Tag Archives: Aging

I’m Back! And Now…the “Road to Medicare…”

Humor, , , , ,

I know it’s been a long time in coming. Most of you follow me on Facebook, so we haven’t truly been out of touch. But, wow! My life has been an amazing roller coaster of wonderfulness since Christmas. Yes, my last blog was about re-entering the Caregiving world. Truth be told, I was not happy about that. And it wasn’t even that dramatic. Well, it was for my husband, who had a serious leg injury, but for me it was “vanilla-caregiving-101.”

Since then, I’ve spent almost two months with my daughter welcoming our new grandchild and then a hasty return to presentations, TV appearances, having a caregiving script-in-hand read by professional actors, and working on getting more gigs to tell the world to get #prepared for the tsunami of caregiving!

I have neglected this blogosphere and I return renewed. I was truly thinking about what best serves my readers. And to look at my most well-received posts, I would say you guys love to laugh……….but even more, you love to be informed. So, like Bob Hope and Bing Crosby, our journey is going to be those “Road to…………” movies where we can have a laugh or two, but I’m going to teach you what I learn about all this aging, caregiving. long-term health care, Medicare, Medicaid, Social Security, nursing home, Elder law, estate issues blather as best I can.

Today…….the “Road to Medicare!” This could be 327 posts or more. In fact, it’s so chock-full of road blocks, potholes, orange cones, warning lights and yes, even smooth paving that we could have a blog about only this.

Lo and behold, I know someone who does that! And in my inbox this morning, she sent me three myths of Medicare. I had already decided to talk to you about our Medicare experience after dinner with friends last night when everyone was chiming in about signing up…and there in my inbox was Universe confirmation that yup, we need to talk about this.

My husband will turn 65 soon, and since I try to take my own advice, we called the Medicare Guru and asked her to guide us a bit. We are fortunate to have retirees’ insurance, and since I won’t turn age 65 for AGES (um hmmmm, had to say that), we knew this could be shark-infested waters. If we made a mistake in the sign-up process we could suffer some real financial consequences. The Guru gave us sage advice and the following week my hubby went online to sign up for Medicare.

Five minutes into a seven-minute process I hear, “Cathy!” Uh-oh. I run to the office to see consternation all over my husband’s face. There’s a trick question. Are you covered by your employers’ health care plan? Yes, we are, sort of. No box for that answer. I know it means, are you currently employed with health insurance? I know that because, well, because I know that. But lots of people don’t know that. Right next to the trick question on the computer screen is a teeny, tiny button with a question mark in a circle above it that says, “help.”

“Push that button,” I say to my husband. He looks at me like I told him to engage the nuclear codes. But he does it with a rivulet of sweat poring down his forhead. Right there in black and white it says, “this does not mean retiree insurance.” Hmm! Okay then. Up until that moment, my husband would have answered that one question, the only trick question for him, incorrectly. And that could’ve caused some real problems for us in the immediate future. And that is one teeny, tiny problem with signing up for Medicare.

Below are the three myths that the Medicare Guru, Joanne Giardini Russell at Boomer Health Group shared in my email today. You can reach Joanne or her associate Gwynn Sharick-Elberson at 248-871-7756. It’s free to talk to them. They are super nice! Tell them Cathy sent you! You will love them.

Joanne Giardini-Russell

810-599-7116 – mobile

248-871-7756, ext 101 – office

Check out this Video

Check out this video: https://share.vidyard.com/watch/rApnWNNRYtwo3KBSW58Y42?

Clean Up, Clean Up, Everybody, Everywhere…….

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I have been trying to give you wonderful readers important information about aging, healthcare, and caregiving. It just hasn’t been that humorous, now has it?

Let’s change it up. Just for laughs.

My Mom has bravely embraced her new Smart Phone. But, oh the journey. Almost on a daily basis, she struggles with re-learning how to delete messages, listen to messages, text a message, delete texts and just answer the damn phone.

What’s fascinating about this…and I notice it with my other friends ‘of a certain age’, is that she is obsessed with “cleaning out” her phone. There can be no messages in the inbox. No texts hanging around when she has ended the conversation. No emails that offensively fill up her mailbox when she must make room for more email that may arrive at any moment. I usually have to stop her from doing what this guy is doing.

 

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via GIPHY

I’ve tried to explain that those texts and emails can stay there as long as she needs them. If she wants to look at a text later, share it with someone, or just remember what someone texted her, there is no need to clean up five minutes after the conversation ends.

via GIPHY

This is the deal….you clean up your mess. You clean up after yourself. You make your bed. You wash the dirty dishes. You do not leave them in the sink for someone else. You vacuum, dust, and tidy up every day, all the time. You do this because you never know who may show up at your door, or what emergency may ensue and someone will be unexpectedly in your lair. And you do it with an Entemann’s cake on hand, just in case.

Your phone is no different. God forbid someone sees that you have 15 messages in your queue. You have 42 unread emails. You have not cleaned up your mess. Anyone can pick up your phone and see what an absolute slob you are. A disgrace.

I, myself, often have 1500 messages floating around in my email. This drives many people insane. But not me. I don’t care. I really don’t. Then again, I’m cleaning up at 11:00 PM for my cleaning lady, who bravely shows up tomorrow. Maybe I’d be better if this guy were coming.

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via GIPHY

 

On top of all this, while my mom is riding next to me in my car, feeling quite smug since we tidied up her phone, I catch her looking through the camera lens of the phone, just to see what is in the hole.

 

via GIPHY

Yeah, I caught you.

“You Just have to Laugh……”

©2018 Cathy Sikorski

And You Thought “Mooning” Went Out With Hot Rods…………

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In the beginning of 2017, Medicare implemented the new Medicare Outpatient Observation Notice which seems to have the same effect as the old ‘mooning’ we think about from American Grafitti.

You see, MOONing in Medicare (sounds like a love song from Cole Porter, doesn’t it?) means that within 36 hours of entering a hospital, if you will not be admitted, but only kept under  “observation,” they must inform you with a written explanation.  This is the form, if you’d like to see it!

MOON FORM

The problem with this form is the unintended consequences it might have for you, if you are on Medicare, or your loved one, if you are a caregiver for someone who is on Medicare.

If a patient is placed under observation, typically in the Emergency Room, and is never formally “admitted” to the hospital, Part A hospitalization of Medicare does not pay. In other words, you are paying as an outpatient.  For a quick trip to the ER (is there such a thing?) that’s no big deal. After all, the Part A deductible is $1340.00 so you may not even spend that much if you’re only there a few hours.

However, if you are there a few days, and you stay on observation, it is likely that you will start racking up fairly high medical costs with co-pays for every service you are getting. Not to mention any drugs, that likely will not be covered by your Part D while you are in the hospital. It’s complicated, scary and could be costly.

The worst result could be that you are sent to rehabilitation, and because you never met the “admitted to the hospital for 3 days” requirement to have Medicare pay for at least 20 days in that rehabilitation center, you are now responsible for a significant bill coming out of that rehabilitation center. This has happened to people to the tune of thousands of dollars.

So what can you do?

This advice comes directly from this AARP article, which oddly was written before MOON became a regulation and before the MOON form existed. So I have added two of my own suggestions at the end:

Medicare: Inpatient or Outpatient?

  • Ask about your status each day you are in the hospital, as it can be changed (from inpatient to observation, or vice versa) at any time.
  • Ask the hospital doctor to reconsider your case or refer it to the hospital committee that decides status.
  • Ask your own doctor whether observation status is justified. If not, ask him or her to call the hospital to explain the medical reasons why you should be admitted as an inpatient.
  • If, after discharge, you need rehab or other kinds of continuing care but learn that Medicare won’t cover your stay in a skilled nursing facility, ask your doctor whether you qualify for similar care at home through Medicare’s home health care benefit, or for Medicare-covered care in a rehabilitation hospital.
  • If you go to a skilled nursing facility and have to pay for it yourself, you can try formally appealing Medicare’s decision. When you receive your quarterly Medicare Summary Notice, make a copy and highlight the facility’s charge. Send this to the address provided on the notice with a letter saying you want to appeal Medicare’s decision of noncoverage on the basis that you should have been classified as an inpatient during your hospital stay and not placed under observation. If this is denied, you can go to a higher level of appeal, following instructions on the denial letter.

Additionally,

  •         You can refuse to sign the form. All that does is make the hospital sign it, and make them a bit testy. But it signifies that you do not accept this and hopefully is evidence on Appeal that you were trying to fight the observation status.
  • You can take your patient home. I am not recommending this, especially if the whole reason you are fighting ‘observation status’ is because your patient is very sick and you are certain they will end up in the hospital, a rehab center, or a skilled nursing facility after this event. But one of the problems with Medicare is that they penalize hospitals for re-admissions. So discussing the possibility that you might take your loved one home, that might force a re-admission, may move them to admit your loved one.

Sometimes this feels like the “Art of War,” when dealing with healthcare issues. Being forewarned is being forearmed, as they say. Seems like anything is better than being MOONED!

“You Just have to Laugh…..”

©2018 Cathy Sikorski

You’ve Come A Long Way Baby……

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My mom has become obsessed with creating photo albums for her six children from the hundreds of photos in her treasure chest.  She must make 6 copies of almost every photo, or at least as the photos progress and a child is added to the history books. I have no idea why this project might be frustrating for her 88-year-old self, do you? Duh, comes to mind.

Every once in awhile, when I’m in the mood for a little frustration myself, I stop over to my mom’s house to call the VA, or fix her iPad, or fight with Verizon.  Invariably, we start to look at the pictures together.

Yesterday, she showed me this photo.

 

My Nana is the one circled in yellow. She is about 35 years old in this picture. Her name wasn’t even Nana yet, as my mom is the cutest little 8-year-old circled in pink. I made my mom go find a photo of herself at around the age of 35.

Adorable me second from left! Even tho that’s not the point.

Then I came home and looked for one of me around the same age.

Please Note: 80’s fashion is not helping me make my point.

I would like to posit the following: Rather than continuing to punish women for adopting a youth culture look, perhaps we are actually just trying to enjoy life, look like we are having fun, and present a ‘picture’ to the world of what we actually look like, at the age we are at. Perhaps over the last 50 years, we started rebelling against being portrayed as “Nana” before we were even done having children. Perhaps, just because we have children doesn’t mean we have to wear orthopedic shoes, bras with no support, dresses made from tablecloths, or a hairstyle that would confuse us with Grandma Moses.

Perhaps my mother’s generation actually clandestinely started a revolution where women got to enjoy their youth, even if they had 6 youths of their own running around. Maybe that’s what began way back in the ’50’s and ‘ 60’s when no one was paying attention to the everyday housewife. And maybe that’s what’s still happening today to women in their ’50’s and ’60’s when no one is still paying attention.

Just sayin………

My Nana apparently didn’t change her look for 60 years. My mom, on the other hand, created generations of hot tomatoes! Yay, Mary Ann!

 

Photo by Dani Almond Photography

Photo by Dani Almond Photography

“You Just have to Laugh…………..”

©2017 Cathy Sikorski

Um….yeah…..not paying that….

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You think when your caregiving ends….well, your caregiving ends. But not so, intrepid caregivers. I’m now steeped in estate work and it, too has it’s unbelievable encounters. I have to call billing department after billing department to make certain that a bill is legitimate before I concede to pay. And each billing experience makes the last one look like child’s play.

Billing Experience Number One (really probably number 157)

“Hello? I have a billing question. Can you help me with that?”

“Sure.”

“What information do you need?”

” How about do you have a name and birthdate?”

“Why yes, yes I do.” And do I give her all the necessary information to retrieve the bill for my mother-in-law.

“My question is, this bill seems to have been processed by all her insurance carriers, and so there should be no balance due, and I know that she has also met her deductible.”

“Well, there is still a balance due after that.”

“No, I don’t think so. I’m pretty sure that according to the laws in Pennsylvania, if someone is on Medicare and they have a Medigap policy and both insurances have paid AND the patient has met their deductible that you must accept that as payment in full.”

“One moment, please.”

Oh boy, Muzak.

She returns pretty quickly, which in and of itself makes me happy.

“Well, ok, then. There is no balance due, but we didn’t have in our records that she was on Medicare.”

“Really? Because you just asked me to identify her by her birthdate, which is 1916, which makes her 97 years old AND you are showing on your bill that Medicare made a payment, just sayin’…”

“Well……”

And she hung up.

Billing Experience Number 2 (Actually not even 157, more like 210 by now)

“Hello. I have a billing question. Can you help me with that?”

” I will transfer you to billing.”

“Hello, I have a billing question. What information do you need?”

“Sorry ma’am this isn’t billing. Let me transfer you.”

“Hello, I have a billing question. What information do you  need?”

“Can you hold a moment?”

Of course, I don’t get to answer that question. I just get more Motley Crue Muzak.

“How can I help you?”

“I need to know if this bill for Aunt J is final?”

“Well, let me see…..hmmmm…..no, it looks like there is another bill with an additional balance.”

“Well, I’m sorry to tell you that there are no funds to pay this bill or any future bills. There will be no estate and the patient was visiting from Australia.”

“What? Australia? I don’t understand.”

Really? I’m thinking…..what’s not to understand. That seems pretty clear to me, but OK, I’ll just lather, rinse and repeat.

“Well, I’m sorry to tell you that there are no funds to pay this bill or any future bills. There will be no estate and the patient was visiting from Australia.”

“Um…ok…so could you send us a letter to that effect with a death certificate?”

“Sure. I would be delighted to do that.”

So far I’ve had to send that letter and death certificate 11 times. Do you think they would send me anything for free?

You just have to Laugh……

Cathy Sikorski

Beauty is in the Eye of the Beholder……

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This is a warning and a blessing for those of us who are aging….which is all of us………..there are some upsides to technological ignorance.

My husband and I took my Mom, who is a very “with it” 85 year-old, who uses her own computer and iPad, to an orchestral pop’s concert yesterday afternoon. What intrigued me about the ad I read in the paper (yes, I do still read an actual newspaper) was that the theme of this concert was Ellis Island. The concert would include live performance pieces and a series of photos on a large screen to add to the music accompaniment. It was a new piece and had been around the world and shown on Public Television. “Wow!” I thought, “this would be great for all ages!” Honestly, though the average age in that audience was easily 90 or above.  I guess Ellis Island has a certain age appeal. Now that I think of it,  most of the ads in the program were for home care and assisted living. Not kidding.

The concert is held in a beautiful fairly new theater in a local public middle school. This theater is pretty darn magnificent for 11 to 14 year-olds. My theatrical-career-yearning heart is sobbing over the cafegymatorium we used for our productions in my high school in the ’70’s. Nonetheless, I am impressed and happy to be in a theater this beautiful and with all kinds of groovy acoustic equipment, lighting panels and comfy, cushy seats for this Ellis Island extravaganza.

I tell the ticket seller that I’m excited for the concert. And he, appearing to be a long time volunteer for the orchestra says” “Well, it’s different, hope you like it!”

But, not so different from any other Pops, I think. The first half is music from Fiddler on the Roof, and a tribute to Louis Armstrong. It’s wonderful and fun to hear. Then a short break and the Ellis Island themed presentation begins.

A huge projection screen slowly decends down from the ceiling, the maestro appears, the audience claps heartily and the music begins. It’s lovely. the screen projects a million dots in gray, black and white and then ‘pulls out’ so that the photo you see is actually millions of people on the deck of a boat. There is not an empty space between any of the heads. It’s overwhelming. The photos continue with individual pictures of immigrants and places on Ellis Island. The change in each photo is timed perfectly to the music. It is grand.

The first actor appears. She reads a charming account of an immigrant from Rumania, all the while beautiful music is lowly playing behind her. When she is finished, she leaves the stage and the music begins again in real earnest. The projection screen lights up and an error message appears….”NO SIGNAL.” Again, the screen goes from gray to the cursed blue of noncompliance, and the same error message appears. There’s a tiny little groan in the audience….mostly from people under 60, I think. We all know what that error message means. And, that’s it for the photo display. The rest of the concert takes about 40 minutes and never another photo is shown.

Six more actors appear. The music continues, and it’s really quite beautiful. But the whole time now I am literally having an internal boxing match with myself about why this stupid technology isn’t working, and can’t they fix it, and just put up some pictures, and hasn’t this ever happened before, where’s the back up plan and just UGH!!!! So it’s a good concert…..no really, it is…..but I’m  a victim of my techno-google-pc(that’s private computer not politically correct)time, and I can’t get this dumb error out of my head. I’m feeling cheated of half the performance.

The show ends with all seven actors reciting Emma Lazarus’ poem that is engraved on the Statue of Liberty. When they finish the recitation they all raise one arm to the screen, where I imagine the Statue of Liberty is supposed to appear. Nope, just a blank screen.

The crowd goes wild, struggles with their seat handles and their coats and programs to raise their sweet bent old bodies for a standing ovation. And then it hits me. Maybe 5 per cent of this audience knows what went wrong. So I do a survey of one, to my Mom:

“So, how did you like it?” I ask

“It was wonderful! Thanks so much for bringing me, it was really beautiful. The music was beautiful and the actors were great. I really enjoyed it.”

“Did you notice anything wrong?”

“No, what? It seemed fine to me. What?”

“After the first actor the projector didn’t work, there was an error message and no more photos. And at the end the actors raised there hands to indicate something on the screen, but nothing was there. You didn’t see that??”

“Nope. Loved it. It was beautiful.”

See….there are distinct advantages to aging…

You just have to Laugh……

Cathy Sikorski

The most important meal of the day…..

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I wanted to return to ‘my roots’ of why I started this blog. I believed (and still do) that there is a real honest place in caregiving for laughter. There’s no way you can do this day in and day out and not see the humor in all the craziness around you.

Today is an homage to my dear mother-in-law. She was known for her subtle sense of humor. She would laugh at whatever you tossed out there as funny and she could come up with a zinger or two herself when necessary. So I feel quite certain that given the time and the retrospective, she too, would see.

So once my 94 year-old mother-in-law moved into her assisted living facility, she was quite content. She adjusted quickly and enjoyed her feisty bingo games, where the winner got a quarter for each victory(I too became a little over zealous with “BINGO!” when helping her play…to WIN)She seemed to enjoy her table companions at breakfast, lunch and dinner, as well. The facility tried to keep the table companions constant so that they could get acquainted and hopefully, enjoy some conversation at mealtime.

Things were going swimmingly. But as time rolled on and Mom became more comfortable with her surroundings, she actually began to backslide into more childlike behavior. Eventually, she needed more help dressing, reminders to go to meals, and assistance to get ready for and go to bed. Otherwise she would never change her clothes, forget to go to meals, and stay up all night watching TV and dozing in her favorite chair. (This became such a pastime for her over the last 20 years, that I was tempted to put her in that chair for her viewing….most of us would have said “Oh she looks so natural.”)

Then her time clock began to get out of whack. She would put her pajamas on after breakfast, she would refuse to go to meals because she just ate, and she would wonder why no one was coming to get her for a meal, when she had just returned to her room from lunch.

One day I went to see her and she was sound asleep in her bed at 11 o’clock in the morning. This was extremely unusual for Mom. She has been an early riser since the dawn of time, and she NEVER would go back to bed for a nap or if she was sick. She would just get dressed, take to her beloved chair, and snore away the day resting comfortably…but NEVER napping. (I think that’s reserved for lazy people like me who try to nap every day, if possible).

I go to the nurse’s office to see if they know why Mom is in bed.

“Hey, ladies! Do you happen to know why my Mom is in bed at 11:00 in the morning?”

“Ummm, not really, maybe  her aide knows?”

I hunt down her aide, and this is the story:

“She got up around 1:00 AM. I saw that she was out of her pj’s and completely dressed for the day. So I said, ‘Hey M, where are you off to?’

“I’m going down for breakfast.”

“No, darlin’ it’s not time yet, let me help you back in bed. It won’t be for awhile, so you need to get some rest.”

“Ok,” she said.

The aide took her back to her room, put her back in her nightgown and tucked her in bed.

At 3:00 AM, the aide sees my mother-in-law down in the dining room.

“Hey M, what’s going on?”

“I’m here for my breakfast.”

“No, sweetie, it’s not time yet, let’s go rest for a bit and then we will come get you for breakfast.”

Back they go to her room, get her back in her pj’s and tuck her in.

At 5:00 AM, my mother-in-law enters the dining room, perfectly coiffed and ready for breakfast. It’s dark in there and no one is at her table.

“Good Morning, M. you’re down here a bit early,” says the aide.

“I’m here for breakfast.”

“Well, that ‘s not until 8 o’clock, how about I take you back to your room to watch TV until we come get you?”

“Ok.”

At a quarter to 8, the aide goes into Marie’s room. She has now changed herself BACK into her nightgown and is asleep in her bed, as the morning sun streams brightly into her room.

“C’mon, M, it’s time to get up and go to breakfast!” says the aide.

“Oh forget it,” says my mother-in-law, and turns over and goes back to sleep.

You just have to Laugh……

Cathy Sikorski