Elder CareTips:
Mastering The Eldercare Maze™
October 23,
2007

A hearty
welcome to all our new readers. We're glad to
have you along on this up and down ride!
Remember, there's no such thing as a dumb
question, and none of us know what we don't
know.

Hospice Caps May
Restrict Care
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Like most eldercare advisors I
tend to recommend that families consider Hospice
care when a patient seems to have exhausted all
the available medical options. As a rule we
encourage this option as early as possible,
because the support and care offered by most
Hospice agencies is so beneficial to the patient
and their families. Rather than wait until the
end is imminent, we hope that patients and
families will opt for Hospice as soon as they
are eligible.
In 1998 Hospice regulations were loosened to
permit Medicare beneficiaries to receive care
for longer than six months if, in the best
judgment of their physician, their life
expectancy remained at six months or less. This
meant that Hospice patients could be
"recertified" for an unlimited number of 6 month
periods, as long as their life expectancy
remained 6 months or less. Many patients have
received Hospice care for several "certification
periods" under this new rule.
However, things may be changing again, and it is
important to know how Hospice agencies are paid
for their work so you can understand and
hopefully work around any Hospice roadblocks you
may encounter in the future.
Continued >>>

The definition of success is a person who
falls down 99 times but gets up 100 times.
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Grab bars in the kitchen. Why not? Where
do we spend more time on our feet than in the bathroom and
the kitchen? Why should the bathroom get all the
attention? Install a grab bar at the kitchen sink. There's
usually plenty of room between the underside of the
counter and the cabinet doors. A grab bar here will
provide something firm to hold to while loading and
unloading the dishwasher, when reaching up or down into a
cabinet, and just as a steadying point while working.
Another at the stove top wouldn't be a bad idea, either.
Wipes Warmer
Baby
wipes aren't always for babies. Most caregivers find
they come in really handy for those times when you
don't want to do a full bath, but a quick wipe-down is
needed. They're wonderful, that is, until the weather
gets cooler and that cold wipe on warm skin is a
shocker. It may feel great to have a cooling cloth in
the dog days of August, but when it's snowing outside,
think again.
This is a
baby wipes warmer. It keeps wipes warm and moist.
Pull one out and use it right away and it won't be
such a shock to thin elderly skin. Obviously, if you
pull one out and wave it around for a while before you
use it, it'll be like ice. You have to be fairly well
organized and have the container within reach of where
you'll want to use it. Other than that common sense
bit of advice, just add a little water whenever you
add new wipes so they stay moist.
Baby
Wipes Warmer by DEX

I rarely take the opportunity to
strongly express my personal views here. I usually
reserve that for more private venues. However, I had
an experience this week that illustrates why Hospice
agencies are being pressed to admit patients who may
jeopardize the care they can offer to truly deserving
patients.
Background: I am
working with a client who is a practicing Christian
Scientist. He has never used traditional medical care
as most of us know it, and he does not want to start
now. He is a little wobbly (uses a walker), and wants
to accompany his wife (who is accepting medical care)
into an assisted living residence.
The family went to look at a few residences. One (that
I had not recommended) had nice chandeliers. It was a
pretty place. The "nurse" at this facility recommended
that the gentleman be referred to Hospice. That way,
she said, he would not have to have any medical care,
and there would be no questions about the lack a
treating physician in their records.
Here starts the rant:
This facility could easily accommodate the needs of a
resident who is not having medical treatment, even
when the resident is not terminally ill (as this
gentleman is certainly not). There is such a thing as
resident's rights, and no resident is ever required to
accept unwanted care. However, there would be certain
documentation needed to satisfy the State. This nurse
was so unwilling to do the necessary paperwork that
she was willing to send a resident to Hospice care
simply to avoid it. And this in a residence that is
not inexpensive.
The family had the sense to walk away from this
outrageous suggestion. Any ethical Hospice agency
would do the same. But it is this kind of unethical
manipulation that puts access to Hospice care at risk
for those who really need it. Luckily, I wasn't there.
It might have gotten ugly.
If you are ever presented with such a ridiculous
offer, please ask yourself what it might tell you
about the quality of care the residence will really
provide. Any residence willing to do such an unethical
thing will certainly cut corners in other areas that
might not be so obvious.
That's it for this time around.
Live Well!

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