Can Strokes Be Prevented?

Strokes. Can they be prevented? What is a stroke? Am I at risk for a stroke? How can I tell if I am having a stroke? What does Medicare cover?strokes rehab

Anyone at any age can have a stroke but the likelihood of strokes increases with age. Immediate treatment can minimize the long term effects of the attack.

 

Can Strokes Be Prevented?

The old saw that prevention is the best medicine is good advice. Before we look at what a stroke is and how it should be treated let’s review preventive measures.

Strokes threaten millions of lives — every 40 seconds someone in the U.S. has a stroke. And, on average, one American dies from a stroke every 4 minutes, taking 130,000 lives a year and making it the 5th-leading cause of death in our country. And, too, among survivors, it can cause severe long-term disability and handicap.

The facts are that strokes are largely preventable, treatable and beatable – but action is required. In fact, research shows that 80% of all strokes are preventable by taking action. – Washington Times

An active, healthy lifestyle is the best prevention. If you are heavy, lose weight. Stop smoking. Monitor your blood and cholesterol levels.

Any of these conditions puts you at risk for a stroke.

Many cases of hypertension or hyperlipidemia can be controlled with diet and exercise, but if you need more help your doctor may prescribe medication. Have regular check ups. Monitor your blood pressure at home.

 

What Is A Stroke?

Strokes are classified in different ways.

  • Ischemic (ih-skee-mik): The artery gets blocked, often by a clot, and this prevents adequate blood flow. It is responsible for 87 percent of all strokes.
  • Hemorrhagic (hem-ur-ajic): An artery leaks or ruptures and the resultant leaked blood puts pressure on the neurons, causing damage. This can result from dangerously high blood pressures that overwhelm the blood vessel walls, chronic high blood pressures that cause wear and tear over time, and/or weakened blood vessels.
  • Mini-stroke:” A temporary blockage caused by a clot. This is also referred to as a transient ischemic attack (TIA). Unlike a stroke, the symptoms resolve and there is no permanent injury to the brain. A TIA is a warning sign for a future stroke and must be taken seriously: more than 30 percent of people who have a TIA end up having a major stroke within 1 year if they do not receive treatment. Recognizing and treating TIAs can reduce the risk of a major stroke. If you have a TIA, your health care team can find the cause and take steps to prevent a major stroke.

The type of stroke you have often determines the treatment as well as long term effects. When the stroke victim is diagnosed and treated quickly the chances of recovery are much improved. Triage in the hospital ER will determine if the patient needs a clot busting injection or surgery.

 

Am I Having A Stroke?

Most of the time you will know something is wrong but it may take people around you to see the visible signs and call for emergency care. How do you know if you are having a stroke? Think F.A.S.T.

  • FACE: Ask the person to smile. Does one side of the face droop?
  • ARMS: Ask the person to raise both arms. Does one arm drift downward?
  • SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
  • TIME: If you observe any of these signs, call 911 immediately (even if they resolve)

If you are with someone and see any of the above symptoms do not hesitate to call 911.

 

Does Medicare Cover Treatment for Strokes?

Medicare does in fact include emergency treatment for your stroke. Medicare Part B covers ambulance transport and ER care. Your 2016 Part B calendar year deductible is $166. Once the deductible is satisfied Medicare pays 80% of approved charges and you are responsible for the remaining 20%.

That 20% is not capped. You pay until you are better, run out of money or die.

Medigap plans F and G will pay the 20% remainder after Medicare pays their portion.

ga medigap rates

If you are admitted to the hospital as an inpatient, your stay will be covered under Medicare Part A. Your Medicare per admission Part A deductible for 2016 is $1288. Supplement plans F, G and N pay this deductible for you.

Not all hospital admissions are as an inpatient. If you are admitted for observation the charges are covered under Part B. If you are then discharged to a skilled nursing facility (SNF) or rehab unit, Medicare does NOT pay for this care. In order for SNF or rehab to be covered by Medicare you must have had a 3 day stay as an inpatient.

If your post discharge stay qualifies under Medicare rules but exceeds 60 days you will be responsible for a daily coinsurance of $322 for days 61 – 90. That amount doubles to $644 per day for stays lasting longer than 90 days and up to 180 days.

All Medigap plans cover your Part A coinsurance and extends that coverage up to 365 days lifetime.

Private long term care insurance, short term care insurance and home health care are types of policies that should be explored to supplement your Medicare coverage.

Georgia Medicare Plans specializes in finding  Medigap coverage that fits your needs and budget. Bob Vineyard has more than 40 years experience in the health insurance industry. In addition, he is also a Medicare beneficiary covered by original Medicare and a Medigap plan.

With more than 170 different Medicare supplement plans in Georgia it is impossible to find the right plan without expert guidance. We shop the market for you and show you the best plans based on your needs.

GA Medigap rates

Click the image above for an instant Medigap quote. Compare up to 30 plans side by side. A free report showing all plans in your area will follow by email.

 

Stroke Aftermath

I have friends who have had strokes. Some have mostly recovered, while others would be considered an invalid requiring round the clock home health care. Medicare only covers a portion of the bills and provides no coverage for care that is not medically necessary.

Without additional insurance you and your family will bear the cost of attending to your activities of daily living.

 

Additional Resources For Learning About Strokes

Medicare Coverage for Skilled Nursing Facility

Long Term Care – Medicare, Medicaid and More

National Stroke Association – Medicare Basics

Caring – Will Medicare or Medicaid Pay for Long Term Care?

 

 

#Stroke #Medicare #LongTermCare #ShortTermCare #HomeHealthCare

 

Senior Care, Giving it Your Best Shot

Senior care resources. How do I find caregiving tools for seniors? Can you trust the internet? How do I find local Georgia senior care resources? How much does senior care cost? How do I compare doctors and hospitals based on quality of care? senior care

Some of us are old enough to remember Pat Benatar strutting and kicking as she belted out the lyrics to “Hit me with your best shot”. At age 27 this classically trained vocalist had already had one hit album before the song that defined Pat as a rocker that knew where she wanted to go.

But if you are responsible for the senior care of someone close, where do you go for information?

Certainly the internet is a popular choice but if you don’t know where to look, or how to evaluate and process the information you are no better off than when you started your elder care search.

Fortunately the people at Minute Women have put together a list of 50 Best Senior Caregiving Tools you can find online. On one single page you find over 50 links devoted to senior. The list is divided into 10 different sections, making it easy to find the answers you seek.

Some of the links go to government websites while others are to pages that deal with elder care issues and resources. You will also find forums at the bottom of the page that can guide you in your senior care search.

Whether you are seeking general information on topics like long term care or hospice information, or sources relevant to your needs in Georgia, we believe this is a page you should bookmark for future reference.

And here is another tip you can use.

Medicare supplement plan F is the most heavily promoted Medigap plan in Georgia. It is also overpriced in our opinion. Blue Cross recently increased prices for their Medicare supplement plans. So did a well known mutual company, but they only increased rates for EXISTING policyholders. New applicants got a discounted rate.

AARP will probably follow suit with an increase in April, which is the time of year when they typically raise rates.

At Georgia Medicare Plans we usually help our clients save $450 over their current Medigap plan with no loss in benefits. Why not shop and compare GA Medigap quotes now?

And for senior care information, check out the 50 Best Senior Caregiving Tools.

 

Hospice Patients Aren’t Dying

Medicare has a problem. Hospice patients aren’t dying like they are supposed to. When you are approved for hospice you are expected to die within 6 months. When hospice patients don’t die, the cost to Medicare goes up.    hospice patients

Over the past decade, the number of “hospice survivors” in the United States has risen dramatically, in part because hospice companies earn more by recruiting patients who aren’t actually dying, a Washington Post investigation has found. Healthier patients are more profitable because they require fewer visits and stay enrolled longer.

Washington Post

Hospice patients that don’t die are big business for companies that care for the dying.

The hospice “movement,” once led by religious and community organizations, was evolving into a $17 billion industry dominated by for-profit companies. Much of that is paid for by the U.S. government — roughly $15 billion of industry revenue came from Medicare last year.

88% of hospice patient revenue is paid for with taxpayer dollars from Medicare. End of life care is big business.

Care for hospice patients is a covered expense under Medicare Part B. When you have original medicare and a Georgia Medicare supplement plan you are covered. Medigap plan F pays 100% of your approved Medicare Part B expenses.

Are you still paying too much for your Medicare supplement plan? If you have Medigap plan F from AARP (United Healthcare), Blue Cross of Georgia, or Mutual of Omaha you are probably paying more than you should.

Shop and compare your plan costs now.

GA Medigap Quotes

Do you want to know what Medicare covers if you are a hospice patient? Click to review Medicare Hospice Benefits.

At AseraCare, for example, one of the nation’s largest for-profit chains, hospice patients kept on living. About 78 percent of patients who enrolled at the Mobile, Ala., branch left the hospice’s care alive, according to company figures.

That’s good news for the patients and their families, but bad news for Medicare. One wonders if these runaway costs will catch the eye of lawmakers that will respond with reduced funding for hospice patients.

Medicare Cuts Fund Obamacare

Georgia seniors will get a rude awakening in January when Medicare cuts fund Obamacare. You were warned. Obamacare is medicare cutsfunded, at least in part, on the backs of seniors that rely on Medicare.

Starting Jan. 1, the Centers for Medicare and Medicaid Services (CMS) will begin slashing 14 percent of their Home Health Care Prospective Payment Program budget, driving small home health-care providers out of business and potentially affecting millions of poor, elderly citizens in need of physical rehabilitation.

The cuts — which are being made to fund Obamacare — will slash the homecare budget 3.5 percent every year for the next four.

Daily Caller

How will those 14% Medicare cuts impact home health care providers?

“By CMS’s own calculation, 40 percent or nearly 5,000 home health companies — mainly small businesses — will experience a “net loss” in revenue due to the cuts and go into the red by 2017,” The Washington Examiner reports. “That will put many of them out of business.”

More job losses due to Obamacare.

The cuts to Medicare are part of approximately $716 billion Obamacare takes from the program between now and 2022.

You may recall during the last election, Mitt Romney was called a liar for claiming Medicare cuts would be used to fund Obamacare.

Now who looks foolish?

Medicare cuts are like the Saturday Night Live Samurai deli except without the humor.

Nursing Home vs Home Care

Nursing home operators, faced with soaring health care costs and shrinking Medicare and Medicaid financing, are closing some facilities and embracing an emerging model of care that allows many elderly patients to remain in their homes and still receive the medical and social services available in institutions.nursing home or home health care

The rapid expansion of this new type of care comes at a time when health care experts argue that for many aged patients, the nursing home model is no longer financially viable or medically justified.

In the newer model, a team of doctors, social workers, physical and occupational therapists and other specialists provides managed care for individual patients at home, at adult day-care centers and in visits to specialists. Studies suggest that it can be less expensive than traditional nursing homes while providing better medical outcomes.

The number of such programs has expanded rapidly, growing from 42 programs in 22 states in 2007 to 84 in 29 states today. In New York City, a program run by a division of CenterLight Health System, formerly known as the Beth Abraham Family of Health Services, has over 2,500 participants at 12 sites in the metropolitan area.

“It used to be that if you needed some kind of long-term care, the only way you could get that service was in a nursing home, with 24-hour nursing care,” said Jason A. Helgerson, the Medicaid director for New York State. “That meant we were institutionalizing service for people, many of whom didn’t need 24-hour nursing care. If a person can get a service like home health care or Meals on Wheels, they can stay in an apartment and thrive in that environment, and it’s a lower cost to taxpayers.”

The recent influx of adult day-care centers and other managed care plans for the frail elderly is being driven by financial constraints as President Obama and Congressional leaders seek hundreds of billions of dollars in savings in Medicare and Medicaid. Nursing homes, which tend to rely heavily on Medicare and Medicaid dollars, are facing enormous financial pressure — Mr. Obama’s proposed budget includes a $56 billion Medicare cut over 10 years achieved by restricting payments to nursing homes and other long-term care providers.

Nationally, the number of nursing homes has declined by nearly 350 in the past six years, according to the American Health Care Association. In New York, the number of nursing homes declined to 634 this January from 649 in October 2007, and the number of beds to 116,514 from 119,691.

Over the next three years, New York State plans to shift 70,000 to 80,000 people who need more than 120 days of Medicaid-reimbursed long-term care services and are not in nursing homes into managed care models, Mr. Helgerson said.

The move away from nursing homes was highlighted on Thursday when Cardinal Timothy M. Dolan announced that the Archdiocese of New York, one of the state’s largest providers of nursing home care, is selling two of its seven nursing homes and opening or planning to open seven new adult day-care centers over the next three years.

“Seniors and others who have chronic health needs should not have to give up their homes and independence just to get the medical care and other attention they need to live safely and comfortably,” Cardinal Dolan said in a statement before he opened a 250-patient program at Saint Vincent de Paul Catholic Healthcare Center in the South Bronx.

These new adult day-care centers, known around the nation by the acronym PACE — Program of All-Inclusive Care for the Elderly — provide almost all the services a nursing home might, including periodic examinations by doctors and nurses, daytime social activities like sing-alongs and lectures, physical and occupational therapy and two or three daily meals. All the participants are considered eligible for nursing homes because they cannot perform two or more essential activities on their own like bathing, dressing and going to the toilet. But they get to sleep in their own beds at night, often with a home health care aide or relative nearby.

The nonprofit groups that operate them receive a fixed monthly fee for each participant and manage their entire care, including visits to specialists, hospitalizations, home care and even placement in a nursing home. Because Medicare and Medicaid pay set fees instead of paying for specific procedures, center operators are motivated to provide preventive care to avoid costly hospitalizations or nursing home care.

Some elderly people, however, spurn PACE programs because under managed care, they would have to switch their physicians to those at the PACE center or in its network.

Most elderly people want to live out their lives at home, a desire evident in interviews in the PACE center the archdiocese opened in 2009 in Harlem, which has a staff of three doctors and is visited regularly by a dentist, a podiatrist and a psychiatrist.

Edna Blandon, 74, a diabetic weakened on her left side by a stroke who relies on a wheelchair, is transported by specialized van to the Harlem PACE center three days a week and appreciates that it provides not only a home care attendant but sends a nurse every two weeks to change pills in her pillbox and load a 14-day supply of insulin into syringes that she will inject.

“My spirits would drop if I went to a nursing home,” she said. “I love the fact that I can go home at night. There’s no place like home. I can sit down, look at the TV and go to bed when I want.”

James Harper, 70, a retired bank employee who spent 10 months at the archdiocese’s Kateri Residence, a nursing home on the Upper West Side, after a stroke paralyzed his right side, enjoys yoga breathing classes and discussions about black history. Yet he gets to spend nights and weekends with his wife, Albertene, and daughter, Traci, both of whom work during the day and are not around to care for him.

“This way I’m around people,” he said.

Dr. Fredrick T. Sherman, the Harlem PACE medical director, said that a 2009 study showed that PACE programs reduce lengths of stays in hospitals and delay assignments to nursing homes.

The archdiocese, whose new centers will serve a total of 1,500 people, receives an average of $4,000 a month from Medicaid for each participant and $3,300 from Medicare. By comparison, said Scott LaRue, the chief executive of ArchCare, the archdiocesan health care network, a month of nursing home care can cost the government $9,000.

Ultimately, the archdiocese hopes that half of its elderly clients will be served in community settings rather than in nursing homes, which currently serve about 90 percent of the archdiocese’s clients. For-profit companies have not yet moved into the managed care market, in part because of uncertainties about reimbursement formulas and the risks of taking on a nursing home population.

The PACE population tends to be younger than that at nursing homes, which raises the question of whether many PACE clients would really need nursing homes without PACE. Dr. Sherman replies to such skepticism by saying that his clients “need that level of service — the question is where they’re going to get it.”

Without PACE, he said, “they’re going to end up in nursing homes.”