Frequently asked medical questions and their answers.
Q: I would like to have my family know what kind of care I want if I no longer can make decisions for myself. How do I do that?
A: Advance care planning is important for every family, not just for seniors, so that they are prepared in the event of a sudden illness, or as a chronic illness progresses. Some people have their attorneys draft a “medical power of attorney” when they do their wills. You can also get information and forms from New York State.
Q: My mother is currently in the hospital and I do not think she can care for herself at home. What can I do?
A: First, talk to all the members of the family about what kind of help you think your mother will need and what personal and financial resources are available. Talk to the discharge planner (social worker or a care coordinator) in the hospital as soon as possible about whether your mother can benefit from rehabilitation or home health services in the short term while you are determining a more permanent solution regarding assisted living, personal care at home, or a skilled nursing facility.
Q: I can take care of myself at home, but I recently gave up driving. How can I find transportation to medical appointments?
A: Transportation is a big problem for many people and there is no ideal situation.
Medicaid does fund and provide taxi / ambulette transport.
Private pay ambulette services are available, if necessary. However, there are some non- medical resources that might help:
You must call ahead to make appointments.
Q: My Dad has always been very active, but lately, he is just not the same man. He has lost interest in going to his senior center, does not sleep well, lost his appetite and does not have any desire to see his grandchildren. When I try to encourage him to go out, he just says "What's the point? There's nothing to live for."
A: It sounds like your father may be showing signs of depression. He might benefit from a comprehensive assessment by a psychiatrist who specializes in the mental health needs of older adults. Individual and group therapies are also available to enhance the quality of care to help your father regain his enjoyment of life.
Q: My wife is a very intelligent woman, but in the past year or so, I have noticed that her memory is getting worse. She became lost driving home from the supermarket the other day and when I asked her about it, she just laughed and said "what's the big deal? I made it home, didn't I?" Frankly, I am frightened that this could be something serious.
A: Memory loss can be caused by any number of factors. Depending on the accompanying issues, several professionals can provide a full evaluation of your wife's cognitive functioning and offer treatment to address this issue. Financing Care
Q: How do I know if I am eligible for financial benefits and how to apply
A: You can do a quick evaluation on www.benefitscheckup.org and find information about financial aid for drugs, medical care and daily living expenses.
Q: What is the difference between Medicare and Medicaid?
A: Medicare is a federal health insurance program that serves 41million people, 35 million of whom are age 65 or older, and 6 million are under 65 and have permanent disabilities. At least a third of Medicare beneficiaries of all ages—or some 13 million people1—have disabilities or a long-term illness that limits their daily independence. About 7 million of these beneficiaries are retired Americans and their dependents, and the other 6 million Medicare beneficiaries are persons under age 65 who have worked, but have become disabled. Medicare helps to pay for a broad array of routine, acute, and preventive care; rehabilitation, mental health, and home health services; and durable medical equipment essential to the health and independence of such beneficiaries. However, Medicare’s coverage of long-term care is limited to post-acute care through its skilled nursing facility benefit and home health care benefit. Medicaid is often referred to as America’s safety net for its poor. For millions of children, adults, and older Americans with disabilities, it’s that and far more. For someone with a disability, being able to obtain Medicaid services and community living supports can mean: Receiving the personal assistance you need to get out of bed, to eat, to get
dressed, and go about your day. Getting the epilepsy medication your need to control your seizures. Being able to see a mental health counselor to help your depression. Waking up in your own home instead of in a nursing home. Medicaid is a nationwide program funded jointly by the federal government and the states. Medicaid pays for health care, institutional long-term care, and community living services for about 50 million low-income children and their families, people with disabilities, and older persons. No other public or private insurance plan covers such a comprehensive range of health care, institution all ong-term care, and community living services. Because every state plays a significant role in financing Medicaid services, each one has broad discretion in designing and administering its Medicaid program. See this report (PDF Format) for more information about navigating Medicare and Medicaid.
Q: Does Medicare pay for sub-acute rehabilitation?
A: Yes, in specific circumstances. The Medicare Part A benefit includes a benefit for up to100 days in a skilled nursing facility for skilled care, such as restorative rehabilitation, wound care, and IV treatment. To be eligible for this care, the patient must have been hospitalized for three days and require services for the condition for which he or she was hospitalized. Medicare has established specific criteria for eligibility for different skilled services in a skilled nursing (sub-acute) facility. When the need for the skilled services in the facility ends, Medicare coverage also ends. This is often prior to the use of the full 100 day benefit. If the patient remains in the facility beyond the period of Medicare coverage, another source of payment will be needed. When a person qualifies for Medicare in a skilled nursing facility, Medicare will cover the first 20 days in full and all but $119.00 a day (in 2006) from days 21 to 100, provided the Medicare-covered services are needed during that time.
Q: I have a Medicare supplemental insurance policy. Will it cover the charges Medicare does not cover in the skilled nursing facility?
A: Medicare supplemental policies have different levels of benefit and not all cover charges in a skilled nursing facility. You need to check your policy to determine if you have a benefit for coverage in a skilled nursing facility. It is important to remember that Medicare and Medicare supplemental policies do not cover custodial care or convenience items, such as telephone and television services.
Q: What about Long Term Care Insurance? Should I consider purchasing a policy?
A: Long-term Care Insurance can provide much needed financial support for home care or a skilled nursing facility. Policies vary greatly according to beneficiaries age, deductibles and length of the policy. For more information, go to HIICAP.
Q: I still cannot afford my medications, even after enrolling in a prescription drug plan. Is there any other help available?
A: New York State has a very generous prescription drug program, called EPIC. Arranging for Care
Q: My elder refuses to accept help. How can I convince him/her?
A: Most older people refuse help because they feel it will compromise their independence. He is more likely to accept help if it is offered in a way that allows him to make the decisions. Talk over the situation with him; perhaps there are certain tasks that he would appreciate help with, even if they are not the ones you would prioritize. Often, an elder may be concerned about the cost of services. If you can address this issue, perhaps your parent will be more willing. Ultimately, it is important to respect your parent’s right to make his own decisions, if they have the capacity to make them.
Q: There are so many housing options that seem to be called “assisted living” How can I evaluate them?
A: “Assisted Living” is a term that is used to describe an array of housing-service combinations for elderly who need some assistance with their daily activities. They have different licenses and financing arrangements. For more information about services in continuing care facilities, go to The New York Association of Housing and Services for the Aging.
Q: My parents live near me and I shop for them and do their bills. Recently, my father was diagnosed with diabetes and he and my mother are having difficulty understanding how to manage his insulin. I am working and cannot get over there every day. What can I do?
A: Ask your doctor to make a community referral to a Home Health Agency. A nurse will see your parents and reinforce the doctor’s instructions. If you can’t be there on the day that the nurse visits, make sure that your parents sign a confidentiality form that allows you to talk to the nurse about follow-up.
