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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

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.

~ Unknown
 


ElderCareTip
 

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 WarmerBaby 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

Mini-Rant

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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