Advocacy Groups

Inside the Brain: Unraveling the Mystery of Alzheimer's Disease

Seniorhelpdesk.com healthcare blog credited to the National Institute On Aging.

For more information visit: https://www.nih.gov

Categories: 
City: 
Milford
States: 
Connecticut
County: 
New Haven

Greater Bridgeport Elderly Services Council / GBESC Meeting Notice: Please Join Us For Our 1st After Hours Networking Event on Wednesday June 7, 2017 from 5:30 pm-7:00 pm. Location/Host: Bridges by Epoch at Trumbull 2415 Reservoir Avenue Trumbull, CT 06611

Greater Bridgeport Elderly Services Council /GBESC END OF YEAR EVENT!!!!

SAVE THE DATE:

Our 1st After Hours Networking Event

Wednesday, June 7, 2017
from 5:30 pm-7:00 pm

Come mingle/network, enjoy the roof deck and light appetizers to kick off the end of our GBESC season!

Graciously hosted by:  Bridges by Epoch at Trumbull

2415 Reservoir Avenue

Trumbull, CT 06611

Please RSVP to ajamison@seniorlivingoptionsne.com if you have not done so already- thank you! 

Categories: 
Advocacy Groups
City: 
Trumbull
States: 
Connecticut
Zip code: 
06611
County: 
Fairfield
start time: 
Wednesday, June 7, 2017 - 5:30pm

What is Senior Corps

About The National Senior Corps Association:

 

The National Senior Corps Association is the nationally recognized leadership organization representing the combined interests of the Foster Grandparent, RSVP, and Senior Companion programs.

For more information visit our web page at:    http://www.nscatogether.org

 

seniorhelpdesk.com video blog credited to;  The National Senior Corps Association:

Categories: 
City: 
Milford
States: 
Connecticut

Measuring blood pressure accurately is the first step toward blood pressure control: 7 tips to follow at your next check-up!

It’s important to have an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke. But many things can affect a blood pressure reading, including how you sit and what you wear. In honor of National High Blood Pressure Education Month, learn the right way to have your blood pressure measured and tips for keeping track of it at home.

One in three Americans, or about 75 million people, has high blood pressure, and nearly half of them do not have it under control.1 In fact, about one in six people with high blood pressure do not know it.2
High blood pressure raises your risk for heart disease and stroke—the leading causes of death for Americans.

What Affects a Blood Pressure Reading?

Many things can affect a blood pressure reading, including:

  • Nervousness at having your blood pressure taken. This is called “white coat syndrome.” As many as one in three people who have a high blood pressure reading at the doctor’s office have normal blood pressure readings outside of it.3
  • What you ate, drank, or did before your reading. If you smoked, drank alcohol or a caffeinated beverage, or exercised within 30 minutes of having your blood pressure measured, your reading might be falsely high.4
  • How you are sitting.5 Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.

A reading that underestimates your blood pressure might give you a false sense of security about your health. But a reading that overestimates your blood pressure might lead to treatment you don’t really need.

Man checking his blood pressure

Your arm should be supported and at chest height to help ensure an accurate blood pressure reading.

The Correct Way to Measure Blood Pressure

Learn the correct way to have your blood pressure taken, whether you’re monitoring it at home or at the doctor’s office. Use this checklist:

  • Don’t eat or drink anything in the half hour before you take your blood pressure.
  • Empty your bladder before your reading.
  • Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
  • Put both feet flat on the ground, and keep your legs uncrossed.
  • Rest your arm with the cuff on a table at chest height.
  • Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
  • Do not talk while your blood pressure is being measured.

If you are keeping track of your blood pressure at home, try these additional tips 6:

  • Use a chart, notebook, or app to keep track of your readings.
  • Always take your blood pressure at the same time every day.
  • Take at least two readings, 1 or 2 minutes apart.

Lowering Your Blood Pressure

You can lower your risk for heart disease and stroke by lowering your blood pressure levels.

  • Reduce how much sodium (salt) you eat. Sodium raises blood pressure. Most sodium is found in processed and prepackaged foods. Eat less sodium by cooking at home. Use lots of fresh vegetables and season with spices and lemon juice instead of salt. Learn more about how salt affects your blood pressure.[663 KB]
  • Stay physically active. Exercise helps the most important muscle in your body: your heart. By getting enough physical activity each week, you keep your heart and blood vessels healthy and your blood pressure lower. Most adults should aim for at least 150 minutes of moderate physical activityeach week. Moderate activities include bicycling or taking a brisk walk.
  • Quit smoking. Cigarette smoking causes your blood vessels to thicken and narrow. This raises your blood pressure—and your risk for heart disease.7If you smoke, learn ways to quit. If you don’t smoke, don’t start.
  • Take your medicines as directed. If you have medicines for high blood pressure, take them the way your doctor has prescribed. About one in four adults older than 65 with Medicare Part D do not take their prescribed blood pressure medicines. This puts them at risk for stroke and heart problems.
  •  
  • seniorhelpdesk.com healthcare blog credited to the Centers for Disease Control and Prevention, CDC
  •  
  • Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People 
    For more information from the CDC / Link:  http://www.cdc.gov
Categories: 
Advocacy Groups
City: 
Atlanta
States: 
Georgia

Emerging Tickborne Diseases

 

Dr. Phoebe Thorpe and Dr. Bobbi Pritt discuss the problem of emerging tickborne diseases. Find out the types of ticks in your area and the types of diseases a tick bite can transmit. Learn the ABCs of how the prevent tick bites and what to do if a tick bites you. 
Tick bites can cause co-infections. Health care providers need to consider this when diagnosing and treating potential tickborne diseases. Learn about some of the treatment options and discover the important role Public Health plays in tickborne disease awareness.

seniorhelpdesk.com healthcare video blog credited to the Centers for Disease Control and Prevention, CDC

Categories: 
City: 
Atlanta
States: 
Georgia

CDC's Sun Safety: Time in the sun can increase your skin cancer risk!

 

Sun Safety

seniorhelpdesk.com healthcare blog credited to the Centers for Disease Control and Prevention, CDC

Photo of a mother and two young children at the beach

The sun’s ultraviolet (UV) rays can damage your skin in as little as 15 minutes. Follow these recommendations to help protect yourself and your family.

Shade

You can reduce your risk of skin damage and skin cancer by seeking shade under an umbrella, tree, or other shelter before you need relief from the sun. Your best bet to protect your skin is to use sunscreen or wear protective clothing when you’re outside—even when you’re in the shade.

Clothing

When possible, long-sleeved shirts and long pants and skirts can provide protection from UV rays. Clothes made from tightly woven fabric offer the best protection. A wet T-shirt offers much less UV protection than a dry one, and darker colors may offer more protection than lighter colors. Some clothing certified under international standards comes with information on its ultraviolet protection factor.

If wearing this type of clothing isn’t practical, at least try to wear a T-shirt or a beach cover-up. Keep in mind that a typical T-shirt has an SPF rating lower than 15, so use other types of protection as well.

Hat

For the most protection, wear a hat with a brim all the way around that shades your face, ears, and the back of your neck. A tightly woven fabric, such as canvas, works best to protect your skin from UV rays. Avoid straw hats with holes that let sunlight through. A darker hat may offer more UV protection.

If you wear a baseball cap, you should also protect your ears and the back of your neck by wearing clothing that covers those areas, using a broad spectrum sunscreen with at least SPF 15, or by staying in the shade.

Sunglasses

Sunglasses protect your eyes from UV rays and reduce the risk of cataracts. They also protect the tender skin around your eyes from sun exposure.

Sunglasses that block both UVA and UVB rays offer the best protection. Most sunglasses sold in the United States, regardless of cost, meet this standard. Wrap-around sunglasses work best because they block UV rays from sneaking in from the side.

Photo of a woman putting sunscreen to her young daughter.

Sunscreen

Put on broad spectrum sunscreen with at least SPF 15 before you go outside, even on slightly cloudy or cool days. Don’t forget to put a thick layer on all parts of exposed skin. Get help for hard-to-reach places like your back. And remember, sunscreen works best when combined with other options to prevent UV damage.

How sunscreen works. Most sunscreen products work by absorbing, reflecting, or scattering sunlight. They contain chemicals that interact with the skin to protect it from UV rays. All products do not have the same ingredients; if your skin reacts badly to one product, try another one or call a doctor.

SPF. Sunscreens are assigned a sun protection factor (SPF) number that rates their effectiveness in blocking UV rays. Higher numbers indicate more protection. You should use a broad spectrum sunscreen with at least SPF 15.

Reapplication. Sunscreen wears off. Put it on again if you stay out in the sun for more than two hours and after swimming, sweating, or toweling off.

Expiration date. Check the sunscreen’s expiration date. Sunscreen without an expiration date has a shelf life of no more than three years, but its shelf life is shorter if it has been exposed to high temperatures.

Cosmetics. Some makeup and lip balms contain some of the same chemicals used in sunscreens. If they do not have at least SPF 15, don't use them by themselves.

Categories: 
Advocacy Groups
City: 
Atlanta
States: 
Georgia

Hospital Surprise: Medicare's Observation Care

Seniorhelpdesk.com healthcare video credited to Kaiser Health News  http://khn.org

 

FAQ: Hospital Observation Care Can Be Costly For Medicare Patients

 

Seniorhelpdesk.com healthcare blog credited to Susan Jaffe and Kaiser Health News  http://khn.org

 

Some seniors think Medicare made a mistake.  Others are stunned when they find out that being in a hospital even for a couple of days dosen’t always mean they were actually admitted.

Instead, they received observation care, considered by Medicare to be an outpatient service. The observation designation means they can have higher out-of-pocket expenses and fewer Medicare benefits. Yet, a government investigation found that observation patients often have the same health problems as those who are admitted.

Medicare officials are working to finalize a notice that will inform patients that they are receiving observation care. That is required under a federal law that went into effect in August, and hospitals will likely begin using the notices in January. Some states already require that patients be told about their status.

More Medicare beneficiaries are entering hospitals as observation patients every year. The number doubled since 2006 to nearly 1.9 million in 2014, according to figures from the Centers for Medicare & Medicaid Services. At the same time, enrollment in traditional Medicare grew by 5 percent.

Here are some common questions and answers about observation care and the coverage gap that can result. (Seniors enrolled in Medicare Advantage should ask their plans about their observation care rules since they can vary.)

 

Q. What is observation care? 

A. Hospitals provide observation care for patients who are not well enough to go home but not sick enough to be admitted.  This care requires a doctor’s order and is considered an outpatient service. The hospitalization can include short-term treatment and tests to help doctors decide whether the patient meets the medical criteria for admission. Medicare officials have issued the so-called “two-midnight rule:” Patients whose doctors expect them to stay in the hospital through two midnights should be admitted. Patients expected to stay for less time should be kept in observation.

 

Q. What effect does observation status have on patients’ care and expenses?

A. Because observation care is provided on an outpatient basis, patients usually also have co-payments for doctors’ fees and each hospital service, and they have to pay whatever the hospital charges for any routine drugs the hospital provides that they take at home for chronic conditions such as diabetes or high cholesterol.

Observation patients cannot receive Medicare coverage for follow-up care in a nursing home, even though their doctors recommend it.  To be eligible for nursing home coverage, they must have first spent at least three consecutive days (or through three midnights) as an admitted patient, not counting the day of discharge.

 

Q: Why are more Medicare patients receiving observation care instead of being admitted? 

A. Medicare has strict criteria for admissions as an inpatient and usually won’t pay anything for admitted patients who should have been in observation care. Partly in response to stepped up enforcement of these rules, hospitals in recent years have been placing more patients in observation.

 

Q. Will the cost of my maintenance drugs be covered when I am in the hospital? 

A. No, Medicare does not pay for these routine drugs for patients in the hospital in observation care. Some hospitals allow patients to bring these medications from home. Others do not, citing safety concerns.

If you have a separate Medicare Part D drug plan, the coverage decision will be up to the insurer. If the plan covers your maintenance drugs at home and agrees to cover them in the hospital, it will only pay prices negotiated by the plan with drug companies and in-network pharmacies. Most hospital pharmacies are out-of-network. So even if your plan covers these drugs, you may be left paying most of the bill. However, you can ask hospitals if they would consider waiving the charges.

Medicine to treat the symptoms that brought you to the hospital may be covered as an outpatient service under Part B.

 

Q: How do I know if I’m an observation patient? 

A. Under a new federal law, hospitals across the country must now alert Medicare patients when they are getting observation care and why they were not admitted — even if they stay in the hospital a few nights. For years, seniors often found out only when they got surprise bills for the services Medicare dosen’t cover for observation patients, including some drugs and expensive nursing home care.

 

Q. Can I change my status in the hospital?

A. If your doctor says you are too sick to go home and you are receiving services that can be provided only in a hospital, ask your doctor to admit you to the hospital by changing your status to inpatient. However, even if your doctor does that, you can be switched back to observation status during your hospital stay.

 

Q. What can I do if I’m already in a nursing home and I find out Medicare won’t cover my nursing home care?

A. You have two options, Edelman said. You can agree to pay the bill but continue to seek coverage through a Medicare appeal or you can leave the nursing home.

If you opt to stay in the nursing home, follow these steps to see if Medicare will reimburse you, she said. Ask the nursing home to fill out a form called the “Notice of Exclusions from Medicare Benefits Skilled Nursing Facility.” The form will show what services you need, the estimated cost and the reason why Medicare will probably not pay. The facility will check off the first reason, “no qualifying 3-day inpatient hospital stay.” Then you can check  off the form’s option one, asking the facility to submit it to Medicare along with documentation supporting your need for these services. You will not be billed until Medicare issues a decision.

If Medicare does not pay the bill, you will receive information on how to appeal that decision. Although Medicare officials caution that hospital patients cannot appeal their observation status, the “notice of exclusion” applies to the nursing home charges and clearly states in bold type: “I understand that I can appeal if Medicare decides not to pay.”

 

For more information on filing an appeal, visit the Center for Medicare Advocacy’s observation care website.

This article was produced by Kaiser Health News with support from The SCAN Foundation.

 

For more information on Kaiser Health News, please visit our web page at: http://khn.org

Categories: 
City: 
Milford
States: 
Connecticut
Zip code: 
06460
County: 
New Haven

Gaps In Care Persist During Transition From Hospital To Home

Seniorhelpdesk.com healthcare blog credited to Anna Gorman and Kaiser Health News  http://khn.org

 

SAN DIEGO — Alton Rodgers had just come in from gardening when he suddenly blacked out and collapsed on the floor. The 89-year-old Kentucky native spent about 10 days at Palomar Hospital, where doctors told him a build-up of fluid around his heart was the culprit.

Now, shortly after being released, Rodgers got a knock at the door.

Nurse Tiffanie Abrajano and social worker Valerie Ellis were there to make sure his transition home had gone smoothly. They checked his medications one by one and made sure he knew how to take them. They walked through the house looking for loose rugs and other obstacles that could cause him to fall again. They also asked about safety bars in the bathrooms, and whether he needed a caregiver to help with bathing and dressing.

“We are trying to see if there is anything you might need here in your home to potentially keep you from going to the hospital,” Ellis said. “Do you feel like you have enough assistance?”

“I think I do,” said Rodgers, who lives with a friend. “I feel much stronger… And if I need any help, I can get it.”

For elderly patients like Rodgers, leaving the hospital is fraught with risk. Most are sent home or to nursing facilities after just a few days, still reeling from acute illnesses — not to mention the chronic conditions they are also confronting.

“Just because they have had four days in a hospital doesn’t mean they are better,” said Mary Naylor, a gerontology professor at the University of Pennsylvania School of Nursing.

It’s during that critical time when problems can occur. Patients may get sicker because they don’t have access to medications, transportation, food or crucial equipment such as oxygen tanks. And many don’t have relatives or caregivers to help with the daily tasks that they were able to perform unassisted before being hospitalized.

“There are gaps in care, there are gaps in communication, there are gaps in adequate preparation for patients and families,” said Naylor, who designed a transitions model to address these problems.

In recent years, federal health officials have begun penalizing hospitals for high rates of readmission and sponsoring pilot projects — like the one that sent a social worker and nurse to see Rodgers — to help ensure smoother discharges.

Hospitals and community groups are experimenting with different methods to improve the transition of elderly patients from the hospital.­​

 

 

Nurses and social workers visit patients after being released from the hospital as a way to improve elderly patients’ transitions. They check medications and safety concerns with recently released patients. (Heidi de Marco/KHN)

Some of them seek to strengthen communication with primary care doctors, or use technology to track patients across different health systems. Others emphasize closer partnerships between hospitals and community groups that provide meal delivery, transportation and other social services.

A program developed at the University of Colorado, for example, follows patients for the first month after their discharge, helping them manage their medications, schedule follow-up appointments and recognize signs of trouble.

San Diego County received a federal grant to improve handoffs from the hospital using an adaptation of the University of Colorado’s program. The county’s Aging and Independence Services agency partnered with four hospital systems — Scripps Health; University of California, San Diego; Palomar Health, and Sharp HealthCare — to serve more than 50,000 Medicare beneficiaries at the highest risk of medical complications after discharge.

The efforts aim to improve care and save money. Poorly managed transitions can waste medical services and increase health care costs. The federal government has estimated that nearly 20 percent of Medicare patients return to the hospital within 30 days, costing more than $26 billion annually.

The penalties and programs around the country are starting to make a dent in the problems associated with poorly handled discharges, experts said. The San Diego County program saved Medicare an estimated $13.8 million over a two-year period between 2013 and 2015, primarily because of reduced hospital readmissions.

 

Cathy Statler visits her father, John Statler, 88, at Palomar Hospital in March. Cathy Statler said she wishes her father had experienced a smoother transition after his time in the hospital. (Heidi de Marco/KHN)

But experts are quick to note that more needs to be done. Naylor said providers can’t stop looking after patients just a month after they are discharged.  “It’s not just thinking about today or tomorrow or the next 30 days,” she said. “For chronically ill, older people, what is their long-term trajectory?”

Programs like the one in San Diego County aren’t a panacea. It serves only a portion of Medicare beneficiaries, and people aren’t eligible for the help while they are in a nursing facility.

John Statler, 88, for example, returned to the emergency room at Palomar Hospital three times within the first week of his discharge to a nursing home. Statler had spent several days at the hospital after a fall left him with a severe head wound. His daughter said the hospital saved his life but didn’t then ensure that he had what he needed to recover after being discharged. In the end, he had to be readmitted.

Transition difficulties often start for elderly patients when they’re preparing to be discharged from the hospital. That’s when medical staffers quickly read a list of instructions to patients and hand them new prescriptions. Older patients may not understand what they are being told because they have dementia or are weakened and confused from their time in the hospital. Some are simply anxious to leave and not paying close attention.

“You are trying to reach them and do that education at such a critical time, but they are nowhere near cognitively ready to receive that,” said Joe Parker, lead nurse of care transitions at Palomar Health. “And we don’t have the luxury of time to wait.”

Back at home, family members and caregivers are often asked to take on medical tasks that would make “most first-year RNs shake in their boots,” said Robyn Golden, director of health and aging at Rush University Medical Center in Chicago. That can lead to medication mix-ups, infections and other problems — especially since the average hospital stay has shrunk.

“People are going home sicker, quicker and they are not returning to their prior selves as quickly – if at all,” Golden said.

 

Nurse Patrice Gadd visits Joseph Taylor, 88, at Palomar Hospital on Tuesday, March 22, 2016. Gadd informs Taylor that he’ll get a home visit and a month of follow-up to help keep him out of the hospital. (Heidi de Marco/KHN)

 

Nurse Patrice Gadd visits Joseph Taylor, 88, at Palomar Hospital in March. Gadd informs Taylor that he’ll get a home visit and a month of follow-up to help keep him out of the hospital. (Heidi de Marco/KHN)

Adding to the potential complications is the fact that primary care doctors are often unaware their elderly patients are in the hospital, so they can’t step in to ensure treatment plans are followed.

The main issue the San Diego program is designed to address is the disconnect between hospitals and social services agencies, which have traditionally operated in separate silos, San Diego County and hospital officials said.

“There is a point where the hospital can’t do any more” for patients who have been discharged, said Cecile Davis, coordinator of the remote patient monitoring for Sharp HealthCare. “The key is to know when to turn them over to the community.”

To figure out what patients like Alton Rodgers need, nurses and social workers ask critical questions, said Carol Castillon, who manages the care transitions program for the county.

Do they have transportation to get to the doctor? Do they understand their medications? Do they need an in-home caregiver?

The over-arching question, Castillon said, is: “What are the long-term services we can bring in so that this person isn’t coming back to the hospital?”

 

Patient Joseph Taylor works with physical therapist Jules Stewart on Tuesday, March 22, 2016. (Heidi de Marco/KHN)

 

Taylor works with physical therapist Jules Stewart. (Heidi de Marco/KHN)

Castillon said that before starting the project with the hospitals, the county regularly found older people in their homes who had been recently discharged and were unable to care for themselves. “They were sick, they were unable to get medications, they didn’t have food,” she said.

Participating hospitals identify patients for the program before they are discharged.

At Palomar Hospital one spring day, nurses Patrice Gadd and Rachel Ricchio stood at the bedside of 88-year-old Joseph Taylor, a former physical therapist who had come to the hospital with pneumonia and was diagnosed with congestive heart failure.

Gadd told him that he could get a home visit and a month of follow-up to help keep him out of the hospital. Taylor and his wife, who had recently moved from Colorado, both agreed that any help would be welcome.

Gadd urged Taylor to call the doctor if he started feeling sick again.  “The problem is that the older we get, the less reserves we have in our gas tank,” she said. Things “can go south really, really quickly.”

Nearly three months after his hospitalization, however, Taylor hadn’t returned to the hospital.

This story was reported while its author, Anna Gorman, participated in a fellowship supported by New America Media, the Gerontological Society of America and The Commonwealth Fund.

KHN’s coverage of aging and long-term care issues is supported by a grant from The SCAN Foundation, and its coverage of late life and geriatric care is supported by The John A. Hartford Foundation.

 

For more information on Kaiser Health News, please visit our web page at: http://khn.org

Categories: 
Advocacy Groups
City: 
Milford
States: 
Connecticut
Zip code: 
06460
County: 
New Haven

FAQ: Hospital Observation Care Can Be Costly For Medicare Patients

Seniorhelpdesk.com healthcare blog credited to Susan Jaffe and Kaiser Health News  http://khn.org

 

Some seniors think Medicare made a mistake.  Others are stunned when they find out that being in a hospital even for a couple of days dosen’t always mean they were actually admitted.

Instead, they received observation care, considered by Medicare to be an outpatient service. The observation designation means they can have higher out-of-pocket expenses and fewer Medicare benefits. Yet, a government investigation found that observation patients often have the same health problems as those who are admitted.

Medicare officials are working to finalize a notice that will inform patients that they are receiving observation care. That is required under a federal law that went into effect in August, and hospitals will likely begin using the notices in January. Some states already require that patients be told about their status.

More Medicare beneficiaries are entering hospitals as observation patients every year. The number doubled since 2006 to nearly 1.9 million in 2014, according to figures from the Centers for Medicare & Medicaid Services. At the same time, enrollment in traditional Medicare grew by 5 percent.

Here are some common questions and answers about observation care and the coverage gap that can result. (Seniors enrolled in Medicare Advantage should ask their plans about their observation care rules since they can vary.)

 

Q. What is observation care? 

A. Hospitals provide observation care for patients who are not well enough to go home but not sick enough to be admitted.  This care requires a doctor’s order and is considered an outpatient service. The hospitalization can include short-term treatment and tests to help doctors decide whether the patient meets the medical criteria for admission. Medicare officials have issued the so-called “two-midnight rule:” Patients whose doctors expect them to stay in the hospital through two midnights should be admitted. Patients expected to stay for less time should be kept in observation.

 

Q. What effect does observation status have on patients’ care and expenses?

A. Because observation care is provided on an outpatient basis, patients usually also have co-payments for doctors’ fees and each hospital service, and they have to pay whatever the hospital charges for any routine drugs the hospital provides that they take at home for chronic conditions such as diabetes or high cholesterol.

Observation patients cannot receive Medicare coverage for follow-up care in a nursing home, even though their doctors recommend it.  To be eligible for nursing home coverage, they must have first spent at least three consecutive days (or through three midnights) as an admitted patient, not counting the day of discharge.

 

Q: Why are more Medicare patients receiving observation care instead of being admitted? 

A. Medicare has strict criteria for admissions as an inpatient and usually won’t pay anything for admitted patients who should have been in observation care. Partly in response to stepped up enforcement of these rules, hospitals in recent years have been placing more patients in observation.

 

Q. Will the cost of my maintenance drugs be covered when I am in the hospital? 

A. No, Medicare does not pay for these routine drugs for patients in the hospital in observation care. Some hospitals allow patients to bring these medications from home. Others do not, citing safety concerns.

If you have a separate Medicare Part D drug plan, the coverage decision will be up to the insurer. If the plan covers your maintenance drugs at home and agrees to cover them in the hospital, it will only pay prices negotiated by the plan with drug companies and in-network pharmacies. Most hospital pharmacies are out-of-network. So even if your plan covers these drugs, you may be left paying most of the bill. However, you can ask hospitals if they would consider waiving the charges.

Medicine to treat the symptoms that brought you to the hospital may be covered as an outpatient service under Part B.

 

Q: How do I know if I’m an observation patient? 

A. Under a new federal law, hospitals across the country must now alert Medicare patients when they are getting observation care and why they were not admitted — even if they stay in the hospital a few nights. For years, seniors often found out only when they got surprise bills for the services Medicare dosen’t cover for observation patients, including some drugs and expensive nursing home care.

 

Q. Can I change my status in the hospital?

A. If your doctor says you are too sick to go home and you are receiving services that can be provided only in a hospital, ask your doctor to admit you to the hospital by changing your status to inpatient. However, even if your doctor does that, you can be switched back to observation status during your hospital stay.

 

Q. What can I do if I’m already in a nursing home and I find out Medicare won’t cover my nursing home care?

A. You have two options, Edelman said. You can agree to pay the bill but continue to seek coverage through a Medicare appeal or you can leave the nursing home.

If you opt to stay in the nursing home, follow these steps to see if Medicare will reimburse you, she said. Ask the nursing home to fill out a form called the “Notice of Exclusions from Medicare Benefits Skilled Nursing Facility.” The form will show what services you need, the estimated cost and the reason why Medicare will probably not pay. The facility will check off the first reason, “no qualifying 3-day inpatient hospital stay.” Then you can check  off the form’s option one, asking the facility to submit it to Medicare along with documentation supporting your need for these services. You will not be billed until Medicare issues a decision.

If Medicare does not pay the bill, you will receive information on how to appeal that decision. Although Medicare officials caution that hospital patients cannot appeal their observation status, the “notice of exclusion” applies to the nursing home charges and clearly states in bold type: “I understand that I can appeal if Medicare decides not to pay.”

 

For more information on filing an appeal, visit the Center for Medicare Advocacy’s observation care website.

This article was produced by Kaiser Health News with support from The SCAN Foundation.

 

For more information on Kaiser Health News, please visit our web page at: http://khn.org

Categories: 
Advocacy Groups
City: 
Milford
States: 
Connecticut
Zip code: 
06460
County: 
New Haven

Like Hunger Or Thirst, Loneliness In Seniors Can Be Eased

 

seniorhelpdesk.com healthcare blog credited to Judith Graham and Kaiser Health News  http://khn.org

It’s widely believed that older age is darkened by persistent loneliness. But a considerable body of research confirms this isn’t the case.

In fact, loneliness is the exception rather than the rule in later life. And when it occurs, it can be alleviated: It’s a mutable psychological state.

Only 30 percent of older adults feel lonely fairly frequently, according to data from the National Social Life, Health and Aging Project, the most definitive study of seniors’ social circumstances and their health in the U.S.

The remaining 70 percent have enough fulfilling interactions with other people to meet their fundamental social and emotional needs

“If anything, the intensity of loneliness decreases from young adulthood through middle age and doesn’t become intense again until the oldest old age,” said Louise Hawkley, an internationally recognized authority on the topic and senior research scientist at the National Opinion Research Center (NORC) at the University of Chicago.

 

Understanding the extent of loneliness is important, insofar as this condition has been linked to elevated stress, impaired immune system function, inflammation, high blood pressure, depression, cognitive dysfunction and an earlier-than-expected death in older adults.

A new study, co-authored by Hawkley, highlights another underappreciated feature of this affliction: Loneliness is often transient, not permanent.

That study examined more than 2,200 Americans ages 57 to 85 in 2005 and again in 2010. Of the group who reported being lonely in 2005 (just under one-third of the sample), 40 percent had recovered from that state five years later while 60 percent were still lonely.

What helped older adults who had been lonely recover? Two factors: spending time with other people and eliminating discord and disturbances in family relationships.

Hawkley explains the result by noting that loneliness is a signal that an essential need — a desire for belonging — isn’t being met. Like hunger or thirst, it motivates people to act, and it’s likely that seniors reached out to the people they were closest to more often.

Her study also looked at protective factors that kept seniors from becoming lonely. What made a difference? Lots of support from family members and fewer physical problems that interfere with an individual’s independence and ability to get out and about.

To alleviate loneliness, one must first recognize the perceptions underlying the emotion, Hawkley and other experts said.

The fundamental perception is one of inadequacy. People who are lonely tend to feel that others aren’t meeting their expectations and that something essential is missing. And there’s usually a significant gap between the relationships these people want and those they actually have.

This isn’t the same as social isolation — a lack of contact with other people — although the two can be linked. People can be “lonely in a marriage” that’s characterized by conflict or “lonely in a crowd” when they’re surrounded by other people with whom they can’t connect.

Interventions to address loneliness have received heightened attention since 2011, when the Campaign to End Loneliness launched in Britain.

Here are two essential ways to mitigate this distressing sentiment:

Alter perceptions. Loneliness perpetuates itself through a gloomy feedback cycle. We think people don’t like us, so we convey negativity in their presence, which causes them to withdraw from us, which reinforces our perception that we’re not valued.

Changing the perceptions that underlie this cycle is the most effective way to relieve loneliness, according to a comprehensive evaluation of loneliness interventions published in 2011.

Heidi Grant, associate director of the Motivation Science Center at Columbia University, described this dynamic in an article published in 2010. “If co-worker Bob seems more quiet and distant than usual lately, a lonely person is likely to assume that he’s done something to offend Bob, or that Bob is intentionally giving him the cold shoulder,” she wrote.

With help, people can learn to examine the assumptions underlying their thoughts and ask questions such as “Am I sure Bob doesn’t like me? Could there be other, more likely reasons for his quiet, reserved behavior at work?”

This kind of “cognitive restructuring” is an essential component of LISTEN, a promising intervention to treat loneliness developed by Laurie Theeke, an associate professor in the school of nursing at West Virginia University. In five two-hour sessions, small groups of lonely people probe their expectations of relationships, their needs, their thought patterns and their behaviors while telling their stories and listening to others.

Joining a group can be effective if there’s an educational component and people are actively engaged, experts said.

Invest in relationships. With loneliness, it’s not the quantity of relationships that counts most. It’s the quality.

If you’re married, your relationship with your spouse is critically important in sustaining a feeling of belonging and preventing loneliness, Hawkley said.

If you haven’t been getting along, it’s time to try to turn things around. Remember when you felt most connected to your spouse? How did that feel? Can you emphasize the positive and minimize the negative? If you’re badly stuck, seek professional help.

Investing in relationships with family members and friends is similarly important. This is the time to move beyond old grievances.

“If you want to recover from loneliness, try to deal with difficulties that are disrupting relationships,” Hawkley said.

Also, it’s a good idea to diversify your relationships so you’re not depending exclusively on a few people, according to Jenny de Jong Gierveld and Tineke Fokkema, loneliness researchers from the Netherlands.

Training in social skills can help lonely people deal with problems such as not knowing how to renew contact with an old friend or initiate conversation with a distant relative. And learning coping strategies can enlarge their arsenal of adaptive responses.

Both of these strategies are part of a six-week “friendship enrichment program” developed in the Netherlands. The goal is to help people become aware of their social needs, reflect on their expectations, analyze and improve the quality of existing relationships and develop new friendships.

One simple strategy can make a difference. “If you have good news, share it,” Hawkley said, “because that tends to bring people closer together.”

KHN’s coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

For more information on Kaiser Health News, please visit our web page at: http://khn.org

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