In some cultures, such as in Asia, elders are respected and revered. I think this is how it should be; after all, they raised us, cared for us, and handed down their wisdom. It seems like in other (western) cultures, seniors are not treated with the same respect. In fact in healthcare in the US, numerous scams have arisen which are intended to coerce, scare, or gaslight people into either purchasing (private) insurance plans which promise a lot and deliver little (Medicare Advantage Plans), or deceptive marketing practices are used to commit identity theft or extort money from unsuspecting seniors. I have even witnessed first hand in the hospital, situations where family members of a senior were trying to maintain their parent on life support as long as possible, in order to keep receiving their social security check. Equally as egregious, I have heard clinicians make comments like "well we're not going to treat him for his heart condition because he's 94".
Just because someone is over age 65 does not mean they should get inferior care, be scammed or have money extorted from them, or suffer other types of abuse such as that seen sometimes in care homes. We have to raise our standards, advocate for our seniors, and end programs that were created to try to make profits off of seniors while making them think they have a traditional Medicare plan.
The problem with Medicare Advantage plans, is that they operate in a similar fashion to regular private insurance plans. As such, if a senior is prescribed a medication or is needing to have a procedure, they may be subject to "pre-authorization", meaning the treatment or procedure coverage could be denied. In addition, the patient may not get to visit the doctors of their choice. The way that Medicare Advantage plans are reimbursed relies heavily on diagnosis codes and risk scores. So it is to their advantage to increase profits by "upcoding" a condition, i.e. making the patient seem sicker than they are, in order to be reimbursed at a higher rate. The people who end up paying for this are the taxpayers, and the patients.
If your loved one is a senior, there are some things you can do to help them avoid scams and get the best care possible. One thing is to educate yourself and your loved one about the current scams, of which there are many. They should never give their personal information to someone over the phone who calls them claiming to be from Medicare. Instead, if there are questions, visit the official Medicare site to look at contact options and FAQs. Likewise, anyone trying to sell them a plan either by mail or as a "door to door" salesperson should raise suspicion. It's "buyer beware" when it comes to these scenarios.
Seniors should keep an updated list of all their current medications (prescription and over the counter), as well as a medical history and list of past surgeries. This should be updated at least every 6 months and taken with them to any doctor visits. If they're having surgery, arrange for someone to accompany them to the hospital, have a designated medical power of attorney who is someone they trust and knows their wishes should they encounter serious complications, and have an "Advanced Directive" on file at the hospital and a copy in their home. When they return home after surgery, make sure someone can spend the night with them at least for the first night. Seniors can be at increased risk for falls, especially after receiving pain medications.
Lastly, any office notes and procedure notes should be copied to/ sent to the patient's primary care physician. The better the communication between their doctors is, the better their chances are of having a good outcome from their treatments. As a family member or friend, it is ok for you to speak up if you see that something does not seem right. I certainly have been the "squeaky wheel" a time or two when dealing with the care of my own loved ones; and I don't have any regrets. They took care of us, and it's our turn to look out for them.
Please comment on this post with any questions or topics you'd like to explore further.
In good health,
Dr. B
#healthcare #healthcareforseniors #medicare #patientadvocacy #healthinsurance #avoidingscams #wellness #wellnessatanyage #patientsafety
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