Don’t be Surprised by Medicare’s Out-of-Pocket Costs

My friend Quentin Fottrell is the Moneyologist columnist over at MarketWatch. He recently shared with his facebook group a reader question about whether a woman should help her 75-year-old sister with medical-related credit card debt.

Two commenters asked, “Why does she have medical costs? Isn’t she on Medicare?” They thought that Medicare covered most healthcare costs for older adults.

Unfortunately, this simply isn’t true. While Medicare is the primary health insurer for most older adults, it only pays a part of the healthcare bill. There are three kinds of out-of-pocket costs that we face!

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Throwing In The Towel: The 6 Most Important Questions to Ask When You Want to Quit Caregiving

I don’t know anyone who feels like they can just up and quit taking care of a loved one who needs it. The very nature of this role is that it’s not something you choose.

That doesn’t mean that we don’t often, or even always, wish we could get off the caregiving train. The work’s not fun. It’s unrelenting, hard and requires tremendous sacrifice.

Often in life, quitting can be a healthy thing to do… ending a toxic relationship, leaving a miserable job, or even moving on from a comfortable career so that you can do something more rewarding.

But, there are also times when we, either can’t or don’t really want to stop. We just need to find some way for the pressure, fear, and exhaustion to ease up a little.

If this is your situation, here are 6 questions you need to ask yourself.

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4 Tips for Talking to Your Parents About Death

Earlier this year, I wrote a blog about how important it is to prepare for end-of-life decisions you might have to make on behalf of your parents. I wrote about advance directives, and having important conversations with doctors and family.

I culled so much good advice from books and articles that it inspired me to talk to my own family.

Here’s how that went down.

Me to Dad: So, Dad, I’m writing a blog about preparing for end-of-life decisions and it occurred to me that we haven’t really talked about what you and mom want.
Dad: You think we’re DYING!?
(End of conversation)

Me to Sister: So, I’ve figured this all out. I’ll tell Mom and Dad that you should be the financial power of attorney because you’re good with money and I’ll be the healthcare power of attorney because I’m good with healthcare
Sister: * ? *
Me: Oh, see, I was thinking we should get Mom and Dad to focus on creating their advance directives — you know, end-of-life planning
Sister: Is there a book I can read about this?
Me: You know I’m an expert, right? Don’t you trust me?
(End of conversation)

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3 Medicare Benefits You MUST Know About

“What do you mean Medicare doesn’t cover this?” My friend Sarah was caught off guard when I told her that her parent’s health insurance program doesn’t cover her parents’ care.

What I explained is that there’s a lot Medicare doesn’t cover and one of the biggest gaps is the ongoing, long-term care that people need when they become frail or disabled.

This care is expensive! Hiring someone to help with cooking, laundry, transportation or personal hygiene can cost around $20 per hour!

So what do families do? Well, one of two things. They pay for this care out of their savings… or much of the time, DAUGHTERS PROVIDE THE CARE THEMSELVES.

In fact, new research shows that most of the really frail older adults in this country don’t live in a nursing home. Most live at home and the vast majority — 2/3rds to 3/4s — are being cared for ONLY by family members — unpaid.

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3 Reasons You Might Not Be Getting the Help You Need

It’s 5 am on a Saturday morning and I’m lying awake with that cold, sweaty, anxious feeling that comes from deep existential angst masquerading as too many things to do. I know something has to change – that there’s GOT to be another way to look at my life..to live so that panic isn’t my default emotional channel.

One of the good things about being almost 50 is that I can look back on the last 20 years and realize that being anxious all the time doesn’t change much, regardless of what I’ve got on my plate. In other words, my responsibilities have always felt like too much, even when I was taking math tests in 5th grade.

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3 Powerful Ways to Avoid the Hospital

Americans have a love affair with hospitals.

We tend to think of doctors and nurses as the people who were working hard to make good grades while the rest of us were skipping class. I am pretty sure my brilliant, doctor friend Heather was walking around with a stethoscope at age four while I was still sticking Play-Doh up my nose.

This romantic affection for hospitals is not entirely misplaced. There are zillions of people who need life-saving surgery and who live longer because a hospital was able to treat them effectively. ERs in public hospitals handle an onslaught of some of society’s toughest cases; drug addiction, mental illness, and homelessness.

But, you don’t want to start your caregiver journey in a hospital.

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4 Things You Must Know When Picking a Home Care Agency

Everyone says that they want to stay at home as they age. And, actually most of the frail older adults living in this country today are, in fact, living in a home setting. Really very few live in nursing homes or assisted living facilities.

Now you might think that this is pretty great — our parents want to be at home and we want them at home. The problem, though, is that the vast majority of frail older adults living at home are 100% being cared for by their family and friends. And if you’re the one doing this work, you know that caring for a frail older adult without help is very, very hard.

One way to make it a little easier is to hire someone to help. But, many daughters can’t go this route because one, it’s expensive and two, it’s not covered by insurance. Medicare does not cover the expense of a home care aide — even for very sick people. The program does have a “home health” benefit but it’s extremely limited and pretty much only covers therapy…not ongoing help with basic needs.

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Medicare Therapy Rules Made Easy

Most of us take for granted that we can get out of bed in the morning and do all the things necessary to head out and face our day. You know… the simple everyday things like moving around our house, showering, getting dressed and eating breakfast. I might be a little foggy most mornings but I don’t think about whether I’ll face an enormous challenge in measuring out the coffee or pouring the milk. The point is the routine is just that…routine.

But if your parent is frail, you know that there’s nothing routine about these activities — that for them, doing even the simplest things just can’t be taken for granted anymore.

The mobility and functioning that’s essential to independence and safety suddenly becomes a big effort. And, Daughterhood really happens when we have to get involved in helping our parents do the things that they can no longer do by themselves. This is when their lives and ours get hard.

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A Go-To Guide For Understanding Your Aging Parents’ Rehabilitation

I was 30 weeks pregnant with my daughter when a routine doctor’s visit uncovered the fact that a disconnected placenta had cut her off from getting food and water. Essentially, she was starving in utero. Later that same day, my girl was born by emergency C-section weighing in at just over 2 pounds.

Her early birth kicked off years of specialized healthcare and education, most of which was therapy to help her walk, talk and manipulate the tools she’d need to do even the simplest things like eat, use a pencil, and play with her toys.

I’m happy to report that today she’s a strapping 5’7” teenager who plays softball and the piano. And, while her gritty personality had a lot to do with her success, so did the physical, occupational and speech therapists working with her.

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Creating a Resilient Response to Loss: The Special Challenge of Dementia

I’ve said many times that few things are more disorienting than the shift from being cared for by your parents to caring for your parents. The only thing that makes it harder is when your parent (or spouse) has dementia. This is quite possibly the most challenging of all situations.

Every Sunday, I allow myself the pleasure of spending time on Krista Tippett’s website, www.onbeing.org. A couple of weeks ago, I stumbled onto a podcast entitled, “The Myth of Closure” with family therapist Pauline Boss.

She’s coined the phrase “ambiguous loss,” which I find revelatory. Ambiguous loss refers to “a loss that is unclear, that has no resolution or closure”…. Where a loved one’s “status as absent or present remains hazy.

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