Tuesday, July 28, 2009

Legitimate caregiver concerns mean additional tests, additional costs for Medicare; a problem hard to quantify: "agendas with good intentions"


Caregivers may feel pressured to visit more specialists and ask for more tests for loved ones, especially parents, in order to avoid any risk that adult services departments in some states could think they were negligent. That possibility could increase the cost of end-of-life care and increase expenses by Medicare, particularly in a medical environment where formal referrals (often required by private managed care programs of the past, however unpopular with employees) are often not required. 911 calls and emergency service visits, including Medicare expense, could also increase for that reason. But it seems as though there is little formal study of this problem.

However, the Wall Street Journal today has a long story by Ron Winslow and Jacob Goldstein “Cutting repeat hospital trips: simple idea, hard to pull off,” about an initiate at Berkshire Medical Center in western Massachusetts to reduce readmissions, especially of elderly patients with chronic heart, kidney and diabetes problems. The wsj url link is here. The “nursing gestapo” visited homes for dietary and safety problems, telling adult daughters to remove tempting but unhealthful foods from the refrigerator. I wonder, who do they think they are?

The eldercare “crisis” can easily tempt intervention by those with agendas, it seems.
Liz Crenshaw, of NBC Washington, talked loosely today (July 28) about preparing for caring for aging parents as part of financial planning as if it were simple!

Attribution link for Berkshires picture. I hiked in the area on a winter trip while in college in January 1965.

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