HealthCare Column

Dear HealthCare Team,
My husband and I just took in his aunt who is wheelchair bound and cannot walk on her own, she needs assistance to go to the bathroom, get changed, bathed. I have a physical injury to one arm that I cannot lift her or help change her or bath her with my one good arm right now. She can eat, talk, listen, smile & laugh. We want to help her. What can your services do to help us?
Your husband's aunt is fortunate to have someone to care for her.

Based on the description you provide of your aunt's needs, it sounds like she would require the services of a home care aide, that is, someone who is trained in providing assistance with activities of daily living (bathing, dressing, transferring, toileting). However, to be sure, you would want to have someone from a home care agency provide an assessment of your aunt to make a specific determination of her actual needs.

You can find a home care agency in your area in a number of ways:

• You may have friends who have used the services of a home care agency before. Listen to their recommendations.
• Your aunt's physician may know some agencies who provide good care. Ask the physician for a referral.
• You can find home care agencies listed in the yellow pages of your phone directory.

Of course the biggest question is related to paying for these services. Several options are available for you to pursue.

• If your aunt requires the skills of a nurse to provide services that are medically reasonable and necessary, this service is covered by Medicare if your aunt is homebound. Medicare would also cover the services of a home health aide several times a week if the nurse were necessary.
• If Medicare covered services (the services of a nurse) are not necessary for your aunt at this time, other sources of payment can also be explored:
• Does your aunt qualify for Medicaid?
• Many local health departments or Medicaid departments have special programs to address the needs of the elderly. Ask your aunt's doctor to refer you to one of these special programs or contact them directly (they can be found in the phone book).
• Your local Area Agency for Aging is a good resource for these kinds of services.
• One of your local churches may also have a special program to provide some care for your aunt.

Dear HealthCare Team,
A few years ago My hubby and I adopted a little boy who has J.R.R.P. he has had 68 surgeries to date. Last Feb. My hubby had a stroke and I have a problem keeping up with his diet and he cheats a lot when I am busy. I need to cook (and do so) balanced meals for this child and for him. I am 67 and am getting wore out with this game from my hubby. Can't put food in a lock box to keep him from cheating, he plays the "Oh I didn't know" game when I tell him he shouldn't have a certain amount of carbs or a food with a lot of sugar. Then does it anyway.
It sounds like you have quite a challenge in front of you. You need a little professional guidance from a registered dietician. A registered dietician will provide some structured education for you and your husband that includes lists of appropriate and inappropriate foods, shopping tips and menu ideas. Your physician should be able to refer you to a competent dietician.

Additionally, Medicare has recently stated that they will provide some reimbursement toward a visit to the dietician. Make sure your selected dietician accepts Medicare payments.

Dear HealthCare Team,
Is there any Government financial assistance for home health care?
The government's Medicare program provides for home health services if the Medicare beneficiary meets certain conditions.

• The beneficiary must be homebound and living in a personal residence (not a nursing home or rehab facility).
• He/She must be under the care of a physician who would oversee the home health plan of care.
• He/she must have a need for a skilled nurse or physical therapist to visit periodically.

If the beneficiary has all of these needs, then, yes, he/she qualifies for home health care under the Medicare benefit. Once qualified for the benefit, then he/she is also eligible to receive home health aide assistance for bathing as long as he/she is receiving services from a nurse or therapist.

If the person in question is not a Medicare beneficiary or does not meet the criteria outlined above, he/she may be eligible for Medicaid services. Each state administers their Medicaid program differently, so you will need to contact your local Medicaid program for information.

Any home health agency in your area would be happy to discuss these issues with you in detail. You can find a list of home health agencies in your yellow pages or from your doctor.

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