ElderCare Transitions

Let’s talk about…Medicare and Medicaid.

These two programs are both government programs that do very different things and yet I frequently hear people use the terms either together or interchangeably.  It is very important as you age OR if you care for a loved one who is aging, that you understand what the programs are and what the critical differences are.

Let’s cover Medicare first.  By definition:

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). 

Medicare has Parts A & B – generally speaking Medicare part A is what covers your hospital stay and if necessary, any rehabilitative stay for recovery from surgery/accidents/fractures.  You may choose to complete rehabilitation in an acute rehab facility or a skilled nursing facility (SNF).  Part B covers outpatient costs, physician visits, etc. 

Now, let’s define Medicaid.  By definition:

Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

The website for finding the answers to any questions you may have is https://www.medicare.gov/ .

What is most important for you to understand is that these funding sources are available for hospital stays, rehabilitation stays and for people who require skilled services in a skilled nursing facility or within the home.  If you peruse the website referred to above, you can get a better understanding of what a “skilled service” is...or more importantly, what a “skilled service” is NOT.

As many seniors strive to “age in place”, you may notice areas of need. Providing light housekeeping or assistance with personal care “just to get the day started” or providing meal preparation or doing laundry or managing medication may be just what an aging loved one needs to stay in their home. There are many agencies that provide in-home assistance.  And while the help listed above is necessary and can be provided in your home, it is NOT a skilled service and therefore, would be considered private pay.

The same is true for personal care homes and assisted living facilities.  These facilities are not providing “skilled services” by definition – and are private pay.

Understanding Medicare and Medicaid funding and how you financially cover your health costs as you age requires a thorough understanding of the funding sources and a thoughtful plan.

If you need help starting that conversation, let’s talk!

Let’s talk about…Holidays & Reminiscing.

It’s no surprise that as the holidays near, older family members like to reminisce about the past.  Funny stories, favorite memories, most loved traditions are all a part of the holiday season and the special place the holidays hold in their hearts. 

While Mom and/or Dad may be content to reminisce, you may be feeling the stress and anxiety that frequently accompany the preparation for the holidays. Your idea of reminiscing may be muttering “Please don’t let me forget to thaw the turkey like I did two years ago” or “Remember when Uncle Mark showed up an hour late and forgot to bring the wine?” You may fill in the blank___________ with what may add stress to your holiday gatherings.

There is no doubt that the frenetic pace of our lives can make for stress throughout the holiday season.  Generations blended for a holiday gathering can add to the stress:

• Mom & Dad may be less helpful but still want to feel needed
• College age children want to visit with friends they haven’t seen for weeks – not hang with “the old people”
• High schoolers and “tweens” are busy with their social schedule(s) and social media is always calling
• Youngsters may be enamored with the newest video games available for hours of entertainment

So NOW, let’s get back to the idea of reminiscing – and how it can be a powerful and wonderful way to reach across the generations.

• Talk about the family recipes or food traditions – and have mom/dad talk about how the traditions were started when they were children.
• Go through family picture albums or scrapbooks – and talk about how special those times were.  Perhaps even share the memories of how each of you felt as your family continued to grow.
• Share thoughts of thankfulness and gratitude at the dinner table.

However you choose to reminisce with your older loved ones, know that reminiscing is a meaningful and powerful way for them to feel that their age and wisdom are appreciated and valued…that their voice is still being heard.  That may be the greatest gift they receive this season – someone to listen as they reminisce.

If you would like more ideas of how to make that happen, let’s talk!

Let’s talk about…”Senior Moments.”

Now this is a phrase that is growing in popularity and one that is recognized across generations – “Senior Moment.”   You may have used the phrase yourself – perhaps when you couldn’t find your car keys or couldn’t remember why you walked into a room.  I could offer many examples but you understand the point.  The question becomes - when is it simply a “senior moment” and when is it something more significant? 

Understanding and differentiating natural changes within the aging process, memory loss, and possible presence of dementia requires the help of professionals.  There are several screening and/or assessment tools that are used to determine if you or your loved one is having something more than a “senior moment”.  One of the most recognizable is the Mini-Mental Status Examination (MMSE).  Many physicians and their staff will incorporate this exam into their routine physicals with elderly clients or those they suspect may be experiencing cognitive changes – a condition sometimes referred to as Mild Cognitive Impairment.  Another tool that some consider a more sensitive instrument is the St. Louis University Mental Status (SLUMS) Examination.  The SLUMS provides a scoring range for normal, mild neurocognitive disorder or dementia and has some sensitivity based on the individual’s level of education. Both exams are brief and are meant to be only screening tools.  

If the results from either test suggest the presence of cognitive impairment and/or dementia, a thorough assessment should be completed.  By identifying skills that are diminished AND skills that remain intact, a plan can be developed that will enhance an individual’s ability to participate in life with purpose and dignity.

If you need help starting the conversation, let’s talk!