Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

Two of my client’s families have told me this week that their parent has reached the “donut hole,” that place in the Medicare D (drug plan) where they will need to cover all the costs of prescriptions until they reach an even higher level and then Medicare will cover most of the costs.

The question I pose to all of you is: doesn’t the term “donut hole” conjure up one of two visions – something good to eat or thin air?  Should it be called Medicare D “Pay Some – Pay All – Pay a Little” plan?

Let’s get creative and change the name of the “donut hole”.  Can we give these little treats back to the donut shops!

Maybe we should call the Medicare D gap in paying for prescriptions the “Black Hole” or the “No Pay Zone”.

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

There was recently an online streaming broadcast about Health Care Reform provided by the website www.healthreform.gov where some great information was obtained .  Below, I have summarized what was said about the most recent law affecting Health Care Reform:

1. This new bill does not eliminate anything Medicare currently offers.

2. Starting in 2011, Medicare will not charge for preventive care check-ups and regular physicals.  No co-pay and no deductible.  This includes colonoscopies, which are considered preventive.

3. Seniors who have hit the gap in drug coverage, known as the donut hole, will receive a $250 rebate starting in June or as soon as the donut hole is reached.

4. Senior Medicare Patrol is ramped up to prevent scam artists and fraud to seniors.  The Patrol will also be available to educate seniors on their Medicare benefits by helping them to read about their coverage and interpret their benefits.

5. Early retiree insurance pools will begin in 2014.  Medicare will be offered to those who are forced to retire early or decide to retire early.  New rules will be in place to employers and insurance companies so they do not prevent access to health care upon early retirement.

6. Retiree drug plans will continue to be fully protected.

7. The “high risk pool” are adults or seniors with pre-existing conditions.  This group of people will see a cap on their premiums as of 2014.

For more information look at the following credible website:  http://healthreform.gov/

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

The Caregiving Legacy Award from the Rosalinde and Arthur Gilbert Foundation is being given to the “Alzheimer’s Dementia Strategy and Dementia Summit”.

 I had the honor of serving on this panel with many other leading Dementia experts in San Francisco.  My role, based on expertise, was that of “Care Coordination and Professional Care Manager.”  Most of the research we found pointed to the value and need of a central person to be the guide and contact for primary caregivers.  Families who had Care Management worldwide were better able to cope with the changes and transitions this disease presents.

 Our panel was charged to come up with a plan for the city of San Francisco to be pro-active in designing services needed by caregivers and organizations.  The plan was to look at the needs of this growing population for the next 11 years – pro-active planning at its best.

 The final report will be available soon from The San Francisco Department of Aging and Adult Services and/or The Family Caregiver Alliance.

 It was truly an honor to work with experts in public policy, research, medicine, community services and the private sector.   In this time of a down economy it was good to focus on what we can do, what we want to do and what is most needed.  The Baby Boomers are aging. Everything we can do, for treatment, prevention, public policy, benefits and education of Alzheimer’s, now will prepare us for a future of “positive caring”!

 Congratulations San Francisco!  Thanks for letting me be a part of a pro-active plan.

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

You want this no matter what your position is…good end of life planning gives you control.  If done appropriately and with the right legal tools you can dictate how you want your journey to be played out based on your values and not the values of the doctor, the hospital, your family or others.

I am not sure all doctors are prepared or trained to have this very sensitive discussion with aging patients.  However, some are excellent at counseling individuals and families about choices one can make around health care decisions.  I believe this type of counseling should be done every 5 years and I applaud the designers of the potential new health plan for including this measure.

Professionals from other disciplines might be better at this type of counseling, those who are outside the medical provider area – such as Professional Geriatric Care Managers (PGCM).  A PGCM can help you look at the different tools available for you to record and direct your end of life interventions and ask you about values.  Most importantly, the PGCM can give you peace of mind that someone will advocate for you to ensure the journey goes your way – and that the someone you so name is in agreement to follow your plan – no matter how “outside of the box” it might be.

One tool for Advance Directive Planning is “The Five Wishes”.  This document recognized in many States takes in more of the sensitive end of life wishes of individuals than the standard “Advance Care Directive/Durable Power of Attorney for Health Care.”   This document is honored in most states but not all.   So, if this is a document you want to use – be sure it will be honored in your State.

If you want all medical interventions possible to extend your life these documents are just as important or maybe more so than those that just want comfort care and no “heroic” interventions based on their directives, values, culture and religion.

I cannot defend the Obama Health plan nor can I tear it apart – but I can tell you that each of us should complete some end of life planning tool no matter what our age.  Those who are past 65 should look at all of their legal documents annually – I suggest the month of your birthday – just to see if you should redo something or if your options or thoughts have changed – you can amend your documents.

Elder Law Attorneys (http://www.naela.org) can be a good resource with this planning element as well as Geriatric Care Managers.  Most Elder Law attorneys include these documents in all of their estate planning sessions. However, not everyone practices in the same manor.  So, be pro-active and ask questions about this very important tool to have life your way till the very end.

May each of you who read this have a full and peaceful life.  May you gather the tools you need to have the last journey unfold as directed by you and not others.

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

When your parent is ready to be discharged from a hospital, short-term help could prevent him or her from being readmitted. About 1 in 5 Medicare patients is re-admitted within 30 days according to the New England Journal of Medicine. Often discharge instructions are not understood, medications are changed (but no one cleans out the medicine cabinet at home) and sometimes follow-up appointments with primary care doctors don’t get scheduled.

Be pro-active when parents are hospitalized, even with those who are fiercely independent. Most of us at any age are somewhat off balance after an illness in more ways than one . However, our aging family members have even more difficulty regaining strength due to the aging process. Try to convince your parent to agree to even a few hours a day of caregiving support after any hospitalization. Reminding the elder of new routines (part of the discharge plan), new medications and even new diets can be the difference between health and a re-admission.

Eldercare Services’ Geriatric Care Managers coordinate discharges in a personal client-centered way that can result in increased health and independence. Short-time help for long-term wellness.

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