January/February 2012 Print - Aging Well Eldercare

Choosing healthy ways to cope

It’s a new year. A natural time for personal review. Do you have a good self-care plan?

It’s common for family caregivers to fall in with not-so-great coping habits. Here’s a look at two areas where family caregivers frequently shortchange themselves.

Food. Stressed and on the go, fast food and easy sweets often seem like the only option. We all know that’s a recipe for a health disaster! Consider these swift, healthy alternatives:

Quick oats with fruit or raisins for breakfast. Or a whole-wheat bagel and cup of yogurt.
Single-portion dried soups to grab for lunch. Out on errands, stop at the grocery deli counter for a hearty sandwich on wheat bread (it may be enough for tomorrow’s lunch, too).
Nuts and dried fruit for anytime snacks. Or mini carrots with hummus dip.

When you do cook, make extra. Stash portions in the freezer for a quick microwave meal later. For more tips, see our article about easy cooking for caregivers.

Drink and drugs. The emotional strains of caregiving include loneliness, sadness, and anxiety. So it’s understandable that family caregivers frequently seek the numbing comfort of alcohol, drugs, or prescription medications. But used to excess, these “friends” create their own problems for you and your loved one.

How do you know if you’re in “excess” mode? Consider the CAGE questionnaire:

Do you sometimes feel you should Cut back?
Do you get Annoyed if someone talks to you about your consumption?
Do you feel Guilty about your consumption?
Do you need an “Eye-opener” boost in the morning?

If you answered yes to one question, you may have a dependency. Take action to look for comfort from other sources. Yes to two or more, you very likely should seek professional help from your doctor or a licensed counselor.

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Does Medicare pay for help at home?

If your relative is homebound but needs to connect periodically with a medically trained specialist, Medicare may pay for visits to the home.

Medicare does NOT pay for help that is nonmedical in nature. For instance, Medicare does not pay for help with cooking or housekeeping, even if the need is because of a medical condition such as Alzheimer’s disease.

Medicare DOES pay for medical visits. Home health visits can include:

A nurse coming to monitor progress after surgery
A physical therapist to assist with strengthening muscles
A speech therapist to help with communication after a stroke
An occupational therapist to suggest devices that help with daily chores (lifting, dressing, bathing, getting up or down from a chair, etc.)

To qualify for home health services, your family member must

require considerable assistance to leave home. For example, a wheelchair or hands-on help from another person.
need the services of a medically trained specialist.
have the doctor’s okay. A signed “certification of need.”
use a Medicare-certified agency. A home health agency that meets Medicare criteria and is authorized to bill Medicare.

Two situations can trigger home care:

A hospital stay. Your loved one must be an inpatient for at least three consecutive days. The doctor may then order some temporary “rehab” help at home.
Ongoing, intermittent need for care. Your relative may routinely need part-time nursing help. Perhaps for wound care after a surgery, or extended IV treatment to fight an infection. The doctor can order home delivery of these skilled care services.

If you think your family could benefit from home health services, ask the doctor if home health is right for your situation.

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How to find a good doctor

When a family member is having health issues, having a smart doctor on the case is a top priority. But where do you go to start looking?

Contrary to what you might think, you can find a lot of useful and trustworthy information on the Internet. Andrew Schorr, author of The Web-Savvy Patient, makes these specific recommendations:

Seek board certification. Doctors who are “board certified” have completed advanced training to excel in a medical specialty. At Certification Matters you can search for information based on your location, the specialty of interest, or a doctor’s name.
Connect with other patients. Many disease-specific organizations host patient support networks. Look online for an organization related to your loved one’s illness. If it has an online chat group, ask members for tips about doctors in your community. (Ask at local drop-in support groups, too, if available.)
Review resumes. When you’ve identified a doctor of interest, look online for his or her resume. If the resume reveals participation on a medical or scientific advisory board, that’s a big thumbs-up. Only the most knowledgeable serve on boards.
Check with the state medical board. Disciplinary actions against a doctor, violations of the law, and malpractice decisions are a matter of public record. The Agency for Health Care Research and Quality suggests DocFinder, a clearinghouse website that gives you access to state medical board data across the nation.

Some doctors have acquired patient reviews at medical rating sites such as HealthGrades.com or Angie’s List. Proceed with caution. These reviews can be fun to read. But getting high marks for personality isn’t the same as demonstrating medical skill or experience. And the comments of a few disgruntled patients may not mean someone is a bad doctor. As with everything in life, sometimes there is a good fit, sometimes not.

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