The new regulations create  consistency in the appeals process and extend an external review guarantee to employees of companies that offer their own health insurance plans. This can be done without contracting with an insurance provider.

Previously patient’s rights have varied from state to state and by insurer. “Until the [health care law] reform, only a select number of states honored external review,” says Erin Moaratty, a spokeswoman with the Hampton, Va., nonprofit Patient Advocate Foundation (PAF), which helps patients navigate the appeals process. “Now every state is required to have a process for external appeals.”

In order to be able to overturn a denial, consumers must keep track of paperwork and phone calls. The three most important tips are:

Watch deadlines: Deadlines are spelled out in insurance contracts regarding appeals. If you miss the deadline, it may be impossible to file an appeal.

Keep records: Place records in a folder or a binder and carefully write down the date of each call to your insurer, who you talked to and what you discussed.

Follow up: Send correspondence by certified mail so that you will have a receipt. Don’t assume something is being done just because you called or sent a fax.

Music is a form of sensory stimulation, which provokes responses due to the familiarity, predictability, and feelings of security associated with it. Research in music therapy supports the effectiveness of interventions in many areas such as facilitating movement and overall physical rehabilitation, increasing motivation to engage in treatment, providing emotional support for clients and their families, and creating an outlet for expression of feelings. Because music is a powerful and non-threatening medium, unique outcomes are possible.

Music therapy can provide:

♥ A forum to share common experiences and enjoyment as a couple or family

♥ Meaningful time spent together in a positive, creative way

♥ Relaxation for the entire family

♥ Unity and intimacy for families through verbal and nonverbal interaction

♥ Respite for the caregiver

A gentleman in the early stages of progressive dementia improvised on a xylophone during a music therapy session to express his feelings, and then stated: “I don’t know how anyone can live without music.”

Outcomes:

♥ Positive changes in mood and emotional states

♥ Sense of control over life through successful experiences

♥ Awareness of self and environment which accompanies increased attention to music

♥ Anxiety and stress reduction for older adult and caregiver

♥ Stimulation which provokes interest even when no other approach is effective

♥ Structure which promotes rhythmic and continuous movement or vocal fluency as an adjunct to physical rehabilitation

♥ Emotional intimacy when spouses and families share creative music experiences

♥ Social interaction with caregivers and families

Since September 11th, the US Government has taken steps to encourage all citizens to make their own survival preparations. September was chosen as National Preparedness Month, as the tragedies of September 11th highlighted to the nation the importance of being prepared.

There are many groups with special needs and even those who may not be considered special needs but may enter that category during the time of an incident. People who are otherwise healthy may become a part of this group by injury or change of health status. Military families have their own unique needs because of their tendency to relocate.

Other categories include but are not limited to the visually impaired, hearing impaired, mobility impaired, medical conditions, persons without vehicle, single working parent, Non English speaking, intellectual disabilities and/or special dietary needs.

Steps to take:

♥ Meet with your family and discuss why you need to prepare for disaster.

♥ Discuss the types of disasters that are most likely to happen and explain what to do in each case.

♥ Pick two places to meet, one outside your home and outside of your neighborhood.

♥ Make sure everyone knows the address and phone number of the location outside your neighborhood.

♥ Ask an out of state friend to be your family contact.

♥ Discuss what to do in an evacuation and what you will do with your pets.

♥ Meet with your neighbors to plan how the neighborhood could work together after a disaster until help arrives.  Help neighbors who have special needs, such as disabled and elderly persons.

Persons with special needs and their caregivers need to create a support system and let people know where they keep important documents or medicine. Contact the local emergency management office to let them know what the needs are. Wear alert bracelets if possible and have any payments made electronically if at all possible.

Important considerations:

• List of doctors, relatives and friends to notify
• Extra batteries
• Extra oxygen
• Hearing aid batteries
• Wheelchair batteries
• Extra eyeglasses
• List of medication and doses along with allergies
• Style and serial numbers of equipment

Prepare a disaster supply kit that include: Water, food, first aid kit, tools and supplies, clothing and bedding and medications.

Many of the previous tips are valuable to follow in every day life. Do not wait until a disaster strikes.

Resources:

http://www.fema.gov/plan/prepare/specialplans.shtm

http://www.ready.gov/america/getakit/disabled.html

Your local authorities are also working to help rid of prescription drugs in the home. Check your local newspaper, watch for it on television or listen on the radio for a date that you can bring your unused and/or out dated prescriptions to a place near you to have them disposed of in the correct way.

Federal Guidelines

Do not flush prescription drugs down the toilet or drain unless the label or accompanying patient information specifically instructs you to do so. For information on drugs that should be flushed visit the FDA’s website.

To dispose of prescription drugs not labeled to be flushed, you may be able to take advantage of community drug take‐back programs or other programs, such as household hazardous waste collection events, that collect drugs at a central location for proper disposal. Call your city or county government’s household trash and recycling service and ask if a drug take‐back program is available in your community.

If a drug take‐back or collection program is not available:

1. Take your prescription drugs out of their original containers.

2. Mix drugs with an undesirable substance, such as cat litter or used coffee grounds.

3. Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag.

4. Conceal or remove any personal information, including Rx number, on the empty containers by covering it with black permanent marker or duct tape, or by scratching it off.

5. Place the sealed container with the mixture, and the empty drug containers, in the trash.

Office of National Drug Control Policy October 2009
Proper Disposal of Prescription Drugs
Office of National Drug Control Policy
750 17th St. N.W., Washington, D.C. 20503
p (202) 395‐ 6618 f (202) 395‐6730

Cited: http://www.WhiteHouseDrugPolicy.gov

We all have been tempted to stop taking a prescribed drug because the symptoms went away. It is important to understand why you need to finish a prescription if the instructions say to do so to maximize its effectiveness.

Some of the reasons that a person may not take their prescriptions:

• Expense
• Symptoms subside
• Prescription has unpleasant side effects
• Not knowing how the prescription works
• Not understanding why it is needed
• Or the specific instructions and why they are important
• It is difficult to manage multiple medications and follow the instructions that come with them. They may all have different times of the day and different food avoidances.

Not following instructions can cause costly interactions. Talk to your health care team or pharmacist to help you understand why you need to do the things listed above.

Drug interactions

Metabolism, muscle tissue, digestive changes, liver and kidney functions, medications can affect you differently as you age.

♥ Drug-food interaction can result when drugs react with food or drink then affect either the drugs or nutrients and the way they can be absorbed into the body.

♥ Drug-alcohol interaction occurs when the medicine reacts with an alcoholic drink which in turn can cause you to feel tired and/or slow your reaction time.

♥ Drug-condition interactions happen when a medical condition you already have makes certain drugs harmful to you.

♥ Drug-drug interactions can happen when two or more medicines react with each other and cause the medicine not to work or make a medication stronger than it should be.

Keep medications in plain sight in a cool, dry place like a kitchen counter or desktop. Never keep prescriptions in a bathroom where they can become damaged and less effective from shower steam or moisture.

Set timers and reminders. Program clocks when you are at home and cell phones and watches when you are traveling. Or take advantage of medication tracker software for personal computers. See http://www. consumerreports.org/health/medication-tracker/index.htm.

Avoid having to make last-minute refills. Mark your calendars in advance or look into a mail-order pharmacy, which can also be less expensive.

Keep your medication record and original pill bottles within easy reach. These two tools will include all of your instructions for taking your prescriptions successfully.

In understanding your personal health needs and how your medications work for you, you will be better able to manage your personal health. Stay organized and keep your health care costs lower by faithfully and effectively taking your prescriptions.

Resources:

http://www.n4a.org/files/programs/best-buy-drugs/handouts.pdf

Taking Meds Faithfully

http://www.aapcc.org/DNN/

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults:

http://consultgerirn.org/uploads/File/trythis/issue16_1.pdf

American Association of Poison control centers: http://www.aapcc.org/DNN/

800.222.1222

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults:

http://consultgerirn.org/uploads/File/trythis/issue16_1.pdf

Cited: http://www.n4a.org/

Work with your health care providers, pharmacists and insurance company to find the best value that will reduce your out-of-pocket costs. Private insurance and Medicare both have assistance when it comes to paying for prescription drugs. Medicare Part D prescription drug plans and private Medicare Advantage plans allow flexibility in choosing their pharmacy, the amount paid in premiums, deductibles and coverage.

• Request a list of all medicines covered by your insurance provider.
• Consider generic prescriptions. You can compare best buys by visiting the following website: http://www.CRBestBuyDrugs.org
• Look for senior citizen discount, pharmacy discount cards or mail order pharmacies.

Scam alert!

• Do not give out personal information such as social security number, banking information, birth date or mother’s maiden name over the phone or email
• Ask for references
• Do not feel pressured to make an immediate decision, hang up or delete the email

Get all the benefits you deserve. Find and enroll in federal, state, local and private programs that help pay for prescription drugs, utility bills, meals, health care and other needs at http://www.benefitscheckup.org.

Other helpful resources:

Medicare.gov

• Getting Started
• New Beneficiary
• Find Out if you’re Eligible
• Choosing or Changing Your Coverage
• Medicare & You 2010 Handbook
• Apply Online for Medicare Now

State Health Insurance Assistance Program (SHIP)

Get answers to questions about:

• Choosing a health care plan
• Deciding between original Medicare (fee-for-service) and Medicare Advantage Plan
• Understanding your new health plan choices
• How to understand your Medicare bill
• How/whether to purchase additional health insurance (Medigap policy, long-term care insurance, etc.)
• Understanding how to appeal payment denials
• Understanding your Medicare rights/protections and how to submit a complaint about medical care or treatment

Revisit your plan every year to make sure you have the options that serve you the best. This would be a good time to check your prescriptions and think about getting rid of any that may be outdated. Look for how to do this in an upcoming blog.

Generic drugs often have long, complicated and unfamiliar names and this is not done by accident. Brand name drug companies spend a lot of time and energy devising clever and memorable names for their products, increasing the likelihood that you will request it by name. Usually the generic name is a combination of elements from the chemical make-up. Avoid getting caught up on catchy names by making a habit of asking if there is a generic equivalent.

Common myths:

♦ Generics are not tested.

Generics have been on the market under the original brand name for 10-14 years and have been extensively tested by the original brand name manufacturer.

♦ Generics are not as strong or effective as the brand name prescription and are not the same because they do not look the same as brand name drugs

Generics have the same exact active ingredients or chemical make-up as the original brand name.

Pharmacists are often better at making decisions about generic options because they work more closely with insurance companies. It is easier for him or her to see what tiers your medications are and whether your insurance offers a generic option at a lower or less expensive tier. Because there is no difference between the brand name or generic, the decision to switch does not need to be made by your doctor. To avoid any confusion at the pharmacy, always ask your health provider if there is a generic option available.

You can find other helpful information in downloadable form by going to the following website http://www.n4a.org/programs/best-buy-drugs/.

♦ Generic Drugs: What You Need to Know

♦ From the FDA: Facts and Myths About Generic Drugs

♦ “Off-Label” Drug Use

Cited: http://www.n4a.org

Questions to ask your medical provider

• Should I take this medication with or without food?
• How often should I take it?
• What should I do if I miss a dose?
• What symptom is this prescription intended to treat?
• What are the side effects?
• Does this drug interact with any of the other prescriptions that I take?
• Does my age or health make this drug unsafe for me?
• Can I substitute a non-drug alternative or a generic drug?

Some prescriptions or the mixture of two or more may cause side effects such as agitation, irritability, memory loss or loss of coordination. Report any and all changes in mood or movement to your health professional.

Schedule a brown-bag visit with your medical provider and gather all prescriptions and any over the counter medications, herbal or vitamin supplements to the meeting. Bring any research you have done and prescriptions you have not filled yet. Be honest and tell the doctor why you have not had them filled and why you haven’t taken them.

Never stop taking a prescription without some guidance from a health professional. It is not always safe to quit cold turkey. The medical provider may lower the dose, change when you take the prescription or provide a different medication all together.

For professionals there are promotion and presentation materials:

http://www.n4a.org/programs/best-buy-drugs/?fa=plan-a-presentation

♦ Promotional flyer

♦ Presentation slides

♦ Trainer survey evaluation

♦ Videos

♦ Handouts include information about pill splitting, FDA facts and myths about prescription drugs, generic drugs and a medication review form.

♦ Brown-Bag visit labels

Television, pharmaceutical companies, discount pharmacy chains, newspapers, radio and health plans all vie for your attention. It can often be confusing and difficult to gather honest and up to date information that will be important to your personal health. It is important to work with your medical providers and take an active role in your health care options.

Starting Monday, August 9th the following will be the topics for helping you to make the best decisions:

Part I: Steps to managing medications

Part II: Tips for effective prescription drug use

Part III: Generics and myths

Part IV: Getting the best value

This resource was made available to encourage consumers to take an active role in their overall health care. The information will provide consumers with a better understanding about managing chronic conditions, saving money and help reduce the potential for harmful drug interactions.

Question to ask your health care partners (specialists, local pharmacist, health plan or insurance company, primary care physician, lab technicians, physician assistant or nurse) are:

• Which prescriptions are the most important to maintain good health?
• Are generic drugs as effective as brand name?
• What happens if I skip dose or cut my does in half?
• How can I reduce the risk of drug interaction?
• How can I save money on health care and still maintain good health?

Cited: http://www.n4a.org

Consumer Reports Best Buy Drugs is a public education project that can assist you in talking to your doctor about prescription drugs. It will also help you find the most effective and safe drugs that will in turn give you the best value for your health care dollar.

“One must pick and choose one’s battles in life OR risk living in many emotional foxholes.” ~ Donald Neviaser

Caregiving is a difficult job on it’s own but when you add work, family and other obligations, it often becomes overwhelming. Caregivers are at an increased risk for depression and chronic illnesses.  When caregivers were asked about their anxiety and concerns, the following were in the top five:

Work and caregiving

Work in and of itself can be challenging. Imagine taking care of yourself, your children and your parent(s). Some days it will feel like you don’t know what to do first. Ask for help at work. Let your coworkers know about the basics of your situation. They may be more supportive of your needs when they understand why you get so many phone calls, are late or absent. Do not overburden them with your  problems or use them as a sounding board.

• Ask about the Employee Assistance Programs (EAP) at your place of employment.
• Check out the Family Medical Leave Act (FMLA) with your Human Resources office and see what options may be available to you.
• Ask for temporary adjustments to work schedules.
• Ask about telecommuting polices at your workplace.

Manage your stress

Take preventative steps to reduce and manage your stress. Stress can lead to a break down in the immune system and can even lead to elder abuse.

• Practice relaxation techniques
• Go on short get-aways every month if possible
• Hire a caregiver to come in part time and help out with daily needs

Finding resources

Finding resources can be like trying to find your way out of a maze. One of the easiest ways to go about it is to call 211 and ask for resources that will fit your needs.

The other great resources is The National Association of Area Agencies on Aging. ”Their primary mission is to build the capacity of its members to help older persons and persons with disabilities live with dignity and choices in their homes and communities for as long as possible.”

Finances

Traditional retirement plans did not take into consideration that people will live longer after they retire or consider the rise in inflation. Again, check with your local agency on aging to help you find resources that may be available to you and your family.

You can also call 211 or visit their website http://www.211.org.

Family dynamics

Caring for a family member can put a strain on the family. There will be differences of opinion or denial of the parent’s condition. Often one person will be overburdened and that others are not doing their fair share. Write down clear expectations on a calendar. Note what days the family can help out or be on call.

These tips will not solve all of your problems but it could help you to cope with the challenges of caring for a loved one.