Posts Tagged ‘Medicare’

Choosing a Nursing Home

Tuesday, November 24th, 2009

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If you are thinking about a nursing home for yourself or for a loved one, you might realize that this choice is both difficult and painful. Giving up a home to move in with others represents a loss of liberty to some individuals. But, to others, it may represent the beginning of a whole new life.

We’ve listed a few tips on how to choose a nursing home, along with more tips on what to ask when you visit.

  • Plan in advance. Do your investigation long before you may think you need a home, as it may take some time to visit these homes and to make a decision.
  • Get recommendations. You also may need help in filling out the various forms that nursing homes require.
  • Do not visit a nursing home alone. It may prove too difficult, and a friend or relative may help by asking questions that you may forget to ask.
  • Be open-minded. Accept that no nursing home is perfect, and that other people may provide care differently than you do. If you have a negative visit on one day, return on a different day to see if matters are different. Revisit those nursing homes you initially rejected for nonessential reasons.
  • Pick a convenient location first. A nursing home that is convenient and close at hand will be easier for you to visit.
  • Observe the buildings and staff. Is the building clean and relatively odor-free, well lit and attractive? Are safety features such as fire extinguishers and smoke detectors obvious and in good order?
  • Observe the patients or clients: Do they seem satisfied, if not happy? Are they well dressed, or sloppy in appearance (hair not combed, etc.). Does it appear that these clients are tended with care?

Questions and Observations:

  • Look at size. Larger nursing homes may be surprisingly less expensive yet offer more activities and services.
  • Check about medical services. Are the costs included? Are visits from personal physicians allowed? Is a registered nurse on the premises at all times, and is a doctor in-house or on call? Is the nursing home close to a hospital if needed?
  • Ask about residential services. Is there a special unit for patients who suffer from Alzheimer’s disease? Is patient variety important, or would you or your loved one prefer to live with residents from similar ethnic or religious backgrounds?
  • Ask about admission. Is there a waiting list? Can you fill out forms in advance? Is a physical examination required for admission, and who should conduct that exam?
  • Ask about financing. This is especially important if a nursing home is an immediate need. Is that home eligible for Medicare and/or Medicaid? What services are included in the cost, and what services cost extra?
  • Ask about food. Is a dietitian on staff and are the portions big enough? Is the food good and good for you? Is there help for individuals who may have trouble eating?
  • Ask about activities. Does the home provide activities for clients who can participate?
  • Ask about the living facilities. Can the client bring personal furniture, pictures, plants or other objects? Is there a closet and chest of drawers and privacy for dressing? Is there an available phone? How many people reside in one room?

You can visit the Medicare site, where they offer ideas about how to choose a nursing home. If the home you choose has a Web site, look the site over before you visit. The Web site may answer some questions above, so all you need to do on your visit is to confirm that the Web site was correct.

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Government Web Sites on Aging

Wednesday, September 16th, 2009
The U.S. Government can offer many resources for eldercare.

The U.S. Government can offer many resources for eldercare.

Are you afraid of getting older? Are you unsure about what opportunities might be available to your or your loved ones who also are aging? While many people seem to be distrustful of government entities, the U.S. government has produced some insightful Web sites that deal with aging. These sites are listed below, along with information about what they offer to the aging discussion nationwide.

The list is in alphabetical order for your convenience, and it includes a handful of the most important government agencies on aging, health and welfare.

  • Administration on Aging: The mission of the Administration on Aging (AoA) is to help elderly individuals maintain their dignity and independence in their homes and communities through comprehensive, coordinated, and cost effective systems of long-term care and livable communities across the U.S.
  • Aging: The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. This page at HHS offers a variety of information about senior living, from care givers to resources such as assisted living information and much more.
  • Aging Initiative: This Environmental Protection Agency (EPA) website provides a wealth of information about the Agency’s efforts to protect the environmental health of older persons.
  • Aging Stats: The Federal Interagency Forum on Aging-Related Statistics (Forum) was initially established in 1986, with the goal of bringing together Federal agencies that share a common interest in improving aging-related data.
  • Eldercare Locator: Find a local or long-distance eldercare facility with this public service of the U.S. Administration on Aging (see above). The Eldercare Locator is your first step for finding local agencies, in every U.S. community, that can help older persons and their families access home and community-based services like transportation, meals, home care, and caregiver support services.
  • Healthy Aging for Older Adults: The Center for Disease Control (CDC), a division of the U.S. Department of Health and Human Services, offers a site that focuses on health, aging and chronic disease. The Healthy Aging Program (HAP) serves as the focal point for older adult health at CDC, and establishes programs, develops innovative tools, and provides a comprehensive approach to helping older adults live longer, high-quality, productive, and independent lives. HAP collaborates with other CDC programs, such as those focusing on injury prevention, disability prevention, and adult immunizations, as well as key external partners.
  • Medicare: This is the official U.S. site for people with Medicare. Medicaid information is located as the Health and Human Services site.
  • National Institute on Aging: NIA, one of the 27 Institutes and Centers of NIH (National Institutes of Health), leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people. Subsequent amendments to this legislation designated the NIA as the primary Federal agency on Alzheimer’s disease research.
  • Senior Citizens’ Resources: This page, part of the U.S. Gov Web site, offers information ranging from caregivers’ resources to resources on travel and recreation for seniors. You can provide an email to be notified when any given page is updated with new information.
  • U.S. Senate Special Committee on Aging: The Senate Special Committee on Aging was first established in 1961 as a temporary committee. It was granted permanent status on February 1, 1977. While special committees have no legislative authority, they can study issues, conduct oversight of programs, and investigate reports of fraud and waste. The Committee has a long and influential history. It has called the Congress’ and the nation’s attention to many problems affecting older Americans. The Committee was exploring health insurance coverage of older Americans prior to the enactment of Medicare in 1965.

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In-Home Care vs. Nursing Home

Tuesday, July 14th, 2009
In-House Care can Save Money

In-House Care can Save Money

If you’re planning your retirement, you might note that not every older American ends up in a nursing home or a retirement residence. Many elders continue to live at home with the assistance of in-home care. This type of elder retirement meets the needs of the retiree and – often – the needs of that retiree’s family. This type of care helps to maintain independence and can helpfully delay the need to enter an assisted-living facility.

In-home care is a broad term, and it covers the gamut from nursing to cleaning service and personal assistants. For instance, if you have a medical condition that requires daily monitoring or therapy, you may need to hire a nurse or an aide to help take care of you at home. Look for these services through nursing registries or home health agencies (HHAs). HHAs can match you specifically with a nurse or nurse’s aid who is supervised and trained. HHAs usually are state licensed and may be accredited by a national association such as the National Association for Home Care and Hospice. Most have Medicare certification as well, meaning that they have met minimum federal standards and accept Medicare.

Even if you’re not retiring, you may want to hire household help. Someone who can take care of the cleaning, laundry, shopping or cooking is valuable to any family. Help wanted sections of local classified ads can help in your search for this person, but you may want to run references or ask your friends for their opinions. Some state and local governments may have free or low-cost programs set up to assist the elderly. They may include providing personal assistance services as well as companionship services. To find out what programs are available in your area, check for Department of Social Services, Department of Human Services, Health Department, or the Council (or Office) on Aging in your Yellow Pages.

Personal care may be required if you experience trouble with bathing, dressing, walking or eating. Sometimes, the person who provides household care also may provide personal care. Check with the HHA in your area to learn if they keep references on personal care assistants. While some personal aids work on a consulting or freelance basis, others require that you hire them as employees. This means that you may become responsible for their Social Security taxes and you will need to withhold income tax from his or her salary.

While you might save money with in-home care, you may be surprised at the cost, depending upon where you live and the type of services you may need and how frequently you need them. You may be able to pay for in-home care from your savings or income, but check into care programs offered by your community first. You should also determine if you are entitled to any Medicare or Medicaid benefits that may help defray costs.

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What is Long-Term Care?

Sunday, November 23rd, 2008

Long-term care can help those you love as well as yourself.Long-term care refers to a broad range of medical and personal services designed to assist individuals who have lost the ability to function independently. While the need for long-term care often refers to individuals with chronic disabilities or physical or mental impairments, long-term care also applies to individuals who are at the end of life transition.

Few individuals think about long-term care when healthy, as this subject usually lands at the end of the list of things to do for the day. But, when accidents occur, or when someone is diagnosed with a terminal illness, long-term care often becomes a subject that is addressed. Many times, an attending doctor or a family member will broach the subject, especially when care for an individual becomes overwhelming.

The choice of a long-term care option often depends upon whether the stricken individual carries long-term care insurance (LTCI). Some insurance policies focus specifically on long-term care, while others may subsidize only certain forms of long-term care. In the latter case, it is important to understand the levels of care available:

  • Skilled care: This is round-the-clock care designed to treat a medical condition. Often, a treatment plan is established and ordered by a physician and performed by accomplished medical personnel.
  • Intermediate Care: Often, a physician will order this type of care as well, and a plan where registered nurses, licensed practical nurses and nurses’ aides carry out the doctor’s orders.
  • Custodial Care: This type of care can be carried out by someone who lacks professional medical skills, but who is trained and supervised by a physician or by an organization that specializes in care such as bathing, eating and dressing.

Note that the terms above may be defined differently by Medicare.

An individual can receive long-term care in a nursing home, through a hospice, through home-care options, an adult day-care center or through respite care. Of all these options, the nursing home and hospice care are designed to care for terminally ill patients. With that said, hospice care can be provided in the home. This is especially comforting for those who wish to die in their homes, surrounded by familiar objects and friends and family.

Hospice care is varied, and can include a medical plan designed by a physician or simple care for everyday activities. Home health care often is provided by a visiting or traveling nurse, a therapist or a home health aide. The visit times can range from all-day or all-night care to several visits to the home each week. The visit frequency will depend upon the care required. Once a plan is in place, professionals can help arrange for services, monitor care, and periodically help re-evaluate the plan and make adjustments based upon the client’s personal preferences and needs.

Hospices also treat individuals outside the home in special facilities and even through a local hospital program. Sometimes, family members may need a respite from caring for an elderly or terminally ill family member, and hospices also can provide this service. They may offer temporary care for an individual so family members can take some time off for their own needs.

The individual’s choice of long-term care often depends upon financial and insurance issues, the number of family members who can agree to help provide care, and the options available to the patient. In some cases, the long-term care options are limited; however, some research about long-term care before it is ever needed can open up more possibilities when it’s needed. Some programs, such as the Federal Long Term Care Insurance program (FLTCIP) can help with understanding long-term care and possibilities provided by the U.S. Government.

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