Batesville Herald Tribune, Batesville, Indiana

December 13, 2013

MMH manager offers caregiving tips

Debbie Blank The Herald-Tribune
The Batesville Herald-Tribune

---- — As persons age, relatives and friends often become caregivers. “If it’s something you haven’t done, it’s something you probably will do” temporarily, Margaret Mary Health social services manager Linda Tuttle told about eight listeners Nov. 18 at the Southeastern Indiana YMCA. “It really makes a difference to have someone who loves them and knows them take care of them.”

MMH Home Health Care and private agency workers can go to a senior citizen’s home to check lungs and breathing, help with dressing, breakfast and other tasks. The around $20-per-hour cost might be covered by Medicare. “If you have to have somebody 24/7, that’s even higher than nursing homes,” which charge about $171 daily. “Some people think Medicare pays for that.” Medicare will pay for short-term rehab up to 20 days, then partially for 20-100 days with optional Medicare supplemental paying the rest.

MMH offers three free documents that are very helpful as persons age:

• One can document allergies, doctors and over-the-counter and prescription medications. “This is something you need to keep up to date at all times” for emergency room visits, she advised.

• Two types of advance directives should be completed for caregivers and persons for whom they care. One or two persons can be selected as health care representatives. “It basically says if you’re not able to speak on your own behalf, who do you want to speak to your doctor about your care?” Copies should be given to the hospital and physicians to be added to electronic medical records.

• A living will should be filled out and witnessed by two persons not related to and not providing health care to the person who desires the document. Tuttle pointed out, “Some people say, ‘If I’m at the end of life and I have such a bad heart and I’ve got cancer … I don’t want to be brought back (by medical advancements). Don’t do chest compressions and break my ribs … don’t put a ventilator down my throat and breathe for me … I don’t want that. When the good Lord calls my name, I’m ready to go.’”

Keep original document in a safe place. It might be wise to keep copies in ziplock bags in the person’s purse or bag, ready to be presented to a hospital or physician.

When a senior citizen is in the hospital, “you and your family members are part of the healing team.” The caregiver needs to write down instructions and watch the physical therapist to learn how to get the loved one out of bed and other exercises that may continue at home. “Take notes and ask questions. You’ll have a better outcome for yourself and your patient,” predicted the 23-year social worker.

Tuttle reflected, “Everybody has a season of life.” As an elderly person’s health falters, he or she may go from the home or long-term care facility to a hospital many times, which can be “traumatic ... (and) very disorienting. You need to have that talk with the doctor and nursing home…” to hold off going to the hospital for minor complaints.

If someone needs to go to a long-term care facility, a caregiver should call ahead and make plans. The facility will need paperwork from a physician and LifeTime Resources. MMH social workers can help with the process free of charge.

“Sometimes we have to give up our pride a little bit to ask for help. Never hesitate to call the hospital for anything you need.” Dietitians and social workers can problem solve at 934-6624 and Ask-a-Nurse can be reached at 933-5152.

“Eat less, move more” was her major message. “Two simple rules. If you can prevent diabetes … and heart disease,” living longer won’t be as difficult. “Foot amputation and dialysis are not a pretty road.”

Over 500 Silver Sneakers members are registered at the Y, with the Batesville center paid by insurance companies as members work out. “Of those, only a very small percentage actually use it,” reported Y employee Cathy Sullivan.

According to Tuttle, “In the United States, we spend more on medicine and health care, but we have very poor outcomes … What we need to do is the hard work of self care. Get enough rest, drink enough fluids, eat the right things … Many of us are going to live a lot longer than prior generations, … but how will we be living? We want to live well.”

Debbie Blank can be contacted at debbie.blank@batesvilleheraldtribune.com or 812-934-4343, Ext. 113.

• Tuttle advised tailoring Medicare Part D for current medications. The insurer can be switched annually as medications change. • She suggested that persons 60 and up get shingles vaccines, which cost about $180 and are covered by Medicare and perhaps other insurance companies. "It's really worth it" to prevent the painful infection that can last for a long time. • "Another thing we recommend sometimes is a Lifeline unit" costing $35 a month so a senior citizen who is alone can push a button to phone for help. If he or she can't get to a phone, a Lifeline employee will ask questions using a microphone, then call a neighbor or friend listed to help. First Alert technology senses a fall and calls for help automatically for a $45 monthly fee. • A Phillips Medication Dispensing System sounds an alarm to let the person know it's time to take a medication. The system indicates if a pill is not taken and will not let a person take it late. The system, costing $75 monthly, can be filled with up to 40 days of medication, taken up to six times daily. • Nancy Reagan called Alzheimer's disease "the long goodbye." The manager noted when a person loses his or her memory, it can become "very distracting and upsetting to the mate." Caregivers may attend monthly support groups in Milan and Lawrenceburg. "You need that support." • "One of the things that is a little-known fact: Once you're in a hospital and go home, you're six times more likely to have a fall" due to being in bed, not exercising and taking medications. "The longer you can keep yourself functioning, you're giving yourself a gift" of quality of life. If a person does fall, the best way to get up, especially if alone, is to roll over on one side, rise up on all fours, crawl to a chair and push up.