home page, there's a link in the upper left corner that will help you locate an elder law attorney.
Daily Living Solutions
— products for seniors —
As we grow older, it often becomes difficult to use many everyday products because of arthritis and other conditions. If you or a loved one needs a little help – or a lot – we've selected a group of practical and affordable solutions from our affiliated merchants to help overcome those limitations.
Whether you are looking for yourself, or to help an elderly senior continue living in their own home, you'll find a wide variety of supplies and accessories – raised toilet seats, safety rails, incontinence supplies, large-handle eating utensils, pain relief, diabetic supplies, pill splitters and crushers, big-button telephones, canes, walkers, rollators, wheelchairs – and much more.
Everything is sorted into convenient categories in our Solutions for Seniors section.
Caregiving – Finding the money for care at home
– More Ideas –
In addition to the resources discussed last month (to see last month's issue, click on May 2004), there are a variety of other things you can do to find the money needed to pay for home health care.
If your loved one has become weak or has difficulty walking, both of these conditions can be at least partially overcome with proper physical therapy. If your loved one's doctor agrees, ask the doctor for a written prescription for physical therapy. Medicare will pay for therapists to come to your home to provide the therapy IF it is provided by a Medicare-certified agency. (Important: Less than half of home health agencies are certified. Care at home can be very expensive if you have to pay for it out of your own pocket. Ask the agency if it is Medicare-certified BEFORE you hire them.) When the agency does its initial evaluation of your loved one's needs, they'll be able to tell you how long Medicare will pay for them for your loved one's therapy.
If you provide more than half of your loved one's financial support, you can probably claim them as a dependent on your federal income tax return as well as possibly deduct some of their medical expenses. See a qualified tax accountant for more guidance regarding the IRS requirements.
Your loved one may qualify for Supplemental Security Income (SSI). If they do qualify, SSI pays a flat $564 (in 2004) per month in addition to their monthly Social Security benefit. For more information, read Social Security's pamphlet "Supplemental Security Income" (click on the link). You should also call Social Security's toll-free number, 1-800-772-1213, to find out if your loved one might be eligible for SSI.
If your loved one does qualify for SSI, he or she will probably also qualify for Medicaid. If they do, they won't have to pay Medicare's $66.60 monthly Part B premium, and they won't need to carry a separate Medicare Supplement insurance policy.
And, if they qualify for SSI, they'll also probably qualify for food stamps. That will help stretch their food dollars each month.
For more information, go to Social Security's main page (click on www.ssa.gov). In the middle on their home page, just below the horizontal red and blue bars is a box titled Questions about:. Use the up/down arrows in the right of the box until Supplemental Security Income appears. Then click on Go. That will take you to a page with a number of different questions (and answers) about the SSI program.
Caregiver Tip #2
Loss of sight, hearing loss, memory loss, confusion, incontinence and depression are NOT normal aspects of aging. These conditions are usually treatable. They could even be the result of prescription drug interactions or side effects. Failure to identify these conditions as being treatable could place elderly patients at risk of unnecessary functional decline. For more information about the major health conditions that afflict the elderly, click on Symptoms.
Our visitors ask ...
Q. I have a 72 year old grandfather who has fair health, he only needs some minor assistance with laundry – shopping – maybe some light housekeeping – basically just every day chores. He totally refuses to go to an independent care facility and I was wondering if you knew of any businesses that provide someone who may be able to come over for maybe an hour or two a week to help him out. Do these businesses even exist?
A. There are a large number of businesses that provide the homemaker/companion services you want for your grandfather. They are usually listed in the yellow pages of your telephone directory under Home Health Services. Or, call the Eldercare Locator. Developed by the U.S. Administration on Aging, the Eldercare Locator is a free nationwide directory assistance service. It helps older people and their caregivers find local support services to help them live independently in their own community. This information is available only through their toll-free telephone number 1-800-677-1116, between 8AM and 9PM weekdays, Eastern Time.
Homemaker/companion services provided by private agencies are not paid for by Medicare. Instead, they must be paid for out-of-pocket; many have a 4-hour minimum visit during which they can do everything you describe – and even prepare a few meals every week for storage in the refrigerator.
After you've selected a few that you feel are the best available, let your grandfather make the final choice. After all, they are coming into his home to help him. If their personalities don't mesh, you haven't made any progress in helping him.
Recommended Books and Videos
Many excellent books and videos can help guide you through the caregiving process. For our recommendations, including a brief description of each one, click here.
For more helpful information from our website, click here. To see previous issues of this newsletter, click on Archives.
Aging Solutions is a free service of:
Solutions for Seniors, Inc.
1051 E HILLSDALE BLVD
FOSTER CITY, CA 94404
Your comments or suggestions for future issues are always welcome; email them to us at editor@aging-parents-and-elder-care.com
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