Deathly serious: Time for more talking; odds not great without it - By: Emily Mongan, for McKnight's
It’s no secret that end-of-life discussions can benefit skilled nursing residents. Recent research has shown that such talks have the potential to improve residents’ outcomes, help them appoint a surrogate or representative, and reduce their odds of dying in a hospital.
For all the benefits that end-of-life care talks can bring, studies have shown that a relatively low number of residents actually participate in them. Now a new study in the Journal of the American Geriatrics Society indicates that even when such talks take place, patients’ preferences aren’t always understood or effectively communicated.
A team of researchers from Yale University conducted interviews with 350 veterans over the age of 55, as well as separate interviews with the people the veterans had chosen as their surrogates.
The interviews found that more than 40% of the veteran-representative duos reported that the veteran had not communicated his or her wishes, completed a living will or healthcare proxy. The research also showed that patients and their surrogates disagreed about how well they had communicated about end-of-life care choices.
In total just 20% of the surrogates interviewed correctly predicted the veterans’ end-of-life care preferences; that knowledge increased slightly in the pairs who reported that they communicated well.
“You can’t assume advanced care planning achieves the goal of making sure the surrogate understands what the patient wants,” said lead researcher Terri Fried, M.D. “Planning needs to include a facilitated discussion between the patient and the surrogate to make sure they are hearing each other and talking about things that are important to the patient.”
So what does this have to do with long-term care providers? After all, isn’t the issue here between patients and their representatives? Not quite.
Fried suggests that older patients and their surrogates may need a little extra help with end-of-life care planning, be it in the form of an internet-based tool or clinician facilitator.
As Fried points out, “The jury is still out on the best way to help people,” a statement backed up by the numerous studies on the best way to approach end-of-life care discussions, and the number of seniors who still don’t participate in them.
But as this most recent research shows, a bit of outside encouragement could be what’s needed to help solve some of this miscommunication between patients and their surrogates. And a long-term care staff member may just be the missing piece of that puzzle.
Emily Mongan is Staff Writer at McKnight’s. Follow her @emmongan.
Understanding Your Medicare and Medicaid Entitlements - By: Regency Nursing & Rehabilitation Centers, NJ
Joe Sanders never expected to wind up in the hospital for an extended stay. At age 68, he was in good health, leading an active life. So when a sudden attack on the golf course landed him in the local emergency room, he was surprised to learn that his government health benefits weren’t going to see him through the long haul.
Unfortunately, like most of us, Joe never bothered to take a close look at his entitlements before an emergency struck. Had he understood his options, he might have been better financially prepared for the long-term care he now requires.
MEDICARE Part A & B – Benefits For Your Retirement Years
Medicare is a two part program underwritten by the U.S. Department of Health and Human Services that provides basic hospitalization and medical coverage for people age 65 and over and also serves people under the age of 65 with certain disabilities. For example, if you have permanent kidney failure that is being treated with dialysis or a transplant, or have been receiving Social Security or Railroad Retirement disability checks for at least 24 months, you are eligible for Medicare even if you’re under age 65. Medicare part A provides automatic hospital coverage, as long as you have worked at least 10 years in a Medicare-covered employment. Part B membership helps cover medical and doctors’ bills, and helps pay for rental or purchase of necessary equipment such as prostheses, wheelchairs and post-surgical supplies. Consult you local durable medical equipment carrier for details about this benefit. While Part A is yours free of charge, Part B is considered elective coverage and requires monthly contributions from you.
There are also several health care options available to Medicare beneficiaries which come under the label of Medicare + Choice.
Most people receive a Medicare Enrollment Package just prior to reaching their 65th birthday. At that point they may choose whether or not to opt for Medicare Part B benefits and pay the required premiums for that coverage. If you have reached the age of 65 and have NOT received a Medicare Enrollment Package, you must call your local Social Security Officer in order to determine your eligibility.
MEDICAID: Benefits For Low Income Households
Medicaid is a federal-sate program usually operated by the state welfare or health departments and designed to furnish several basic services to low-income individuals. These include inpatient and outpatient hospital care, physicians’ services, nursing home care, and laboratory and x-ray services. Under financial hardship, Medicaid may also be used to pay for your Medicare premiums, deductibles and co-insurance.
MEDIGAP: Benefits That Take Over Where Medicare Leaves Off.
MediGap refers to one of several supplemental health insurance policies that can be purchased to cover the costs Medicare often doesn’t cover, like prescription drugs, dental care, orthopedics, hearing aids or eyeglasses. For a complete list of recognized MediGap providers, consult your State Office for the Aging.
There is also an option called Medicare Managed Care, which requires you to use the doctors, hospitals and health care providers in the plan’s network in return for more comprehensive coverage. This usually entails paying a small monthly premium, but enables you to dispense with MediGap coverage.
- Pharmaceutical Assistance for the Aging and Disabled (PAAD)
- Hearing Aid Assistance to the Aged or Disabled (HAAAD)
- Lifeline – a utility assistance program for recipients of PAAD
These state funded programs were designed to provide needed benefits in those areas not covered by Medicare and for those individuals whose income levels would make it difficult for them to obtain these services on their own.
Don’t Assume Your Benefits Are Automatic.
Most government entitlements are NOT automatic. You have to apply for them and meet all government requirements for coverage.
Be Aware of the Limitations of Your Coverage.
Be an educated health care consumer. Never assume that you’ll be covered for anything that comes along, or you could be in for an expensive shock. Always familiarize yourself with the details of every aspect of your medical coverage, and make sure to fill in any gaps with a recognized supplementary plan. Consult a trusted attorney or government counselor to help you make sense out of complex requirements or limitations in your coverage.
Regency Nursing Centers receives best of 2017 award from SeniorAdvisor.com!
Regency Nursing Centers receives best of 2017 award from SeniorAdvisor.com!
The annual SeniorAdvisor.com Best of 2017 Awards recognize outstanding senior living and home care providers who have received consistently high ratings from residents and their families.
Winners of the SeniorAdvisor.com Best of 2017 Awards are located all over the country and represent the top tier of in-home care, assisted living, and other senior living providers in the country.
The award places winners in the top one percent of senior care providers nationwide.
To qualify for a Best of 2017 Award, providers must:
- maintain an average overall rating of at least 4.5 stars
- have received 3 or more reviews in 2016
- offer assisted living, in-home care, independent living, skilled nursing or Alzheimer’s care in the United States or Canada
Winners of the SeniorAdvisor.com Best of 2017 Awards are located all over the United States and Canada and represent the top tier of in-home care, assisted living, and other senior living providers in North America. This exclusive designation places the winners in the top one percent of senior care providers nationwide according to those who matter most – their families.
“SeniorAdvisor.com aims to help families research and locate reliable, first-hand feedback on senior care options from other families who have gone through the same experience,” said Eric Seifert, President of SeniorAdvisor.com. “We are proud to celebrate the exceptional businesses who care for our greatest generation and older loved ones, and provide these organizations with the recognition they deserve.”
About Regency Nursing and Rehabilitation Centers
The Regency organization has become synonymous with the best in senior healthcare and has garnered a well deserved reputation for its unsurpassed commitment to its patients and residents.
The Regency Nursing and Rehabilitation Centers and Facilities throughout New Jersey have achieved numerous industry ‘gold standard’ benchmarks an have received accolades from all corners of the HealthCare community.
Launched in early 2013, SeniorAdvisor.com is an early-stage, growth business focused on improving the way people find senior care for themselves and their loved ones through sharing over 135,000 verified consumer reviews and ratings. In just three years, we’ve become one of the largest consumer ratings and reviews site for senior care and services across the United States and Canada.
At SeniorAdvisor.com, their mission is to equip families like yours with the best information available so you can make confident choices about senior care and services.
The Internet as a Tool: How Seniors Can Use It To Improve Their Lives
This article was submitted to us for exclusive publication by our good friend, Karen Weeks of www.elderwellness.net
Learning the Basics
There are several online resources to help seniors get acquainted with the internet if they aren’t already. As the Huffington Post reports, there are many communities across the country that offer beginner, intermediate computer or personal technology classes for people learning to navigate the internet. People can check their local libraries or local senior centers for possible classes that teach some of these skills. Some universities or colleges offer Lifelong Learning Institutes which offer an array of courses to retirees and seniors looking to learn new things.
The Internet as Entertainment
For seniors learning to surf the online universe can serve as a great way of entertainment and finding new hobbies. There are plenty of fun and free online games that are reminiscent of classic games and are favorites for seniors. Many of these games can also be played with your friends online, a great way to stay in touch.
- Chess: For casual and avid chess players and enthusiasts. Playing online chess can be played against another opponent online or on your own.
- Online Scrabble: Scrabble never gets old and offers hours of fun for all ages. This can also be played against several friends online. Get your friends together online for a classic game of scrabble.
- Word Games: A variety of word games and word puzzles can be played online to keep the brain active
- Video Games: Studies published in Science Daily claim that seniors that play video games report a greater sense of well being.
- Memory Games: In order to keep your brain active there are plenty of online games like Lumosity, which are designed specifically to give the brain a good workout and maintain skills of critical thinking and recall.
The Internet as Education
The internet can be a gateway into an entirely new skill or occupation. Plenty of options online for people that are interested in trying new things. From doing basic maintenance on your car, to learning a new musical instrument, to learning tools needed to start a new part time job. Forbes writes that the first place to start when looking to change careers is, in fact, the internet.
Whether you’ve always wanted to play the guitar, or pick up a pair of drumsticks, or learn classics on the piano, going online for free musical education can be a way to not only reap the mental health benefits of learning a new instrument, but to do something you always wanted to.
New Career Opportunities
The internet can offer up some great resources to trying out new work opportunities and get you started in a new and exciting venture. A few examples can include:
- Driver: Because of technology ride services like Uber and Lyft have become a popular way to make some extra cash.
- Real Estate: Perhaps you are someone that loves meeting and helping different kinds of people. A great part time endeavor can include selling houses. As The Balance reports, it’s not uncommon for real estate agents to work part-time, as it offers a good cash pursuit on the side and works well for people with an open schedule.
The possibilities really are endless. The internet, when used effectively, is a great tool to improve one’s life and learn all kinds of new skills and disciplines. Senior citizens don’t have to feel excluded from this new technology. In fact, they have as much to gain as anyone by exploring the online world and stimulating life with new knowledge and information.
Photo Credit: Pixabay