Sleep Apnea – What Your Doctor Might Ask To Determine IF You Need A Sleep Study

As I mentioned in the earlier post, there are several different things your doctor will look at to determine whether he/she wants to test you for sleep apnea.   Some BUT NOT ALL are:

Weight  – If  your BMI (body mass index) is higher than 25, you are at a greater risk of sleep apnea.   This is not always the case as slender people have been know to have it.

Age – Although sleep apnea  happens at any age, it is more common among adulthood to middle age.

Male versus Female – Men have a higher chance of having sleep apnea but the risk increases in women during and after menopause.

High Blood Pressure – This is another thing the doctor will take into consideration as it is common in people with sleep apnea.

Does someone in your family have it? – Believe it or not, this is a heritable condition.  However, that is possibly due to inherited traits like weight and physical features.  Of course, some of this could be due to chosen habits like exercising and/or eating.

Family history – Sleep apnea is a heritable condition. This means that you have a higher risk of sleep apnea if a family member also has it. Inherited traits that increase the risk for sleep apnea include obesity and physical features such as a recessed jaw. Other common family factors – such as physical activity and eating habits – also may play a role.

Headaches – Another possible hint is headaches, especially morning headaches.

If you go in for any surgeries, they will go through a sleep apnea questionnaire which checks on most of the top symptoms.  Naturally they will want to know about snoring, waking up tired, gasping during sleep, etc.

If you have several of the above, your doctor may order a sleep apnea test.  There are a couple basic ways to test for sleep apnea.  In the next post, we will look at the differences between them.

Medicare and nursing homes – who pays?

It is hard enough to be dealing with a personal who is either sick or injured without having to deal with the financial end of things.  I had a friend call this morning in a panic.  She had just found out that Medicare does NOT pay for nursing homes.  She has to pay over $600.00 per day for her father.  She asked what I knew about nursing homes and Medicare so I thought I would write this post.

Here is what I believe to be true from an official AARP website:

Q. I read that Medicare doesn’t pay for staying in a nursing home. But my friend is in a nursing home, and she says Medicare’s picking up the tab. Who’s right?

A. Both are right. Medicare doesn’t normally cover “custodial” care for people who live in nursing homes or other long-term care facilities. Custodial care means help with daily living activities, such as eating, getting in and out of bed, washing and bathing, going to the toilet and moving around. Paying for this type of care is your own responsibility, unless you have long-term care insurance that covers it or you qualify for Medicaid benefits from your state.

But there’s one exception. Medicare’s skilled nursing facility (SNF) benefit covers a temporary stay in a nursing home in certain circumstances.

How to qualify for the SNF benefit:

* You must have Medicare Part A hospital insurance.

* You must have spent at least three days as an admitted patient in the hospital. Days spent “under observation” in the hospital do not usually count toward the three days.

* Your doctor must order that you need skilled nursing services as a result of the same illness or injury that put you in the hospital, or because of a new one that developed while you were there. For example, you may need continuing intravenous injections or physical therapy.

* The services your doctor ordered can be provided only on an inpatient basis at a Medicare-certified SNF (either a nursing home or hospital).

What you get:

Medicare covers up to 100 days in a skilled nursing facility. This includes medical and nursing services, custodial care, semiprivate room, meals and prescription drugs. (Any drugs you need while receiving the SNF benefit are paid for under Medicare Part A hospital insurance, not under Medicare Part D drug coverage.)

What you pay:

* Days 1 to 20: You pay nothing. Medicare pays 100 percent of the cost.

* Days 21 to 100: You pay a daily copayment—$137.50 in 2010—and Medicare pays the rest. (If you have medigap supplementary insurance, long-term care insurance or are in a Medicare Advantage health plan, some or all of this cost may be covered, depending on your policy or plan.)

* Beyond 100 days: You pay the full costs and Medicare pays nothing. (Long-term care insurance may cover part of the costs.)

Do not take this as the hard rule as it seems like different people have different rules.  Mom was lucky enough to have a secondary insurance that paid what Medicare would not after the first 20 days.  However, Medicare only pays if the person is improving daily.  At the point where they decide the patient isn’t, they cut off the money.

I would strongly suggest anyone that can to get a supplemental insurance.  However, these insurance plans vary from state to state and can be very expensive.

Depression – We all have it.

I apologize for the lack of posts lately.  This time last year, my Mom was in the final stage of her life.  My time was consumed by visits to the nursing home, hospital and preparing my home to bring her home for as long as I could safely keep her here.

Mom did not want to die in a nursing home and we had discussed it many times.  Towards the end, Medicare decided mom’s rehab was doing no good so they were going to move her once again to a different wing of the home.  Moving people with dementia is extremely hard on them.

The home told me mom was getting very agitated when I wasn’t there so they wanted to drug her more.  It was time to make a decision.  We decided as a family to bring her back to my home and take care of her here.  We knew it would not be for a long period of time but wanted her at home as long as we could make her comfortable.

There was a whirlwind of activity.  My son came and built a wheelchair ramp in two days.  We had to empty my kitchen of all furniture as mom’s hospital bed and lift would not fit in any of our bedrooms.  Luckily, I had great friends who just appeared and we toted up a lot of things so that we were ready.  My brother’s and their family would have been here if they could have.

I will write a later post about everything we should have done differently.  I just wanted to let you all know that I am still here and will start posting again.

To MOM, I love you and miss you everyday.  See you someday!

Respite Care – Do you need a break?

Respite Care – Do you need a break?

Caregiving can be exhausting.   The day to day care without a break is one of the reasons that caregivers can die before the person needing care.  Respite care can give a temporary break from the struggle of the stress while still giving the person needing care professional help that is trained to take care of your loved one.  Using respite can strengthen and support your abilities as a caregiver.  Seeking help does NOT make you a bad person.  It just means you have a life outside of being caregiver.

Respite can be for many different reasons.  It can be for something as simple as grocery shopping,  medical appointments, a meal out or just going to sit at the park for some ‘me’ time. It can even be for a weekend away for many reasons.  The idea is for you to be able to recharge your batteries WITHOUT sacrificing the care for your loved one.

Respite care can be provided in your home or in a care facility such as a nursing home or adult day care facility.  Generally when done in the home, the respite worker does all the normal things like you do such as cooking, cleaning and personal care along side of any medical care.  With more intensive cases you might need to use a nursing home or adult care facilities.

None of this is generally covered by insurance or Medicare.  But, there are sometimes funds to care for this type of care.  Grants are available from time to time.  The cost varies from person to person but is usually typical for the area.   Where I live the general cost is $10.00 per hour.  This is set by the respite worker.

Since respite care is such an important part of caregiving we will discuss this in three posts.

Next post we will be discussing interviewing the respite caregiver.

Shingles Shot – Does your loved one need it?

Shingles can be a very painful and irritating time.

Shingles usually starts as a painful rash on one side of the face or body. The rash forms blisters that typically scab over in 7–10 days and clears up within 2–4 weeks.

Before the rash develops, there is often pain, itching, or tingling in the area where the rash will develop. This may happen anywhere from 1 to 5 days before the rash appears.

Most commonly, the rash occurs in a single stripe around either the left or the right side of the body. In other cases, the rash occurs on one side of the face. In rare cases (usually among people with weakened immune systems), the rash may be more widespread and look similar to a chickenpox rash. Shingles can affect the eye and cause loss of vision.

Other symptoms of shingles can include:  temperature, headache, chills, nausea

Shingles is not necessary a deadly disease but I have heard people describe it as extremely painful.  If you have had chicken pox, the virus is in your body.

Mom’s doctor suggested one for mom.  In the small town she lived in, we had to go to the pharmacy and pick it up.  It was refrigerated so we had to be at the doctor’s office within one hour.  Mom said it wasn’t the simplest shot she had ever had but it wasn’t horrible.

One thing that struck me odd was that mom had to pay over $100.00 out of her own pocket for it.  This has been a few years ago so Medicare or private insurance might be paying for it now.  Regardless after reading about the symptoms, it was worth it for mom.

I also had an elderly gentleman that I take care of that had the shot and got shingles anyway.  It might have had to do with his condition as he does dialysis and that could have affected it.

Once again, information from the CDC:

http://www.cdc.gov/vaccines/vpd-vac/shingles/vacc-need-know.htm

Shingles Vaccination: What You Need to Know

The vaccine for shingles (Zostavax®) is recommended for use in people 60 years old and older to prevent shingles. The older a person is, the more severe the effects of shingles typically are, so all adults 60 years old or older should get the shingles vaccine.

The shingles vaccine is specifically designed to protect people against shingles and will not protect people against other forms of herpes, such as genital herpes. The shingles vaccine is not recommended to treat active shingles or post-herpetic neuralgia (pain after the rash is gone) once it develops.

Anyone 60 years of age or older should get the shingles vaccine, regardless of whether they recall having had chickenpox or not. Studies show that more than 99% of Americans ages 40 and older have had chickenpox, even if they don’t remember getting the disease.

Some people should NOT get shingles vaccine.

  • A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine. Tell your doctor if you have any severe allergies.
  • A person who has a weakened immune system because of
    • HIV/AIDS or another disease that affects the immune system,
    • treatment with drugs that affect the immune system, such as steroids,
    • cancer treatment such as radiation or chemotherapy,
    • cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.

Remember to talk with your medical person before making the decision.  Your loved ones condition will determine whether it would be good for them.

Have you or someone you known had shingles?  Was it as bad as they said?

 

Great site to check for benefits – FREE – really free

You see it all the time.  Someone tells you they can help you get the benefits you deserve.  You go there, fill in some forms and then they say for $*** we will get you your information.  Well, this site is free and run by the government.  I tried it about four weeks ago and have not had a call or a spam email about it.  I did check into some of the places they told me to check and they are legitimate.

The site is www.benefitscheckup.org.  It asks you questions to personalize your report.  It also asks your zip code so that it makes sure the benefits are available in your area.  It took me less than 10 minutes to answer all the questions and did not ask for any identifying information (Social Security number, name, address, etc)

When I was done, it gave me a report that I could either print out or save.  I saved mine onto my computer so I could look at it several times as I do not have a printer.  Also, with the computer file, I can click on the sites to fill in information if I feel I would qualify.

In my case, some of the suggestions were things I personally don’t want but it was interesting to find out what all is available.

This would be good for anyone that might need help regardless of age.  I realize a lot of seniors are suspicious of putting personal information on a computer (and they should be if it asks for social security numbers) but since this doesn’t, I felt confident doing it.

 

Starting with the facts.

People age.  That is a fact.  How you take care of yourself and others during that time can make a world of difference.  You can hide your head in the sand and think other’s will do all the work or you can do everything you can to make this a good transition.

My mother was under the assumption that Medicare would pay for her nursing home expenses so she did not worry about it.  That was not correct.  Medicare does not pay for nursing home expenses unless you are there for rehabilitation following a hospital stay. Then, they will pay for the first 21 days at full cost and from there it goes to a co-pay.  IF at any time during that first 100 days that Medicare is paying a portion of it and the nursing home decides that you are not progressing, you go to 100% payment on your own.

There are many ways you can avoid a nursing home as much as possible.  During the coming months, we will look into many of these ways.