Sharing information for the well-being of seniors in and around the Motherlode. The Commission on Aging is an informed voice in the community, to advise, support and advocate on any or all matters affecting the aging in Tuolumne County.
MEDICARE IS NOT LONG TERM CARE
THE REALITY-PERCEPTION PARADOX
THE REALITY-PERCEPTION PARADOX
By Commissioner Bill Dorffi, Tuolumne County Commission on Aging
The Reality-Perception Paradox: My perception is my reality and the truth is irrelevant.
Unfortunately, the Reality-Perception Paradox is alive and well regarding Medicare and Long Term Care (LTC). The following illustrate many common mis-perceptions regarding the two.
Medicare, and its supplements, covers medical care. This means the treatment is restorative or rehabilitative and the patient will recover. LTC covers a variety of services, assistance, support and facilities for those who have lost their ability to function independently. LTC does not provide any medical care and Medicare does not provide any LTC service.
Over the past 20 years a number of consumer surveys have consistently reported that a majority of people believe Medicare covers LTC. This perception is so widely held that people don’t adequately plan for LTC. It’s uncertain why this mis-perception is so common. One reason could be that Medicare pays for skilled nursing and many LTC facilities are named a Skilled Nursing Facility. But the reality is only a small percentage of beds are available for skilled nursing care and the great majority of beds are for nursing home care. Another reality is that of the people entering skilled nursing care, less than 5% are Medicare beneficiaries and their average length of stay paid by Medicare is 8 days.
Another common mis-perception is LTC is nursing home care. The reality is that over 95% of LTC is provided outside of a nursing home. There are many services that provide support and assistance in the community and in the home. A few examples are: Meals on Wheels, Adult day care, Alert services that are on call and will send a paramedic when alerted, Visitor services where volunteers visit people in their homes to provide social interactions, as well as a great variety of other home care providers.
The need for LTC develops in different ways. There are three models of disability requiring LTC. Injury, especially falls, or sickness, is one way. If the person does not fully recover from medical treatment they need LTC. In this situation Medicare pays for the medical treatment. But if there is a need for custodial care after the medical treatment, then LTC provides that care.
The other two models are more common and are a result of the aging process. One is cognitive impairment, dementia or Alzheimer’s. The other is frailty, defined as loss of strength or immunity. Both develop rather slowly so family members often are slow to recognize the loss of capability. It’s common for the family to be alerted to the impairment by the family physician or other medical practitioner.
Thus the question, if Medicare doesn’t pay for LTC who does? There are only 4 ways to pay for LTC. First, each individual is responsible for their cost of care. This is the same as being your own insurance company. The odds are after age 60 there’s a 70% probability of needing some form of LTC later in life. At age 85 there’s an 80% probability of needing nursing home care. If these odds are unacceptable, one can transfer the risk with LTC insurance. The third option is a reverse mortgage to pay for care at home. But make sure the terms of the contract are fully understood before taking this option. The last option is MediCal, a welfare program that one must prove impoverishment to be eligible for LTC.
There are probably more perception-reality paradoxes but this is all that comes to mind now. Besides, these are enough to consider and evaluate for now.
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More news affecting seniors: Sierra HouseCalls announces they are accepting new patients! If you are homebound, over 60 years of age, and unable to drive or if you have family members or friends who are homebound, over 60, and can't drive anymore, call Tina at Sierra HouseCalls 209-532-4287 for more information, or if you have questions.
From their website - http://www.shmgi.com/about.html
Sonora physician Matt Personius started Sierra HouseCalls Medical Group in February 2003 with the goal of helping elderly and disabled individuals remain independent. Dr. Personius moved to Tuolumne County in 1997. He relocated to the area to take a position at a local hospital, where he recognized the growing need for home health care in the area.
Most seniors remember the days when physicians commonly made “house calls” and were able to observe the patient in their home environment. This relationship allowed physicians to better understand the social dynamics that impacted the overall health of their patients. Sierra HouseCalls Medical Group innovative medical practice combines “old fashioned” house calls, one-on-one doctor consultations and the newest technology all in the comfort of your home.
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ANNOUNCING 2011 Senior Expo
The 2011 Senior Expo will be held May 25, 2011 from 9am to 2pm at the MOTHERLODE FAIRGROUNDS, John Muir Building. The Expo features the opportunity for blood draws, a very popular Senior Idol contest, and many various for-profit and non-profit groups will present their senior-oriented services and wares. In addition, many booths will be informational. This is a FREE event open to anyone, particularly seniors, family, caregivers, but also any and all interested parties. For more information, to become a sponsor, or to reserve your own booth (the deadline is April 30th!), please call the Senior Expo Coordinator: 209-532-1607 or go to the website: http://www.seniorfair.com/
Features and typical booths:
* Senior Idol contest! DO YOU SING OR DANCE?
* Finance/Insurance
* Medical such as blood draw (nominal fee)
* Caregivers information / options
Commission on Aging Events Calendar 2011
1) Commission on Aging Executive Board meetings 1:00PM, 1st Monday each month, at Senior Center
2) Commission on Aging Public Relations committee meetings, 12:00PM, 1st Wednesday each month, at Interfaith
3) Commission on Aging general meetings 1:30PM, 2nd Monday each month, at Area 12 Agency on Aging, Standard Rd., Conf. Room C
4) May 25 – Senior Fair & Expo, Motherlode Fairgrounds, John Muir Building 9AM-2PM
5) June 22 - Senior Volunteer of the Year Awards Ceremony 11AM at Tuolumne County Board of Supervisors' Chambers, 4th Floor, 2 Green St. Sonora
6) October 19 - Centenarian Awards Ceremony 11AM Senior Center Sonora
All COA meetings are open to the public. Please come and give us your ideas, concerns, and information regarding senior issues!
To go to Friends and Neighbors website go here: http://seniorfan.com/
Blog Editor: Roberta Goodwin
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