Medical Homes Provide Additional Help for Seniors

Posted on April 17th, 2014

Categories: Affordable Care Act,Aging Advocacy,Caring For Elderly,Health Care Reform,Helping Seniors,Medical,Medical Home,Medicare,Resources

Stethoscope and model houseLast week I received a letter from my clinic telling me they had been certified  as a “health care home” (also called Medical Home).  As such I could have a care coordinator if I needed or wanted one.  This week I want to talk about Medical Homes which are one of the Medicare projects funded by the Affordable Care Act.

A Medical Home is a health care clinic that receives additional Medicare funds in order to more closely manage the chronic health conditions of their patients.  These funds come from the Affordable Care Act.  As I have mentioned in a previous post, this is not new Medicare money; it is money acquired through savings within the Medicare program.

In a health care home clinic, seniors with chronic medical conditions (Diabetes, heart disease, high blood pressure, etc.) are assigned a care coordinator to help them manage their health care.  Medical Home care coordination is defined as care that is coordinated across all elements of the  health care system.  This means that if your clinic is considered a medical home, you will receive help with your care beyond the doctor’s office.  Care coordination is the one service that will probably stand out to caregivers and seniors right away because it’s new, it’s personal and it’s helpful.

One example in which a care coordinator can help you manage your health:  You are diagnosed with congestive heart failure (CHF).  Your care coordinator (assigned by your physician) refers you to a health care technology company.  A nurse from the company brings a special scale to your house for you to weigh on daily; your weight is transmitted to a nurse assigned to monitor it.  If the nurse notices a sudden increase in your weight, your doctor is notified, your doctor prescribes medication to reduce the extra fluid in your body, and a trip to the hospital with a worsening bout of CHF is avoided.  Savings of time, dollars and stress!

In addition to offering care coordination, Medical Homes are required to provide:

  • Health promotion
  • Follow-up care after a hospitalization
  • Extra support for patients AND caregivers
  • Referral to community and social services as needed
  • Use of health information technology (like the example above)

All Medicare demonstration projects have to meet the following 3 goals:

  • Improve patient health
  • Improve the quality of care provided
  • Lower Medicare costs

Prior to the Medical Homes model, primary care physicians did not generally provide services to seniors outside of their office. We as caregivers know the need for care extends well beyond the doctor’s office.  Having a care coordinator assigned by your physician should ease caregiver stress (we love this!) by providing information and resources needed after a doctor visit.

Information regarding Medical Homes and other new Medicare models of care can found at the Center for Medicare and Medicaid Innovation.

Have you or your elderly loved ones been assigned a care coordinator?  If so, how is it working for you?  If not, ask your doctor if your clinic is a Medical Home.

Please share your experiences and let me know if you have questions regarding Medical Homes, and I will do my best to assist you!




Caregiver: What Do You Value?

Posted on April 10th, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Helping Seniors,Senior Care Management

care giving handsSomeone asked me last week:  “What do you value?”  Immediately I launched into my answer by listing the roles I play in my life.  I value being a:

  • wife
  • mother
  • daughter
  • grandmother
  • sister
  • caregiver
  • geriatric care manager, etc.

I was proud as I quickly rattled off the answers.

“No, I mean what do you value?” she quipped back.  Then as soon as our conversation began it ended as I had to take a phone call from my dad.

Later, I began to reflect on her question and my answer.  Gosh, I really thought I had answered her sufficiently!  However, she clearly indicated I had not.

As I pondered her question some more, it dawned on me what she was really asking:  what are my core values?

Light bulb!  Because of the current frenetic pace of my life, I haven’t thought about those kind of values in a long long time.  I know they are there.  They drive what I do and who I am all the time.  But I have put them on autopilot as I go about doing the things I need to do!

So it is that I made a conscious decision to take back the wheel (for just a bit) and reacquaint myself with those primal values that subliminally guide my choices yet today.

Values like responsibility, compassion, social justice, perseverance, call to service, and patience.  These are the values that I adopted long ago and are what shape the roles I play in life.  Just thinking about these core values lifted my spirits and solidified my resolve to keep doing the work I am doing.  To keep playing the roles I have chosen in my life!

So caregiver, I encourage you to do some soul searching this week.  Think about what it is you value.  May examining your own values fortify you as you tackle the difficult and invaluable role of family care giving.

And of this one thing, I am certain!  Caregiver, you are valued!

The purpose of human life is to serve, and to show compassion and the will to help others“  Albert Schweitzer.



Anxiety: When is Worry a Worry?

Posted on April 3rd, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Healthcare Advocacy,Helping Seniors,Mental Health and Seniors,Senior Care Management

E006039Throughout our lives, we have all worried about something.  Taking tests in school, interviewing for a job,  and having to give a speech or presentation are universal experiences that cause us to worry or become anxious.    But what if that feeling never went away?  What if we couldn’t control it?  What if we always felt anxiety at the same level as we would if we were at the edge of an airplane door about to take our first skydive?

Sadly, some people do feel this way all of the time.

Our tendency may be to disregard these folks as “worriers”.  That is just who they are.  Some people are calm.  Some people just worry.  It is their nature.  It is their personality.

Do you know or care for someone like that?  If so, it is important (well really imperative) to look beyond the superficial and find out if they have “clinical anxiety”Wikipedia defines anxiety as “an unpleasant state of inner turmoil”.  That’s right.  Turmoil.  And nobody should have to live in constant turmoil!

Anxiety in elderly people is often misdiagnosed as other problems.  In a brochure from the Geriatric Mental Health Foundation, Dr.s Keri-Leigh Cassidy and Neil A. Rector refer to anxiety in elderly patients as “the silent geriatric giant”.  Anxiety disorders are twice as prevalent in elderly folks as dementia, and 4 to 8 times more common than major depression.  The numbers are staggering.  Like other mental health problems, anxiety has not been a focus in the geriatric community until fairly recently.  But even in the elderly population, anxiety can be treated successfully with medication and cognitive behavioral therapy.

Anxiety should be treated for lots of reasons.  It plays a part in other illnesses such as depression, headaches, cardiac issues, and memory problems.  Also, (dare I say it?) undiagnosed anxiety drives up health care costs because it is often mistaken for physical illness and treated as such.

But as a care manager, my thoughts always turn to that word turmoil.  I can’t imagine having to live every moment of every day with such psychological discomfort.  Never feeling relief.  In a constant state of worry.  Some of my elderly folks even call it anguish.

Often elderly people cannot define worry, anxiety, or stress in those terms.  Because of this you will have to focus on the physical signs of anxiety such as worried looks, hand wringing, difficulty sleeping, pacing, or physical complaints that have been checked out thoroughly by a physician.

If you see these signs, it is time for you to worry.  And then get help!

Your elderly loved one doesn’t have to suffer in turmoil any more!








When Care Giving Ends

Posted on March 27th, 2014

Categories: Aging Advocacy,Caring For Elderly,Gerontology,Grief,Helping Seniors,Senior Care Management,Uncategorized

asian-elderWhen you are elbows deep in caring for your aging parents, mostly you can only see the present moment.  The responsibility is great and the work is hard.  The worry can keep you up late into the night.

How can I continue to balance it all? 

But one day it happens.  Your parent dies.  The noise of their absence echoes like receding thunder on a stormy summer day.

Your emotions shift like quicksand.  Your heart tries vainly to fathom what has happened.

You wonder how you can feel so many things at one time.  Grief.  Sadness. Disbelief.  Regret.  Anger.  And yes, even relief.

But in time you will be rewarded with a sense of peace.  Your heart will still be visited by sadness: make no mistake. However, you will be comforted by the comfort you gave.

So for all of you caregivers out there; you have my unending respect and admiration.  Your work is remarkable, noble, difficult and invaluable.

One day it will be over and you will even miss it as you grieve the loss of your elderly loved one.

And for those of you whose care giving responsibilities have ended; may peace be yours for a job well done.

From caring comes courage” Lao Tzu.

Guest Writer:  Cynthia Reid, MA, LSW

Thank you Cynthia.  My friend, colleague, and fellow care giver!







Epilepsy Aware

Posted on March 20th, 2014

Categories: Aging Advocacy,Caring For Elderly,Epilepsy,Helping Seniors,Medical,Planning,Resources

photo (35)March 26 is referred to as “Purple Day”, and is designed to raise awareness of epilepsy.  Epilepsy is an often misunderstood disorder.  As such, people who suffer from epilepsy are often maligned by society.  The elderly are greatly affected by epilepsy.  It is the most common neurological disorder in older people after stroke and dementia.  Epilepsy often mimics other neurological problems so it is often misdiagnosed.

What is epilepsy?:

  • Epilepsy is a medical condition that produces an electrical disturbance in the brain
  • This disturbance results in seizures that affect the body and behavior
  • Two or more unprovoked seizures are considered epilepsy
  • Seizures can occur in the entire brain or just part of it
  • Seizures can last from a few seconds to several minutes
  • Seizures range from staring spells to loss of consciousness and convulsions
  • Seizures are treated with medications and sometimes surgery
  • Many people continue to have seizures even with treatment

How many people are affected?

With the elderly, epilepsy is usually intertwined with another physical problem such as heart disease, dementia and tumors.  Therefore it can be difficult to diagnose.  But once it is diagnosed, epilepsy can be treated in the elderly through the use of medication.

If your elderly loved one develops epilepsy, it is important to learn about the disorder.  Awareness helps in the treatment and reduces the stigma associated with epilepsy.  The Epilepsy Foundation is an excellent resource with specific information for seniors with epilepsy.  There are many local chapters of the Epilepsy Foundation that provide face to face advocacy.  If your senior uses a computer, they even have an online discussion forum for seniors with epilepsy.

I hope this increases your awareness of epilepsy in general and within the senior citizen community.

Feel free to share your thoughts and experiences with epilepsy and aging!





Tips for Tinnitus

Posted on March 13th, 2014

Categories: Aging Advocacy,Caring For Elderly,Helping Seniors,Medical

EarsTinnitus is a common problem, especially for the elderly.  It is defined as the sensation of noise in the ears such as ringing, hissing, buzzing, or clicking.  But the noise does not come from the environment.   Thus it can be maddening for those who suffer from it.

As caregivers, it is important to know that tinnitus is not a disease.  It is a symptom of something else that is happening within the body.  Therefore it is crucial to determine what it stems from in order to treat it.

Also, if it is not treated, a person may develop additional problems such as anxiety, depression, irritability, difficulty sleeping, and memory problems.

Common causes of tinnitus are:

  • Hearing loss
  • Injury to the ear
  • History of being close to loud noises
  • High blood pressure
  • Hardening of the arteries (atherosclerosis)
  • Meniere’s disease (inner ear disorder)
  • Tumors
  • Problems with blood flow
  • Some medications
  • Aspirin in high doses

Tinnitus is tricky to treat, depending on the cause.  When caring for an elder with tinnitus, the place to start is with his or her primary care physician.  The physician will first try to identify the cause of the problem.  If it stems from a physical problem, that is where they will start.  If this is not possible, then there are ways to reduce the noise so that it is less problematic.

Common treatments range from listening to “white noise” (fans, electronics that produce sounds of rain or ocean waves, masking devices worn in the ear, etc) all the way up to taking medication.

Tinnitus is a challenging problem that should not be ignored because of the negative side effects it can produce.

If your senior complains of noises in the ear, it is time for a trip to the doctor!



Ageism in Advertising

Posted on March 6th, 2014

Categories: Ageism,Aging Advocacy,Caring For Elderly,Gerontology,Helping Seniors,Uncategorized

Elderly Couple DignifiedMaybe it’s just me, but I thought the days of maligning the elderly were over.  However, this weekend I watched a little television and darn it if I didn’t see three commercials right off the bat that put older persons in a bad light.  Strangely, they were all ads for insurance companies.

One showed an an elderly woman riding in a motorcycle side car; complaining all the way.  The next showed a woman on a telephone in an outdated kitchen trying to help her family conquer an insurance problem: her son clearly ashamed of her.  The third showed a befuddled older woman trying to show  friends her  “wall” of pictures:  clearly mixing up a real wall with posting pictures on social media.

Really?  Are we still using these tired old stereotypes to sell products?  Haven’t we become more enlightened by now?

Television advertisement is very powerful.  We know that.  Many Americans watch the Superbowl as much for the commercials as for the game itself.

Advertising is a young person’s endeavor.  It is run by young people and it targets young people.  Some (but certainly not all) young people have a distorted view of aging.  I think that is why these woeful commercials slip into public view.

But the population demographic of the United States is dramatically shifting.  The Baby Boomer bulge can’t help but grab the attention of advertisers so that they focus their efforts on products more of interest to aging Americans.

Continuing negative stereotypes of elders in advertising seems to foreshadow a dismal failure in capturing what appears to be a looming lucrative market.

But I digress.

I am a care manager.  I am a caregiver.  I am a daughter.  I am a wife.  I am a mother.  I am a grandmother.  In all of my roles, I stress (well really command!) dignity and respect for elderly people.

I do this not for any commercial gain, but simply because it is the right thing to do.

Yes the market may change and commercials may show the elderly in a more respectful (and I believe more accurate) light.  But…………………………….

We owe our elderly respect and dignity right now.







Senior Advocate: Is this the Right Role for Me?

Posted on February 27th, 2014

Categories: Active Senior Living,Aging Advocacy,Caring For Elderly,Healthcare Advocacy,Helping Seniors,In-Home Care,Long-Distance Care,Medical,Planning

advocacyAs a care manager, I would guess the two words I use most in speaking with clients and families are “advocate” and “plan”.  It is hard to have one without the other, however, today I will focus mainly on advocates!

An advocate is someone who supports or promotes the interests of another; or pleads their cause.

If you think about it, throughout our lives we are constantly selecting advocates we believe will promote our best interest.  We look for the right physician, dentist, hairdresser, realtor and even the right godparents for our children.  In these situations, we use specific criteria based on our own personal values and belief systems.

Sometimes our elders get stuck in thinking that their best advocate should be their first born son, their eldest daughter or even the adult child who lives the closest.  Not very reliable criteria for character and trait selection!  If you fall into one of those categories and the advocacy role is right for you, then great!  But if you know in your heart of hearts that you don’t have the “right stuff” to do what it takes, it’s OK to turn down the job!  Advocating for an elderly person isn’t a good fit for everyone!

To advocate for an elderly friend or relative requires strength of personality, conviction, suspension of one’s own personal biases, and tremendous patience.  Perhaps the most difficult situation would be pleading for your loved one’s cause  even if no one else supports it.  This is an extremely difficult position and not everyone is up to the challenge!

Examples of when strong advocacy is required:

  • Attending physician appointments to be a second set of eyes and ears
  • During hospitalization, surgery or other medical procedures
  • Ensuring proper medication and dosage are followed
  • Assisting in setting follow-up appointments
  • Coordinating medical information among other physicians and medical settings
  • Coordinating insurance coverage, co-pays, and deductibles
  • Coordinating in-home services if needed
  • Planning for future transitions as necessary
  • Assisting with writing advance directives

Finally, if you believe you have the attributes of a strong advocate, you also must ask yourself if you have the time to devote to this important role.  Today, it seems like no one is immune from crazy schedules and advocating for an elder can take a lot of time.

Perhaps Annie Lennox says it best: “I have different hats: I’m a mother, I’m a woman, I’m a human being, I’m an artist and hopefully I’m an advocate.  All of those plates are things I spin all the time“.

Is advocacy the right role for you?  Be honest with yourself.  If the shoe doesn’t fit, don’t try to squeeze into it.  It will be painful for all involved!

Please feel free to share with us your experience as an advocate.




Matters of the Heart

Posted on February 20th, 2014

Categories: Aging Advocacy,Caring For Elderly,depression,Grief,Helping Seniors,Winter

Heart is sadFebruary is American Heart Month.  A very important time to bone up on all things that can and do go wrong with the heart.  The goal, of course, is to encourage us all to make changes in our habits that will decrease our risk of developing heart disease.  Heart disease risk increases with age, so it is especially important for those of us who care for the elderly to understand all things related to heart disease: risk factors, heart problems, and available treatments.

This year, more than ever, it seems as though the media floodgates have opened and information is pouring out with heart health information.  A very good thing!

Because of the richness of available information on physical heart health, I want to focus instead on other matters of the heart.  Specifically loneliness and depression in the elderly.

It’s been a tough winter in Minnesota as it has been in other parts of the country.  Snow, cold, ice, and lack of sunlight start to pierce the soul of even the heartiest winter enthusiasts.  And yet, we carry on with our tasks despite all the challenges the weather throws our way!  Rather than being a hindrance, our daily grind distracts us from the inconveniences of winter.

But for our elders, winter can drape their lives with loneliness and depression.  They often become “housebound” due to safety concerns such as snow, ice, and early darkness.  And let’s face it, we caregivers may not visit as often in the winter as we do in the summer (for the same reasons!).

But we can still monitor our loved ones in many ways.  Calling every day just to “check in” can ease loneliness and provide a bright spot by breaking up the monotony of a long winter day.  Also sending notes and cards via mail gives our elders something to look forward to.  Recruiting grandchildren to do the same makes it even better!  If your loved one is computer savvy, checking in on them with Skype or Face Time makes a virtual visit seem like a real one!

So while you think about your senior’s heart health this month, don’t forget to monitor their emotional health as well!

February is a good month to pay attention to all matters of the heart!




Caring for our Elders through Touch

Posted on February 13th, 2014

Categories: Caring For Elderly,depression,Grandparents,Helping Seniors,holidays

hugging kittens

Tomorrow is Valentine’s Day, a holiday centered around love, romance and caring for our family and friends  Have you ever paid attention to that special feeling you get when your partner gives you a big hug or holds your hand?  That feeling comes from a hormone that is produced in our pituitary glands.   It is critical to the development of human relationships and bonding.

Oxytocin is the name of that “feel good” chemical.  It is released in the body when we are infants and our mothers caress and hold us in that soothing way that mothers have.  In turn, our mother’s body produces that same chemical and the infant-mother bond is forged forever!  It is is also released significantly during that time in human bonding referred to as “romantic love”.  It is what drives us to hold hands, snuggle, kiss and mate.

Maternal love and romantic love are heightened examples of human bonding.  However, even a simple hand shake, pat on the back or light touch on the arm will elicit happiness in those we care for.

One of my greatest joys in life is being a grandmother.  I simply love holding and snuggling each child and just enjoying the miracle of their lives.  My grandmother’s touch is creating a bond between us I hope they will remember forever!

I am blessed by the loving touch of family. But as a geriatric care manager, I wonder about those I work with.  Who is touching our seniors?

Babies are touched and talked to and fussed at even by complete strangers.  Young people hold hands, sit close together and gaze at each other constantly.  Partners touch each other lovingly and hug their children each day.  Grandparents tickle and cuddle their grandchildren every chance they get. But what about elders living apart from family?

We need to make a commitment to touch our elders more as we provide care.  Care provision is more than helping with laundry or balancing a checkbook. We sometimes get so caught up in the “chores” of care giving that we forget the human side of what we are doing.

Perhaps Leo Buscaglia says it best:  “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around”.

Our bodies are so wonderfully made that just  a smile or a touch can alleviate depression, help ease social anxiety and decrease fears in others.  The provision of tender care through touch may be even more important for our elders as many have experienced significant grief and loss.  Not only can we make their day brighter, we might even turn their life around!

The bonds we forge and maintain with others through loving touch are what inevitably make us human.  Valentine’s Day is a good reminder of this!

Will you lovingly touch your senior today?

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