The Savvy Senior

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Disability Related laws
Disability Related laws 150 150 Robert Goodman, MSW

Disability Related laws

By Robert Goodman, MSW

 

  1. What rights do U.S. citizens with visual impairments have today in terms of receiving materials in large print, braille, or audio with pertinent health information?

 

The Rehabilitation Act of 1973 provides for the same requirement, but for government agencies and health care providers that receive federal funds such as Medicare.

 

The Americans with Disabilities Act, passed in 1990 states that local and state governmental entities and businesses, including all health care providers, must provide reasonable accommodation in the way they communicate with their clients or patients. This includes printed materials that must be available in an alternate format such as large print, braille, or audio.

 

Doctor’s offices: reports, instructions for diagnostic tests, instructions for pre- and post-surgical care

 

Home health agencies: information on services, privacy, instructions on care and other important information

Health care facilities: welcome packets, admission forms, discharge instructions

 

  1. In your opinion, what percent of South Florida health companies provide the proper information style (large print, braille, brochures) for people with vision impairment or disabilities?

I would guess less than 1% based on my experience in trying to get companies to comply and avoid (ACHA), Agency for Health Care Administration tags and lawsuits. I would hope I am wrong and more providers are complying with the law. My website disabledamericansact.com will list providers that do comply as we compile this information.

 

 

  1. In your opinion, what percent of U.S. health companies provide the proper information style (large print, braille, brochures) for people with vision impairment or disabilities?

I would say the same as above. Many of the health care providers are national companies and are not complying with the law even after being requested to do so.

 

  1. How can working with an MSW, like yourself, assist health care providers to become compliant with these laws?

 

By working with me, as a consultant, and my graphic designer, health care providers can learn about their obligations under these laws and learn how to accommodate people with disabilities. We can help health care providers convert their materials into large print. There are other companies that can help convert materials to audio or braille.

 

 

Contact: rgoodlobby@gmail.com or

561-465-2224.

 

 

  1. What are the most effective ways you’ve found to get people with visual impairments or disabilities to effectively communicate their needs for health information?

I have been speaking to various organizations who serve people with visual impairments about their rights under these laws. I have also published a handy guide to the ADA for businesses and people with visual impairments. We give out cards that patients can show their health care providers with information on these laws. These are available in large print and on CDs. However, I need sponsors to help reproduce more copies of these materials.

 

 

  1. How did you get involved in helping people with visual impairments or disabilities get health information in the proper format?

 

I am legally blind and need materials myself in large print. I and many of my neighbors received the large packets of information given out by home health agencies and were not able to read it. If we cannot read the materials given to us, how are we supposed to follow doctor’s orders. This can have a negative impact on health care literacy and outcomes and could end with rehospitalizations. That can result in hefty fines by the Federal government.

 

 

  1. What are your hobbies and passions in life outside of health care?

 

Politics. I have a large collection of campaign buttons going back to McKinley.

 

Traveling with my wife. We have visited many countries and taken many cruises. We have toured 45 states.

  • Robert Goodman, MSW
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Your Right to Appeal
Your Right to Appeal 150 150 Robert Goodman, MSW

Your Right to Appeal
The Savvy Senior
By Robert Goodman, MSW

 

Being a good health care consumer means knowing your rights and advocating for yourself. Whether you are applying for or currently receiving services you have the right to appeal if you disagree with a coverage or payment decision made by Medicare, your Medicare plan, Social Security, or any government agency. Different programs and services have different procedures for appeals. The time allowed for appeals also varies.  HMO patients also have the right to appeal adverse decisions.

Hospital patients have the right to appropriate care and appropriate discharges. A person cannot be discharged into an unsafe environment, such as being sent home where they cannot take care of themselves or no one is available to care for them.

A Medicare beneficiary has the right to appeal a hospital discharge if he or she feels too sick to leave. A hospital will provide “An Important Message from Medicare,” which explains how to appeal the discharge. Medicare beneficiaries can call Florida Medical Quality Assurance, Inc (FMQAI) at 800-844-8754 for an appeal. FMQAI staff members will look at the medical record to see if the beneficiary should stay in the hospital. The beneficiary will be informed of the decision. The Medicare beneficiary does not have to leave the hospital. The Medicare beneficiary does not have to pay for the extra days in the hospital while FMQAI staff members review the medical record.

A Medicare beneficiary has the right to appeal a discharge if he or she does not agree with the discontinuation of skilled services (skilled nursing care, hospice, home health care). The beneficiary must be given a letter with the planned discharge date explaining how to appeal the discharge. Once the beneficiary receives the letter, he or she can call FMQAI at 866-800-8768. An FMQAI physician will look at the medical record to see if the services should continue. The Medicare beneficiary will be informed of the decision.

If a Medicare beneficiary is in an HMO, he or she has some additional Medicare rights. If the beneficiary feels he or she cannot get the needed care, he or she has the right to appeal to the HMO. The Medicare beneficiary can appeal things like denials for: referrals to a specialist, approval for tests (like x-rays or blood tests), or payment of a bill.

The HMO has information about how to start the appeal process. A Medicare beneficiary who feels he or she may get worse by waiting too long can ask for an expedited appeal. This means the HMO must make a decision about the appeal within three calendar days. A Medicare beneficiary who needs an expedited appeal must be sure to ask for it.

If a Medicare beneficiary has a concern or is not satisfied with the quality of care received, he or she can call the FMQAI Florida Medicare Beneficiary Complaints Helpline at 800-844-0795. You may also download a quality of care complaint form English or Spanish to complete and fax to 813- 354-0737, or mail to: FMQAI, 5201 West Kennedy Boulevard, Suite 900, Tampa, Florida 33609, Attention: Beneficiary Complaints.

The above information is from www.fmqai.com and www.medicare.gov. For more information on your right to appeal a Medicare related decision call 800.MEDICARE (633-4227).

 

Here are ten steps to help you become an effective self-advocate:

  1. Believe in yourself
  2. Realize you have rights
  3. Discuss your concerns with your service provider
  4. Get the facts in writing
  5. Use the chain of command to solve a problem-ask to speak to a supervisor if an issue wasn’t resolved to your satisfaction
  6. Know your appeal rights if services are denied
  7. Be assertive and persistent, not aggressive
  8. Outline your concerns and be a good listener
  9. Ask for help from other agencies
  10. Follow-up. Be sure you’re getting the service that meets your

needs…and say thank you

  • Robert Goodman, MSW
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Are You or a Neighbor Self-Neglecting?
Are You or a Neighbor Self-Neglecting? 150 150 Robert Goodman, MSW

Are You or a Neighbor Self-Neglecting?
The Savvy Senior
By Robert Goodman, MSW

 

There are many stories in Century Village, and you hear them all while riding the buses. I have heard stories of people laying on the floor for four days and not allowing anyone to call 911, stories about residents who cannot take care of themselves and have no food in their home who will not let anyone in to help, people who have money and won’t use it to care for themselves. One who does this or allows it to happen is guilty of neglect.

As a geriatric social worker, I want to help all these people, but realize I cannot save the world. But each one of us has a responsibility to help our neighbors as best we can when they are in need.

Self-neglect is a general term used to describe a vulnerable adult living in a way that puts his or her health, safety, or well-being at risk. The state’s definition of neglect is “Unexplained or unexpected deterioration of health, personal care or living situation. This includes inadequate food, clothing, and/or shelter.” Self-neglect is defined as “when individuals fail to provide themselves with whatever is necessary to prevent physical or emotional harm or pain.” Some people get to a point when they become a danger to themselves or others. These are serious situations and need to be dealt with.

Vulnerable adults who neglect themselves are unwilling or unable to do needed self-care.  This can include such things as:

  • Not eating enough food to the point of malnourishment.
  • Wearing clothes that are filthy, torn, or not suited for the weather.
  • Living in filthy, unsanitary, or hazardous conditions.
  • Not getting needed medical care.

 

There are some common characteristics of adults who neglect themselves.  He/ or she is more likely to:

  • Live alone.
  • Be female (possibly because more women than men live alone).
  • Be depressed and/or increasingly confused.
  • Be frail and elderly.
  • Have alcohol and drug problems.
  • Have a history of poor personal hygiene or living conditions.

 

Signs to look for:

 

The Home

  • Not enough food, water, heat.
  • Garbage and rotting food in refrigerator
  • Filth or bad odors, hazardous, unsafe, or unclean living conditions or fire hazards.
  • Major repairs are needed and not done.
  • Human or animal feces.
  • Hoarding: nothing is thrown away, stacks of papers, magazines.
  • Animal or insect infestation.

 

The Person

  • Poor personal hygiene (dirty hair, nails, skin).
  • Smells of feces or urine.
  • Unclothed, or improperly dressed for weather.
  • Skin rashes or bed sores (pressure ulcers).
  • Dehydrated, malnourished or weight loss.
  • Absence of needed dentures, eyeglasses, hearing aids, walkers, wheelchairs, braces, or a commode.
  • Increased dementia, confusion, disorientation.
  • Unexpected or unexplained worsening of health or living conditions.
  • Spending too much time alone or isolated from former activities.
  • Lack of interest or concern about life.
  • Untreated medical conditions.  Failure to take medications or go to doctor or dentist.
  • Self-destructive behaviors or significant behavior changes.
  • Hallucinations, delusions.
  • Misusing drugs or alcohol.

 

A self-neglecting older adult may have the capacity to make decisions, but his/her ability to identify and remove oneself from a harmful situation may be limited or compromised.

There are many possible reasons why a formerly meticulous person may have changed so drastically. Some of the more common reasons include:

  • Medications
  • Cognitive impairments
  • Depression
  • Alcohol or drug abuse
  • Isolation

 

If you know of or suspect someone is a victim of abuse or neglect call 1-800-ABUSE (2873). You can remain anonymous. When calling to report abuse or neglect give the person’s name, address, family contact information if available, and describe the situation. For general information on services for seniors call the Elder Helpline at 1-866-684-5885 or 211.

 

(Sources: Palm Beach County Area Agency on Aging, State of Washington Department of Human Services, AARP)

Resources on Elder Abuse and Neglect:

Foundation for Healthy Aging

www.healthyaging.org

National Institute of Health Medline

www.nlm.nih.gov/medlineplus/elderabuse.html

National Committee for the Prevention of Elder Abuse

www.preventelderabuse.org

National Center on Elder Abuse

www.ncea.aoa.gov

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Prevent Elder Abuse and Neglect
Prevent Elder Abuse and Neglect 150 150 Robert Goodman, MSW

Prevent Elder Abuse and Neglect
The Savvy Senior
By Robert Goodman, MSW

 

April is Elder Abuse month. Elder abuse and neglect are a major issue in Florida where so many seniors retire. Elder abuse comes in many forms: physical, psychological, financial, and sexual. Many older adults cannot take of themselves due to frailty or dementia and either self-neglect or are neglected or exploited by others. Tens of thousands of seniors are abusing each year. The most vulnerable seniors are white women 77 years of age or older.

You can help stop abuse and neglect of the elderly by understanding what abuse and neglect are and by learning the signs. Reporting elder abuse and neglect is an obligation for all Florida residents.

Physical abuse includes any physical contact with an older adult that results in a physical injury. Self-neglect is often indicated by a person’s inability to care for themselves. Neglect by others may result in malnutrition, dehydration, or a failure to get help or services for a frail older person. Psychological abuse is indicated when a person is being harassed, berated, put down, and made to feel bad about themselves. Financial exploitation involves the improper use of someone’s funds, property, or assets.

If you believe someone is being abused, neglected, exploited by someone else, neglecting themselves you have a legal obligation and moral responsibility to call the state abuse hotline: 1-800-96ABUSE or 1-800-962-2873 and report the situation. You can report anonymously.

A new ordinance passed in Palm Beach County now requires any home health aide to be licensed and fingerprinted. This law was passed in an effort to combat abuse in our county. For information contact the Department of Consumer Affairs at 1-888-852-7362.

 

Elder Abuse and Neglect Resource Contacts:

Elder Helpline

1-800-96ELDER

Fraud Hotline

1-800-378-0445

Statewide Senior Legal Helpline

1-888-895-7873

Consumer Services

800-435-7352

Financial Services

1-800-342-2762

National Fraud Information Center

1-800-876-7060

 

 

Resources on Elder Abuse and Neglect:

Foundation for Healthy Aging

www.healthyaging.org

National Institute of Health Medline

www.nlm.nih.gov/medlineplus/elderabuse.html

National Committee for the Prevention of Elder Abuse

www.preventelderabuse.org

National Center on Elder Abuse

www.ncea.aoa.gov

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A Month of Holidays
A Month of Holidays 150 150 Robert Goodman, MSW

A Month of Holidays

By Robert Goodman, MSW

 

March is a month that celebrates many deserving groups. One is the importance of community and the other is the important role women play in History.

It takes a village, women, men, health professionals and others at all levels, doing their part, to make our world safer and healthier. This includes the days of appreciation this month.   

March is both Social Work Month, Women’s History Month, Doctor and Nurse appreciation days. This month’s holidays celebrate the important role that women and social workers, a vast number of whom are women, play in our community and to our society as a whole. We show our appreciation for health care professionals on given days.

       Women have always had  an outsized influence in history. Social Workers play an important role in helping to build and improve our  community.

       Woman caregivers should be honored in their roles as caregiver of their parents, families and adult children with disabilities. Nannies for young children and elderly people are indispensable to working parents. Women also should be recognized for their contributions to charity, and in working for the betterment of our community.

       The Hebrew expression, tikkun olam, taking care of and repairing the community is an important aspect of social work. We must work to repair the world around us and to make it a better place to live for all. We cannot separate ourselves from the needs of the community. We practice this concept by serving society and helping those in need.

          A unified community was needed throughout history to make our country as great as it is and to meet the needs of the people, care for the unfortunate and to keep our community safe. Unity is now needed more than ever.

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A Neighbor Needs Help
A Neighbor Needs Help 150 150 Robert Goodman, MSW

The Savvy Senior
By Robert Goodman, MSW
A Neighbor Needs Help
Revised July 2021

Perhaps you know of someone who can no longer take care of him/herself and has no one to help. Or perhaps you know of someone who is getting inadequate help. The question you need to ask is, does this person pose a danger to him/herself (or others)?

We all want to live independently for as long as we can. The idea of going into a nursing home is a horrible thought. Even assisted living is not considered a viable option by many. Families don’t want to institutionalize their loved ones. An aide 24/7 may not always be the best answer. So, what do we do?

First, we are our neighbor’s keeper. If you suspect a neighbor is having difficulty taking care of him/herself you may want to voice your concern to a friend or member of the family. If no one is taking responsibility and that person is in need of help you can call a local social service agency or call your state abuse hotline (1.877-Elder80). You can call anonymously. The Elder Protection Center www.elderprotectioncenter.com lists the elder abuse hotlines for each state.

Here are some indicators that there may be a need for intervention:

  1. APARTMENT:
  • Garbage piling up in the apartment.
  • Hazardous living conditions due to lack of repairs, utilities and/or equipment
  • Human excrement on floors and furniture
  • Evidence of obvious fire hazards, such as piles of boxes, newspapers, old clothes, blocked exits
  1. FOOD AND CLOTHING:
  • Little or no food in the house
  • Food is spoiled or lying around
  • Insufficient/inappropriate clothing for the weather

When calling the Florida Abuse Hotline to report personal neglect (or abuse or exploitation), be prepared to provide the following information:

  1. Person’s name, address or location, approximate age, race and sex;
  2. Physical, mental or behavioral indications that the person is infirm or disabled;
  3. Signs or indication of harm or injury or potential harm or injury (physical description or behavioral changes);
  4. Relationship of the person responsible for the senior’s care, if known. If the relationship is unknown, a report will still be taken if other reporting criteria are met.

The state agency assigned to investigate elder abuse will conduct an investigation of all reports received that alleges self-neglect by a vulnerable adult. The purpose of the investigation is to determine if there is evidence that a person is a danger to him/herself, and if assistance is necessary to protect the individual’s health and safety.

A protective investigator from the department will make face-to-face contact with the vulnerable adult within 24 hours of receiving an abuse, neglect or exploitation report. The protective investigator will interview all persons who may have knowledge of the victim’s situation, evaluate the information obtained, and make a decision as to whether the reported allegations did or did not occur. The investigator then refers the case to an agency for follow up so the victim can get the services s/he needs to be safe. This may include placement in a more suitable living environment.

Remember to report abuse, neglect, self-neglect, or exploitation call your state  Abuse Hotline. Help your neighbors who cannot help themselves.

Many 211 services have a telephone reassurance program for those who are homebound.

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Driving Alternatives
Driving Alternatives 150 150 Robert Goodman, MSW

The Savvy Senior

Driving Alternatives

By Robert Goodman, MSW

 

In light of some recent accidents in Century Village, including one that severely injured a resident, I think people need to look seriously at their ability to continue driving. I know it is a hard to decision to make to give up driving but your safety and the safety of others is of paramount importance. One of the hardest things in life to do is to give up driving. Giving up driving affects one’s independence and self-esteem. If vision, hearing and reflexes are impaired you need to look at driving alternatives.

As our population ages, so does the number of older drivers. Some drivers outlive the ability to safely operate a motor vehicle. Cognitive and sensory losses are gradual and often the driver is unaware of the changes.

According to the Florida Department of Motor Vehicles, the leading cause of injury-related deaths in 65-74 year olds are crash injuries. The second leading cause of injury related deaths (after falls) in 75-85 year olds are crash injuries. We read countless numbers of stories in the newspaper and on television about older drivers who confuse the gas and brake pedals and crash into buildings or other people.

In 2011 17.6% of the population was 65+. 19% of drivers were over age 65. 13.9% of older drivers were involved in crashes, 19.4% were fatal crashes and 16.2% involved injuries. (Source: http://www.safeandmobileseniors.org/FloridaCoalition.htm).

Poor vision, hearing, memory, and reaction time negatively affect one’s ability to drive. The most radical increase of at-risk crashes comes with medical conditions which impact cognitive skills. Co-piloting does not help.

When driving affects one’s own safety and the safety of others, it is time to stop driving. Indicators that it might be time to stop driving include confusing the brake and gas pedals, getting lost, near misses or multiple accidents, stopping in traffic for no reason, confusion at exits, parking inappropriately, hitting curbs, driving at inappropriate speeds, delayed responses to unexpected situations, not anticipating dangerous situations, or forgetting how to start the car or where things are on the car dashboard. Having a spouse or friend guide you as you drive is not an alternative.

The Pepper Institute on Aging and Public Policy publishes a booklet “Florida Guide for Aging Drivers”. This book has information that can help older drivers evaluate their driving skills. Questions include assessing how other drivers react to your driving and how well you function behind the wheel. To receive a copy  Email them at: safe-mobility-for-life@fsu.edu. Another resource is the Safe Mobility for Life Coalition at http://www.safeandmobileseniors.org.

One of the main fears of someone faced with giving up driving is loss of independence. Prepare now for the time when it may be necessary to give up driving. List your regular transportation needs and the modes of transportation available in our community. Compare your transportation needs with your transportation alternatives and the cost of driving and maintaining your car with the cost of alternative transportation.

How well do you fit into your car? How safe is your car? CarFit is a program that looks at the safety and comfort of one’s car. Each February Congregation Torah Ohr sponsors this program. CarFit checks safety features like seating, mirrors, lights, and other aspectso f your vehicle.

There are programs in our community that can help one evaluate his/her ability to drive safely. Florida Atlantic University Memory Wellness Center has a driver safety evaluation program. For information call 561.297-0502. Pinecrest Rehabilitation Hospital has a similar program. For information call 561.495-3634. AARP sponsors a driver safety program. For locations in this area call 888-2277669 or log onto www.aarp.org/drive. Florida offers a non-drivers ID card to place the driver’s license as a photo ID. This is available at local Driver’s License bureaus.

Living in Century Village gives us many alternatives to driving. We have just acquired new wheelchair (and walker) accessible buses that take residents to local shopping centers, supermarkets, as well as the library. Schedules are available at the Clubhouse information desk.

The County’s Palm Tran bus #91 travels eastbound to Town Center Mall, Boca Community Hospital, Mizner Park, and other destinations every half hour. The westbound bus travels to Publix, West Boca Hospital, Western Beef, and Sandalfoot Square every hour. The #91 bus connects with other routes that go to the VA hospital and other destinations in Palm Beach County. For bus route information contact Palm Tran at 877.930-4287. The #91 bus schedule is available in the clubhouse.

Palm Tran Connection is a door-to-door service that transports people who cannot use public transportation to any location in Palm Beach County between Jupiter and Boca Raton. For an application contact Palm Tran Connection at 877.870-9849.

Jewish Family Services provides a transportation program $50/year. They provide six round trip rides a month in the Boca Delray area. The client must be mobile and able to get in and out of the car. For information call 561-852-3333.

The Volen Center provides transportation in the Boca Delray area. For information on services and cost call 561-395-8920 ext 228 & 229. They also provide transportation to the Volen Center which offers a variety of services for seniors.

When driving safety becomes an issue, make a confidential report to the Florida Department of Highway Safety and Motor Vehicles. Florida law requires any physician, person or agency who knows of any licensed driver’s or applicant’s mental or physical disability that prevents him/her from driving safely should report this to the Florida Division of Driver’s Licenses at 850.617-3814 or fill out Form #72190 which can be found at www.flhsmv.gov/forms/72190.html. The report should be made in writing giving the full name, date of birth, address and a description of the alleged physical or mental disability of any person over 15 years of age that could affect the driving ability.  No civil action can be brought against any person who provides this information.

As a service to Century Village residents who give up driving, I am willing to familiarize them with local bus services. For information contact Robert Goodman at We Care at 487-2827.

  • Robert Goodman, MSW
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Mental Health Issues for Older Adults
Mental Health Issues for Older Adults 150 150 Robert Goodman, MSW

Mental Health Issues for Older Adults

The Savvy Senior

By Robert Goodman, MSW

Mental Health Issues for Older Adults

 

  1. Many older adults experience problems with gambling, misuse of prescription drugs, alcohol, anxiety, and depression. The American Psychological Association estimates that around 20% of adults age 55 and above face mental health issues. Yet, less than 3 percent of older adults report seeing a mental health professional for their problems. Anxiety and depression are the most common mental health problems faced older adults. Mental health professionals have found that as a result of coronavirus restrictions the risk for social isolation and loneliness, anxiety and depression increases among seniors. Virtual communication does not replace in-person contact. The use of Facetime and WhatsApp are ways to see others in person.

The Medicare Advantage.com website lists several ideas for coping with these mental health issues:

  1. Use telemedicine as a way to contact your health care
  2. Use computers and smartphones to stay connected.

4.    Make lifestyle improvements such as physical activities, improved nutrition and getting involved with hobbies and other activities to manage physical and mental health.

There are many symptoms associated with anxiety and depression. Some of the most common symptoms are:

  1. Hopelessness
  2. Sleep problems
  3. Social withdrawal
  4. Eating more or less than usual
  5. Loss or interest in once pleasurable activities, including sex
  6. Frequent crying
  7. Difficulty focusing, remembering, or making decisions
  8. Thoughts of death or suicide, or a suicide attempt

If you have several of these symptoms for more than two weeks, you may have depression.

The abuse or misuse of drugs was once considered a problem only among the young. According to the American Geriatric Society, substance abuse has become a growing problem among older adults as well. Misuse of alcohol or other drugs is a common cause of physical and mental health problems among older adults, especially men.

 

Four questions can provide a quick way to determine alcohol abuse:

  1. “Have you ever felt you should slow down on your drinking?”
  2. “Have you ever felt annoyed at criticism about your drinking?”
  3. “Have you ever felt guilty or bad about drinking?”
  4. “Have you ever felt the need for an “eye opener” in the morning to steady your nerves?”

 

A “yes” answer to any two of these questions indicates that a problem is likely? A “yes” answer to even one of question indicates a possible problem that should be further evaluated.

(Source: AGS Foundation for Health in Aging)

According to the Florida Council on Compulsive Gambling a growing percentage of Florida seniors are developing serious gambling problems. Symptoms of problem gambling among older adults include:

1.     Preoccupation with gambling

2.     Withdrawing from family, friends or regular activities because of gambling

3.     Neglecting personal needs or health due to gambling

4.     Gambling larger amounts of money to experience the thrill

5.     Betting more than planned

6.     Experiencing unaccounted blocks of time due to gambling

7.     Communicating a sudden need for money or loans

8.     Uncomfortable feelings or lying when questioned about gambling habits

9.     Gambling to calm nerves, forget worries or reduce depression

10.  Experiencing mood swings based upon winnings and losses 

11.  Pawning or selling personal items

12.  Feeling restless or having anxiety when trying to cut down or stop gambling

13.  Using retirement funds or other savings to gamble

14.  Attempting to stop gambling but unable to do so

Answering “yes” to one of more of these questions may indicate a gambling problem. For information or help contact the 24 hour FCCG helpline at 1-888-236-4848.

There is no shame asking for help if you have one of these problems. Help is available through psychotherapy, consumer education, inpatient or outpatient management of symptoms, medication.

Call 211 for information on local programs to assist you in dealing with depression, anxiety, problem drinking, or problems related to gambling.

Many older adults experience problems with gambling, misuse of prescription drugs, alcohol, anxiety, and depression. The American Psychological Association estimates that around 20% of adults age 55 and above face mental health issues. Yet, less than 3 percent of older adults report seeing a mental health professional for their problems.  Anxiety and depression are the most common mental health problems faced older adults. Mental health professionals have found that as a result of coronavirus restrictions the risk for social isolation and loneliness, anxiety and depression increases among seniors. Virtual communication does not replace in-person contact. The use of Facetime and WhatsApp are ways to see others in person.

The Medicare Advantage.com website lists several ideas for coping with these mental health issues:

  1. Use telemedicine as a way to contact your health care
  2. Use computers and smartphones to stay connected.

3.     Make lifestyle improvements such as physical activities, improved nutrition and getting involved with hobbies and other activities to manage physical and mental health.

There are many symptoms associated with anxiety and depression. Some of the most common symptoms are:

  1. Hopelessness
  2. Sleep problems
  3. Social withdrawal
  4. Eating more or less than usual
  5. Loss or interest in once pleasurable activities, including sex
  6. Frequent crying
  7. Difficulty focusing, remembering, or making decisions
  8. Thoughts of death or suicide, or a suicide attempt

If you have several of these symptoms for more than two weeks, you may have depression.

The abuse or misuse of drugs was once considered a problem only among the young. According to the American Geriatric Society, substance abuse has become a growing problem among older adults as well. Misuse of alcohol or other drugs is a common cause of physical and mental health problems among older adults, especially men.

 

Four questions can provide a quick way to determine alcohol abuse:

  1. “Have you ever felt you should slow down on your drinking?”
  2. “Have you ever felt annoyed at criticism about your drinking?”
  3. “Have you ever felt guilty or bad about drinking?”
  4. “Have you ever felt the need for an “eye opener” in the morning to steady your nerves?”

 

A “yes” answer to any two of these questions indicates that a problem is likely? A “yes” answer to even one of question indicates a possible problem that should be further evaluated.

(Source: AGS Foundation for Health in Aging)

According to the Florida Council on Compulsive Gambling a growing percentage of Florida seniors are developing serious gambling problems. Symptoms of problem gambling among older adults include:

15.  Preoccupation with gambling

16.  Withdrawing from family, friends or regular activities because of gambling

17.  Neglecting personal needs or health due to gambling

18.  Gambling larger amounts of money to experience the thrill

19.  Betting more than planned

20.  Experiencing unaccounted blocks of time due to gambling

21.  Communicating a sudden need for money or loans

22.  Uncomfortable feelings or lying when questioned about gambling habits

23.  Gambling to calm nerves, forget worries or reduce depression

24.  Experiencing mood swings based upon winnings and losses 

25.  Pawning or selling personal items

26.  Feeling restless or having anxiety when trying to cut down or stop gambling

27.  Using retirement funds or other savings to gamble

28.  Attempting to stop gambling but unable to do so

Answering “yes” to one of more of these questions may indicate a gambling problem. For information or help contact the 24 hour FCCG helpline at 1-888-236-4848.

There is no shame in asking for help if you have one of the above problems. Help is available through psychotherapy, support groups, consumer education, inpatient or outpatient care for management of symptoms and medication.

Call 211 for information on local programs to assist you in dealing with depression, anxiety, problem drinking, or problems related to gambling.

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Medicare 2022
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Senior Savvy
By Robert Goodman, MSW
 Medicare 2022
Updated July 2021

 

The time has come to evaluate your Medicare coverage for 2022. From October 15 to December 7, you will have the option of joining or changing your Medicare Advantage Plan. You have several choices.

You can stay with original Medicare and/or buy a supplemental (Medigap) policy. If you want prescription drug coverage, you must also join with a Medicare Prescription Drug Plan (Part D).

You can choose to join a Medicare Advantage Plan  Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.

If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. You must take the drug coverage that comes with the Medicare Advantage Plan. Some plans offer additional benefits, such as vision and hearing screenings, disease management, and other services not covered under Original Medicare. Medicare Advantage Plans must offer emergency coverage outside of the plan’s service area (but not outside the U.S.).

A Health Maintenance Organization (HMO) plan is a health care plan in which you generally must get your care and services from doctors or hospitals in the plan’s network, and you may need a referral to see a specialist.

A Preferred Provider Organization (PPO) plan you can generally obtain health care from any doctor or hospital you want within their network. You have the flexibility to go to any doctors, specialists, or hospitals that aren’t in the network, but it will usually cost more. Monthly premiums and how much you pay for services vary depending on the plan.

 

Questions to ask Medicare Advantage Providers

  1. Is there a monthly premium and how much is it?
  2. What doctors can I see and how much it will cost me to see a doctor.
  3. What hospitals can I use and how much it will cost me to use a

hospital (either as inpatient or in an emergency).

  1. What happens if I am traveling and need to see a doctor?
  2. How much it will cost me for outpatient procedures.
  3. Is there a monthly drug premium and how much is it?
  4. How much it will cost me for your medicines over the course of a year.
  5. Are there any changes in my plan from last year?

 

For help in selecting a Medicare Advantage Plan go to the Medicare Plan helper at www.medicare.gov. The website has been revised and updated.

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States. For information go to http://ssa.gov/prescriptionhelp.

The source for much of the information in this article is from www.Medicare.gov. You can find information on Medicare; look for a Medicare plan in your area, or compare Medicare Advantage Plans. Another good resource on Medicare policy and information is www.medicarerights.org.

Florida Navigator in cooperation with Temple Beth Shalom will be sponsoring a health fair and Medicare forum on Thursday, November 18  from 9:00 AM to 12 Noon where you can meet representatives of various Medicare advantage plans.

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Lessons Learned from COVID 19
Lessons Learned from COVID 19 150 150 Robert Goodman, MSW

Lessons Learned from COVID 19
The Savvy Senior
By Robert Goodman, MSW

In 1620 the Pilgrims were exploring a new world. In 2020 the coronavirus is creating a new world for us to navigate. We have had to adapt to a lot of adjustments in our changed environment.

We have faced many challenges during this pandemic. Loneliness and isolation caused by the COVID19 virus has brought to the surface underlying depression, anxiety and other mental health issues. People have had to deal with fear of the unknown.

I was trying to think of some positive things that have come out of our experience during this COVID 19 pandemic. The creativity of children who could not leave their homes for months was incredible. The way our residents have adapted is also amazing. But it has not been easy for everyone.

Helping each other through this crisis became a goal of neighbors who shopped for someone who could not get out. More people attended classes online than before. They were uplifted by the many interesting lectures via Zoom.

We have learned new ways to interact with each other. Communication became communal since you could not speak one on one. Residents spoke to each other from their catwalk. We have participated in holidays, birthdays, bar mitzvahs, weddings, and funerals via Zoom.

People who were homebound or lived alone faced a number of challenges. Interacting meaningfully with family and friends was a big concern. We all had to learn about new ways to communicate using newer technologies, whether through email, texting, Zoom, WhatsApp or facetime. We learned to have meetings and therapy sessions via Zoom. The telephone never had so much use.

We have learned new ways of coping with life’s challenges. We have begun to exercise more, including taking long walks in the neighborhood. Virtual communication and working from home have become a natural phenomenon. Hopefully we have also learned to listen to health experts instead of politicians.

To survive these troubling times emotionally and physically experts advise people to stop dwelling on the news, try to get more sunshine, exercise regularly, eat healthy, sleep regular hours and maintain social contacts.

Let’s hope we can take the positive lessons learnt from coping during the pandemic as we move forward with our lives.

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