There are some significant changes coming to Medicare in 2011, as a result of healthcare reform and a number of initiatives. Here is a brief summary of the key changes:

Preventative Services:

Next year, all Medicare preventive services, such as screenings for colon, prostate and breast cancer, will be free. Annual wellness visits will also be free starting in 2011. *In the past, Medicare allowed for a one time “welcome to Medicare” wellness/physical only.

Durable Medical Equipment:

In certain areas, recipients will be required to go through specific providers.

“Doughnut hole” changes/Medicare Prescription Drug Benefit:

2010: Anyone who fell in to the “doughnut hole” received a $250 rebate check to assist with those costs. This doesn’t apply to those receiving “special assistance” with costs through Social Security. Be aware that there have been several scams related to this rebate, as well as continued scams where clients are asked for their Medicare # or contacted via phone to sign up for a new plan.

2011: 50% discount on covered brand name drugs in doughnut hole period

2012-2020 and beyond: This discount incrementally increases until eventually the coverage gap is eliminated.

New open enrollment periods/dates to change plans:

1/1/11-2/14/11: If you’re in a Medicare Advantage Plan, you can leave your plan and switch back to original Medicare (and join a prescription drug plan)-coverage effective 1st day of month after the plan gets your enrollment.

10/15/11-12/7/11: New Open Enrollment period for switching Medicare health & prescription drug plans (effective 1/1/12). This is the period that has previously been 11/15-12/31 each year (including 2010)—the purpose is to allow more time for decisions, as well as processing before the effective date.

Healthcare Information Technology:

There is a big push towards use of information technology to streamline and improve healthcare, such as electronic prescribing and personal health records. Medicare has information and resources on their site, though there remains no universal system at this time.

Income Adjusted Premiums:

Currently, Part B premiums are income adjusted for higher income individuals. Sarting in 2011, higher income individuals (those making more than $85,000 filing an individual return and $170,000 filing jointly) will also pay an income-related monthly adjustment to Part D premiums. This will be deducted from the recipient’s Social Security check, no matter how they usually pay the Part D premium.

Medicare Advantage Plans:

Subsidies to these plans will be phased out. This may mean plans reduce extra benefits, or even decide to no longer participate in this market, but those will be business decisions by the insurance companies so the impact is unclear at this point.

The Medicare and You 2011 Guidebook is currently available on Personal Medicare Analysis provides you the best, unbiased information so that you can make wise decisions and save money on healthcare in retirement.

One of the biggest challenges of caring for a loved one with Alzheimer’s disease can be handling changing personality and behaviors, and learning new ways to react. Your usual reaction of logical arguments and reasoning won’t work, and it is easy to become frustrated.

Here are a few basic tips for reacting to dementia behaviors, from sundowning to agitation and repetitive behaviors or paranoia and arguing:

1. Use “Yes, and…” statements, as a means to acknowledge the person’s feelings and beliefs (which are very real to them) without arguing about realities, and to lead the focus on to another issue or behavior. For example, the person with Alzheimer’s disease states “I want to go home or I need to be at work now” and you might say “Yes and why don’t we go over here and…” or “I understand, and maybe we should go find out what those people are doing in that group over there.”
2. As follow up to #1, acknowledge the person’s feelings, fears, concerns, even if the solutions they seek are not an option, or the fears seem unfounded. Focus on the feelings, not the behavior or argument.
3. Know that your emotions and state of mind will impact the interaction. This is one reason why having assistance or respite can be so important. If you are rushed and upset, the person will usually reflect those attitudes in their behavior.
4. Try to identify underlying causes of behavioral changes or agitation, such as changes to routine, noises, infections/underlying medical conditions. If you notice a sudden, severe change in behavior, there is almost always an underlying cause. Be vigilant in pursuing possible infections or medical concerns with medical and care professionals.

We offer one on one consultations with our care managers, who have in depth education and experience in Alzheimer’s disease and related dementias. Caregiver consultations may include: techniques for managing behaviors, ideas for adapting the environment, resources to assist or offer respite, understanding the diagnostic process or getting an evaluation for specific needs.

You may also wish to visit our page about Sundowner’s Syndrome or sundowning behaviors, and we invite you to sign up for our email newsletter, with regular updates on eldercare and caregiving tips. Let our experienced geriatric care managers work for you, to help support you as an Alzheimer’s caregiver and to help ensure the safety and wellbeing of your loved one.