3GenFamily Blog

I just watched an amazing documentary on the PBS website. It is Caring for Your Parents. My post about it is at 3GenFamily.com. –CK Wilde

3GenFamily Blog has moved to a new location on the web.

Please come visit us at 3GenFamily.com

By CK Wilde for 3GenFamily Blog.
Ripe, juicy tomatoes were my father’s obsession. Every year, Dad would plant enough tomato plants to keep our family of four and my grandparents, my aunt and her husband and my uncle and his family with huge beefsteak and oval plum tomatoes all summer long. At summer’s end, he and my mother would spend weekends canning tomatoes.

After many August weekends of canning whole tomatoes, my mother revolutionized her life by canning tomato sauce which could be used right from the jar to prepare meals. Much later on my parents discovered the wonders of freezing the sauce to keep more of the fresh made taste.

Getting bumper crops of tomatoes took a lot of work preparing the soil, starting plants from seeds, planting and then watering and tending the plants. Most spring and summer evenings, you would find my father out in his garden helping plants grow.

Two Packs A Day

And, during that time, my father was a two pack-a-day smoker. He quit “cold turkey” one day after 35 years of smoking because a coughing fit left him wheezing and unable to catch his breath. In that instant, he finally realized that his only choice was to stop smoking.

He continued to vigorously garden until his late 70’s when his second wife pronounced the garden “too much work for him” and urged him to give it up. Believe it or not, the garden seemed to be the source of his energy and strength.

Over the next few years, Dad’s health slid into decline. Hospitalizations became more frequent.

Gardening and Salads?

So even though it seems a bit far fetched, it doesn’t surprise me that the researchers at the University of Texas M.D. Anderson Cancer Center found recently (December 2007) that smokers and non-smokers may be able to reduce the risk of lung cancer by eating salads 4 or more times per week and working in the garden 1 or 2 times per week.

Cynical reviewers could say that this research is nothing more than getting exercise and eating the right kinds of foods. Yet, I wonder if there is something additional going on?

Thwarting Pesky Gophers!

When my children were in preschool and first grade, we tended a little garden in tubs placed in a sunny spot near our front door. We grew all plants in containers to thwart the gophers who managed to devour everything in their path.

After a few minutes of pulling weeds and watering, I would lapse into a reverie — an almost primal connection to the earth. The warmth of the sun would melt the tension from the week. Stretching and bending felt so good after a week of desk sitting. I would be refreshed and ready for the hectic week ahead.

In a number of weeks after all of my solicitous garden tending, we would be rewarded with the most delicious tasting vegetable and herbs. An added benefit of all of the work in the garden is that , even today, my sons willingly eat salads and vegetables!

And now, the researchers at M.D. Anderson Cancer Center have been able to empirically show that eating vegetables (antioxidants, vitamins and minerals) and getting outdoors to get some sun (Vitamin D) and exercise (reduce stress and condition the heart and lungs) can save smokers lives.

It is a sad irony that just a few years after my father gave up gardening, he died of lung cancer.

If you have a parent or spouse who smokes, don’t give up on getting him or her to quit. 80 percent of lung cancers are related to smoking tobacco.

In the meantime, you might want to suggest heading out to the garden to plant some veggies.

3GenFamily Blog has moved to a new location on the web.

Please come visit us at 3GenFamily.com

By CK Wilde for 3GenFamily Blog

Over the past 19 years since my first son was born, we have had a number of doctors care for us. Dr. G, our first pediatrician, was reassuring and supportive even when I was 2 hours late for the first baby check up.

When Dr. G accepted a partnership opportunity 80 miles away, we moved to Dr. H who gave my children friendly, practical care until it was our turn to move away.

Dr. H gave us a referral to Dr. B, a distinguished, elderly man trained in Europe. I really appreciated Dr. B’s concern and care when it came to treating my son’s asthma.

Unfortunately, our insurance carrier changed and I was forced to find a different doctor who was accepted by the plan. That’s how Dr. F entered our lives.

Every time we made a change, I dutifully requested that my sons’ medical records be sent to the new doctor. Dr. F inherited two files that were over 2 inches thick. The last time I saw a complete file was during an office visit for my youngest son two years ago.

(Here’s the Health Record organizer I recommend.)

Reason Number 1 - Medical Records Get Lost or Destroyed

Recently, it was time to changed doctors again. I requested copies from Dr. F’s staff and paid $50 for them photocopy the entire files.

What I got was only 10 pages for each son!

The doctors’ staff insists that I got everything they had.

So, what happened to all of those old records?

I can only suppose that someone was cleaning up the doctors files and moved ours to some unlabeled box in a storage facility. Or, perhaps they shredded them (California has enormous penalties for failing to destroy medical records properly).

HIPPA, the Health Insurance Portability and Accountability Act, requires information it defines as “protected health information” to be maintained by the physician for at least 6 years from the date of its creation or the date it was last in effect. The earliest date in the records I received was 1997. So Dr. F’s staff had actually kept records going back more than 10 years.

Isn’t that good enough?

Not always.

Reason Number 2 - Memory Fails & Doctors’ Notes are Impossible to Read

My oldest son recently came down with a sinus infection at college. He needed to tell Health Services if he had any reactions to medication. I recalled he had some issue with one antibiotic a long time ago. But which one was it?

I couldn’t remember the name so I searched the records I received. Dr. F’s scribbles were impossible to read. How I wish I had kept a set of records myself. The benefit claim forms that the insurance company sends don’t have any of these kinds of details.

So my son had to take the medication he was prescribed and hope for the best.

We lucked out. Number one son is recuperating nicely. But, there could have been a problem. All I had to do was make a legible note in a binder and put it in a safe place. But I didn’t because I thought I would remember.

My father tried to capture his key medical issues on pieces of note paper. I found a few of these notes in his tax paperwork for 2005. But, Dad didn’t have these papers with him the times he was hospitalized in the past two years.

My father wasn’t always able to tell the hospital doctors his medical history. It is clear from the records I have that they were in the dark about it. He ended up having multiple tests and x-rays over and over again because of it.

Reason Number 3 - Doctors Don’t Always Communicate With Each Other

In my post, Google Doesn’t Belong in the Health Records Business, I mentioned that my Dad’s family doctor did not always get records after my Dad’s hospitalizations because she was not affiliated with that hospital.

The hospital would assign a doctor to my father. Dad would protest that he had a doctor. They would explain that she couldn’t attend him that their hospital. My father would be angry and frustrated. The hospital staff would just call him difficult.

Eventually, I convinced my father to switch doctors so that he would have a family practitioner close to where he lived. With the help of the nurse at the retirement community, I arranged for my father to consult with two of the doctors who made visits to the community. He wasn’t sure which doctor he wanted as his primary care physician so we arranged for him to meet both doctors and then decide.

I requested my father’s medical records from his original doctor but her staff did not want to release them. The office manager said she would only release his medical records to another doctor. (Note: Each individual has a right to his/her own medical records.) They said they were afraid he would lose them and it would be too much work to copy them again.

Frustrated but unable to do much by long distance, I suggested to my father than I would give his old doctor one of the names of the new doctors, have the file sent, and then he could choose from the two new doctors. The nurse at the retirement community promised to get the file to the right doctor when it arrived.

Dad had a “meet and greet” with one of the doctors. Still no medical record for the new doctor to review. The other doctor had an emergency that day and canceled office visits.

Meanwhile, I continued to badger the office manager to release my father’s records.

Dad’s records eventually arrived, but not before he was hospitalized again. More tests, more x-rays.

You Need to Protect Yourself and Your Family

My family has had its share of doctors’ visits since the time my children were born. Most of those have been routine checkups. Never in all that time has any medical professional ever suggested I keep a binder to keep track of things.

My latest experiences tell me that I really need to get a binder together for my family. After doing some research, I settled on Jakoter Health Organizers.

The Jakoter Health Organizer includes a sturdy binder, 75 separate pages to record important information, pocket pages to hold instructions, notes and charts, even business card holder pages to keep all of your doctors’ business cards handy.

Click this link to see more information about the Jakoter Health Organizer.

Are you carrying around stacks of doctors’ business cards in your purse just in case you will need them? I was. The business card pages in this kit are a way to lighten your load and still be prepared.

This organizer was created by an enterprising mom, Laura Heuer, who needed a way to deal with the overload of details about her son who had severe reactions to antibiotics given for a strep throat. Her son eventually got better. Out of her struggle to stay organized and on top of issues, the Jakoter Health Organizer was born.

Please check it out. Having organized health records will make it easier to communicate with your doctors, prevent unnecessary procedures and help your doctor make better diagnoses.

Today is a great day to get started.

3GenFamily Blog has moved to a new location on the web.

Please come visit us at 3GenFamily.com

By CK Wilde for 3GenFamily Blog

My father only had a couple thousand dollars of life insurance in force by the time he turned 83. He outlived the term of one policy, so the insurance company paid him the cash value and terminated the policy.

As someone who was deeply affected by the Depression, Dad would probably have jumped at the chance to sell a life insurance policy for more than the cash value. But, as someone in the early stages of dementia, he was vulnerable to being swindled. We had one close call with his investments.

I want to alert you to the booming business in life settlements that is still largely unregulated.

Help for the Terminally Ill

It started out as a compassionate way to help someone who has large medical bills to pay. It’s called a viatical settlement. It gives a person, typically with less than two years to live, who owns a large cash value life insurance policy but does not have a spouse or children, a way to get cash out of the policy.

Cash value insurance policies (also called whole life) have provisions for the owner to cancel the policy and receive the “surrender value”. But, this amount is usually very small compared to the total amount of insurance. The settlement company is usually willing to pay much more. The viatical settlement became popular during the 1980’s as a way to help terminally ill AIDS patients deal with the high cost of medical care.

A New Investment is Born

The purchased insurance policies from those early viatical settlements were sold to individual investors. Because this new investment was unregulated, it attracted some unscrupulous dealers. Salesmen were paid high commissions to sell the policies to investors who did not always understand what they were buying. The investment community soured on buying settlements.

In 2001, the National Association of Insurance Commissioners released the Viatical Settlements Model Act which established guidelines for ensuring sound business practices and avoiding fraud. It was about that same time that settlement dealers began purchasing policies using institutional capital. The demand for settlements as an investment began to increase.

Better Than Mortgages?

From an investor’s standpoint, buying insurance policies is even better than buying mortgages. Everyone dies! As long as the insurance policy was written by a company that is solid, the investor gets paid.

Investing in mortgages, once considered much safer than stocks or bonds, is not as predictable. People can get sick or disabled, lose there jobs, or have other life events that prevent them from paying the mortgage. US economic problems today were caused in part by defaults on mortgages — many made by unscrupulous brokers who bent the rules.

Most mortgages today are combined into packages that re-sold to large institutional investors. It wasn’t long before some enterprising folks figured out that they could package these purchased policies, now called life settlements, and sell them to institutional investors for generous commissions.

Easy To Be Taken In By Easy Money

It happened to Larry King, CNN’s famous talk show host. King alleges in a lawsuit filed recently that he was the victim of a scam to buy and sell life insurance on himself, also called “flipping” policies. While King made $1.4 million on the deals, he now realizes that he would have been better off if he had kept the policies. He feels that he was cheated.

An insurance company owns the $15 million in policies, a company by the name of Coventry Insurance. Coventry was sued last year by the State of New York for alleged predatory practices.

Yesterday, our local newspaper, the San Jose Mercury News, reported that flyers were circulating at a San Luis Obispo, California senior center telling seniors they could get as much as $50,000 from “investors that want to speculate on our life expectancy.”

Although the NAIC issued the Viatical Settlements Model Act in 2001 and amended it in 2007 to strengthen consumer protections for “Stranger- Originated Life Insurance” only 35 states have officially adopted the guidelines. California, where I live, has not yet adopted any guidelines.

What’s The Harm?

If Larry King, who is a reasonably intelligent 73 year old, could be duped, anyone could be. Particularly someone in the early stages of dementia.

Life insurance is just one part of a total financial plan. Selling a life insurance policy really needs to be evaluated in terms of the person’s overall needs and financial status. These life settlement companies are not doing that.

So we caregivers need to be alert to these issues. If your parent tells you about a wonderful opportunity to sell an old life insurance policy, get to the financial planner or attorney to have the deal reviewed right away. Who is buying the policy? Will it be sold to a third party? Who is that?

The Mercury News article quoted Jay Adkisson, an attorney who writes a blog about financial fraud, “You ought to know who you are selling to. You don’t want Tony Soprano buying your life insurance policy.”

Good advice.

And, Make Sure to Have Pudding for Dessert

What?!

A popular nutrition newsletter arrived in my email today talking about Vitamin D deficiency in the US. I was surprised to read that Vitamin D deficiency is very common in the US. A recent study in the American Journal of Clinical Nutrition (January 200 found that a low blood concentration of Vitamin D was associated with higher blood pressure in Caucasians (but not African Americans.)

It seems that researchers are finding all sorts of health issues that a little bit more vitamin D would lessen or prevent. Most important for seniors — Vitamin D helps your body use calcium to build stronger bones.

Hip or other bone fractures are often the beginning of a grindingly slow downward spiral for many seniors. Less mobility leads to even less mobility. The end of the line is the nursing home.

The crying shame is that Vitamin D is so easy to get through our diet, supplements and sunlight. Eggs, tuna, salmon, mackerel and sardines are good sources of Vitamin D along with fortified milk products.

Your daily vitamin probably contains it, but not enough. The recommended daily allowance is 400 IUs. Many all in one supplements contain less than half that amount.

More Is Better

Dr. Andrew Weil, (click here) highly respected for his approach to combining nutrition with traditional medicine, recommends 1000 IUs per day and even more if you don’t get out in the sun at all. His recommendation comes after extensive research into the latest studies on Vitamin D.

His conclusion: More is Better!

Love the One You’re With

Here’s an easy way to show your Valentine you care. Take your parent (or loved one) out for a walk in the sunshine, weather permitting. Just 15-20 minutes of sun on your hands and face is enough. But, don’t put on sunscreen. It blocks your body’s ability to make Vitamin D. Take the sunscreen with you to apply after you get a bit of sun if you’ll be out more than 20 minutes.

Then, have a lovely salmon dinner. Tuna sandwiches are ok, too (go light on the mayo.)

And, top it off with pudding made with fortified milk (nondairy, if milk is a problem). Sorry, milk chocolate truffles don’t count.

Both People Benefit

Spending time with someone to celebrate has benefits for your parent, loved one and you. Mind, body and spirit. Don’t miss out.

3GenFamily Blog has moved to a new location on the web.

Please come visit us at 3GenFamily.com

By CK Wilde for 3GenFamily Blog

Dad rarely travelled outside of a 10 mile radius of his home. The one or two times each year that he needed to go farther, he would enlist someone to drive with him. So, I never pressed the issue of getting a cell phone for emergencies.

When I showed him my newest phone, he dismissed it saying,” The buttons are too small. I can’t read that screen. I’m hard of hearing, you know!”

Then came the accident.

Dad was driving back from the car dealership, took a wrong turn onto the New Jersey Turnpike, got lost and tried to find his way back through a neighborhood he had never seen before. Peering sideways to read the street signs, he veered into a parked car. Crash!!

My father was a very lucky man. The owners of the parked car were looking out their kitchen window when it happened. They rushed to help him.

He climbed out of his car, shaken, but not injured. At first, the police thought he was drunk. When my father told the police he was a diabetic and could not drink, they worried that his blood sugar was too low.

Eventually, Dad convinced them that he didn’t need an ambulance, just someone to take care of his car and give him a ride home. Those good samaritans who witnessed the accident called someone to take care of the car. The car repairman took my Dad home.

My father waited for several days before telling me about the accident. He knew before I said a word that I would urge him to give up driving. He did stop driving shortly after that incident. It had scared him that much!

It scared me, too. What if nobody had been around to help?

I wish that my Dad had had a Jitterbug phone.

Jitterbug cell phones are designed to be easy to use with big, back-lit buttons, large text, and a powerful speaker for loud, clear conversations.

What makes the Jitterbug phone perfect for seniors is the live, 24 hour operator service. The operators will make calls for you, assist you with finding a phone number from a directory or add names to your phone list. (5 minutes are deducted from your minutes for each operator assist.)

The best part is there are no contracts and no long distance roaming fees. You choose the plan that’s right for you (as low as $10 per month.) You can even share minutes with another family member.

If your parent likes to go out and about but you worry, get your parent this phone for the holidays or any gift giving occasion. The price of the phone is very modest — $147. The peace of mind for a caregiver is priceless.

To learn more about the Jitterbug phone and service plans, click here.

photo courtesy of GreatCall, Inc.

 The mood was relaxed and happy on the five hour flight from California to New Jersey. It was Thanksgiving Day. The sun was just beginning to set on what must have been an unseasonably warm day on the East Coast. I smiled to myself. The plane had arrived ahead of schedule. I would be at my father’s home in time for dinner with him.

The airport shuttle driver let me off outside the patio of my Dad’s place. I could see Dad was sitting motionless in his recliner in the corner of the room. Only the kitchen light was on, but I could easily peer into this tiny garden apartment in an independent senior living community. It had been my father’s comfortable home for the past year.

The TV was off. Dad must have fallen asleep, again.

I knocked on the glass patio door and eventually woke him from his nap. He was overjoyed to see me. But, his mood went from gleeful to glum in only a minute. “I’m sorry. I’m afraid I don’t have dinner for you,” he said.

In our phone conversations over the past few days, my father had chatted cheerfully about preparing his favorite dish, baked turkey legs, for us for Thanksgiving.  He had discovered a great recipe by accident and wanted to share it with me.

“I guess I fell asleep and didn’t hear the timer,” he continued. “ The turkey legs were totally burnt even though I had them in a low, 250 degree oven.”

“How long do you think you overslept?” I asked.

“Oh, it might have been six hours,” Dad said sheepishly.

“That’s ok. You have some hamburgers in the freezer that we can make, right?” I said trying to sound upbeat. (Did I hear that right, six hours?)

I walked into the kitchen to start preparing the hamburgers. The stove was dirty. Pots had boiled over and burnt remains littered the trays under the burners. I peered into the oven. It was just as dirty. The entire apartment smelled like burnt food. This was a major change since my last visit.

I tried to hide my uneasiness as the realization began dawning on me that Dad was not able to safely cook for himself anymore.

“Gee, Dad, it looks like you had a few pots spill over,” I said.

“Yeah, pots boil over from time to time. It’s no big deal,” he growled.

“Looks like you could use some help with the cleaning, Dad. “

“I’m doing fine by myself! I don’t have extra money pay for cleaners. I have barely enough to live on! ” Dad’s growl had turned into a shout.

Lowering my voice, I turned to him with a big smile, “I know you have done a really great job managing your money. It is looking like you could use a little help here, that’s all.”

That was the beginning of a weekend-long argument.  I gave my father all sorts of suggestions for ways he could get help. He rejected every one.

We met with a non-medical in home care provider.  Dad turned pale when he heard the hourly rate.  I got out the rate sheet for the additional cleaning services that the senior apartment complex offered.

“That’s too much! Dad shouted.

Finally, I hit upon the idea of Dad purchasing the meal plan from the dining room. Together, we figured out how much he spent on food. It looked like buying dinner on the meal plan would not cost much more than he was already spending.

I reasoned and cajoled. Dad finally agreed that he would enjoy getting his evening meal from the dining room.  All that was left to do was for my father to sign up for the plan on Monday. He said he would do it.

I left for the airport on Sunday evening with a light heart.

On Monday, I phoned to remind him to sign up for the meal plan. He began to waffle. Maybe he would wait until December. Maybe he would wait until he finished the food in the freezer. Maybe he would wait until . . .

Of course, I knew these were just excuses. For each one, I countered with a reasonable argument. Dad thought up another.  He wasn’t going to do it and I was too far away to exert the same kind of influence I had when I was physically there.

A November 2007 study by the National Alliance for Caregiving and Evercare found that the long distance caregivers spend an average of $8728 per year out of their own pockets to help an elderly family member. Local caregivers spend somewhat less — approximately $5000 annually.

And, it is no surprise to me that the largest percentage of this expense is going to provide care attendants, followed closely by medical expenses and long distance travel. I had already been spending money for travel to see my Dad. Once your parent needs care, but cannot or will not pay for help, the family may need to provide it. Those of us who work are forced to rely on paid helpers to to assist with eldercare. Bu, this can have a negative financial impact on the family members paying for care.

Fate took a different turn with my father. Later that week, he developed a nose bleed that the nurses at the retirement community could not stop. His trip to the hospital ended up lasting over three months.

The nurses also reported to the managers that Dad was having trouble keeping up the apartment. The managers said they would refuse to allow him back into his apartment when he was released from the hospital for his own safety.

Now instead of convincing him to eat in the dining room, I had to convince him to move to the next level of care. To be continued . . .

What’s all the fuss about the Medicare Prescription Drug Program?

Open enrollment started on November 15th and runs to December 31st. This is the time when anyone can change from one plan to another without paying a premium penalty. If your parent is already enrolled in a program, you may be wondering why you need to worry about this.

Medicare and health care advocates in every state are trying to get the word out that the rates are changing. There are major rate increases coming to the most subscribed plans, while some of the smaller plans are decreasing rates. Here in California rates in some plans are increasing by 31%.

All seniors should reevaluate their Medicare Drug plans to see if it still makes sense to stay where they are.  They can check Medicare’s website for help with choosing a plan that covers the specific prescriptions that they need at a cost they can afford. It is important to do it now before the enrollment period ends.

Can there really be that much of a difference?

Yes.

This year doing nothing could be very expensive for your parent. Monthly premiums could increase substantially. Or, you may discover that required medications are not covered by your plan. 

And, of course, there is the highly confusing problem of the “donut hole.” I don’t know who invented this “cute” name but it is a gap in coverage that can take a lot out of your pocketbook.  Here’s how it works:

You enroll in a plan and pay a monthly premium. You pay for your prescriptions until the deductible is reached. Once you have met the deductible of $265, the basic prescription drug plan will pay 75% of your drug costs and you will pay the remaining 25% until your total drug costs reach $2,400.

Then, you are responsible for 100% of your drug costs between $2,401 and $5,451.25. This gap in coverage, the “donut hole”, requires that you pay $3050.25 out of your own pocket before Medicare pays any more for you.

While this is happening, you are still paying your monthly premium. If you get to December 31st without going past $5451.25 prescription costs, there is no additional help. You start the new year meeting the deductible again.

Once your total drug costs reach $5,451.25, the basic prescription drug plan will pay 95% of your additional prescription costs and you will pay up to 5% (or a small co-payment) of your remaining drug costs for the rest of the calendar year.

Each insurance company that offers Medicare Drug coverage has the option to add benefits. Each company can also determine which drug they will or won’t cover. Some companies will pay for certain generic drugs during the coverage gap while others pay nothing.

There are so many plans, with different options,  that vary from state to state, that you need to evaluate before you sign up.  It’s just plain confusing!

Fortunately, every state has Health Insurance Counseling and Assistance Programs. You can find someone in your area to provide free counseling about the plans that would be right for you. You can attend workshops on choosing the best plan.

Before you contact the Health Insurance Counseling and Assistance Program in your area, it’s a good idea to figure out your total drug costs for the past year and make a list of your regular prescriptions so you can compare it with the list of approved drugs for each plan.

It’s work to do this, I know. It is so tempting to just stay with the plan your parent already has.

Don’t do it! Make time now for your parent (or yourself) to find the best plan that is available. You’ll be glad you did.

3GenFamily Blog has moved to a new location on the web.

Please come visit us at 3GenFamily.com

By CK Wilde for 3GenFamily Blog

It wasn’t until Dad mailed me the collection notice that I realized he was losing his ability to track and pay his medical bills. He had complained during our phone chats on several occasions that the hospital had messed up his billing. They kept phoning him to get him to pay his bill.

He insisted that he had paid the bill– $124.34. The hospital billing staff asked him to send a copy of the cancelled check. But, Dad adamantly refused to go through the work of getting the cancelled check. It was the hospital’s mistake for losing the payment.

I was dumbfounded by his vehement refusal to deal with a straightforward problem. Ironically, in his younger days, my father had been a stickler for financial details. As a young adult, I would have gotten a scalding rebuke for failing to take action on something like this.

His unusual behavior was a warning that his dementia was beginning to impair his judgement, while his anemia left him so fatigued that even a trip to the bank seemed like an overwhelming task. I didn’t recognize it for what it was. I thought he was just being obstinate.

Being 3000 miles away, I tried to get my father to read his checkbook to tell me the check number for that hospital bill. Then, I went online to see if that check had cleared. The check number he gave me had been cashed but it wasn’t anywhere near the correct amount for the bill. I looked for another check with the amount $124.34. I didn’t see any in that month that matched.

I told my father that the only thing to do was pay the bill. He refused. No amount of reasoning worked. So I made a deal with him — I would pay the bill and he would reimburse me.

Grudgingly, he agreed.

My father had already signed a power of attorney giving me the authority to handle his finances and one for health care, too. So, I began learning first hand about Medicare, supplemental heath coverage and prescription drug benefits.

Dad had to sign a form to allow me to access his online medical insurance claims and to speak for him to the insurance representatives. I left instructions for them to phone me first since Dad’s hearing was poor.

I paid the bill. Dad eventually reimbursed me. The collection notices and phone calls stopped.

It wasn’t until a couple of months after my father’s death that I found the entry in his checkbook. Dad was right all along. He had paid the hospital within days of receiving the bill. But, he was so certain he remembered the correct check number that he never looked it up. I was too far away at that time to double check it myself.

The story doesn’t end there.

Another billing mistake almost happened today. I started to pay a doctor’s bill for my father’s estate and discovered that it was more than it should have been.

The doctor is supposed to bill Medicare first. After Medicare determines what it will pay, the doctor sends the bill to the supplemental insurance.

Only after the supplemental insuror has completed the claim, should the doctor bill the patient for any balance due. But this latest bill didn’t show any payment from the supplemental insurance, so I checked the online claims information.

The supplemental insuror had rejected the claim because documentation was missing. Well, sometimes paperwork does get lost. You need to follow up to get another copy sent.

I called and spoke to the medical billing person in the doctor’s office. She pulled up the records on her computer. She stated that my father owed this amount of money. I asked if she sent it to the supplemental carrier.

She said, “Yes.” And promptly read my father’s account number for the insurance.

I asked her, “Why do the online records say your claim was rejected for lack of documentation? The amount you are billing doesn’t appear to include any payment from the supplemental insurance.”

People do make mistakes (including me). Where there is an honest mistake, you can hear the surprise in the person’s voice. “How did that happen?” Sometimes, they laugh self consciously.

There was no surprise in this woman’s voice. There was no admission of a mistake. “We understand your concern . . . we will make sure it gets handled.” She was billing my Dad for the entire amount rather than resubmit the bill to the insuror with the information that was needed. Efficient but totally lacking in ethics.

I wish I could say this was the only mistake I have found. Unfortunately, billing mistakes have happened so many times in the past 9 months of settling my father’s estate.

How many elderly patients pay too much because they don’t have the patience or focus to follow up?

If you have been wondering how you can help your aging parents, discuss helping them with tracking medical bills. Have your parents collect everything (bills, medicare statements, supplemental insurance statements) in a folder. Set up online access to insurance if its available. Make a regular date to go over the bills each month before anyone writes checks.

You may need to make phone calls for your parents. Be aware that privacy rules prevent the insurors from talking with you about your parents’ account unless your parents have given permission in writing.

You’ll be providing peace of mind and possibly saving money for your parents, too.

3GenFamily Blog has moved to a new location on the web.

Please come visit us at 3GenFamily.com

By CK Wilde for 3GenFamily Blog

The court reporter was readying her equipment while waiting for the next case to begin. The bailiff brought in the defendant. The court reporter glanced up to see the next man on trial. Imagine the her shock to see that the defendant being brought into criminal court was her mother’s court appointed guardian!

This man was accused of embezzling from his nephew’s trust account. Was this the same man who was managing her mother’s affairs through the county’s Public Guardian Office? Yes, it was.

This true story made the front page of our local newspaper last week. The woman’s mother has Alzheimer’s Disease. Unfortunately, the mother never completed a power of attorney or health care directive before she became ill and unable to speak for herself.

But that’s only part of the story. The other part, that the newspaper barely mentioned, is about siblings battling over what’s best for their parent. Mom has one son and five daughters. The son was taking care of his mother, but the sisters disagreed with what he was doing.

The adult siblings ended up in court fighting over who should care for their mother. The judge chose to place Mom under the care of the Public Guardian’s Office rather than with one of her children. It doesn’t make sense . . . unless you have been involved in a dispute among siblings.

Despite educational and career advancement after years away from the family homestead, brothers and sisters all too often fall back into the old roles they occupied at age 9 or 10 when they return home to help mom or dad. All of the silly, and ugly, unresolved issues begin to surface. Old behavior patterns and ways of communicating arise like time magically reversed itself.

Unlearning those old behavior patterns takes a lot of work. That work must be done together as a family as well as individually. Career, young families, and misunderstandings occupy brothers’ and sisters’ lives, too. “Why do we need to re-hash that old stuff?” someone questions.

So the old patterns persist. And a judge, seeing dissention that may never end in the siblings lifetimes, chooses a neutral party to manage Mom’s affairs. The county didn’t know about their employee’s little problem.

I can’t say who was right or wrong. But, I know that these are gut wrenching experiences. Hurtful comments from siblings about actions, or lack of action, can leave you feeling incredibly wounded even retaliatory. Siblings may stop speaking to each other altogether, retreating to the safety of their own lives.

You can’t always make the other person understand what you were trying to do, but there is something you can do to heal the hurt.

Jack Canfield, creator of the Chicken Soup for the Soul series, in his all encompasing book, The Success Principles, offers a 6 step process for getting rid of those negative feelings.

“The following steps are all integral to forgiving:

1. Acknowledge your anger and resentment.
2. Acknowledge the hurt and pain it created.
3. Acknowledge the fears and self-doubts that it created.
4. Own any part you may have played in letting it occur or letting it continue
5. Acknowledge what you were wanting that you didn’t get, and then put yourself in the other person’s shoes and attempt to understand where he or she was coming from at the time, and what needs the person was trying to meet — however inelegantly — by his or her behavior.
6. Let go and forgive the person.”

You may be wondering why anyone needs 6 steps. Why not just jump to the last one?

If the hurt goes deep, your inner self won’t be able to “just let go”. It is most important to go through each step and acknowledge all of your feelings not just ignore or suppress them. Take as much time as you need.

You can write out your feelings and thoughts for each step, or pretend you are talking to the person. What you don’t have to do is actually confront the other person. Your job is healing yourself.

Interestingly enough, when you heal your hurt, your relationship with the other person may actually get better. I’ve seen that happen in our extended family.

The newspaper story ended on a happy note, by the way. The court reporter and her family reached an agreement wth the county Public Guardian’s Office. Their mom is safe, now being cared for in a facility not far away from her family. She’s not really aware of what has happened. And that may be a blessing.