Information Links for Seniors and the Disabled

I received the following email from Richard Wright. I appreciate that he took the time to send these links to me. I hope you find some of these resources informative and useful. Thanks, Richard.

"Since you have so much great info on it [LWKD blog] for individuals who are senior citizens and/or have a disability, I thought you may like to update it with a few additional life- and financial-planning resources I found in my research. They cover a variety of topics, from healthcare and insurance, to home modifications, to canine assistance, and based on the information you’ve already shared on your site, I think they’ll be extremely helpful to your readers.

Here they are:

How to Use the Medicare Plan Finder

8 Types of Life Insurance Policies - Which Policy is Best for You?

What is Burial or Funeral Insurance & How Does it Work?

Home Modification Self-Help Guide

The Ultimate Guide to Getting a Service Dog

Types of Durable Medical Equipment (DME) Covered by Medicare

Calculating Your Social Security: 5 Tools to Optimize Benefits

The Senior’s Guide to Paying for At-Home Long-Term Care: How Your Home Can be a Great Asset

Home Modification Programs from the VA

I hope you can find a way to use these! I’ve also been working on a project where I write articles about how people can create a plan for paying for any future long-term care needs that may arise. If you think an article on that topic would be relevant for your blog, I’d be happy to write a piece for you as well."

Planning for Long-Term Care: The Costs and Potential Issues

A special "thank you" to Hazel Bridges who has written another informative article on long-term care. 

Long-Term Care

Planning for long-term care can be tricky, to say the least; you never know what might happen in the next five or 10 years, and it can be difficult to think about financial planning when you’re unsure of what the future may bring. For seniors, however, it’s imperative to start thinking about how you might pay for your care should you need to stay in a hospital or nursing facility for an extended amount of time. Health insurance and Medicare are wonderful resources, but they only cover so much of the cost associated with long-term care.

For now, think about how to boost your savings and ensure that you are doing everything in your power to prevent issues down the road. This means making your health and mobility a priority and making changes to your home to make it more accessible. This will ensure that you are able to live in it longer, even if your health should fall into decline, and that you will stay safe.

Keep reading for some great tips on how to plan for long-term care.

Turn Your Home Into a Safe Haven

Prevention is one of the best ways to ensure that your health and safety are a priority. Making changes to your home is a great way to start, as it will help you remain there longer without the need for an assisted living facility. For example, you might add grab bars in the shower, place sturdy railings on both sides of the stairs, widen doorways to allow for medical equipment, add lighting to prevent falls, or remove loose rugs or carpeting that can be trip hazards. Think about what each room in your home needs in regard to safety and comfort, and do a little research to figure out what the cost will be to make the changes. Check out this guide for some great tips on which changes you should make and how to get started.

Know Your Policies

You may have a health insurance policy that will help pay for care down the road, but how much will it cover in the long term? Take a good look at your policy, and carefully read over your Medicare or Medicaid paperwork to see exactly what you will be responsible for should you need long-term or daily care due to an injury or major health issue.

Consider Selling Your Life Insurance Policy

If you need a large sum of money to cover care costs, or if you just want to pad your savings account, consider selling your life insurance policy or see if your policy offers a cash value option that would allow you to take money from the total benefit amount now. This will reduce the amount that your loved ones would receive in the event of your death, but it could be a viable option if you need cash to pay medical bills or to put aside for your future needs.

Make Lifestyle Changes

Along with the changes to your home, you can make changes to your lifestyle that will allow you to stay healthy, which, in turn, can possibly reduce the risk that you will need long-term care down the road. This includes eating right, getting daily exercise, and eliminating bad habits, such as smoking or using substances such as alcohol to excess.

Planning for long-term care does not have to be stressful. By starting now, you are on the right track toward ensuring that your healthcare needs won’t be overwhelming in the future. Make the necessary changes to help your body and mind stay healthy, and remember to ask for help when you need it.

Photo via Pixabay by Sabinevanerp

Financially Prepare For Assisted Living

Today's topic is a guest post by Hazel Bridges (hazel@agingwellness.org). Planning for the future is important to most of us living with Kennedy's Disease, but also for any family with senior citizens liiving at home. Thanks, Hazel.

7 Things You Can Do to 

Financially Prepare For Assisted Living

By Hazel Bridges

Medicare is useful in many ways. However, Medicare doesn’t cover very much when it comes to assisted living. As a result, you will need to be prepared for whatever circumstances you might run into in the future. Here’s how you can plan financially for you or a loved one so you can be prepared for whatever curveballs life might throw your way.

Figure Out Which Kind of Housing Is Necessary

As pointed out by a recent Forbes article, when most people think of long-term care, their first thought is nursing homes. However, there are a variety of assisted living facilities that also provide substantial benefits. The trick is finding out which ones are best. Assess your loved one’s needs and see which facilities suit it best. Try to get it right the first time, since moving from home to home can be difficult.

Upgrade Parts of the Home

When it seems like assisted living might be part of the inevitable future for your loved one, consider ways that you can upgrade the home they live in to help them maintain a little bit of independence and keep things easier for everyone. Do small things like installing grab bars in bathrooms, removing loose rugs or carpet on the floor, or installing a chair lift. This helps your loved one live in their home a bit longer, which can free up money for care.

Leverage Life Insurance

Some life insurance plans can be used for what are called advanced death benefits (ADBs), which can help in paying for your loved one’s care. The US Department of Health and Human Services describes ADBs as life insurance features that allow a tax-free advance on your life insurance policy while you are still alive. If you’re unfamiliar with your insurance policy or aren’t sure about the terms of ADBs, talk with your provider about the details of the benefits.

Talk to a Financial Advisor

Many seniors wonder where they can get sound financial advice that can help them or their families financially prepare for an assisted living scenario. A couple of good resources to consider are banks, community center events, and the AARP, all of which will likely have financial advisors who can assist for little to no cost.

Look Into What Tax Breaks You Can Take

Tax breaks are available to seniors whose medical expenses, including some of their assisted living costs, exceed 7.5 percent of their adjusted gross income. If you care for your loved one, you should look into some of the tax benefits that you qualify for because of your role.

Consider Government-Assisted Programs

There are programs like Section 202 Supportive Housing for the Elderly that provide subsidized housing options where seniors can get assistance with tasks like cooking, cleaning, and transportation. One disadvantage of many of these programs is that they have lengthy waiting lists, so if you’re looking into it, get on them now.

Consider a Reverse Mortgage

If your loved one owns a home, they might be able to afford some long-term care by using a reverse mortgage. A reverse mortgage allows the homeowner to borrowmoney against the equity that they have in their home. This money doesn’t have to be paid back to the bank until a future time. However, the amount due on the loan must be paid if your loved one dies or changes their primary residence. A reverse mortgage isn’t right for everyone, so be aware of the financial implications of receiving one and get familiar with the unique contract wording.

It’s important to secure your future. Change can come eventually, or it can come tomorrow. Work regularly to do what you can to ensure you or your loved one’s financial security so you can live worry-free. 

Image via Pixabay

New Medicare Cards

New Medicare cards are in the mail

3 things to know

1. Your new card will automatically come to you. You don't need to do anything as long as your address is up to date. If you need to update your address, visit your My Social Security account.- Opens in a new tab
2. Once you get your new Medicare card, destroy your old Medicare card and start using your new card right away.
3. Your new Medicare Number is a unique combination of numbers and letters. The letters S, L, O, I, B, and Z are never used.

Watch out for scams

Medicare will never call you uninvited and ask you to give us personal or private information to get your new Medicare Number and card.

Scam artists may try to get personal information (like your current Medicare Number) by contacting you about your new card.

If someone asks you for your information, for money, or threatens to cancel your health benefits if you don't share your personal information, hang up and call us at 1-800-MEDICARE (1-800-633-4227).

Learn more about the limited situations in which Medicare can call you.- Opens in a new tab

Learn more about your Medicare card.- Opens in a new tab

Buying a wheelchair is like buying a car

So many types and models, and so many options...how do I know what is best for me?

Quest Magazine has some great articles. A while back, there was one written by Kathy Wechsler called, “Front, Middle or Rear … Finding the Power Chair Drive System that’s Right for you.” For anyone in need of a wheelchair, new or replacement, this article is a good read.

Ms. Wechsler wrote that it is best to work with a certified rehabilitation technology supplier (CRTS) as well as an occupational or physical therapist who specializes in wheelchairs. They will perform an assessment and evaluate your particular needs and capabilities. She also recommends that you ask a lot of questions, and not quit asking until you feel comfortable with the answers you are getting.

My first wheelchair was a mid-wheel. It served its purpose, but the seat would not elevate. After about three years, I found myself having difficulty standing up from the chair. When I upgraded to a new chair, I spent several hours with a seating-specialist and occupational therapist. They evaluated my situation and my current capabilities. They asked dozens of questions regarding what my needs are today and what my capabilities might be five years out. Yes, five years.

Chairs are an expensive investment and you do not want to purchase one that will only fit your needs for the next 2-3 years. When I transitioned from a mid-wheel to a front-wheel drive with seat elevation, it was very different and I scarred a few door-frames in the first few weeks. I tend to like front-wheel more, but it took a little while to get used to it because of my experience with a mid-wheel.

Based upon information provided in the article and my personal experiences, I have listed some questions and considerations before purchasing a chair.

• Don't just consider today's needs. Since you want to have a chair that is comfortable and yet capable, always consider your lifestyle, capabilities and needs, now and five years into the future. Take your time and consider the right chair for the right reasons.

• How is your home configured? The size and setup of your home and office is very important in helping to make the right decision. Does the home have an open floor plan? How tight are the kitchen turns? Carpeting takes a beating with a wheelchair. Hardwood floors and tile are far more accepting. What are your home’s exterior and interior door widths? You want to be able to access your kitchen, living room, bedroom, bathroom, and closet. 

• What is the width and turning radius of the chair you are considering? Mid-wheel chair require a smaller turning radius. Are the chair’s arms adjustable? 

• How will you gain access to your home? There are portable ramps that are
  
  reasonably priced, or you can build a ramp. Portable ramps are nice when you visit other locations that are not handicap accessible. But, they are not light and easy to handle. Always consider a secondary exit plan in case of a fire or other emergency. Do you have a rear deck or porch that you want to access? 

• What type of seat and backrest do you need? Comfort is king. Since you will be spending several hours a day in your chair, a properly measured seat and backrest are important. There is nothing worse than having a seat or backrest that is uncomfortable or not quite right. An improper fit can also cause pressure ulcers (bed sores).

• How will you transport your chair? Do you have a wheelchair accessible vehicle?
  
  If so, will the new chair work with it? If you do not have a vehicle, what is needed to be able to take the chair with you? Wheelchair accessible vans are a fantastic tool. Fortunately, there are many used vans available today. There are also transport platforms that can be used on sedans or SUVs. 

• What type of suspension system do you need? Do you spend a lot of time outdoors? Usually front and rear-wheel drive units perform the best. There are also specialty chairs for the outdoorsman. 

• What kind of obstacles and inclines will you encounter during normal use? Front-wheel drive units perform the best for curbs, grass, gravel, snow and uneven terrain. Mid-wheel drive chairs can become hung up because they have front and rear casters. On the other hand, mid-wheel drive units are usually the most stable on inclines and declines. Normally, rear-wheel drive units are the least stable on inclines and declines, so it is important to have anti-tippers installed. 

• How fast do you need to go? For speeds up to 5 or 6 mph, all chairs perform well. For higher speeds, front and rear wheel drive chairs are more stable and easier to drive. 

• Do I need a Group 2 or Group 3 chair? Group what? There are seven groups of chairs. Most of us living with Kennedy's Disease will start out with a Group 2 chair and at some point might require a Group 3. Within these two groups, there are a variety of options (like accessories on a car). Some are not needed, but others might be helpful or even needed. 

• New or Used? There are a lot of good quality used chairs available. Most are a cost-efficient way to purchase your first chair when it is not medically needed yet. The key learning to take from a used chair consideration is the next point on who will service the chair. Do not assume your local dealer will service your chair if you buy it somewhere else. I learned this the hard way and it was no fun.

• Who will service your chair? Just like your car, this is very important. And, it is especially important if you purchase a used chair. I know of one man who lived two hours away from the nearest dealer. When his chair needed servicing, he could not find anyone who would make the trip. In-home-service is a wonderful convenience especially if the chair stops working for some reason.

• And, what will be your out-of-pocket costs - those not covered by your insurance provider? Most every provider has certain pre-purchase requirements. Know what they are ahead of time. With Medicare, for example, requires a Certificate of Medical Necessity (CMS) provided by your doctor. Also, they do not cover any of the cost for an elevated seat. They do not feel it is necessary. Those of us living with Kennedy's Disease might reach a point where the only way to transfer from a chair is with an elevated seat. 

To summarize—all three models of chairs have their pros and cons. That is why it is important to get a personal evaluation and assessment as well as to ask a lot of questions. I also advise asking an occupational therapist to tour your home. He/she will see things that you and I would not even consider.

If you have questions or additional comments based upon your experience, please let me know.

Many Mistakes and Many Learnings

Since Kennedy’s Disease is a progressive neurological disorder, your capabilities and needs will change over the years. I found that quality of life decisions are an important factor in how we view our condition. Fortunately, there are tools that will progressively provide greater support and mobility when you need it. Unfortunately, if your ego is anything like mine, it gets in the way of your timing, purchase and use of these tools.

Cane: I should have started using a cane way before I did. If I would have, there would have far less falls, and a few less injuries. Using a good quality cane, sized correctly, would have been an easy transition; yet, my ego would not let me use one. It took a broken fibula to force me to try using one. Once I started, I loved it because it provided me with greater confidence and more support.

Tip: The cane should be adjusted to the proper height so that your forearm is bent at a 25-30 degree angle when the cane is parallel with your leg (straight down your side). The cane should have a grip that is easy to hold on to and an end-tip that does not slip. For better balance while walking, look straight ahead (not down).

Walker: A walker should have been another easy transition, but … my darn ego got in the way again. I could not picture myself using a walker under any circumstances. It took another serious injury before I progressed to using one. I also found that I did not need the walker all of the time, but it sure was a useful tool when I needed it.

Tip: The walker height should be set so that your posture is upright and your forearms are bent at a 25-30 degree angle when grasping the walker. The walker is meant for balance, not for holding up your weight. For better balance while walking, look straight ahead (not down). Tennis balls placed on the end tips help improve traction on slippery surfaces.

Scooter: A scooter was far easier for me to accept. Even though a wheelchair would have been a smarter purchase at the time, I could not envision myself in a wheelchair. Somehow, however, I could see myself using the Evil Knievel endorsed four-wheel scooter. I figured anybody that could jump over twenty school buses or attempt to jump across the Snake River in a rocket sled must know something about scooters. I wanted something that would allow me to go with my wife when she went for walks. I needed a scooter that would take me back into the wilds of southern Pennsylvania.

Unfortunately, I did not use my head and spend a few more bucks for a model that would be more versatile and allow me to go into the woods without getting consistently stuck. Now that would have been a worthwhile investment. I also learned quickly that a scooter is not very good indoors—poor turning radius. In addition, it is much more difficult to transport. In the end, my Evil Knievel special did not allow me to jump anything … not even a small branch in the path. Bummer!

Wheelchair: It took a broken tibia and fibula before I finally progressed to a power wheelchair. This was a good investment and well worthwhile. We also bought a platform lift (another good investment) that lifted the wheelchair into the van and actually charged it while in transit. The wheelchair allowed me to go for walks with my wife and attend community events (both indoors and out) without the fear of falling or becoming too fatigued. I no longer slowed down the other walkers and normally they wear down before my battery does. Being able to travel 25-30 miles on a charge and cruise around at 5-6 mph works well for almost any situation.

Once again, however, I missed the boat by not thinking 3-5 years into the future. Even though the wheelchair opened many doors (opportunities) for me, a little more research and a few more bucks invested up front would have really made a difference. For example, the ability to elevate the seat to make it easier to stand up.

By now, you should see the pattern. I waited too long, did not consider my needs thoroughly—especially 3-5 years out, and placed price above needs. Through the process, I learned several things that I want to share with you.

#1 - Do not wait until you are injured to consider a mobility aid (cane, walker, scooter, or wheelchair). With the right mobility equipment, your life does not have to come to a stop.

#2 - Do not just consider your current needs. Take into consideration your future needs—what you might need in the next 3-5 years. Then, look at what you have recently given up because of your safety concerns. Are there devices or options that will allow you to enjoy life a little more fully. For example, if you can no longer stand for long periods of time, would a chair that has a seat that rises up be helpful? It allows you to be eye-level with others in group settings. Do you need a chair that can climb a curb, stairs, or be capable of cruising through the woods? Almost anything is available today, but it comes with a price.

#3 - Do not just consider cost. You are talking about your safety, lifestyle, and future mobility. A few extra bucks spent upfront could make all the difference in the world to your safety and happiness.

#4 - Do not be afraid to negotiate. As mentioned, a scooter or wheelchair is a major investment. If you have done your research, shopped around, and considered all of your options, you will know what the best deal is.

#5 - Do ask for advice from others. Many of us have experience with the equipment you are considering (options, makes, models, maintenance, etc.) I saw a seating specialist. She determined my needs now and in the future. She let my try several different chairs, several options, and several types of seats. It really made a difference in my confidence level.

#6 - Do consult with a physical and occupational therapist. For scooters and wheelchairs, we are talking a major investment (even if the insurance company pays for most of it). For canes and walkers, therapists know how to adjust them correctly and what you should be considering. Their expertise could be very beneficial as well as save you some grief down the road.

#7- Do shop around. The internet is an excellent place to check on prices, options, models, and suppliers, but it is not the only place. Visit a show room and ‘test drive’ the models you are considering.

#8 – Do consider used equipment. Previously owned mobility equipment is an excellent option, especially for a first time user. When considering used equipment, have a qualified person inspect it before sealing the deal.

#9 – Do consider who will service your mobility equipment. No matter how good a deal you get, if you are stranded somewhere, it is no fun. Ask for recommendations from other users. If you do decide to buy online or from some out-of-area supplier, talk to a local company to see if they will service (both warranty and other maintenance/repairs) your scooter or chair. 

#10 – Do check to see what your insurance provider or Medicare will pay for. Medicare, for example, will not pay for an elevated seat option. Without it, however, I am reliant on others to help me transfer. So, I am willing to pay for this option.

I hope this is helpful. If you have other suggestions or questions, please do not hesitate to comment. Remember, safety is job #1.

It is that time again ...

Health care is in the news and it is time to take action once again. The MDA Advocacy Group is asking for our help.

Health Care Reform

As health care reform debates continue in the Senate, MDA remains committed to advocating for principles of coverage set out in conjunction with leading national patient organizations that establish key elements necessary for adequate health care coverage.  The principles require that meaningful access to care be affordable, accessible, adequate and understandable.  In addition to these elements, maintaining a robust Medicaid program is essential to ensuring our community has access to the care it needs.  In May the U.S. House of Representatives passed its version of health care reform, and now that the U.S. Senate is working on its bill, we continue to work with the Senate and encourage all members of Congress to engage in a bipartisan effort to find solutions to the challenges with access to care and with maintaining the critical protections set out in the Medicaid program.  Thank you to all advocates who reached out to your members of Congress earlier this spring to advocate for the principles of coverage and Medicaid protections.  As the Senate considers its bill this week, we urge you to again ask your senators to keep the priciples of coverage in mind when moving their bill forward, and to highlight the importance of Medicaid coverage for the neuromuscular disease community.

Take action today. Click here to go to the MDA website

Another call for help

It is time to let our lawmakers know the importance of complex rehab technologies for wheelchairs.. Please consider contacting your senators and representatives by using this easy MDA program.

As available technologies improve, I can see devices in the near future that will make life easier and keep us independent longer. Thank you for your consideration.


Help Ensure Access to CRT

Last year, we asked for your support in preserving access to complex rehab technologies (CRT) by urging Congress to stop the Center for Medicare and Medicaid Services (CMS) from applying competitive bidding pricing to complex rehab wheelchair accessories.  CRT and related companion parts or accessories are needed by many people living with muscular dystrophy, ALS, spinal muscular atrophy (SMA) and related neuromuscular diseases to live healthy and independent lives. The collective efforts were successful in securing a one-year delay prohibiting CMS from applying the cuts to power wheelchairs through December 31, 2016.  With that date fast approaching, we need your help again.  Take action below to let your members of Congress know that access to CRT is critical, and urge them to support and bring H.R. 3229/S. 2196 to a vote.

Healthcare Fraud

In This month’s CostCo Connection, there is a good article written by David and Amanda Horowitz titled, “Take Care with Medicare.” It discusses the Medicare fraud issues plaguing users and our government today. Below are a few highlights from the article.

Protect yourself from Medicare fraud by taking these steps. (Note: The advice is also good for any health insurance claim)

• Make sure providers are Medicare approved. Go to medicare.gov or call 1-800-633-4227 to see if the provider is approved.

• Keep a record. Record your healthcare services including dates and keep the receipts. Review your Medicare (or insurance) statement of services provided and compare it to your records. If something doesn’t appear to be correct. Contact your local Senior Medicare Patrol (smpresource.org) or your provider to discuss the potential issue.

• Protect your Medicare card and number. Know who you are sharing your personal information with, be on guard for potential scams, and do not give out personal or sensitive information to anyone you do not know. If you believe you lost your card or it was stolen, contact the Social Security Administration at 1-800-772-1213.

• Be suspicious of healthcare providers, doctors or suppliers who call and say they represent Medicare or the federal government. Or, they offer free Medicare services, or non-medical transportation or housekeeping services that are supposedly approved by Medicare. The adage, “If it sounds too good to be true, it probably is.”

• If you suspect Medicare fraud, contact Medicare immediately at 1-800-633-4227.

 

Throwing the baby out with the bathwater

In this morning’s paper there was an article from the McClatchy Newspapers in Ft. Lauderdale, Fl.  The title was “Report targets unnecessary power wheelchairs … 61% paid for by Medicare were not needed”.  
 


The article sites a July report by the Inspector General of Health and Human Services stating the chairs were not needed or not right for the elderly patient wasting about $100 million in a six month period in 2007.
 
These findings led to a 10% cut in payments and tougher regulations.  Furthermore, nine metropolitan areas in south and central Florida are testing a controversial new system for power wheelchairs and other medical equipment.  Suppliers must pass an accreditation process.  They hope this process will weed out many of the companies that are taking advantage of the elderly.  As part of the system, Medicare and the patients will pay 25-30% less for the power chairs.
 
I believe Medicare fraud, not just with wheelchairs, is a huge issue that no one has been able to get their hands around.  This problem is partly due to the patient’s inability or lack of desire to review and question charges made to Medicare on their behalf.   Medicare sends out statements every time a charge is made against a patient’s account.  There is a fairly easy process available to challenge any questionable payments.

Don't Penalize Everyone
 

That being said, I believe the real problem is that all rules and regulations are normally established for the very small group who take advantage of the system.  Probably 90-95% of all charges are legitimate.  It is the 5-10% that cause the problem for everyone else.  And, with the government trying to keep the dike from leaking, they rebuild the entire dam making it less user friendly and far less functional.
 
For example, the government does not recognize that some people might need a power seat on their wheelchair.  Chairs are designed to provide mobility for anyone that can no longer safely walk with a walker or cane.  The regulations are strictly designed to satisfy the mobility need.  However, transferring is never considered even though it is a mobility issue and safety concern.  I believe this happens because the people making the regulations have never been in a wheelchair or consulted with people that need the ability to have a power-assisted transfer capability.
 
As anyone in the later stages of Kennedy’s Disease knows, our arm strength weakens as much or even more than our leg strength.  We cannot easily transfer to the bed or toilet, for example, by sliding across on a board or using our arms to swing over.  I need a power chair to get around safely.  I also need a power seat to be able to transfer safely (and not cause my wife to hurt herself trying to help me transfer).  
 
A power seat is an expensive option on any wheelchair, but it is a necessity for some of us.  Quality of life should be taken into consideration when accessing the need for mobility equipment.  
 
Focus on the Corruption

Yes, we need to stop corruption within our Medicare system.  And, yes, medical necessity should be the determining factor for mobility equipment.  BUT, don’t penalize everyone that needs mobility equipment just because of a few fraudulent companies.  Instead, focus on the corruption.  

And, take it one step further.  Stop generalizing the interpretation of necessity.  Allow the doctors and medical equipment specialists (i.e., physical and occupational therapists) to provide adequate documentation that a long-term need exists for a particular piece of equipment or accessory.  

Follow-Up

I would even go one step further.  Establish a follow-up with the patient to review of the mobility equipment prescribed to make certain it satisfied their needs.  If not, go back to the specialists and hold them accountable for the recommendation.  Begin to suspend licenses, if necessary.  But, don’t continue to tighten the regulations to make it even more difficult to obtain mobility equipment.
 
I know I am just dreaming, but it would be nice to have at least one system that works the way it is supposed to.