Answers for Elders Podcasts: Mission Healthcare (a Careage company)

I was fortunate enough to have Beth Deems, community liaison for Mission Healthcare from Bellevue, sit down and talk with me about several crucial, and often difficult to Aunderstand, aspects of caregiving. Beth does such an amazing job of giving tips on fall prevention, understanding Medicare, defining skilled nursing and elaborating on continuum of care and makes it so easy to understand. Careage has more than 50 years experience of focusing on various aspects of senior living.

Fall prevention is one of the best things we as caregivers can do for our senior parents. And while it may not be possible to prevent all falls, mitigating that risk is so important. One in five falls results in a serious injury, such as broken bone or head injury, according to the Center for Disease Control. Even if the fall itself does not result in an injury, the inability to get up or call for help may result in complications, such as dehydration, pressure sores, or hypothermia, per the National Council on Aging. Falls may stem from changes in your parent’s gait. Balance, peripheral neuropathy in the feet, or dizziness due to medications are all things that can affect someone’s gait. Do you notice your parent furniture walking (holding on and moving from furniture piece to piece or the wall?) This could be indicative of a gait issue. Making sure they have good, comfortable shoes with sufficient tread and support is important. More causes of falls include throw rugs, uneven walkways, and clutter. Clutter could easily fall (especially with furniture walking) and cause unexpected obstacles. Good lighting is also important. These causes may be indoors or outdoors, so do a thorough assessment of the entire property. Bathrooms are a common room for falls. Installing preventive measures such as handrails in the shower, along the walls, and beside the commode could be useful.

If your parent has experienced a fall or illness resulting in hospitalization, your head may be swimming, trying to understand Medicare. Or maybe you are walking your senior loved one through the application process and need help understanding what it covers and what you need to buy. Fear not! Beth is here to help. First things first…this information is accurate as of May 2017. Like all Federal programs, it is subject to change. Medicare Part A covers inpatient hospitalization and inpatient skilled nursing rehabilitation on a short-term basis at 80%. Part B (an option for which you pay extra) provides outpatient coverage, including doctor’s office visits. Part D covers prescriptions. And Plan F is a supplemental policy you can buy to help cover things such as copays and the 20% that Medicare may not cover.  When it comes to hospitalization and getting covered to move from the hospital to a skilled nursing facility to do rehab, Medicare has very specific guidelines. The patient must have a “qualifying stay” of three days (three midnights) for which they were ADMITTED into the hospital. If your parent was only under observation, it does not matter how long they are in the hospital. You may have to advocate for your parent to be admitted, or to stay through the qualifying period. Otherwise, Medicare will deny coverage for the rehabilitation.

Once your parent has moved to skilled nursing, you may wonder what exactly that entails and why it is preferable to outpatient or in-home rehabilitation. Skilled nursing is not the same as assisted living or retirement living. Rather, it is focused on getting your loved one back to their prior living situation. By having 6 days of therapy a week (instead of 2 days, like in-home or outpatient,) the patient progresses faster and returns to more independent living. While in skilled nursing, measures of home comfort are so helpful to the rehabilitative process. Having comfortable workout clothes, photos of loved ones, cheerful plants, or a comforting quilt can help ease the mental and emotional stress of being away from home.

Finally, how do you understand and manage your parent’s potential ongoing care and living needs? Being able to predict the potential course of their needs is tricky. That’s where Continuum of Care comes into play. Selecting a facility that can help your loved one transition easily as their needs change may be the right move. A Continuing Care Retirement Community (CCRC) can work with your parent as they progress from needing simply assisted living (not round-the-clock nursing, but help with meal preparations, dressing, and other Activities of Daily Living (ADL)) to skilled nursing (higher level of nursing need) to Memory Care, such as for patients with Dementia or Alzheimer’s.

Beth Deems and the wonderful staff at Mission Healthcare and other Careage facilities are happy to answer your questions and walk you through the options and process of finding the ideal living scenario for your parent. For more information, contact Beth at 206-930-2873 or .

For more details on these important issues, listen to

For more information and resources for caregiving, go to