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Aging Wisely November, 2011 | Aging Wisely

How do I know Mom’s okay? Warning Signs for Long-Distance Elder Caregivers

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telephone call to older adult

Aging Wisely receives many calls from family members all across the United States who have concerns about an elderly relative(s) living in Clearwater/Tampa Bay. Sometimes there has been a crisis such as a fall or hospitalization, or the loved one is trying to find out what eldercare resources and aging services exist in Florida. Many times the son or daughter is just concerned about Mom or Dad, perhaps after a recent visit in which things seem to have changed.

We have previously shared some resources to help caregivers with this topic:

Warning Signs for Family Members (Am I in Denial about Potential Problems?) & Resources to Help

10 Warning Signs of Dementia/Alzheimer’s Disease

Tips for Long-Distance Caregivers: What to do on a visit with your aging loved one

Signs and Symptoms of Depression in Older Adults

With the holidays (and wintery weather up north), this is a time of year when many long-distance family members visit their loved ones in Florida so we felt it was important to revisit this topic and offer some advice and tips. If you notice any of the signs in the articles above or see major changes in your loved one, it may be time to consider setting up an eldercare consultation, getting a geriatric care management assessment and/or bringing in some in-home senior care to ensure safety and wellbeing.

Here are some pointers about how you can prepare to handle concerns as a long-distance caregiver:

• Ask your parent, for planning purposes, if they are willing to introduce you to key professionals who you may have to interact with in case of an emergency or change. Find out for example, if your parent is willing, what various doctors’ offices need so that you are permitted to receive information (a healthcare surrogate document is important for you to act on someone’s behalf, but you may also need to assist your parent while he or she is still competent and typically the doctor’s office has a privacy form on which the patient can permit access). Get contact information for professionals such as your parent’s financial advisor and CPA and get introduced or attend an appointment if feasible.

• Has your parent executed advanced planning documents to allow someone to step in to make decisions when needed?

• Is your parent close with neighbors? Make sure they have your contact information in case of an emergency. Be conscious of not relying unrealistically on neighbors, however.

• Does your parent have a File or Vial of Life? This is information posted for emergency personnel, which includes emergency contact persons, medications, and conditions/diagnoses. Your local fire department and the Red Cross can usually provide the File or Vial of Life (The Vial is a medication-like vial that goes inside the refrigerator with the information inside, and a red dot to alert medical personnel that it is there, whereas the File of Life is a magnetic pouch which is placed on the refrigerator door). You may also contact Aging Wisely and we can provide you a complimentary File of Life.

• Consider installing a personal emergency response system (system to call for help).

• What type of plan do you have in place for checking in? Consider setting up a schedule of visits with various family members as well as checking in via telephone. A home health caregiver coming in weekly can also help ensure someone is there regularly and can help your parent with tasks he or she finds difficult.

Noticed some concerns on your recent visit or call with your elderly parent? Want to talk to someone about how to address your concerns with your loved one? Think it may be time to get a geriatric assessment to really get a pulse on how your aging parent is managing?

Contact Aging Wisely for answers, advice and peace of mind.

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Warning Signs & Tips for Long-Distance Elder Caregivers

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telephone call to older adult

How do I know Mom’s okay?

Aging Wisely receives many calls from family members all across the United States who have concerns about an elderly relative(s) living in Clearwater/Tampa Bay. Sometimes there has been a crisis such as a fall or hospitalization, or the loved one is trying to find out what eldercare resources and aging services exist in Florida. Many times the son or daughter is just concerned about Mom or Dad, perhaps after a recent visit in which things seem to have changed.

We have previously shared some resources to help caregivers with this topic:

Warning Signs for Family Members (Am I in Denial about Potential Problems?) & Resources to Help

10 Warning Signs of Dementia/Alzheimer’s Disease

Tips for Long-Distance Caregivers: What to do on a visit with your aging loved one

Signs and Symptoms of Depression in Older Adults

With the holidays (and wintery weather up north), this is a time of year when many long-distance family members visit their loved ones in Florida so we felt it was important to revisit this topic and offer some advice and tips. If you notice any of the signs in the articles above or see major changes in your loved one, it may be time to consider setting up an eldercare consultation, getting a geriatric care management assessment and/or bringing in some in-home senior care to ensure safety and wellbeing.

Here are some pointers about how you can prepare to handle concerns as a long-distance caregiver:

• Ask your parent, for planning purposes, if they are willing to introduce you to key professionals who you may have to interact with in case of an emergency or change. Find out for example, if your parent is willing, what various doctors’ offices need so that you are permitted to receive information (a healthcare surrogate document is important for you to act on someone’s behalf, but you may also need to assist your parent while he or she is still competent and typically the doctor’s office has a privacy form on which the patient can permit access). Get contact information for professionals such as your parent’s financial advisor and CPA and get introduced or attend an appointment if feasible.

• Has your parent executed advanced planning documents to allow someone to step in to make decisions when needed?

• Is your parent close with neighbors? Make sure they have your contact information in case of an emergency. Be conscious of not relying unrealistically on neighbors, however.

• Does your parent have a File or Vial of Life? This is information posted for emergency personnel, which includes emergency contact persons, medications, and conditions/diagnoses. Your local fire department and the Red Cross can usually provide the File or Vial of Life (The Vial is a medication-like vial that goes inside the refrigerator with the information inside, and a red dot to alert medical personnel that it is there, whereas the File of Life is a magnetic pouch which is placed on the refrigerator door). You may also contact Aging Wisely and we can provide you a complimentary File of Life.

• Consider installing a personal emergency response system (system to call for help).

• What type of plan do you have in place for checking in? Consider setting up a schedule of visits with various family members as well as checking in via telephone. A home health caregiver coming in weekly can also help ensure someone is there regularly and can help your parent with tasks he or she finds difficult.

Noticed some concerns on your recent visit or call with your elderly parent? Want to talk to someone about how to address your concerns with your loved one? Think it may be time to get a geriatric assessment to really get a pulse on how your aging parent is managing?

Contact Aging Wisely for answers, advice and peace of mind.

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Think You’ve Been Admitted to the Hospital? Beware of Observation Status

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In our recent educational series on Medicare, we answered a lot of questions about the Medicare program, the various options for insurance coverage for retirees, some of the most common coverage misconceptions and Florida Medicare plans. One of the topics that most intrigued and surprised our audience was Medicare coverage of a hospital stay and follow up care. A phenomena that we are seeing more and more often is that patients are not being “admitted” but kept under “observation status”, which means they are not considered inpatients at the hospital.

Why is this happening more? There are a number of factors causing this phenomena, including regulatory and payment issues. As Medicare (and private insurers) crack down on hospitals and providers for what might be considered unnecessary care, the providers are more cautious about each case and carefully looking at criteria for admission. There are several sets of criteria that doctors and providers use to analyze the medical necessity of an admission…all of which means little to the average elderly person or caregiver. What you probably think is…”well, I spent the night at the hospital so I was admitted” or “My Mom has been at the hospital a few days now and so this should be like any other hospital stay”.

What’s the difference between being admitted and being under observation? Being admitted to the hospital is not a matter of spending the night, getting a lot of tests and care, etc. A doctor has to write an order specifically admitting you as an inpatient, based on his or her analysis of medical necessity/use of standard criteria. How do you know if you or your loved one has been admitted? Ask your doctor or the hospital to confirm for you. As a caregiver and patient advocate, it is vital to ask a lot of questions and take good notes on the hospital stay anyway, and it can come in handy for billing issues as well. If you are not comfortable with what questions to ask or reviewing a medical chart, consider the value of a professional patient advocate.

What difference does it make?
The main reason to know about your status at the hospital is the potential costs you will face. Here is Medicare’s summary of what you will pay if you are not admitted to the hospital: “Medicare Part B covers outpatient hospital services. Generally, this means you pay a copayment for each individual outpatient hospital service. This amount may vary by service. Note: The copayment for a single outpatient hospital service can’t be more than the inpatient hospital deductible. However, your total copayment for all outpatient services may be more than the inpatient hospital deductible”. As an inpatient, you are covered under Medicare Part A, which has a deductible of $1132 ($1156 in 2012) for any stay up to 60 days. In addition, for Medicare to cover inpatient rehabilitation/nursing care, a person must have a three-day qualifying hospital stay. If you are not admitted to the hospital, you will not qualify. Each day in inpatient rehabilitation can cost hundreds of dollars, so this care can be quite costly to pay out of pocket when you may need this follow-up care for recovery.

Click here for Medicare’s overview of Hospital Inpatient vs. Outpatient Status.

Click here to read Aging Wisely’s Medicare 2012 fact sheet, with all of the Medicare costs and important information about coverage.

Contact us today for information and assistance with Medicare analysis and consultation, patient advocacy and eldercare/geriatric care management services in Tampa Bay/Clearwater, Florida.

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Medicare and Hospital Costs: Beware of Observation Status

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Think you’ve been admitted to the hospital?

In our recent educational series on Medicare, we answered a lot of questions about the Medicare program, the various options for insurance coverage for retirees, some of the most common coverage misconceptions and Florida Medicare plans. One of the topics that most intrigued and surprised our audience was Medicare coverage of a hospital stay and follow up care. A phenomena that we are seeing more and more often is that patients are not being “admitted” but kept under “observation status”, which means they are not considered inpatients at the hospital.

Why is this happening more? There are a number of factors causing this phenomena, including regulatory and payment issues. As Medicare (and private insurers) crack down on hospitals and providers for what might be considered unnecessary care, the providers are more cautious about each case and carefully looking at criteria for admission. There are several sets of criteria that doctors and providers use to analyze the medical necessity of an admission…all of which means little to the average elderly person or caregiver. What you probably think is…”well, I spent the night at the hospital so I was admitted” or “My Mom has been at the hospital a few days now and so this should be like any other hospital stay”.

What’s the difference between being admitted and being under observation? Being admitted to the hospital is not a matter of spending the night, getting a lot of tests and care, etc. A doctor has to write an order specifically admitting you as an inpatient, based on his or her analysis of medical necessity/use of standard criteria. How do you know if you or your loved one has been admitted? Ask your doctor or the hospital to confirm for you. As a caregiver and patient advocate, it is vital to ask a lot of questions and take good notes on the hospital stay anyway, and it can come in handy for billing issues as well. If you are not comfortable with what questions to ask or reviewing a medical chart, consider the value of a professional patient advocate.

What difference does it make? The main reason to know about your status at the hospital is the potential costs you will face. Here is Medicare’s summary of what you will pay if you are not admitted to the hospital: “Medicare Part B covers outpatient hospital services. Generally, this means you pay a copayment for each individual outpatient hospital service. This amount may vary by service. Note: The copayment for a single outpatient hospital service can’t be more than the inpatient hospital deductible. However, your total copayment for all outpatient services may be more than the inpatient hospital deductible”. As an inpatient, you are covered under Medicare Part A, which has a deductible of $1132 ($1156 in 2012) for any stay up to 60 days. In addition, for Medicare to cover inpatient rehabilitation/nursing care, a person must have a three-day qualifying hospital stay. If you are not admitted to the hospital, you will not qualify. Each day in inpatient rehabilitation can cost hundreds of dollars, so this care can be quite costly to pay out of pocket when you may need this follow-up care for recovery.

Click here for Medicare’s overview of Hospital Inpatient vs. Outpatient Status.

Click here to read Aging Wisely’s Medicare 2012 fact sheet, with all of the Medicare costs and important information about coverage.

Contact us today for information and assistance with Medicare analysis and consultation, patient advocacy and eldercare/geriatric care management services in Tampa Bay/Clearwater, Florida.

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Senior Care for Veterans

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Veteran’s Benefits Veteran's Day

There are a number of benefit programs designed to help our Veterans, but the system can often be complex to navigate. In honor of Veterans Day, we wanted to give an overview of some of the programs that are most applicable to aging veterans, or senior veterans needing care, medical help and other assistance as they age or deal with the progression of disabilities. This is not meant to be an exhaustive list of all benefits and all the details, but we will also provide some resources to continue your research. Many times elder clients, veteran or not, can benefit from starting with a care management assessment or family members may wish to take advantage of one of our eldercare consultations to pinpoint the variety of resources that might be available to help.

To start, one of our favorite resources in the state of Florida to help with Veterans’ Benefits is the county Veterans Services office. Each county in Florida has such an office, run by the county government, to help local Veterans navigate and access benefits. Here is information for the local county Veterans Services offices in Tampa Bay, Florida:

Pinellas County Veterans Service Office website
Main Office
2189 Cleveland St., Suite 201,
Clearwater, FL 33765
(727) 464-8460

St Petersburg Office
501 1st Avenue N., Suite 517,
St. Petersburg, FL 33701
(727) 582-7828

Pasco County Veterans Service Office website
West Pasco: 8620 Galen Wison Boulevard
Port Richey, FL 34668
(727)834-3282

East Pasco: 13853 15th Street
Dade City, FL 33525
(352)521-5172

Hillsborough County Veterans Affairs website
Flier with map and contact information for Hillsborough County Veterans Affairs offices.

Compensation and Pension: Some of the most common benefits provided to our elderly Veteran clients are in the Compensation and Pension category. As a brief overview: You may receive a monthly compensation if you are at least 10 percent disabled as a result of your military service. Also, you may receive a monthly pension if you are a wartime veteran with limited income and assets and are permanently and totally disabled or at least 65 years old. Many of our clients who do not have a disability rating from their wartime service are able to benefit from the pension as they age. The eligibility is based on having limited assets and income, but these requirements are typically less stringent than, for example, Medicaid qualifications.

Specifically, there are additional pension levels called “Aid & Attendance” and “Homebound” which provide higher benefit amounts for individuals needing care and assistance, which take in to account the Veteran’s medical/care expenses. Spouses/widows may also be eligible for pensions. Here is the VA page about Compensation and Pension Benefits for Veterans.

Additionally, Veterans who require Nursing Home care (not Assisted Living) due to a service-connected disability or are 70% to 100% service-connected may receive such care from the VA. Each VA hospital in the Tampa Bay area (Tampa and St. Petersburg/Bay Pines) has a nursing home. The VA hospitals each have one or more “contract” nursing homes in each county of their catchment areas. For example, Pinellas County has 17 contract nursing homes in the Bay Pines VA Hospital catchment area.

Veterans’ Health Care: There are several different ways to qualify to receive healthcare through the VA and at the VA medical centers and clinics across the country. To learn more, visit the Veterans Service Office or read more at the VA website link regarding healthcare.

Burial Allowances/Funeral Benefits: VA burial allowances are partial reimbursements of an eligible veteran’s burial and funeral costs.

How Much Does VA Pay?
Service-Related Death. VA will pay up to $2,000 toward burial expenses for deaths on or after September 11, 2001. VA will pay up to $1,500 for deaths prior to September 10, 2001. If the veteran is buried in a VA national cemetery, some or all of the cost of transporting the deceased may be reimbursed.

Nonservice-Related Death. VA will pay up to $300 toward burial and funeral expenses and a $300 plot-interment allowance for deaths on or after December 1, 2001. The plot-interment allowance is $150 for deaths prior to December 1, 2001. If the death happened while the veteran was in a VA hospital or under VA contracted nursing home care, some or all of the costs for transporting the veteran’s remains may be reimbursed.

For more on this, read the VA’s document on burial help or one of the county service offices.

We salute our Veterans for all that you have done for this country! It is our honor to serve Veterans and to help all of our elder clients to access the help and resources they need. Contact us at 727-447-5845 today for questions and assistance.

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Medicare: What Might Surprise You

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If you are a Medicare recipient or a caregiver who helps an aging parent with medical, financial or care needs, it is important that you understand Medicare coverage, options, restrictions, etc. We talk to many family members who care for aging parents and are surprised by needs that Medicare does not cover. To get a concise overview of the various parts of Medicare and what each covers, start with our Medicare Fact Sheet (with 2012 Medicare co-pays and deductible information). Contact us for printed copies of this information and Medicare educational materials or seminars, if you have a support group, community group, or clients with whom you’d like to share this information.

We are currently in one of Medicare’s annual open enrollment periods. This year, from October 15th to December 7th, Medicare recipients can switch Medicare drug plans (Part D) and switch to or from a Medicare Advantage plan. Each Medicare recipient or caregiver should review their current coverage during this period. Plans make changes and it is likely you or your loved one has had some health changes, which may cause a different plan to be more appropriate for you. The changes you make become effective on January 1st. Additionally, from January 1st-February 14th, those enrolled in a Medicare Advantage plan can disenroll and switch back to regular Medicare (this is the only change that can be made during that period).

Medicare Advantage Plans are an option for receiving various Medicare benefits via a private insurance company. Typically, these plans will have preferred providers or networks (or providers may not accept the coverage due to the reimbursement rates) and may require a primary care physician or have other restrictions. They may also include additional benefits such as eye or dental care or gym memberships, and the deductibles, co-pays, etc. are usually less expensive for the recipient. If a person is enrolled in a Medicare Advantage Plan and is not pleased with the plan’s coverage and choices, there are several special enrollment periods to make changes.

You may, for example, be caring for an aging parent who is enrolled in a Medicare Advantage plan and becomes hospitalized. After the hospital stay, he/she may need inpatient rehabilitation care at a Skilled Nursing Facility. However, the Medicare Advantage Plan may have limited skilled nursing facilities within the network and you may not be pleased with the options. In that situation, there is what is known as the OEPI (Open Enrollment Period for Institutionalized Individuals). Persons “institutionalized” (i.e. residing in or moving in and out of a skilled nursing facility and other eligible institutions) have a continual enrollment period. The person can disenroll from a Medicare Advantage plan while in the facility and return to regular Medicare (or a different MA if accepting enrollment) the beginning of the next month.

There are other special enrollment periods for those wishing to switch plans, including a “trial period” when you first sign up for a Medicare Advantage Plan of 12 months, in which you can disenroll and switch back to standard Medicare at any time during that period. If you are concerned about coverage under any plan or do not understand a plan’s coverage decision, it is important to learn about your Medicare rights, including the right to appeal. Medicare and health insurance can be complicated to navigate, so it is vital to be your loved one’s advocate as a caregiver and to seek outside help when you have questions or difficulties.

We will be covering a number of the key issues that surprise caregivers about Medicare coverage in upcoming blog posts so stay tuned, or sign up for the Aging Wisely blog feed to get updates.

On November 17th, we are offering a free educational seminar, The Ins and Outs of Medicare, in honor of National Family Caregivers Month. Come learn more about Medicare coverage, questions to ask and how to better understand your coverage. We navigate the healthcare system every day with our clients, so let our expertise benefit your family.

If you would like help analyzing your Medicare plan during this year’s open enrollment period, or you are preparing to retire and want a complete analysis of your options and what you need to do regarding Medicare coverage, call us today at 727-447-5845 or fill out our contact form to discuss our Medicare Analysis services.

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Medicare Assistance: Learn the Ins and Outs

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If you are a Medicare recipient or a caregiver who helps an aging parent with medical, financial or care needs, it is important that you understand Medicare coverage, options, restrictions, etc. We talk to many family members who care for aging parents and are surprised by needs that Medicare does not cover. To get a concise overview of the various parts of Medicare and what each covers, start with our Medicare Fact Sheet (with 2012 Medicare co-pays and deductible information). Contact us for printed copies of this information and Medicare educational materials or seminars, if you have a support group, community group, or clients with whom you’d like to share this information.

We are currently in one of Medicare’s annual open enrollment periods. This year, from October 15th to December 7th, Medicare recipients can switch Medicare drug plans (Part D) and switch to or from a Medicare Advantage plan. Each Medicare recipient or caregiver should review their current coverage during this period. Plans make changes and it is likely you or your loved one has had some health changes, which may cause a different plan to be more appropriate for you. The changes you make become effective on January 1st. Additionally, from January 1st-February 14th, those enrolled in a Medicare Advantage plan can disenroll and switch back to regular Medicare (this is the only change that can be made during that period).

Medicare Advantage Plans are an option for receiving various Medicare benefits via a private insurance company. Typically, these plans will have preferred providers or networks (or providers may not accept the coverage due to the reimbursement rates) and may require a primary care physician or have other restrictions. They may also include additional benefits such as eye or dental care or gym memberships, and the deductibles, co-pays, etc. are usually less expensive for the recipient. If a person is enrolled in a Medicare Advantage Plan and is not pleased with the plan’s coverage and choices, there are several special enrollment periods to make changes.

You may, for example, be caring for an aging parent who is enrolled in a Medicare Advantage plan and becomes hospitalized. After the hospital stay, he/she may need inpatient rehabilitation care at a Skilled Nursing Facility. However, the Medicare Advantage Plan may have limited skilled nursing facilities within the network and you may not be pleased with the options. In that situation, there is what is known as the OEPI (Open Enrollment Period for Institutionalized Individuals). Persons “institutionalized” (i.e. residing in or moving in and out of a skilled nursing facility and other eligible institutions) have a continual enrollment period. The person can disenroll from a Medicare Advantage plan while in the facility and return to regular Medicare (or a different MA if accepting enrollment) the beginning of the next month.

There are other special enrollment periods for those wishing to switch plans, including a “trial period” when you first sign up for a Medicare Advantage Plan of 12 months, in which you can disenroll and switch back to standard Medicare at any time during that period. If you are concerned about coverage under any plan or do not understand a plan’s coverage decision, it is important to learn about your Medicare rights, including the right to appeal. Medicare and health insurance can be complicated to navigate, so it is vital to be your loved one’s advocate as a caregiver and to seek outside help when you have questions or difficulties.

We will be covering a number of the key issues that surprise caregivers about Medicare coverage in upcoming blog posts so stay tuned, or sign up for the Aging Wisely blog feed to get updates.

On November 17th, we are offering a free educational seminar, The Ins and Outs of Medicare, in honor of National Family Caregivers Month. Come learn more about Medicare coverage, questions to ask and how to better understand your coverage. We navigate the healthcare system every day with our clients, so let our expertise benefit your family.

If you would like help analyzing your Medicare plan during this year’s open enrollment period, or you are preparing to retire and want a complete analysis of your options and what you need to do regarding Medicare coverage, call us today at 727-447-5845 or fill out our contact form to discuss our Medicare Analysis services.

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Payment Concerns
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How to keep a loved one safe at home, and when it may be time to consider assisted living.




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Our goal is to enable every individual we work with to live the most fulfilling life possible, with utmost dignity, focusing on their physical, mental, spiritual, family and financial wellbeing.