Tag Archives: access to care

Dementia and Care Dollar$

Last week I wrote out the monthly checks to pay my mom’s care expenses. At these moments, I’m thankful that she was such a saver who planned wisely for the future. But I worry about family caregivers in my generation. We didn’t grow up with the same ethic about saving — and today almost every type of business has cut costs by shaving worker health benefits. How can we meet our own future health care costs?

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Caregivers face a grim set of questions when they look at the financial landscape. There’s no telling how Medicare costs will change over the coming decades. Elected officials have health plans paid for by our tax dollars. Their solid health benefits insulate them from the reality of rising healthcare costs. According to the Factcheck.org project of the Annenberg Public Policy Center, on average “the government pays 72 percent of the premiums for its workers, up to a maximum of 75 percent depending on the policy chosen.” They can select plans like the “Blue Cross and Blue Shield standard fee-for-service family plan [with] a total premium of $1,327.80 per month [for which they] would pay $430; or the Kaiser standard family plan [with] a total premium of $825.15 per month, of which the employee pays only $206.29.” Members of Congress qualify for other health benefits, too. They can receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, after payment of an annual fee ($491 in 2007), or get care at military hospitals like Walter Reed Army Medical Center and National Naval Medical Center.

While Congressmen enjoy this deluxe menu of choices, Bruce Jaspen’s 2013 article in Forbes Magazine warns that, in the near future, the rest of us may be competing to get the any doctor’s attention once we enroll in Medicare.  In response to today’s federally-set low Medicare reimbursement rates “one in five physicians are restricting the number of Medicare patients in their practice and one in three primary care doctors – [those who are] keeping the cost of seniors’ care low – are restricting Medicare patients.”

Our future doctor shortage will be further complicated if we are collecting the same levels of benefits our elders now receive. The January/February 2013 AARP Bulletin estimates that the average annual out of pocket costs for Medicare are $3069.80. That total includes Part A for hospital stays, Part B for doctor’s visits, and Part D for drug coverage. But the figure doesn’t include the cost of pricey specialty drugs that have no generic counterpart. These are exactly the medications we’ll want  if we, like our elders, require dementia treatment.

Maybe this means that the best strategy for meeting our future health costs is to save more money. But one factor that never seems to enter into financial discussions is the income that many family caregivers forego so they can look after a loved one with dementia. On many occasions I have reduced my workload to make myself more available to help my mom. And I know there are thousands of other children and spouses out there who don’t collect overtime or seek promotions because more work would upset the care routine.

If there’s any good idea out there, it’s probably long-term care insurance. It was mom’s genius decision — one that has greatly eased her financial burden. The dementia epidemic has probably made some insurers cut benefits on future policies. But if you want more power to cover your future health costs, start doing research now to get yourself the best deal you can afford. Now that mom’s monthly bills are paid, I think I will use some of my “free” time to take my own advice.

 

 

 

Drug Trials for Alzheimer’s and Dementia

Across the country, large medical centers have been conducting drug trials for new medicines that may help halt Alzheimer’s Disease and other forms of dementia. These drugs raise the hopes of many families who want to see their loved ones cured. But study participation can be full of challenges that scare potential patients away. This week I read an interesting article about a family that made a group choice to overcome all challenges and get involved.

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One of the biggest hurdles to enrolling in a drug trial is the fact that research centers doing cutting edge work are typically located in big cities. For families living in distant towns or suburbs, just transporting the patient to the study site can be a huge undertaking. Caregivers need to manage time off from work, make the trip to the medical facility, and provide support for the person in the research study — who may or may not benefit from the experience.

The Babcock family, featured in this month’s issue of inSight from the Penn Memory Center, felt there were many reasons to solve these problems so their father could travel from Scranton to Philadelphia for the “Bapi study”. Bapineuzumab —  is an antibody that showed some potential for clearing beta amyloid protein from the brain. Scientists hypothesize that this protein forms the plaques that promote Alzheimer’s symptoms.

The article explains how the 125 mile trips became a group activity that united their family to support their dad. Dean Babcock, son of the study participant, felt that the hope a family gets from being involved in such as study can “help manage the process.” While he said that he was initially motivated by the “selfish” desire to “cure his father”, he eventually realized that the study was “still beneficial” because it “allowed experts to rule out Bapi and move on to the next thing.”

The research side of the story ended by documenting that “bapi” showed “no positive improvements on cognitive testing and functional scales of research participants with a gene believed to be connected with Alzheimer’s”. But members of the Babcock family did not feel they had wasted their time. They see how information from the study may help researchers as they continue their search for effective medications. And Dean Babcock maintains the hope that younger family members may have better treatment options if it turns out they need them one day.