Let's Talk About the Weather

February 11th, 2008

Kelso House Adult Foster Care is in Northern Michigan, and this time of year can bring some pretty extreme weather conditions to our area. For example, the past two days saw temperatures around -20 degrees Fahrenheit — NOT counting the wind chill. And it WAS windy.

To add to these conditions, the electric power was knocked out for about 2 hours last night. This was right during dinner, so out come the candles. Northern Michigan Adult Foster Care Tip Number One: keep plenty of candles around. Know where a working flashlight is, and know where to find matches or a lighter for just such emergencies.

We have a gas furnace - but, it needs electricity for the thermostat to even kick the furnace on. We finished our dinner by candlelight, then all stayed in one room and wrapped up for the duration. Northern Michgan Adult Foster Care Tip Number Two: have plenty of extra blankets on hand - comforters and feather beds are the best.

Ailie and my wife curled up on the large sofa together with two large blankets over them to stay good and warm, and I got under the feather bed on a smaller sofa and read a book by candlelight.

Kelso House Adult Foster Care is well-insulated and the heat conserved well. It has crossed my mind a few times to have a back up generator. This is not a bad idea. On the other hand, we have been here for over 8 years now, and the electricity has never been out for more than a few hours. This time was no exception. Ailie had actually fallen asleep, when the lights popped back on and the smoke alarms started beeping around 9 pm and roused us all.

Even when the electricity is fully operational, keeping elderly clients warm in rough winter weather is of primary concern. A blanket is kept over them at all times - even while watching television on the cushy sofa. At night, the temperature always drops a little more, and keeping our clients warm in bed is very important. Northern Michigan Adult Foster Care Tip Number Three: Ailie’s bed is equipped with a heated mattress pad, which we keep at a low heat during the night, and she reports that this keeps her very warm and cozy.

Remember that your clients may not always voice their needs to you. You must always be thinking of their needs and asking them if they need such things as blankets while they are sitting on the sofa, for instance. Better yet - just bring it to them, and they will most likely use it once they see it in front of them.

In Northern Michigan, just when you think winter is letting up - that’s when it always can catch you off guard. Be prepared - stock up on batteries - know where to find flashlights and lighters and matches. Keep heavy blanket and comforters handy. And always try to anticipate your aged clients’ needs before they need to ask.

Hoping the rest of YOUR winter is safe and warm,

Kelso House - a Northern Michigan Adult Foster Care Home for the Aged.

Is New Blue Cross Plan Bad for Michigan?

Blue Cross / Blue Shield of Michigan is trying to push a controversial insurance bill through the Michigan state legislature. Michigan attorney general Mike Cox is adamantly opposed to the bill, and he recently wrote an editorial expressing his opinion and his reasons. Here is that editorial. Please take the time to weigh in on this serious topic — the new bill could adversely affect Michigan’s elderly population and hamper the efforts of Senior Care Providers, Assisted Living Facilities, Adult Foster Care Homes, and Nursing Homes, to keep their clients in good health.

Published January 13, 2008 [ From Ingham County Community News ]

Blue Cross plan is bad for Michigan

by Mike Cox — Attorney General for State of Michigan

Michigan citizens could see dramatic changes to their health insurance rates and coverage if the legislature approves a package of bills being pushed by Blue Cross. If signed into law, House bills 5282-5285 will cause subscribers, especially the old, sick and most vulnerable, to pay much more for coverage or lose their insurance altogether, while fattening Blue Cross’ already profitable bottom line.

The Blues were created in 1939 and given a social mission; specifically, to be the “insurer of last resort.” As a result, Blue Cross was also made tax-exempt. By their own admission, this tax-exempt status benefits the Blues by at least $82 million each year.

And Blue Cross has done well. Their share of the commercial health insurance market in Michigan is 70 percent. Their surplus has more than doubled in the last five years, to more than $2.8 billion, the highest in history. Blue Cross makes more than a million dollars a day in profits.

Salaries are on the rise, too. According to data filed with state regulators, Blue Cross paid its top ten officers $11.5 million in salary and compensation in 2006 — that’s a 42 percent increase since just 2004.

Guess what else has been going up? Rates. Individuals seeking health insurance have seen their rates skyrocket by 79 percent since 2003. And for those folks who have converted from group policies, their insurance rates have shot up even more — a 92 percent increase since 2003.

Not surprisingly, these massive rate hikes mean that more and more Michigan citizens and families can’t afford insurance. The number of uninsured in Michigan has gone up 8 percent since 2001. And the number of people on Medicaid has ballooned by 38 percent in that same time period. The result: One out of every four Michigan citizens is either uninsured or on Medicaid.

But Blue Cross says that it is heading for a “death spiral.” So the Blues are pushing a package of bills that will do the following:

# Deny coverage of pre-existing conditions for 12 months, a doubling of denial time;

# Charge new customers with chronic diseases such as diabetes up to 80% more;

# Charge new customers with serious illnesses such as cancer up to 250% more;

# Enable the Blues to triple their margins for administrative expenses and profits; and

# Eliminate oversight by the Attorney General and the Governor’s Office of Financial and Insurance Services (OFIS).

Oversight is crucial. This year, Blue Cross sought a 50 percent hike on the premiums that seniors pay for Medigap insurance. I intervened, saving more than 215,000 Michigan seniors $97.5 million initially, and over $69 million per year after that.

These bills would also eliminate the Governor’s ability to provide oversight of rates, by eliminating the ability of the Commissioner of OFIS to set rates. As a result, all state oversight — the ability to intervene and fight for lower rates — for any of Blue Cross’s future rate hikes would, for all practical purposes, be wiped out.

These bills seriously jeopardize Blue Cross’ social mission to care for the oldest and sickest in Michigan, and they destroy the Attorney General’s mission to protect them. I call upon citizens to contact their state legislators and urge Blue Cross stay true to its traditional — and legally required — mission “to secure for al of the people of this state … the opportunity for access to health care services at a fair and reasonable price.”

Mike Cox is Michigan attorney general.

Number of Presciption Drugs Covered by Medicare Dropped for 2008

Drug coverage - by number of drugs covered - from the four largest Medicare providers have been slashed by an average of 30% from 2007. AARP MedicareRx Preferred, AARP MedicareRx Saver, Humana PDP Standard, and Humana PDP Enhanced have all lowered the number of prescription drugs they will cover for seniors. In the case of AARP MedicarRx, for example, the number has dropped from 3,763 in 2007 to 2,627 different drugs covered for the current year. Of the top ten prescription drug providers, all but two have decreased the total number of covered drugs under Medicare Part D.Seniors and their care providers need to carefully review the changes in policies and their medications to avoid costly shocks at the prescription booth.

A reason for some of the drops is the Center for Medicare-Medicaid Services (CMS) decision to eliminate coverage for drugs either not approved by the FDA, or drugs approved prior to 1962 - when approval was based upon safety but not efficacy. According to CMS policy, drugs approved in the period 1938-1962 which have since been determined to be “less than effective,” should not be covered by Part D plans.

The Official U.S. Government Website for People with Medicare offers a Formulary Finder, organized by state. The Finder allows you to find plans in your state that match your required drug list:

Formulary Finder

Safety in the Adult Foster Care Setting

(originally posted - 30 December 2007)

Winter is fully upon us in northern Michigan — snow and ice present hazards that can lead to slips and falls by a senior client or your older loved one. From the National Center for Injury Prevention and Control:

“ Among people 65 years and older, falls are the leading cause of injury deaths and the most common cause of nonfatal injuries and hospital admissions for trauma. Each year in the United States, nearly one third of older adults experience a fall.

In 2003, more than 13,700 people 65 years or older died of fall-related injuries. Another 1.8 million were treated in emergency departments for nonfatal injuries related to falls. The total direct cost for falls among older adults in 2000 was about $19 billion. Given the growing population of this age group, this cost is expected to reach $43.8 billion by 2020.”

And this: “From 1988 to 2000, the unintentional fall death rates for both men and women increased significantly (p<.01, test for linear trend). In 2000, rates for men were 20% higher than rates for women.
(Data: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2002.)

There are things you can do to help prevent such accidents. The following is from the guide, “What YOU Can do to Prevent a Fall,” published through the Center for Disease Control and Prevention.

What You Can Do to Prevent Falls

Many falls can be prevented. By making some changes, you can lower the chances that an elderly person may fall.

Four things YOU can do to prevent falls:

1. Begin a regular exercise program

2. Have your health care provider review your medicines

3. Have your vision checked

4. Make your home safer

1. Begin a regular exercise program

Exercise is one of the most important ways to lower your chances of falling. It makes you stronger and helps you feel better. Exercises that improve balance and coordination (like Tai Chi) are the most helpful. Lack of exercise leads to weakness and increases your chances of falling. Ask your doctor or health care provider about the best type of exercise program for you.

2. Have your health care provider review your medicines

Have your doctor or pharmacist review all the medicines you take, even over-the-counter medicines. As you get older, the way medicines work in your body can change. Some medicines, or combinations of medicines, can make you sleepy or dizzy and can cause you to fall.

3. Have your vision checked

Have your eyes checked by an eye doctor at least once a year. You may be wearing the wrong glasses or have a condition like glaucoma or cataracts that limits your vision. Poor vision can increase your chances of falling.

4. Make your home safer

About half of all falls happen at home. To make your home safer:

• Remove things you can trip over (like papers, books, clothes, and shoes) from stairs and places where you walk.

• Remove small throw rugs or use double-sided tape to keep the rugs from slipping.

• Keep items you use often in cabinets you can reach easily without using a step stool.

• Have grab bars put in next to your toilet and in the tub or shower.

• Use non-slip mats in the bathtub and on shower floors.

• Improve the lighting in your home. As you get older, you need brighter lights to see well. Hang light-weight curtains or shades to reduce glare.

• Have handrails and lights put in on all staircases.

• Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.