Deciding When it is Time for Hospice.

The Medicare rules for hospice services require certification from 2 physicians to verify that the individual is expected to live 6 months or less, if the disease runs its natural course. Usually, the 2 physicians would include the individual’s primary care physician. This is the person that you would want to consult with first. The other physician can be the medical director of the hospice agency. 

It is expected that anyone who receives hospice services will no longer receive any life saving treatments, such as chemotherapy. The focus will then become the alleviation of physical, emotional, and social symptoms. Hospice can provide some valuable end-of-life services for patients and families.

The 6 month rule does not mean that if the individuals do not die in 6 months, they can no longer receive hospice. It just means that they need to be recertified by the hospice agency.

If one is not quite ready to make the decision for hospice services, it does not hurt to investigate obtaining palliative care services that focus on alleviation of symptoms experienced with diseases and their treatments. Receiving palliative care does not automatically disqualify one from continued life saving treatment.

My book, Healthcare Handbook For Senior Citizens and Their Families, provides more details about Hospice services and end-of-life care. See my website http://www.seniorhealthbook.com. Also, you can find information about the hospice regulations on the Centers for Medicare and Medicaid Services CMS website (www.cms.gov).

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Do Not Forget Home Health Care Can Be An Option.

If you or a loved one is being discharged from a hospital or care facility, be aware that if you run into problems caring for yourself after you get home, home health care is a good option. The doctor or nurse may ask you if you need a home health visit before you are discharged. At that time you may not see the need for a visit, but that does not mean that you can not change your mind after you get home. Also, do not assume that the doctor will automatically refer you, if you qualify. The doctor does not always know if your home situation would call for a home visit. Home Health agencies will make an evaluation visit to see if there is a skilled need and if your health insurance will cover the visits. Frequently, it only takes a few visits to help you adjust your care. My book, Healthcare Handbook for Senior Citizens and Their Families discusses the requirements for reimbursement for home care services.

Financial Assistance for Skilled Nursing Facilities and Assisted Living

A common question that is asked on discussion websites for caregivers is: Where do I get financial assistance for Skilled Nursing Facility or assisted living care?

My book: Healthcare Handbook for Senior Citizens and Their Families, describes the types of facilities available for assistance and care. It also discusses the different payer sources and their rules and regulations.

There are many sources available for financial assistance but the assistance depends upon the types of services required for the individual and that person’s financial situation. Regular health insurance and Medicare usually will not pay for care, if the need is only for assistance with activities of daily living, such as bathing and meals. Unfortunately, there are many people in their final years who fit in that category. Often this care is what drains individuals’ and/or couples’ savings.

Throughout the book, I encourage purchasing Long Term Care Insurance. The sooner you get it, the cheaper it will be. Many of these insurances cover care in a nursing home, assisted living or at home.

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Take care when shaking hands with Seniors.

In recent years, I have noticed that some people have the habit of giving an extra squeeze at the end of their hand shake. Probably I have noticed this lately because I have developed some arthritis in my hands. That extra squeeze causes some pain, to the point that I have begun to hesitate shaking hands. 

A firm handshake does not seem to be a problem; it is that extra squeeze that hurts. I think that people who give an extra squeeze with their handshakes do it to show that they are sincere. I have noticed that most of the ‘extra squeezers’ are men, however there are some women who have this habit.

Have any other seniors experienced this problem?

Protections against Antibiotic Resistant Infections (continued)

Another precaution against antibiotic resistant infections is the proper use of antibiotics. One reason that we are seeing more antibiotic resistant infections is because of the overuse of antibiotics.

I live near the Mexican border. It is common practice for people to go across the border to buy antibiotics, when they have a ‘bad’ cold or flu, These conditions are usually caused by a virus and unaffected by antibiotics.

One should only take an antibiotic when it is ordered by their physician or health care provider. When taking an antibiotic, you need to take the full course of the prescription, otherwise the organism will not be killed.

These practices contribute to the organisms developing increased resistance to the antibiotics.

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