Source: SeriousIllness.org

We usually associate the word “vaccine” with children. But vaccines play an important role in disease prevention for seniors, too. Because aging weakens the immune system, even common infections can cause serious problems for those over age 65.
The annual flu shot

The flu takes a heavy toll on aging bodies. Hospitalization rates for seniors surge during flu season. Really, what we call “the flu” is a constantly changing virus. Because there’s a new type circulating each winter, an annual shot is essential. That is true for your aging relative, but also recommended for any adult caring for a frail elder. For greatest effect, get the shot sometime in the October to December time frame.

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One of every three older women is dealing with urinary incontinence. And one of every six older men. If your loved one has this problem, he or she is likely not talking about it. Not talking to you. Not talking to the doctor.

She may be embarrassed. Or he may assume nothing can be done.

In fact, urinary incontinence is a medical problem with many treatment options. Untreated, urinary incontinence is associated with

• social isolation. Fear of accidents often leads to withdrawal from activities outside the home.

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When you are caring for a relative, it seems obvious that health care providers would readily answer your questions. But health professionals and health plans are not permitted to freely give information. This can interfere with your ability to help your loved one follow doctor’s orders or figure out insurance billing.

Rules about confidentiality

You’ve probably heard the term “HIPAA.”

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It seems that the older we get, the more pills we take. Remembering to take them, and to take them on time, can challenge even the sharpest mind.

If your loved one has occasional memory lapses, getting into a good routine for taking medications might be all that’s necessary to stick with the doctor’s recommendations. Some suggestions:

• Keep pills in sight. Good places might include the kitchen table or counter, or a bureau top. Keep them away from direct sunlight by a window or a steamy room, such as a bathroom.
• Link with other habits. Work with your loved one to associate pill-taking time with other routines, such as morning coffee or brushing teeth.
• Use a pill box. Pill boxes organize daily doses for a week. The simplest have seven compartments. Others have two or three compartments per day for am/pm doses.
• Add an alarm. Consider a pill box or a wristwatch with an alarm. Or program your loved one’s cell phone to ring a specific tone when it’s time to take a pill.

More active support may be necessary if your loved one has ongoing memory issues. Among the options available:

• Automated pill dispenser. These dispensers sound an alarm and open a dispensing drawer when it is time to take a pill. Some can notify you if a dose is skipped. Check the federal government’s database of available products.
• Telephone reminder. For a monthly fee, your loved one receives timed, daily phone calls and an automated message to take his or her medications. Some services will notify you if the phone is not answered.
• Email or text message. MyMedSchedule’s no-cost service provides email or text reminders. Or check online for smart phone medication apps.
• Personal medical alert. Many home-based medical alert systems include an optional medication reminder service.

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Did your mom teach you to “do what the doctor says”? If she’s not following doctor’s orders for medications now, you’re probably feeling confused. And concerned.

It’s common for patients not to take pills as directed. Some reasons include:

- “It’s too costly.” One quarter of new prescriptions are never filled because of cost. Make sure the drug is on the insurance plan formulary. Or ask about generics. Find a discount pharmacy, or consider mail order.

- “I feel fine.” Many illnesses lack noticeable symptoms. High blood pressure and high cholesterol, for example. These prescriptions often go unfilled. Many people don’t finish their antibiotics for similar reasons: the symptoms went away. Ask the doctor or pharmacist to review with your loved one why a medication is necessary.

- “It made things worse.” Consult with the doctor or pharmacist. Reducing the dose or changing from morning to evening may fix the problem. Or taking a different medication may be advised.

- “It was too complicated.” Some drugs require multiple doses in a day. Others are restrictive (“30 minutes before eating”). Ask the doctor or pharmacist about alternatives.

- “I can’t get the bottle open” or “I can’t read the label.” Arthritic hands and poor eyesight can make it difficult to follow directions. Ask the pharmacist for large type on the label and a NON-child-proof container.

- “Why bother?” Hopelessness and depression are common reasons why people don’t take their medications. If you suspect depression, ask the doctor to do an evaluation.

- “It won’t do anything.” Perhaps your loved one has an entirely different interpretation of what is wrong. Consider using the motivational interviewing techniques described in our article, “Your changing role: Becoming a partner-in-care.” The discoveries you make in the conversation can help you increase the likelihood that he or she will follow the doctor’s orders.

- “I forgot.” Simple memory lapses are a fact of aging. Look for solutions to forgetfulness in next month’s newsletter.

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Are drug costs a worry for your elder family member? This year, new assistance is available for many Medicare Part D participants.

Your family member may qualify for “Extra Help.” This program helps pay for a Medicare prescription plan. It trims monthly premiums and the annual deductible. And it shrinks the co-pay costs for prescriptions. The average annual savings is $3,900.

If your family member didn’t qualify for the program last year, apply again. There are new criteria this year. They make the “extra help” available to more people. Eligibility is based on income and financial resources. Specifically,

• Income must be less than $16,245 per year for an individual or $21,855 for a couple.
• This year, income does NOT include any help received from others for expenses such as rent, utilities, and food.
• Financial resources include bank savings, stocks, and bonds. An individual can have no more than $12,510 in such savings. A couple can have no more than $25,010.
• This year, life insurance policies are not counted.

You can apply online or call Social Security at 800-772-1213. Ask for help with prescription drug plan costs. They will send you the application.

Even without Extra Help, your loved one may get a rebate. The rebate is for individuals who fall into the Medicare Part D coverage gap. This is also called the “donut hole.” This year, everyone reaching the coverage gap will receive a tax-free rebate of $250. No application is necessary. A rebate check will be sent automatically to those who qualify. Next year, a 50% drug discount is planned for people who fall in the donut hole. The discount will apply to brand name drugs covered by the individual’s Part D plan.

Some drug companies offer special assistance programs. Check our prescription assistance page for information.

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