There are several pieces to the Medicare program, and each comes with specific enrollment rules and costs. It is important to understand how these parts work together, along with how they work with other senior healthcare coverage you may have such as Veteran’s Healthcare or Employer/Retiree Insurance.

Download our Medicare 2012 Fact Sheet for a more detailed (but easy to understand) guide to the parts of Medicare, along with the costs for 2012 and key enrollment dates and facts. We explain terms such as late enrollment penalties and dual eligibility.

Here is a basic overview of the components of Medicare:

Part A: “Hospital Insurance”, covers inpatient hospital, certain skilled nursing and skilled home health services. It does not cover long term or custodial care.

Part B: “Outpatient Services”, covers Medicare eligible physician’s services, outpatient hospital services, certain home health services or therapies, and durable medical equipment.

Part D: “Prescription Drug Coverage”, offered through stand alone plans via private insurers or as part of a Medicare Advantage Plan.

Medicare Advantage Plan (AKA Part C): Health Plans such as PPOs and HMOs that are approved by Medicare and run by private companies. Beneficiaries opting for Medicare Advantage chose to receive the various Medicare benefits through the insurer rather than the traditional Medicare program.

Medigap Plan (AKA Supplemental Policy): These policies help pay some of the costs not covered by regular Medicare (such as co-pays/deductibles).

Aging Wisely’s patient advocates offer a unique Medicare Analysis program, in which we gather information from you, discuss your priorities, budget and health concerns/history and from that, provide specific guidance on how to make a wise choice for your Medicare plans.

We work with clients in the Tampa Bay area every day in various transitions. Many times we are involved in the process of helping families and clients who are moving to an Assisted Living Facility or Retirement Community. Often, families contact us to help with the research and decision-making process regarding the best Florida Assisted Living Facility for the individual (read “One Daughter’s Contrasting Eldercare Experiences” for examples of how we assist families in choosing Assisted Living Facilities and arranging eldercare).

Once the decision has been made, making a smooth transition is vital.

What are some tips we can offer to families to have a positive move to a new home in Assisted Living?

1. Plan the move-in day carefully around the individual. This may mean planning a special outing when the physical move is taking place to make it a special day and reduce the stress. Think about timing and little things like when it is best for the person to arrive and details such as meal times.

2. Orient the person to the new home and introduce them to their new neighbors and staff. Make sure they know things like meal times and the layout of the building (make sure they have written information in the apartment). Keep in mind that the move day can be tiring, so it may help to do a basic orientation but repeat this again and spread out some of the introductions and activities.

3. Consider hiring a home health caregiver/companion to help with little tasks as well as to encourage getting out to some of the activities. That person can help with a continued orientation tour as well as remind your loved one about activities and encourage “let’s check it out”. If your loved one had caregivers in the home prior to moving, make a transition plan. He or she may have become pretty attached to regular caregivers and to end this relationship suddenly only exacerbates the changes taking place.

4. Depending on the person/circumstances, help complete change of address cards to friends and family and think about holding an “open house” or small lunch or dinner party for family members and friends. This puts the move in a more positive light and can help those friends and family members gain comfort with visiting.

5. Do your best to ensure the staff know your loved one…their past, their personality, routine, and preferences. We all relate better when we know more about someone and you can help staff connect better with your loved one, as well as perhaps identify other residents who may share commonalities. Some questions you may want to ask when exploring facilities: “How do you handle the move-in day? How do you help staff and other residents get to know my loved one and vice versa? What do you find helps with the transition?” You’ll get a gut feeling about the facility when you hear the answers to these questions.

6. Figure out ways to maintain familiar habits, preferences, surroundings. Personal items and the physical environment provide comfort, but a person’s routine and habits provide comfort too. There may even be an outside community activity that you can plan to help your loved one continue, such as arranging transportation to a bridge group in the old neighborhood. Not everyone functions on the same schedule. If your loved one sleeps in or maintains an unusual meal schedule, talk to staff about how a different schedule can be accommodated.

What are some of the ways an Aging Wisely Florida geriatric care manager can help with the move to Assisted Living?

• Most importantly, we provide expertise and guidance to help you and your family make the best decision on the most appropriate Florida Assisted Living Facility. We know the facilities, we don’t accept referral fees, we see the care provided as patient advocates, and we can help you navigate the many options.

• We also help with things like understanding fees and the admissions process, negotiating fees and financial assistance programs such as Medicaid and Veteran’s benefits such as VA Aid and Attendance.

• Our care managers’ social work and gerontology backgrounds can be put to use as you approach the conversation and transition with your elderly loved one. Read Mark’s story on our client testimonials page for an example of an Aging Wisely care manager’s assistance with a “loving intervention” to get Mom help.

• We can help you with the preliminary planning, including making referrals/setting up movers and all of the different assistance you might need (i.e. estate sales help, realtors, senior move managers).

• We help plan the move day and anticipate ways to make the smoothest transition. Our care managers often assist families throughout the day and help orient clients to the new environment.

• We provide advocacy and oversight services, especially for families at a distance. We can check in on a regular basis with your loved one, review care charts, update medical records and attend doctor’s appointments and troubleshoot any issues that arise, as well as keep you fully informed. For our clients, we are on-call 24/7 for emergencies also.

CONTACT US today for help choosing the best Assisted Living Facilities in the Tampa Bay, Florida area for your loved one or for your questions about eldercare, Medicare/Medicaid and resources for senior care.

A Tale of Two Transitions: My Divergent Stories about Helping Aging Parents Move to Assisted Living

A few years ago, my widowed mother-in-law began having trouble managing at home. We lived about an hour away and had been called three times when she fell or had a medical crisis and was taken to the emergency room. We also saw that she was limiting her movements in the home to one room and no longer cooking. My husband helped her with bill paying and visited regularly, but it was apparent it was time for a change. We felt the best option, especially as she seemed to be more lonely and isolated, was to find a good Assisted Living Facility closer to us (she refused to move in with us and we were busting at the seams with two teenagers at home anyway).

We asked around among some friends and went on a few tours of local facilities. We fell in love with a beautiful facility about 10 minutes from our home and thought it would be perfect for her. My husband went over to talk to her about what we thought would be best. Well, to put it mildly, the conversation did not go well. She felt blind-sided and had a lot of reasons why a move was “impossible”. My husband listened to her and decided to regroup and perhaps approach this slowly over time, i.e. “work on her”. I think a lot of her initial reluctance was fear and feeling overwhelmed with such a big change. We did eventually convince her and took her for a visit to the assisted living facility. She was very quiet and later told us she felt it was “awfully fancy”. We thought it was gorgeous and wanted to move in ourselves! We knew we’d have to help contribute some money to her monthly costs, but figured with the time we were spending running back and forth to her home, it would be worth it.

We arranged movers, helped go through her things (completely exhausting both her and us with the emotional draining process) and set up the move. The day of the move was not so great. She was upset; we were busy trying to arrange everything and we felt less than welcomed at the facility. They had a nice flower arrangement for her, and helped with logistics but things were fairly disorganized. Unfortunately, we arrived just after lunch (but without having had any ourselves) so we had to run out and get something for her as she missed the facility’s lunch time. Eventually, she began to settle in but remained reluctant to participate in the many activities offered. She began to need more assistance, and her fees went up quite a bit to get her the extra help. We realized our idea that we’d be saving so much time and stress were slightly off the mark, as we were at the assisted living facility or in touch with them almost every day.

She began having more medical issues and had a number of hospitalizations. At one hospitalization, we spoke to the facility staff and they felt her needs were beyond what they could handle, unless she got additional private-pay caregivers for many hours. She and we could not afford this. It was only later that we even began finding out about any options for financial assistance, some of which would have helped with better planning initially. The decision was made for her to move to a nursing home. Again, we were in the dark about which places were good but we looked up some information on the internet and picked a place. It did turn out to be a good place with good staff, but we were feeling very unsettled and anxious trying to make all these decisions. She never really recovered from her recent health issues and we lost her within a few months. I think we did all we could with what we knew and we certainly worked hard to do the best for her, but we learned quickly that you rarely “know what you don’t know” and we were in the dark about a lot of eldercare options and Florida aging services resources that could have helped.

Part 2:
As most of us “Boomers” can relate, this was not the end of our years of “caregiving” as my Mom and Dad were a bit younger but also beginning to have more health difficulties. After our prior experiences, we sat down and talked through a lot of these healthcare and aging issues with Mom and Dad. We asked them what they wanted should they need help and opened up a discussion about the financial side of things, so that we had a better idea where things stood for them and could begin doing a little research. We made sure they had their advance directives and legal paperwork in place and got introduced by them to their attorney and financial advisor. After Mom had a stroke, her financial advisor suggested we may want to meet with a professional who helps with aging issues, a geriatric care manager. We set up a consultation appointment with Aging Wisely. Mom wasn’t able to attend this first appointment, but Dad came along.

We filled out some paperwork before the appointment and had a great first meeting. It was reassuring to know we were talking to a Florida senior care expert, but one who wasn’t working for a particular facility and could help with anything from home care to assisted living to financial resources. We got some recommendations and began implementing them to get Mom home safely from the hospital. We decided after a couple months to hire the geriatric care manager to help oversee things and attend Mom’s neurology follow up appointments (in this case we lived over an hour away and we also knew the care manager had a better handle on the questions to ask and how to advocate for Mom). Mom and Dad had some wonderful caregivers to help them at home and the care manager had a number of suggestions which helped with their various needs. The biggest comfort was probably just knowing that if a crisis arose, I could pick up the phone and have an expert right there to help me (or even console me as I felt I was boring my friends with the constant stories and woes).

A couple years later, we were at a transitional point again as Mom’s health had worsened and both were feeling overwhelmed with the household. We delved once again in to the world of finding a good assisted care facility and making the transition. This time it was an all together different experience. Our care manager already knew Mom and Dad and helped us to quickly narrow down the options that were not only quality places, but the right fit for Mom and Dad’s needs (which can be even harder when trying to accommodate a couple, at varying care levels). Our care manager arranged for tours/lunches at each of the facilities for Mom and Dad and they felt very involved in the decision.

It is almost too much to list, but here are a few of the other things the Aging Wisely care manager did for us:
• Reviewed the payment options/contract and helped us ask important questions to ensure understanding, as well as negotiate some of the fees related to the move.
• Connected us with the local Veterans Service Office to begin the process of applying for Veteran’s Aid and Attendance benefits.
• Helped us map out the move process and move day to make it less stressful for everyone.
• Made arrangements the day of the move to reduce the stress on Mom and Dad as well as introduce them to their new home (and suggested things like how to integrate their favorite caregivers as they made the transition).

I share this story because I want others to know there are options. You care for your loved ones and will do the best job you can, but sometimes doing the best job means knowing who can help you. A professional knows the questions you won’t even think to ask. An independent advocate made such a difference to our family and I know they can for yours as well. When it comes to eldercare and resources for the elderly in the Tampa Bay/Pinellas County, Florida area, Aging Wisely is the go-to resource.

We appreciate being able to share stories from caregivers and welcome contributions that may help other families facing caregiving and eldercare concerns. Contact us at 727-447-5845 about sharing your story, or for more information and assistance with caregiver consultations and Florida geriatric care management and senior care services.