Benefits You Might Be Missing Out On

With all that the sandwich generation has on their plate, it might be hard to take the time to review your benefits for your aging ward. However, an afternoon dedicated to your own insurance policy review, as well as those of your ward, could reap you several hundreds of dollars of profit. Or, think of it as your annual physical exam - an annoyance...a pain in the keester...momentary discomfort. However, you get a year of peace of mind. So, bend over...I mean keep reading!! :)

For low income Medicare beneficiaries, look into www.benefitscheckup.org. It is a free, comprehensive online screening site where you will find more than 2,000 public and private programs to assist you. Assistance for meds or food. Links to Older Americans Act and other public policies. If they saved 3.1 Million people over 11 Billion dollars, that's about $350 per person.

Eldercare.gov is one of many sites on the Internet that hosts information about local agencies and organizations that support seniors, their families, and their caregivers.

Finally, my company, Guardian Angels of the Suncoast, offers a bill review service. As a nurse, I can tell you that medical bills are often times miscoded, entered twice by mistake, or flat out wrong. My first suggestion is to request a fully itemized bill with the appropriate ICD-9 or CPT coding. It forces them to look at the bill again and it gives you a apples to apples comparison when speaking to your insurance company when challenging the bill.

If you'd like, I can perform this task for you. After all, don't you deserve a fair and accurate medical bill?

Happy Spring to All!

Consumer - Heal Thyself

Recently, I was out to dinner with a friend of mine at a local Indian restaurant named Tandoor. Very good food there. But while my guest and I were talking we noticed an elderly couple making their way to the door. Since we are both nurses, we continued our conversation but kept an eye on the couple as they shuffled towards the door. Simultaneously, my guest's eyes got quite large and the elderly man stumbled.

I was about to ask her what she was responding to when the gentleman fell into my lap! I quickly wrapped him up and held him there until he could get his bearings about him. We stood up together and he apologized profusely. I asked a few questions but his embarrassment had the better of him. Since he was limping on his left side, I handed his cane to him in his left hand and off he went. His wife was quick to explain that they just purchased the cane from the drug store. I kept an eye on them until they were safely in their car.

My concern is this...buying a medical device like a OTC medication and not receiving any instruction. He did not know to use his cane on the weak side of his body. As a consequence, he collapsed in the direction of that left sided weakness. So often, consumers go to the store and buy a vitamin, supplement, or appliance without knowing how to properly use it or the consequences that may result.

I fully support our society elders to live in a manner they want - as long as they are safe and educated on the consequences of their decisions. Your doctor has a nurse dedicated to taking calls, getting information and returning that call back to you. When you buy something at a drug store, talk to your pharmacist. Even if it is not in the pharmacy area, they are highly educated professionals who's job is to educate and care for their clients.

In a pinch, give me a call. Falling into my lap at dinner is not required. :)

The best way to get through the donut hole

The best way to get through the donut hole is to never have to use it. For those folks who are uninsured, under insured, small business owners and people just trying to save a buck, I would recommend Discount Rx Direct located at Lockwood Ridge and University. If you know where the discount movie theater and the British pub are located, the stop half way in between and you're there!


Judy is a great resource for helping folks maximize their dollars spent on prescriptions. As a RN, I have seen so many people living a miserable life because they are chopping up their pills or not taking them at all. Judy is willing to work with your needs and direct you to other local pharmacies where you can get some brands for as little as $4. The brand name stuff can then be obtained through her company. Her meds are from FDA approved sites outside the US.


She's a good egg. Call her and find out on for yourself.

Valuable Legal Links

VALUAB:E LEGAL LINKS

So when I hit the ground running, I needed to help Mom with her medical care, find support personnel and folks I could trust. Here's that list. Please send me an email if a link is broken.

http://www.boyerjacks... - Boyer & Jackson was a law firm I recommended to my mom when she needed a Will and other pertinant documents. The staff went the following morning to her bedside and facilitated getting her documents in order. A quick turnaround time and a patient staff was my experience. Also, their website is enormously informative. You can tell the difference between someone who practices elder law and who has helped shape elder law in Florida. My personal dealings with Andrew have been exemplary.

Dummies.com was a great site for me. With the swirl of emotions, drama, and frustrations, getting new information in a concise but meaningful way was essential. I strongly urge you to check out this site. It discusses probate, trusts, Executor responsibilities and potential pitfalls related thereto. 

Affordable Attorney was helpful to me personally as their rate was more suitable to my needs. They are a bit removed from the Sarasota Court House and there is very little "face time". However, if your case is uncomplicated and you don't mind extra travel, I'd recommend them.

Valuable Financial Links

VALUABLE FINANCIAL LINKS

My Mom's filing system was a reflection of her 30 years of mortgage banking and another several years of nursing. The Dewey Decimal Dude would be proud. (I chuckle knowing that some of you have no idea what the Dewey Decimal System is.) However, the last few years, it became obvious she wasn't thinking clearly and no longer cared. I had 4 desks and a garbage bag to sort through. Here are the folks who saved my sanity.

HR Block - Premium located on Bee Ridge Rd has a Master Tax Advisor named Merilynn and she was a godsend. Granted, she has been doing my mom's taxes for several years, however, she answered all of my questions, she cleared up some false paper trails that my mom had started at home but never completed, she found an IRA that was previously undiscovered. In short, she had my best interests at heart and stepped outside her job discription more than once to get the job done.

Iberia Bank - University Pkwy was one of the banks my mom used. Of her 4 accounts, I was co-owner of one of the accounts which I paid her debts from both before and after her passing. This branch allowed me to move funds that were not mine, not once but twice. After I paid bills from these funds, I received threatening phone calls daily to restore those funds immediately or there would be legal action. Then, without forewarning, they deleted my internet banking account and prevented me from paying bills from a distance. Because of their errors and inflexibility, I had to quit my job in Chicago and come down here AND I had to acquire legal defense. With that being said, your mileage may vary.

Cheryl T. Rhodes, CPA is a no nonsense, through and patient person who helped my complete my mom's taxes. There were folders of potential documents that she sifted through and assembled so that the return was ready the following week. She also reviewed my own taxes and discovered mistakes that were made by a professional, nationwide company. Her personal touch has encouraged me to run both my personal and professional tax needs through her.

Susan J Keeton, CPA - is a very down to earth, approachable professional who has a depth of knowledge that inspires trust within the first 10 minutes of meeting her. She is also a Forensic Accountant so solving problems is second nature for her. I presented to her as a discombobbled client that represented a person, two companies, and an estate. Her calm but thorough nature was exactly what a person in crisis needed. I am throughly pleased with her assistance.

An Eldercare Case Manager would have saved my Mom

To begin, this is based upon my own experiences. Your mileage may vary.

The Sarasota Herald Tribune recently ran an article about a patient who died at a local nursing home – Harmony Healthcare. The article link is HERE. The error was attributed to nothing nefarious. It wasn’t a drug error, a incorrect diagnosis, an infected bedsore, a fall, exposure after wandering off campus, but rather to an innocent mistake. Someone gave “Patient 15” a cookie. Specifically, the story infers that the patient was given a NPO status (nothing by mouth) due to a tracheotomy. Someone gave the patient a cookie. They choked and died. The chart noted that they were given a cookie and then the charting was crossed out. There are more nuances to the story and I encourage you to read the article and make your own judgment.

Judgments aside, I can tell you that the patients in a long term facility, assisted living facility and acute care facility, who have an advocate, are generally given more attention than those who do not. I entered the health care system as an employee in 1995 and have witnessed this behavior in the aforementioned facilities. This unfortunate fact, in my experience, can be mitigated by involved management, good hiring practices, anonymous reporting with facilities, periodic training / retraining, state ombudsman’s investigations, the state’s periodic inspections, and family involvement. In today’s healthcare environment, all of the aforementioned safety nets are stressed. Again, referring to the news article, several incidents were noted at the facility. The state agency would note the discrepancies and the time frame for correction. Corrections were made and the state deemed them compliant.

However, where there is smoke, there is fire. The fact is that minor infractions can go on and on as long as the quality of the infraction is not too severe by the state’s standards. It is the rare institution that is infraction free AND they do exist. However, if we suspend the fact that these are human lives at stake, then like any other industry (oil, coal, nuclear) there are situations where human oversight, greed or other reasons can result in catastrophes (BP, Coal River Mountain, 3 Mile Island). In the health care industry with multiple variables, how in the world can one person, encumbered by illness and lack of control, hope to navigate these treacherous waters?

I have witnessed situations where the patients having family members and / or other advocates coming by on a regular basis, are physically seen more frequently by the direct care providers. Rather than having to prepare the patient / paperwork for morning rounds, the direct care providers will re-engage with the patient because of a family member or other surrogate (friend, clergy, etc) who visits often and engages the staff. 

As both a nurse and a former comatose patient, I have been the beneficiary of the “X factor” that patient-centric advocates provide. I do not ever remember having an empty water pitcher. I do not remember ever having a messy room. I only remember one occasion in a month long stay in a hospital where my call light was not answered. Short of staff and a “Code Blue” meant I had to lie in a wet bed for about an hour. However, when my situation was discovered, five people came in to my room to manage my IV lines, my respirator tubes, deflate / inflate my bed and get me cleaned up. During this time, there was cross talk over me. However, there was also talking to me. I was a patient to be cared for and not a problem to be resolved. The end result is the same but the quality of care I received that night was better than many I have seen on either side of the stethoscope.

The system is rife with opportunities for failure. Yes, there are safeguards in place but no one particular system is infallible. So, like holes in a slice of Swiss cheese, there are gaps. When a gap in a system, lines up with gaps in other safety systems, serious / fatal events occur. The industry refers to them as sentinel events. Having sat in training courses where sentinel events (e.g overdoses of heparin) are examined, contingency plans are developed and training is put into place so that similar errors do not repeat themselves.

So, back to the cookie. Should there be a state law forbidding cookies in health care institutions? Obviously, no. Should individual facilities have a cookie free environment and then market themselves as a safer facility. Again, no. Does the facility have the responsibility of training everyone who comes into contact with a patient to know what NPO means? Yes, they do. Do dietary slips have NPO written on them so that food is not delivered to the inadvertently? Yes. Do facilities mark NPO in patient’s charts and put signs up in the patient’s rooms to prevent those errors? Yes. Did someone give a NPO patient a cookie? Yes, a cookie passed through all of the safety filters and it killed someone. 

How could the X factor have possibly played a roll in this scenario? If there was an advocate in the room, there would have been another set of eyes and ears to act as another layer of protection. If there was an advocate focusing the attention of the primary care team, there may have been a reinforcement of the physician’s order of NPO. There may have been a second thought on patient assignments and a more caring / attentive nurse would have had the patient’s status in mind. Then again, the outcome may have been the same. As with any complex equation, a single variable may make a huge difference. To borrow from Mark Twain, it could be the difference between “lightning” and “lightning bug”.

My final thought here is this – when considering your entry into the healthcare system, having an advocate to be another set of eyes and ears is always helpful and many family members can play that role. However, for those of us who are separated from our families, having a health care proxy can at least make sense of all that is going on around you. At most, they can save your life. To that end, you should educate yourself on the following titles: Nurse Navigator, Certified Guardianship, and an Eldercare Care Manager.

Welcome to the Sandwich Generation

Welcome to the Sandwich Generation! 

You have kids. Therefore, you are the social director, the limo driver, the chef, the parent, and you are pretty much slammed with all the responsibilities required therein. Suddenly, you have an elder parent or relative down on the Suncoast that needs assistance. Where the heck do you start? 

This is where I found myself in August of 2011. 

Here’s the fruit of my labors for your benefit: 

Betterliving.com: Articles / Information / Advertisements focusing on senior citizens in Manatee & Sarasota counties.

Mandirectory.org: Manatee Aging Network’s on line senior services directory for those in Manatee County.

Scandirectory.org: Sarasota County Aging Network’s on line senior services directory.

Sarasotaphysiciansguide.com: guide to MDs and ancillary services (transport, oxygen, rehab, home health, etc)

Bradentonphysiciansguide.com: guide to MD and ancillary services (transport, oxygen, rehab, home health, etc)

Seniorlivingonline.com: support service directory that also include Pasco, Pinellas and Hillsborough counties.