A Spoonful of Knowledge Helps the Medicine Go Down

 

The average senior takes five prescription medications per day and fills between 9 – 13 prescriptions each year. That is a startling number of pill bottles lining the typical seniors’ counter, each one representing an opportunity for a mistake to be made.

Older adults may struggle to remember to take the proper medicine at the correct time; they may have been prescribed medications that could potentially cause dangerous interactions when taken together; or they may be unable to fill all of their prescriptions because of the high cost of drugs or lack of access to a pharmacy. Any of these issues could have an impact on medication adherence.

Medication adherence is the terminology health professionals use to describe the act of taking medications correctly. Medication adherence is influenced by a patient’s ability to get his or her prescriptions filled, remembering to take the medication on time, and understanding the doctor’s instructions.

Lack of adherence may account for up to 50 percent of treatment failures, an estimated 125,000 deaths, and up to 25% of hospitalizations each year in the United States. It is estimated that chronically ill patients’ medication adherence is only about 50 percent, which leaves hundreds of thousands of adults at risk.

Medication reconciliation is an important function that can help prevent medication errors such as duplication, dosing errors or drug interactions. Medication reconciliation should be done at every encounter with a health care provider, whether in the doctor’s office, a hospital or other inpatient setting. It involves comparing a patient’s medication orders to all of the medications that the patient has been taking.

As caregivers and patients we play an important role in safeguarding our own safety when it comes to medication use. Here are a few steps you can take to help avoid a dangerous medication error:

  • Only use one pharmacy for all your medications and ask the pharmacist any questions you may have regarding how and when to take your medication.
  • If possible, use an independent pharmacist. They tend to be smaller and may offer more personalized services such as coming to the home to fill pill boxes or providing blister packs for easier medication management and adherence.
  • Ask if it is possible to receive a larger supply of medication so that you can make pharmacy visits less often.
  • Have your own medication list and update it as things change. It should include the date, prescription name, dosage, what the medication is treating, when you take it and who prescribed it.
  • Ask a caregiver or friend to act as your medication manager to make sure your medication list is available and updated and to act as your liaison with the pharmacist.
  • If you are discharged from a hospital always ask for a list of medications and review the list before leaving the hospital. Ask which prescriptions you should continue to take, which you should discontinue, and compare that list to the list of medicines you were taking before hospitalization. Ask if should go back to taking anything you were taking prior to hospitalization or if you should discontinue any of your previous medications. Take the new list to your pharmacist. Again, ask questions.

Cost of Medications

It’s Medicare enrollment time which means it is time to review the Medicare Prescription Drug Plans (Medicare Part D) to make sure you choose the right plan for you. Medicare Part D rules are changing in 2020.  Under the new rules, medications may be covered only when prescribed for certain conditions, or there may be higher co-pays depending upon the condition for which the drug is prescribed.  That’s why this year more than ever, it is important to do your homework and don’t get stuck with a plan that does not cover your medication when it is prescribed for your specific condition.

Here is what you can do to pick the right plan for you

  • Go to mymedicare.gov and create an account to find out what coverage will be best for you.
  • Contact the Health Insurance Information and Assistance Program HIICAP for free assistance finding Medicare Plans, or Medicare Rights National Consumer Helpline (800-333-4114) with any questions
  • Contact Care Answered and we can help you find a Medicare specialist/broker at no cost to you.
  • If you find that a plan covers many but not all your meds you may ask for a 90-day supply as a “transition dose” so you can delay the new increased drug price

If you can’t afford your medications, visit the website of the drug manufacturer. Many of them offer patient assistance programs. You can also look for financial assistance on the following websites:

needymeds.com

rxassist.org

 

 

Put Your Own Oxygen Mask on First…Even if You Never Fly

 

 

All of our lives we have been taught the importance of working hard and taking care of others, but it is equally important to make time to take care of ourselves. On an airplane, flight attendants remind us during the safety drill to put our own oxygen masks on first before assisting others with theirs. That is what self-care is all about. If we don’t put on our own oxygen mask first – figuratively speaking, of course – then we will not be able to take care of the others who depend on us.

And there are so many depending on us! If you are part of the so-called “sandwich generation,” you may be taking care of aging parents or other relatives while still raising young children or teens. For you, August is consumed by a to-do list. I encourage you to start thinking about annual school physicals, making sure that your school-aged children are up to date on their vaccines and check-ups. If you are the parent of a young adult heading off to college or beyond, I urge you to have your son or daughter complete a Health Care Proxy so that you are able to speak with doctors and make medical decisions on their behalf should the need arise. (See my earlier blog post on this topic.)

But most importantly, make sure that you are taking care of yourself. Don’t skip your own annual check-ups. Make sure you undergo the recommended age-based health screenings such as colonoscopy, mammography, osteoporosis screening, and others. Follow up on any red flags that are found during your physical. Get enough rest, drink enough fluids (but limit your alcohol intake), and try to get some exercise every day.

It isn’t always easy to do! Remember when summertime meant long, lazy days, when the pace seemed to slow down both at work and at home, when families scheduled vacations and spent weeks at the shore or in the mountains? These days it seems to be more difficult to take time for ourselves.

This month, Care Answered will be taking our own advice. Our office will be closed from August 12 until August 26. Our staff will be taking a breather to relax, re-set, and reconnect with family and friends. I hope you have an opportunity to do the same this summer, even if it is just for a short spell. Time away is a great opportunity to put your own oxygen mask on first to ensure that you are fully able to take care of all those you love.

Enjoy the rest of the summer!

 

 

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.”

 

 

Nicole Christensen on Project Independence WCWP.org with John Ryan & Ann Hirsch

Recently, Care Answered Director Nicole Christensen appeared on Project Independence, a radio program dedicated to the needs of older adults. Hear the shocking statistics she shared with hosts John Ryan and Ann Hirsch about preventable medical errors and how to be your own healthcare advocate.

Listen here:

https://northhempsteadny.gov/PI-2019-01-Radio-Shows

 

 

What to do when you receive a difficult diagnosis

woman listening“Everyone who is born holds dual citizenship, in the kingdom of the well and the kingdom of the sick . . . Sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” – Susan Sontag

Receiving a diagnosis of a chronic condition or any serious medical issue can be devastating, forcing a person to move from the kingdom of the well to the kingdom of the sick in one sudden, awful moment.

If this happens to you, take a moment to breathe. Then follow these tips to help you cope:

  1. Take some time. Unless emergency medical care is required, in most instances, there is no need to react immediately. You may find yourself overwhelmed by various emotions: anger, fear, sadness and confusion are common. Give yourself a little time to process the information you have been given.
  2. Assemble your support team. Identify the friends and family members who are willing and able to help you through this time. Assign tasks if appropriate; people will appreciate knowing that there is something they can do to help.
  3. Reach out for support. Many local hospitals and community-based organizations offer support groups that focus on specific diagnoses. Call or visit the website of your local hospital, or organizations like the American Heart Association, American Cancer Society, Alzheimer’s Foundation, and others to learn if there is a support group in your area.
  4. Consider hiring a healthcare advocate. An advocate can help you navigate the healthcare system, sort through complex medical information, arrange for the most appropriate treatment and facilities, coordinate insurance coverage, and more.
  5. Take notes. Jot down your questions prior to your doctor’s appointments and write down the information you are told. Use a journal or notebook to keep track of this information and to log appointments, tests, medications and dosages, and other details surrounding your journey.
  6. Get a second opinion. Corroboration by another trusted professional will reassure you that you are making the best decisions.
  7. Educate yourself – but be wary of what you find online. The internet has given everyone a platform to share their opinions, which can lead to confusion when you are seeking reliable information about a disease or condition. Verify the source of any information you find online and stick to well-known and respected websites and organizations.
  8. Take care of you. Remember to get enough rest, focus on managing stress through yoga or meditation, spend time with friends, and try to live as normal a life as your diagnosis allows. Keeping a positive attitude and focus on the future will help you cope with the challenges ahead.

Have a question or want to talk? Call me. I can help you figure out your next step. Give me a call at (516) 584-2007.

Healthcare 101: The Document All College Students Must Complete

It’s the time of year when parents everywhere are preparing to send their newly minted 18-year-olds off to college for the first time. Whether this rite of passage will include teary embraces and promises to check in regularly, or victory laps around the (at last!) empty nest, there is an important item that many parents neglect to add to their “to do” list. Along with dorm supplies and required vaccinations, make sure to have your child complete a health care proxy.

In New York State, when a child turns 18, he or she is considered an adult, regardless whether or not mom and dad are still paying the bills and carrying the health insurance. That means that medical professionals are bound by federal privacy laws, known collectively as HIPAA (for the Health Insurance Portability and Accountability Act), to keep your child’s medical information private, and to only discuss details with individuals who are authorized by the patient (your kid) to have that information.

You may not want to think about the potential for your child to require medical care while away at college, but accidents, injuries and illness do happen. And for a parent who is far away, trying to get information over the telephone from healthcare providers in another city or state, not having a health care proxy could be a major problem. Without the form, healthcare providers are unable to discuss your child’s specific conditions, you are unable to make decisions regarding your child’s care, and you can be denied information on what your child is suffering from, even for something as simple as a stomach bug or appendicitis.

Experts recommend having your young adult children complete a health care proxy form. Keep a copy of the form handy, and scan or take a picture of the form with your cell phone so that the document is always available.

If you have any further questions or would like a health care proxy form that you and your family can fill out before move-in day, reach out to us here at Care Answered. We’re happy to help you cross one more item off your college prep “to do” list.

Changes on Tap for Managed Long Term Care Providers in NYS and Your Community Medicaid

If you receive Medicaid and/or Medicare in New York State, are chronically ill or disabled and require aides or other services in order remain safely in your home, you are likely to be enrolled with one of the state’s Managed Long Term Care (MLTC) providers. MLTCs are agencies that help manage and oversee the services that patients requiring this level of care receive.

The NYS Department of Health, the agency that oversees MLTC agencies, recently announced changes to the program. Among the new rules:

  • Those who enroll in a MLTC plan after Dec. 1, 2018 will be barred from changing plans for 9 months, after the first 90 days. This makes it imperative that the family select the most appropriate agency at the start.*
  • There will be a limit on the number of home care agencies that each MLTC is able to contract with. The result could be make it more difficult for MLTCs to place aides in the homes of patients who need them. This begins October 2018.*
  • People placed in a nursing home for three months or more will no longer be able to enroll in a MLTC. In addition, patients who are MLTC members will be dis-enrolled from MLTC after three months in a nursing home. Some consumer advocates fear that when MLTC plans are no longer responsible for the cost of nursing home care, the plans will have an incentive to place members with high needs in nursing homes, rather than approve more hours of home care needed for the member to remain in the community. The start for date this change was initially July 1, 2018 but has been postponed to an unspecified date in the future.*

Navigating this process is challenging even for savvy and experienced healthcare professionals. The implications of rapidly changing rules and regulations leave many people with unanswered questions. A professional health advocate can assist families with obtaining the appropriate level of care at the right time and in the setting that makes the most sense. Care Answered is here to help. Give us a call at (516) 584-2007.

 

*Source: New York Western Law Center-State Dept of Health Moves to Implement MLTC Changes Enacted in 2018-19 NYS Budget

How Healthcare Advocacy Can Benefit Your Employees

Our healthcare system is growing more and more complex. Medical breakthroughs create new treatment options to consider. Regulatory reforms are changing the way physicians practice, while economic factors impact on the way insurance companies pay for the services we receive. The outcomes of the choices and decisions we make can truly be life altering. These are important and complicated issues.

At the same time, healthcare costs continue to be a concern for companies and workers alike.

To help address these complicated issues, many employers have begun offering healthcare advocacy services as an employee benefit.

Healthcare advocates can save time and money for both employers and employees. They do this by:

  • Reducing stress and improving productivity for employees
  • Helping employees select lowest cost, highest quality providers and facilities
  • Providing healthcare navigation for employees and their family members, including aging relatives
  • Reviewing medical bills for accuracy
  • Answering questions that would otherwise require handling by internal human resources staff

 

Offering healthcare advocacy as an employee benefit is cost-effective. Advocacy services can be added to a benefits package for just a few dollars per employee per month.

According to a 2017 survey by consulting firm Mercer, nearly half of employers with 500 or more employees offer healthcare advocacy services as part of their benefits package. Among very large employers – those with 20,000 workers or more – 60% offer advocacy as a benefit.

The advantages are magnified for smaller employers. If even one key employee at a smaller company needs healthcare advocacy for themselves or a family member, providing the service so that the employee can focus fully on their work can mean the difference between continued success and financial devastation for a small company.

To learn more about how healthcare advocacy could benefit your workforce, contact Care Answered.

 

Do you Need a Medicare Supplemental Insurance Policy?

Medicare supplemental insurance coverage medical charges

If you are near or past the magical age of 65, chances are you have already given a good deal of thought to Medicare, the health insurance program that covers Americans over 65 and the disabled. In addition to Medicare Part A, which covers in-hospital care, Part B, which covers doctor’s and outpatient office visits, and Part D, which covers prescription drugs, you may have heard about Supplemental Policies. These products are sold by commercial insurance companies to help you pay for additional expenses, like co-pays and deductibles, not covered by traditional Medicare. But are these policies worth buying? The answer is…it depends.

Medicare supplemental insurance – sometimes referred to as Medigap – claims to cover anything that Medicare does not. But if you read the fine print, it turns out that there isn’t much that Medicare doesn’t cover. Medicare pays for the majority of the medical procedures. The adjustors at Medicare will calculate a fair value for the services rendered, pay the provider for around 80% of the calculated cost, and the remaining 20% or so is left to you as a patient. This means that under Medicare you will be left with a considerably low out-of-pocket cost for your health care.

However, Medicare does not cover everything nor everyone, and that is where supplemental plans come into play. Deductibles and co-pays – the amount for which you are responsible if you are on Medicare – are covered by Medigap insurance. If you anticipate a high volume of hospitalizations or doctor’s visits, supplemental insurance may be a wise investment for you. If, however, you only visit the doctor a few times a year, the cost of supplemental insurance may not be offset by the amount of coverage offered.

In short, the answer really does depend on your individual needs. You can get more information by visiting the Medicare website. If you would like to know more or would like assistance with choosing a plan, reach out to us at Care Answered.

How to Find a Home Care Provider

Illness, injury or advancing age can result in the need for assistance in our day-to-day lives. When this happens, it is important to make sure that you have the appropriate provider to care for you or your loved one. The question then becomes, how do you know if your loved one is in good hands? The answer is through preparation and asking questions

The first thing you need to do is start a conversation. Include your loved ones and primary care physician in the discussion about the need for home care and the type of care needed. This will ensure that everyone can bring their concerns to the table. Step two is to start compiling lists. Make a list of daily activities with which you/your loved one need assistance. Every person is different and no two home care providers will need to perform the same exact tasks.

Building off of this, you should determine what hours of the day and how many days a week you/your loved one needs care. It is also important to create a medication list (include supplements) that contains information on why the medication is taken, what dosage, and when it is taken. Keep in mind many home care agencies can’t have their aides “administer” medications. This means the aides cannot take the medicines out of the bottle to give you, but they can give reminders. (Always ask any care provider what they are able to do based on your list of daily activities.)

After you’ve described the specific needs of you/your loved one, it is recommended that you make a list of personality traits you/your loved one would find ideal, because remember, this person will be in your home. For example, would you have a preference for someone chatty or quiet/reserved? Is there a language in which you are more comfortable communicating? Would you be more comfortable with a man or a woman? Is there a culture that you feel most at ease around? These are all important questions that should be answered before choosing an aide.

It is also helpful to establish a communication plan with the home care provider if you are a loved one. Perhaps you want to be contacted immediately if any change of behavior is noticed, or establish a protocol for any emergency situations. In addition, whether you decide to find a home care agency or choose a home care provider privately, make sure a background check is done. While it would be ideal to interview all of your prospective home care providers, sometimes it is not possible to conduct in-person or phone interviews with all of them. The lists and schedules that were made earlier can help prevent any unforeseen issues.

Of course, even after preparing as best as possible, it’s important to follow through. Try to have a loved one or advocate stop by unannounced to make sure that the home care provider is meeting all expectations.

Still have questions? Contact Care Answered for personalized help with selecting the right in-home caregiver for you.