No Holiday from Good Health

Happy summer! I hope that you enjoyed all that June and early July had to offer…Father’s Day, graduations, Fourth of July celebrations and more! With summer in full swing, you may be thinking about vacation plans and relaxing with friends and family. But please don’t forget to take care of your health this summer.

While there’s never a good time to get sick, it turns out that there are times which are especially bad – namely, any weekend and the entire month of July.

Healthcare veterans all know about the so-called “July Effect.” This phenomenon begins every July 1 in the nation’s teaching hospitals, where men and women who have just graduated from medical school begin their very first weeks of field training. At the same time, more experienced trainees graduate and move on to even more specialized fellowship training programs or private practice.

With their lack of experience, newly minted doctors are more likely to run unnecessary or duplicative tests, may be unfamiliar with hospital pharmacies and prescribing standards, and are more prone to make medical errors. As a result, studies have shown that the death rate in teaching hospitals is significantly higher in July than other months.

A related phenomenon is the so-called “Weekend Effect.” This affects all healthcare settings, including non-teaching hospitals, and is observed all year long. It refers to the fact that many hospitals have fewer expert staff available on weekends and overnight, which coincides with the times when many medical emergencies occur. Numerous studies have shown that patients who visit emergency departments, undergo surgery or experience strokes or other significant episodes on a Saturday are likely to have worse outcomes than patients with similar medical conditions who seek care on other days of the week.

Unfortunately, accidents and illness do not take holidays. While enjoying the summer weather, remember to focus on health and safety to help avoid the need for emergency medical care. Here are a few basic tips to help you stay well:
• Stay hydrated by drinking plenty of water.
• Use sunscreen with an SPF of at least 30, especially if you are out during the warmest part of the day, usually between 11 a.m. and 2 p.m.
• Exercise extra caution around pools and water. Never leave a child unattended around water, even for a few seconds.
• Do not leave children or pets inside parked vehicles, even for a few minutes. The interior of a parked car can become dangerously hot very quickly.

Of course, in a medical emergency, there is not much that you can do to avoid either the July Effect or the Weekend Effect. But there are steps you can take to safeguard your health.
• Avoid scheduling elective surgery or procedures in July. Instead, postpone elective procedures until the fall if it is safe for you to do so.
• Hire a health care advocate. If you must undergo medical treatment over the summer, having an advocate by your side may help ensure that you receive safe, appropriate care.
• If you are unable to hire an advocate, ask a trusted friend or family member to stay with you if you are hospitalized over the summer. Make sure this person writes down the names of all of your medications, tests and procedures and keeps track of the staff who are providing your care.

If you have any questions, give me a call! I’d be happy to talk to you about your healthcare needs or upcoming medical encounters. I can be reached at (516) 584-2007.

You Can’t Take Them with You: April is National Donate Life Month

 

 

This month I had to renew my license and once again checked off the box for organ donor.  What a sense of accomplishment with such little effort!  Will you join me?

The Need

About 114,000 Americans – roughly the population of Ann Arbor, Michigan – are awaiting a life-saving organ transplant. Every day, 20 people on that list die waiting, while another person is added every ten minutes.

Deciding to become an organ donor is a simple process that requires registration with your state. In New York, you can easily register to become an organ donor when you renew your license or non-driver identification card with the Department of Motor Vehicles (DMV). While New York is home to 10 percent of all Americans awaiting an organ donation, the state lags the national average for organ donors, with only 29% of eligible adults enrolled in the registry compared to 51% who have registered nationwide.

Anyone aged 16 and over can join the New York State Organ Donor Registry, and there is no upper age limit for potential donors. In fact, the oldest organ donor in the U.S. was 93. Donor suitability is based solely on the donor’s medical condition and history. Organs that may be donated to help save a life include the heart, lungs, kidneys, liver, and intestines. Corneas may be donated to help restore sight. Tissue donation may be used to replace bone, cartilage and ligaments damaged by disease or injury.

One single organ donor can save up to eight lives and benefit 75 other patients who are in need of donor tissue.

Overcoming Objections

There are many reasons why people shy away from enrolling in the donor registry. Some worry that being an organ donor is against their religion. In reality, all major faiths support organ donation. You can read more about your faith’s position on organ donation here.

Others may be concerned that organ donation will disfigure the body or preclude an open casket funeral service. This is not the case; organ donors may still have an open casket as there is no visible evidence of organ donation on the donor’s body.

Some people question whether their decision to donate organs will impact on their medical care at the end of life. This is not an issue. The organ donor team and the medical treatment team are separate. Every effort is made to save the life of the organ donor. Only when those efforts have been exhausted is the organ donation team notified of the potential availability of organs for a recipient on the waiting list.

April is National Donate Life Month, an annual campaign designed to increase awareness of the dire need for organ donors and to dispel myths surrounding organ donation. As Spring makes a return across our region, it’s natural to think about rebirth and new life. Why not take a moment this month to help another person by making the ultimate gift of life: become an organ donor.

Learn more about becoming an organ donor in New York State.

When the Caregiver Needs Care, You Need an Advocate

 

 

Rick Pantuliano lives with his wife and two daughters just a short drive away from his parents’ Nassau County home. This proximity has allowed them to maintain a close relationship with his 77-year-old mother. Yet even though he is nearby, he still needed professional help when his mother’s dementia became significant enough that she required round-the-clock care.

“It got to a point where my mom needed to go on Medicaid,” Rick said. “Applying was a confusing process. I was pulling my hair out.”

His attorney recommended that he contact Nicole Christensen of Care Answered.

“She held my hand through the entire process,” he recalled. “She helped me understand every step of a very time consuming and complicated situation.”

Describing his mom, Raffaela, as a strong woman who was traditionally the caregiver for other family members, Rick related how she began to show signs of dementia about six years ago, six years after his father passed away from emphysema.

“She took care of her sick aunt, who died of cancer. Then she cared for her uncle who passed away of old age. She took care of her own mom and dad who lived with them for years. She took care of a lot of people,” Rick said. “Now it’s her turn, and there’s nobody there but me.”

Commuting from Long Island each day to his job in New Jersey keeps him away for long hours, adding to the stress of trying to ensure that his mom’s needs were being met. Nicole’s assistance helped Rick feel confident that he was arranging for the most appropriate care possible for his mom.

“I would still be at the starting line if it wasn’t for Nicole,” he noted. “She was my advocate. She walked me through the entire process and stepped in whenever I felt I was hitting a brick wall. She translated everything and made it understandable and easy.”

More importantly, Nicole’s intervention will ultimately save the family a significant amount of money. With her help, Rick was able to access funding to pay for live-in aides for his mom – services for which he had been paying out of pocket each month.

Rick worked with Nicole for about five months. She brought him to a point where he has a much better understanding of how the system works and feels empowered to handle the hurdles he faces. She reassured him recently by saying, “You got this,” when he was confronted with yet another form to fill out.

And he agrees. “I am basically comfortable with everything at this point,” he said.

His mom is living safely at home with 24-hour aides. Rick is thankful for the ongoing support of his wife and daughters, and for Nicole’s intervention when he needed her expertise most.

“I would highly recommend Nicole to anybody,” he said. “Unless you’re home 24 hours a day and don’t have a job and understand the ins and outs of the healthcare system, you absolutely need an advocate. Nicole is a wonderful person. She is very caring, very in tune to your needs, and she just does her job very, very well.”

 

 

Women’s History Month Panel Shines a Light on Healthcare Disparities

Earlier this month, I had the opportunity to participate as a panelist in a discussion on diversity, women’s issues, and entrepreneurship. The panel was part of a Women’s History Month presentation to the Health & Business Alliance, a trade and networking group to which I belong. My co-panelists, Lauren Tanen and Susan Ganz, each brought their own unique perspective on the challenges that confront many women as well as people of color as they navigate their workplaces, healthcare and educational institutions, and other parts of their lives.

My own contribution to the panel centered on healthcare disparities. African Americans have a 40% greater risk than whites of getting high blood pressure, which can lead to heart disease, heart failure, kidney disease and stroke. African Americans are also twice as likely as whites to be diabetic, which leads to a host of serious medical complications.

Last year, the New York Times ran a feature report called “Why America’s Black Mothers and Babies are in a Life-and-Death Crisis.” In an article full of shocking statistics, this one stands out: Black infants in America are more than twice as likely to die as white infants. But what’s even more shocking is the fact that this disparity has actually increased in the past century and a half, since statistics like this were first recorded in 1850, 15 years before the end of slavery.

And these disparities extend to other minority groups as well. The Centers for Disease Control (CDC) reports that compared to whites, Hispanics are about 50% more likely to die of diabetes or liver disease.

These ongoing inequities are part of what drives me to continue my professional quest as a healthcare advocate. A significant part of what I do is to advocate for patients, whoever they are, whenever and wherever they interact with the healthcare system.

It is essential that every person fully understands the information presented by medical professionals and is able to carry out the doctors’ recommendations. Our American healthcare system is complex, involving interactions with insurance companies, government payers, employers, healthcare providers, pharmacies, medical device companies, long term care providers, assisted living centers, rehabilitation facilities, home care agencies, and more. I specialize in helping clients cut through the clutter so that they are armed with clear, understandable information and are empowered to make the healthcare decisions that are best for them and their families.

I’d love to hear about your experiences. Whether you are a man or a woman, member of a minority group or not, what has it been like for you when dealing with a doctor, hospital, school, workplace, government agency or other institution? Did you feel heard, respected, and understood, or marginalized? By sharing our stories, as I and my fellow panelists did, and speaking up for one another, I believe we will begin to make a much needed change.

 

Helping a Loved One Manage Chronic Conditions

Six in ten adults live with at least one chronic disease, such as cancer, heart disease, asthma, stroke and diabetes, while four in ten have multiple chronic conditions, according to the Centers for Disease Control and Prevention.

While many adults are able to manage their own chronic medical conditions, as they age this can become a challenging juggling act, especially when there are multiple medical conditions being treated.

Knowing When to Help

Some people with chronic medical conditions develop tricks and habits to help them cope. These techniques may make it appear that they are managing fine, when in reality they are just barely getting by. A seemingly inconsequential issue – a minor cold, a missed trip to the pharmacy, or a skipped meal – may be all that it takes for disaster to strike. The trick for loved ones is to know when to step in with assistance.

older man looking into camera

Get Involved Early

Don’t be afraid to ask questions. Offer to accompany your loved one to doctor’s appointments if your schedule permits. This will enable you to assess whether your loved one appears to understand the doctor’s instructions and is following his or her medication regimen and dietary recommendations.

Try to encourage frank discussions about your loved one’s condition. Encourage them to be honest about their symptoms, pain, and ability to function. Listen without judgment.

When More Help is Needed

If you feel that your loved one may need more help as their disease progresses, explore all of your options. The areas in which assistance may be needed include:

  • Personal care – bathing, dressing, washing hair. A family member may be able to assist with this, or a personal care aide can be brought in to help with these types of tasks.
  • Household chores – cooking, cleaning, laundry, minor household repairs. Again, a friend or family member may be able to visit the home to help with cooking and housework. Another option is for someone to deliver pre-cooked meals or for your loved one to travel to a senior center or local club for a hot meal. Often minor repairs can be outsourced to a local handyman; ask neighbors and friends for a trustworthy referral. If more help is needed, a personal care aide may be able to pitch in.
  • Medication compliance – pill boxes, alarms, phone calls and other technological devices can help remind your loved one about which medication to take and when to take it.

An Advocate can Help

When the juggling act of trying to coordinate the multiple aspects of a loved one’s care becomes overwhelming, it might be time to consider hiring an advocate. A healthcare advocate can help you determine what care options are available and put those services into place, accompany your loved one to doctor’s appointments, make sense of complex medical information and untangle medical bills and insurance documents, arrange for in-home care or nursing home placement as needed. To learn more about what an advocate can do, call us at 516-584-2007.

Forget Politics…Talk About Healthcare Decisions this Holiday Season

Thanksgiving is right around the corner. As you get ready to roast the turkey, bake the pies and gather with loved ones, think about adding one new tradition to your family gatherings. Take politics off the table and instead use the time together to talk about healthcare. Share any important family medical history and discuss the decisions you would like made on your behalf should you become unable to make care decisions for yourself.

A good place to start is to give your loved ones peace of mind by selecting your health care proxy.

What is a Healthcare Proxy?

The New York Health Care Proxy Law allows you to appoint someone you trust — for example, a family member or close friend – to make health care decisions for you if you lose the ability to make decisions yourself. By appointing a health care agent, you can make sure that health care providers follow your wishes. Learn more here.

How do you talk about healthcare decisions?

Once you have selected your proxy, be sure to inform that person about his or her role and let him or her know about your wishes should an illness or injury leave you unable to make your own healthcare decisions.

Sometimes these topics make people uncomfortable. Try to ease the discomfort with these suggested opening lines:

“My faith is important to me and I don’t want to have….”

“I’m allergic to …. Please make sure that I don’t receive that medicine”

Talk about what you value as specifically as you can. You might say:

“I don’t want to ever be sustained by machines,” or “I have to be able to live independently,” or “There are new health findings every day. I would like to be kept alive until they find a cure.”

Points to remember about healthcare decisions

The discussion with your healthcare proxy can and should be ongoing. You cannot imagine every possible scenario but if the person you select as your healthcare proxy understands your values and knows the types of life-sustaining treatments that you would want, as well as those interventions that you would not want, your proxy will feel confident that they are following your wishes rather than having to decide your fate on their own.

This is not a contest of who loves you the most; rather, it’s about who will be able to carry out your wishes.

It is a tremendous burden to expect your loved ones to make these decisions for you if you have not expressly told them your wishes. Help them be your proxy by freely sharing your feelings.

Take time this holiday season to begin your discussion. And fill out your healthcare proxy form. Think of it as a compassionate gift to your loved ones should they ever have to make an important healthcare decision for you.

 

What Does Medicare Cover, Anyway?

Medicare is the health insurance program run by the federal government for those who are 65 and older, as well as those under 65 who are disabled and collect Social Security Disability Insurance (SSDI).

When people learn that they need post-hospital care – home care, inpatient rehabilitation or a stay in a nursing home – they often assume that Medicare covers these services. But much like private insurance, there are limitations on the services that Medicare will cover.

Before you need this level of care, here is an overview of exactly what Medicare will cover.

If you are 65 or over you likely have Medicare coverage A and B. Medicare coverage part A is “hospital insurance.” It covers care you receive in the hospital. Skilled nursing (nursing home) or rehab care is covered ONLY if:

  • Your care is “medically necessary.”
  • You are expected to improve over time
  • You meet the 3 DAY inpatient hospital stay. This means you must be FORMALLY ADMITTED to the hospital. If you are in the emergency room for three days but not admitted to the hospital, or you are admitted to an “observation unit,” you will not receive insurance coverage for your rehabilitation or skilled nursing care.

Even if you feel you have great insurance to fill in the gaps of Medicare A and B coverage, if you do not satisfy the three-day admission rule, there is likely no insurance that will cover your rehabilitation or skilled nursing care.

How Much is Covered?

If you meet the three-day admission requirement, the first 20 days you spend in a skilled nursing facility is fully covered. On days 21 – 100, you are responsible for a co-pay of $167.50 per day. After the 100th day, you are responsible for all costs related to your stay in a skilled nursing facility.

What Isn’t Covered?

Custodial care, which provides assistance with performing the basic tasks of daily living, such as dressing, bathing or eating, is typically not covered by Medicare at all. You are responsible for the full cost of this type of care, which on Long Island can run upwards of $100,000 a year.

Questions? A healthcare advocate can help you navigate the system in order to maximize your benefits and help you sort out your options for care and payment.

You can learn more about Medicare Part A hospital and skilled nursing facility coverage. Visit medicarerights.org for additional information. Care Answered is available to answer your questions and help you make the best decisions based on your individual situation and needs. Contact us here or call (516) 584-2007.

 

You are in the hospital! Now what?

Nurse Helping Senior Woman To Walk

You are in the hospital! Now what?

You find yourself or your loved one in the hospital. It’s emotional and overwhelming. So what is the first thing you do?

First, make sure that you have a written record including your current diagnosis, any medications/supplements you take (including name, specific dosage, when you take it, how long you have been taking it).

Next, make sure that you are asking the right questions. These include:

  • What tests are being given?
  • What can these tests tell you/me?
  • What medications are being given now?
  • What are these medications for specifically?
  • Have any pre-hospitalization medications been discontinued?
  • Am I being officially admitted into the hospital?
  • What is my diagnosis?
  • Will you contact my primary care physician?

Immediately upon admission to the hospital, you and your caregivers should begin planning for your discharge.

Your safe and healthy discharge should be on your care team’s minds the moment you’re admitted. You don’t want any surprises. You should have input and understanding of your health goals. Yes, you want to get the heck out of the hospital! Make sure you are on track to leave and understand all of the steps required for you to make a full recovery.

MOST IMPORTANTLY, CONSIDER A PATIENT ADVOCATE

An advocate can help you in a variety of ways…

  • Help you understand complicated medical jargon
  • Help you make sense of your insurance coverage and your financial responsibility
  • Help you navigate the medical maze – diagnostic testing, treatment options
  • Help you transition to the next level of care – long or short-term rehabilitation, skilled nursing facility, home care
  • Act as your advocate, looking out for you and your best interests

There is so much more to do and know but this is to get you started and thinking. A professional healthcare coordinator and advocate can ensure that you cover all the bases.

Advocacy in the Hospital- Webinar 4/27/17-Register Today

Advocating in the Hospital-Webinar 4/27/17 Register today
When
Thursday, April 27, 2017 from 1:00 PM to 2:00 PM EDT
Where
This is an online event.

Family First Home Companions hosts their next webinar- Advocating For a Family Member in the Hospital.  This webinar will feature guest speaker, Nicole Christensen, patient advocate and CEO of Care Answered.  Nicole will provide tips and tricks to give you the information you need to be ready if/when your loved one is hospitalized.  The presentation will include the following:
  • Key things to watch our for to prevent medical errors
  • Communicate your loved one’s needs without alienating the medical team
  • Who to turn to for support in the hospital
  • How to interpret your hospital bill and catch mistakes
Attendees will leave this webinar fully equipped to handle the next hospitalization.
Click on the link below to register or RSVP.
About The Speaker:
Nicole Christensen is the CEO of Care Answered, a healthcare coordination and advocacy organization specializing in older adults and their families.  Care Answered expertly navigates the healthcare system for clients and helps remove the strenuous obstacles common place in the healthcare process.  Holding a Master of Science in Urban Affairs, Ms. Christensen has over 15 years of professional advocacy experience.  In her work, she had the opportunity to develop and strengthen advocacy programs in Washington DC, NYC and Long Island.  In addition to her professional experience, she has personal knowledge of the challenges of healthcare coordination and advocacy from assisting her own parents. Ms. Christensen’s expert opinions and presentations are requested by Feeding America, news outlets, businesses, civic organizations, congregations, and legislators.