How to Become a Social Worker

Every day, the nation’s 680,000 social workers work to empower and elevate millions of people, including some of the most vulnerable in our society.

National Professional Social Work Month in March 2019 is an opportunity for social workers around the nation and world and their supporters to educate the public about the invaluable contributions of the profession. 

Being a social worker is a rewarding profession. Following are tips on how to get into the field and the academic background needed.

According to socialworklicensure.org, there is no better time than now to become a social worker. Professionals in the field address social ills through diverse specialties. Whether you want to work with children in public schools, with elderly individuals in care facilities, or in various healthcare branches, social work provides several fulfilling employment opportunities.

The Bureau of Labor Statistics projects 16% employment growth for social workers between 2016 and 2026, much faster than the 7% projected growth rate for the economy as a whole. This projected growth is partially attributable to the continuing demand for social workers who specialize in working with children and families. Moreover, the increase in healthcare facilities around the country has stoked demand for social workers to assist aging populations, mental health patients, and substance abuse patients.

What Does a Social Worker Do?

It is helpful to think of the various responsibilities social workers have. All social workers deliver specialized care, helping individual patients address a particular challenge or obstacle in their lives. At the macro level, social workers may also institute large-scale organizational change.

Typical day-to-day social work duties include identifying, evaluating, and addressing client needs in individual, group, and community settings. Client care often involves helping people cope with daily challenges, and many social workers work with mental health specialists, such as counselors and psychologists.

School social workers often collaborate with teachers, parents, and administrators to improve students’ academic performance and support their social development. Healthcare and mental health social workers find employment in hospitals, clinics, and clients’ homes. Social work careers often center on helping clients transition from care facilities back to their daily lives.

Bachelor’s Degree in Social Work

A bachelor’s degree in social work is the field’s minimum credential. Social work bachelor’s programs provide a comprehensive overview of the field. Students typically learn about case management, community and program organization, and utilizing community resources. Undergraduate social work students acquire essential skills for client advocacy, crisis response, and treatment design.

Students who earn an online degree in social work often focus on one area of specialization. Commonly offered specialties include child and family services, geriatrics, hospice, and school social work.

Many states require social workers to hold a master’s, so it is important to determine your state’s licensing requirements when choosing an online bachelor’s degree in social work. That said, some social workers may practice without licensure.

After completing an on-campus or online bachelor’s degree in social work, graduates find employment in school settings, child and family case management, mental health, and substance abuse recovery.

 

 

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Learning Has Shaped Oncology Nurse’s View of Patient Care

Published in oncnursingnews.com by Jean Sellers, MSN, RN

There is an old proverb I’ve heard many times, attributed to several sources: “When the student is ready, the teacher will appear.” Although I was anything but ready to face the concepts of death and dying, in 1990, my teacher appeared. He was 59 years old and presented to the emergency department with sudden onset nausea and vomiting, along with a severe headache. I vividly remember standing outside the thin curtain separating his stretcher from where I stood, dumbfounded, as the doctor introduced the words “temporal mass” and “cerebral edema” into my life.

I wasn’t a nurse then. I was a mother to 2 young girls, and I was not prepared to take care of the man behind the curtain. He was the greatest man I had ever known, the same man whom I would forever refer to as my first patient. My father. His diagnosis was an aggressive glioblastoma, and he lived 9 months from that day. I was forced into a crash course on surgery, radiation therapy, and end-of-life care. His final 2 months were spent in my home. The man who defined a “good day” as 18 holes on a golf course was now confined to a hospital bed in my guest bedroom, wearing diapers.

My family came together with the best of intentions, but we never quite had the conversations we needed to have. Some family members refused to acknowledge he was dying, and others viewed hospice care as giving up. Some did not want to treat his pain with narcotics for fear he would become addicted. I was desperate to find anyone who could help me ensure that my father would not suffer, which finally led me to call the hospice answering service—and brought another teacher in to my life.

The hospice nurse returned my call later that evening. Nothing could have prepared me for the way it felt to feel so completely heard and understood in the midst of that terrifying time. She listened to my concerns, fears, and confusion. She became my lifeline and helped my family to have the difficult conversations exploring what a “good death” could look like and what my father would want.

These lessons started me on the path I still walk today, that of an oncology nurse who advocates for quality cancer care throughout the healthcare continuum. Caring for my father opened my eyes to what was missing and I believe is still lacking today: effective palliative care.

Palliative care addresses not only symptom management but also the emotional devastation that affects both patients and their families. Today, research shows that when palliative care is integrated earlier in the disease process, outcomes improve.1 Our ability to achieve better outcomes lies in how we engage in difficult conversations. This includes an understanding of what quality of life is and, most importantly, what it means to the patient.

Nursing continues to be ranked as the most trusted profession. It should not be a surprise, as many of us are able to share a sacred space the moment we enter into the darkness with our patients. Having difficult conversations is more effective when empathy is included. Theresa Wiseman, RGN, BSc(Hons) Psych, RCNT, RNT, PGDE, a nursing researcher and scholar at the University of Southampton in the United Kingdom, says that although providing empathy is not always easy, it is a skill that can be mastered.2 It requires that we:

1. See the world as others see it
2. Be nonjudgmental
3. Understand another person’s feelings
4. Communicate understanding of what was shared

Brene Brown, PhD, LMSW, a research professor at the University of Houston Graduate School of Social Work, says empathy reminds us that we are not alone. Her research focuses on authentic leadership and the healing power of listening while allowing someone to feel they are truly heard and valued. She speaks to the basic elements of what we need to master if we, as nurses and human beings, hope to provide compassionate, empathetic care. Understanding our own vulnerabilities is a critical first step.3 Our ability to foster difficult conversations can be instrumental to breaking through feelings of isolation and loneliness that our patients and families face. This can be hard work. By acknowledging the difficulty, we take the first step toward meeting them where they are.

We may not always be ready when our teachers appear. However, I have found that when I seek to learn and enhance my ability to be there for others, I’m surrounded by many experts. I’ve lost count of the number of teachers I have been grateful to meet along the way. My teachers include nursing colleagues, physicians, researchers, and especially patients who have trusted me with their deepest thoughts. I use every opportunity I can now to urge nurses to always remember the reasons they chose this career and to remember their teachers. I urge them to never stop learning.

Jean Sellers is an administrative clinical director at UNC Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina.

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New Year is a good time for Veterans to review benefits

The New Year is a time for resolutions and fresh starts. For veterans it’s also a good time to review their benefits with a professional to ensure they are receiving the benefits they have earned through their service and sacrifice.

“All veterans should occasionally check with a Veterans Service Officer to see if changes in a veteran’s circumstances or changes to benefit policies may have modified the programs a veteran may be eligible to receive,” said Brian Natali, chief, Division of Veterans Services and Programs with the Pennsylvania Department of Military and Veterans Affairs (DMVA). “Veterans should take these important steps to secure their benefits, and there are numerous accredited Veterans Service Officers and organizations eager to help.”

Natali said safeguarding military paperwork, especially the DD-214, which is used to verify military service, is an important first step.

The easiest way to manage military documents is to make sure they are filed in a safe place immediately upon leaving the military. Veterans often find that filing their documents for free at their county courthouse of record is an easy way to secure them until needed, which can often be decades into the future.

Another key step, says Natali, is for veterans to apply for federal health care and state benefits by visiting their local county director of veterans affairs or area accredited service organizations to take a look at what benefits they may be eligible for and to get help applying for those benefits.

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How to Plan, Prepare, and Realistically Pay for Long-Term Care

Published in caringfromafar.com

When you plan for your future, do you include any plans for long-term care? It’s an aspect of life that too many adults fail to properly plan for, and that can leave seniors and family members struggling to find a solution. So, if you really want to prepare beforehand, you need to make some smart plans to cope with and pay for long-term care.

Focus on Your Long-Term Care Strategy First

Use Medicare to Your Advantage

Before you begin setting aside funds for long-term care, it’s important to have a good idea of what that situation may look like for you or a loved one. For many older adults, this means taking a look at how Medicare will offset any long-term care needs. While Medicare and Medicaid offer little long-term care assistance, the former can offer peace of mind through Medicare Advantage plans. These supplemental plans cover more of your future care, but it’s important to know the enrollment dates so you don’t miss out on this opportunity.

Know What Factors Put You at Risk

Another smart way to plan for long-term care is to examine your family history and lifestyle choices. For example, seniors with Alzheimer’s are likely to need progressive long-term care, and this is a condition which tends to be passed on from one generation to the next. But knowing you have a risk of developing dementia or Alzheimer’s also allows you to make changes in your life to potentially halt the impact of these illnesses. You can exercise more, change your diet, and even use puzzles and games to help decrease your need for long-term care in the near future. Cognitive decline is a major risk factor for long-term care, but serious falls can be a culprit as well. Also, dedicate some time to making your home a safe spot to age in place.

Put Together Your Plan to Pay for Care

Photo by Pixabay

Assess Your Insurance Coverage Options

You know that Medicare Advantage plans can help seniors stay better prepared for the future, but do you know how Medicare or health insurance covers long-term care costs? This may be a shock, but Medicare and Medicaid offer minimal long-term care coverage. In fact, the only aspects most health insurance plans will pay for are actions directly related to your health. So, the more routine care that most long-term care seniors need likely won’t be included in your average healthcare coverage. For many seniors, this is where options like long-term care insurance come in handy. If you plan ahead, this supplemental coverage is not as expensive and can offset some of the financial burdens. Understanding this kind of coverage can be a challenge, so make sure you carefully read through and research policies before you commit.

Research Other Viable Ways to Pay for Care

Medicare may not help, and long-term care insurance is not the perfect option for everyone. So, how can seniors find other ways to make sure they get the long-term help needed? Thankfully, there are some smart solutions to help give seniors and their families financial peace of mind. If you have served in the military, you may be eligible for more comprehensive VA coverage for your future care needs. It’s a benefit many veterans and loved ones forget, but this assistance is priceless for those struggling to find ways to afford long-term care. For adults who are not veterans, there may still be tools to help with costs. Financial assistance is available for seniors and family caregivers, but you can also reduce the expenses of care by carefully researching facilities and care providers. In essence, you can cut down your expenses by planning ahead.

Long-term care doesn’t have to be stressful, expensive, or, most importantly, an afterthought. It’s an essential step most adults will likely face at some point in the future. So, you should plan for long-term care just like you do any other important aspect of life and give yourself and your family some needed peace of mind in the process.

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How to Help Your Loved One Stay in Touch with You

During the holidays, relatives will especially rely heavily on two-way communication to stay connected.

Published in caringfromafar.com 

Technology makes communicating with your loved one as easy as the push of a button, which is a true blessing for long-distance caregivers. However, your loved one might not be as tech-savvy as you are, or they may have trouble communicating due to vision or hearing deficiencies. The following are simple ways to make staying in touch a breeze:

Start with the Basics

You might have gotten rid of your landline phone years ago, but for older adults, this is the phone they grew up using and are most comfortable with. Technology is confusing, and trying to teach your loved one how to use it could be more stressful than it is helpful. In fact, a landline phone may even be the safest option, as it reduces time spent routing the call to the correct emergency response center. In addition, calls from landlines automatically show emergency responders the address, name of the residence, and a map, which could be a lifesaver should your loved one call for help and be unable to talk or get confused about where they are.

Depending on your loved one’s needs, you can switch out the landline for something more feasible such as a phone with larger buttons or a high ringer volume. Keep in mind that getting your loved one a cell phone, and teaching them how is use it, is still a good idea, as they can take it with them when they are out of the house. To really ramp up the communication measures, install a medical alert system that makes communication with emergency services quick and simple.

Set a Schedule

Once you choose the preferred communication, set up a time each day to check in and stick to it. This not only gives you peace of mind that your loved one is okay, but even simply hearing a familiar voice could be the daily pick-me-up they need. If your loved one is tech-savvy, use video chat such as Skype or FaceTime, or have a local family member or in-home caregiver assist them.

In addition to communication with your loved one, it is imperative that you chat regularly with their primary caregiver to get details and information your loved one might not feel comfortable sharing with you. If you chose to hire an in-home caregiver, check in with them daily, and don’t be afraid to request a log of what they did each day. Don’t forget to ask your loved one how they feel – sometimes caregivers aren’t the right match.

Staying in touch with your loved one will take a continued effort on your end, but it is just one of the many responsibilities that come along with being a long-distance caregiver. With the right technology and a consistent schedule, you can make the miles between you seem far less.

 

 

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How to Choose Hospice Care

Important questions to consider before you arrive at a decision

Published in NextAvenue By Liz Seegert

Part of the LIVING TO THE END OF LIFE SPECIAL REPORT

(Editor’s note: This story is part of a special report for The John A. Hartford Foundation.)

Making the decision to transition your loved one to hospice care (for people whose medical conditions mean they are expected to die within six months) is a time of emotional upheaval. It’s often accompanied by confusion, with little understanding of available options or how hospice actually works.

Knowing ahead of time which hospice services are available and the tasks you may be required to take on can help you make the right choices when decision time comes.

Home Hospice, Hospital-Based Care or Stand-Alone Facility

One of the first things you will need to decide is whether to use a home hospice service, hospital-based care or — if available — a stand-alone facility. Nursing homes may also have hospice units or hospice floors.

There are advantages and disadvantages to each, according to Gilbert Oakley, a hospice nurse with Visiting Nurse Service of New York, who’s been providing home hospice care for over a decade.

You’ll have to balance what the person who is dying wants versus what you and the family can realistically provide.

If opting for in-home hospice, a home hospice agency will work with you to determine whether an adequate support system exists. Can the family pitch in with necessary tasks — from administering pain medication to bathing to helping the person toilet? Are you financially prepared to pay for additional help beyond what insurance covers?

Medicare-reimbursed hospices (for people 65 and older) all provide the same basic services. However, there still may be differences between providers that might make one a better choice for you over another, according to the Hospice Foundation of America. The best way to know is to compare. Medicare’s Hospice Compare provides lists and ratings of hospice providers in your community.

Your loved one’s physician, hospital discharge planner or social worker can recommend specific hospice agencies or facilities. Geriatric care managers can also be a good resource. Often a physician has privileges at certain facilities, which may limit choices. Ask these experts questions about their experiences working with the agencies or facilities. Then contact a few for informational appointments.

Hospice Questions to Think About

Credit: Adobe Stock

Many of the questions are the same whether you opt for in-home hospice or facility care. Here are some important questions to consider:

Is the hospice Medicare certified? Most are, and are therefore required to follow Medicare rules and regulations. This is important if your loved one receives the Medicare home hospice benefit.

Is the hospice nationally accredited?  This designation lets you know that the agency or facility meets certain quality standards. While accreditation isn’t required, it can be a clue to the agency’s commitment to quality.

Has the facility or agency been cited in a negative way in the last few years by a state or federal oversight agency? Find out whether any violations or deficiencies been corrected.

Are the hospice’s doctors and nurses certified in palliative care (providing relief from the symptoms and stress of a serious illness)? Experience counts for a lot, but having the credential indicates specialized study in palliative medicine and/or nursing.

How quickly is a plan of care developed for the individual? Some hospices can begin the admissions process and start hospice services within a few hours — even at night or on weekends. Others may only provide intake during normal business hours. Depending on your loved one’s situation, a hospice’s ability to start services quickly might be very important.

How often will a nurse visit my loved one? Medicare only requires one visit every 14 days, but your family member may need more support, according to Perry Farmer, CEO of Crossroads Hospice, a for-profit provider. Find out the answer to this: How often do social workers, care aides, clergy, volunteers or bereavement support counselors come?

What are the options for inpatient care? Patients being cared for at home at some point may need to go to an inpatient unit for management of complicated symptoms or to give their family respite. Facilities vary — from the hospice having its own private inpatient unit to leased beds in a hospital or nursing home. If possible, visit the facilities (or delegate the task to a trusted family friend) to ensure that they are conveniently located and that you are comfortable with what they offer.

How rapid is crisis response? You want to know who would be available after normal business hours, on weekends and holidays. Ask about the hospice’s average response time and who will make the visit. Some hospices offer limited in-home support on nights and weekends, while others are able to send staff out to a patient’s home no matter when a crisis arises.

What are the expectations for the family’s role in caregiving? See whether the hospice’s expectations are consistent with what the family can provide. Often the care partner has no idea what it’s going to take to be with someone as they die at home — administering medication, helping with bathing and toileting and more. Will the hospice provide training to family caregivers?

How quickly can we expect pain and/or symptoms to be managed? Pain management is a key part of hospice care. Ask about the process if medications don’t seem to sufficiently address pain or symptoms, and how quickly they can be adjusted.

What out-of-pocket expenses should the family anticipate? Original Medicare’s hospice benefit covers everything needed related to the terminal illness, from doctor and nursing care to short term respite and grief counseling. This is true even if the individual chooses to also remain in a Medicare Advantage Plan or other Medicare health plan. There may be a small co-pay for some services like respite care. Medigap and Part D prescription drug plans pay for other care and certain medications.

Taking this all into a account, having a plan of care is vital, according to Oakley. The caretaker(s) need to be aware of what the hospice can or cannot provide and what you or other family members must do.

If your loved one is a veteran, it’s important to select a hospice with the necessary, appropriate experience. Next Avenue published a story detailing how the toll of war on veterans can complicate end-of-life care and present unique needs that must be addressed. You may want to check out the We Honor Veterans program which works with experienced providers of this type of care.

Oakley also recommends finding out how the hospice handles patient and family concerns. Is there a clear process for sharing issues with appropriate hospice staff and ensuring the concerns are addressed, including a process for escalation if the concern is not adequately resolved at lower levels?

Facility-Based Care or Hospice Houses

There are times when patients with very complex symptoms or conditions cannot be cared for at home. Sometimes family members are geographically distant or just don’t have the emotional or physical resources to deal with the situation on a day-to-day basis.

One alternative is a freestanding facility known as a hospice house. Hospice houses offer a more home-like atmosphere than typically found in a hospital or nursing home. They’re designed for short stays and may be a good option when the person requires around-the-clock care. Some hospice house programs mandate that a patient be within a month or two of death, so be sure to ask about admission criteria.

“If you have an opportunity to go with a free-standing hospice house, jump wholeheartedly into it because the environment is created specifically to help people as they die and the family members of people as they die,” said Dr. Rebecca Allen, a geropsychologist and professor of psychology at the University of Alabama’s Research Institute on Aging.

Bereavement Support

Allen recommends asking all hospices about available bereavement services. Grief support can vary widely. It may include individual counseling, support groups, educational materials and outreach letters. If you opt for individual or group support, find out what credentials the session leader has.

What’s Most Important

Think about your general impressions after the initial contact with the provider. What was your reaction to the people you spoke with?

Remember to focus on what is most important to your family — most importantly the person who is dying.

Keeping that at the center will help narrow the field, whether there are three options or 30.

New York-based journalist Liz Seegert has spent more than 30 years reporting and writing about health and general news topics for print, digital and broadcast media. Her primary beats currently include aging, boomers, social determinants of health and health policy. She is topic editor on aging for the Association of Health Care Journalists. Her work has appeared in numerous media outlets, including Consumer Reports, AARP.com, Medical Economics, The Los Angeles Times and The Hartford Courant.

 

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How to take the worry out of providing long-distance care to seniors

By caringfromafar.com

Photo by Pexels

Are you taking up the role of caregiver for a parent or older loved one? Wondering how to provide that care when you live far away? Long-distance caregiving doesn’t have to be so stressful if you take care of the following essential steps.

Get Familiar with Your Loved One’s Medicare Options

The number one concern for seniors is their health, and the number one source of senior healthcare coverage is Medicare. If you are providing care for a loved one from afar, you need to spend some time making sure they have the best Medicare coverage for their situation. Learn the pros and cons of coverage and supplemental plans, as well as important deadlines.

Primarily, you both should know that the Annual Election Period for coverage started on October 15, and you have until December 7 to help your family member make their choices. This crucial enrollment period is the only time you can make changes to current plans, and the deadline is fast approaching, so sit down with a checklist so you can go over all the options in detail. Pick a time when you can visit in-person so that you can have your family member’s Medicare card, copies of the previous year’s medical bills, and a list of any pertinent healthcare information (provider names, prescriptions, etc.). If you can’t do this in-person, use a video call service to connect and have your loved one show or scan you copies of needed materials.

Make Sure Your Family Member Is Safe at Home

Did you know that falls send more seniors to the hospital than any other injury? More importantly, most serious falls happen at home when seniors live on their own. This statistic is not meant to make you feel guilty, but rather to stress the importance of making sure your loved one’s home is free of any fall hazards, both inside and out. If you can make a trip, take a walk around your loved one’s home and look out for issues that could cause them to slip or trip. Clutter can be a recipe for disaster, so make sure any random objects are safely stowed off the floor and out of the path of your family member.

Bathrooms are another sore spot in senior homes, so you may want to help your loved one make changes, such as installing grab bars or putting a seat in the shower. When you need to make these upgrades from afar, you’ll need to find a contractor you can trust. Check reviews online, or ask friends for referrals, so you can find reliable, affordable help to assist your senior loved one with these projects, as well as future issues they may have in their home.

Stay in Touch with a Local Network of Help

When you are providing care from a distance, there will likely come a day when your loved one will need some help and you may not be immediately available to assist them. This is why it is important to build rapport with any neighbors, friends, or community members who may be able to help your family member in their time of need. It’s a major step in effectively providing care for loved ones without adding more stress to your life.

Don’t be afraid to ask neighbors to check in with your parent or loved one, or at least let you know if there is cause for concern. This may include severe weather, odd behavior, or anything else out of the ordinary. Your network can help your loved one get prepared for emergencies, get help when needed, or simply connect with you. As an added layer of protection and connection, look into medical alert services for your parent as well.

Providing care to a senior loved one, when you do not live nearby, can be nerve-wracking. But if you can do some planning, connect with locals, and find ways to keep them safe at home, you can take a lot of the guesswork out of being an effective long-distance caregiver.

 

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Hospice month celebrates success of nation’s first coordinated care model

Published in The Hill by Edo Banach, Opinion Contributor

While there’s no shortage of partisan disagreements on Capitol Hill, one hopes the combative environment that’s become the norm in Washington might take a brief pause now that midterm elections are behind us. At a time when unity and common ground are sorely needed in our politics and our policymaking, one health care program stands out as a reminder of how bipartisanship works at its best: the Medicare Hospice Benefit.

This extraordinary policy achievement was made possible by lawmakers who put aside their differences in the interest of the Americans they served. Enacted as a demonstration in 1978 and a Medicare benefit in 1982, hospice programs have served millions of Americans and their families with compassionate care to relieve pain, manage symptoms, supported beneficiaries and their family caregivers, and provided bereavement services for individuals following the death of a loved one. The benefit has been invaluable to patients and lifesaving for families. And it never would have happened without lawmakers who were committed to the concept, and to working together.

Democrats, including Sens. John Glenn (Ohio) and Bill Bradley (N.J.), joined with Republican senators like Bob Dole (Kan.) and Chuck Grassley(Iowa) to pass what then-Rep. Leon Panetta (D-Calif.) called a “political miracle.” Sen. John Heinz (R-Pa.) personally collected commitments from 68 senators to pass the Heinz-Dole-Packwood amendment to provide hospice services to terminally ill Medicare patients.

Not only did this bipartisan act show how a diverse group of legislators could come together for the good of the country but the hospice benefit itself has become an example of how our fragmented health care system can – and should – work together for the betterment of patients. As America’s original coordinated care model, hospice brings together a multidisciplinary team of providers to meet all aspects of a dying patient’s physical, spiritual and emotional needs. No other health care sector is required to address all aspects of a patient’s, and their family’s, health and wellbeing.

Those elected to serve in the upcoming Congress should know that hospice is a program that works and a Medicare benefit that matters to their constituents. As seasoned and novice legislators alike consider health policy reforms, they should look to the success of the hospice model as an example of preserving what works, and help expand access to comprehensive, coordinated care and person- and family- centered care to all patients with serious, advanced and life-limiting illness. We should also reinforce the foundation of hospice to ensure access, choice and quality care at the end of life.

Hospice is not only best for patients at the end of life, it is also good for the Medicare program. Study after study show hospice care improves quality of life, delivers on patient and family satisfaction and reduces unnecessary costs for Medicare beneficiaries at the end of life. Thirty-plus years later, hospice is a reminder that there are policy solutions that work for both sides of the aisle and across our nation for all Americans. The fruits of cooperation live on today in a Medicare benefit that serves 1.43 million Americans annually.

It’s sometimes unclear if the dust will ever settle in Washington, and if we’ll ever get back to a place of collegiality and bipartisanship in Congress. If our nation’s remarkable hospice benefit is any indication, great things can certainly happen if it does.

Edo Banach is President and CEO of the National Hospice and Palliative Care Organization (NHPCO).

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NHPCO Highlights Importance of Hospice in Healthcare Since 70s

November begins National Hospice & Palliative Care Month. National Hospice & Palliative Care Organization (NHPCO) writes that hat began as primarily a volunteer-driven, grassroots movement in the 1970’s, is now an integrated part of our nation’s health care delivery system that provides care to more than 1.43 million Medicare beneficiaries and their families every year.

“Enacted as a demonstration in 1978 and a Medicare benefit in 1982 as our nation’s first coordinated care model, hospice programs have served millions of Americans and their families with compassionate care to relieve pain, manage symptoms, support patients and their family caregivers, and provided bereavement services for individuals following the death of a loved one,” said Edo Banach, president and CEO of NHPCO. “The benefit has been invaluable to patients and lifesaving for families.”

NHPCO offers a snapshot of hospice care with representative statistics from the current edition of its report, Facts and Figures: Hospice Care in America (PDF):

NHPCO provides a valuable abundance of resources with data and statistics on hospice. The organization is integral to a broad spectrum of efforts in leading the public’s understanding of hospice and palliative care and advancing the ever more vital role of hospice across the healthcare industry.

In addition, this month honors the home care and hospice community including the millions of nurses, home care aides, therapists, and social workers who make a remarkable difference for the patients and families they serve.

These heroic caregivers play a central role in our health care system and in homes across the nation.
  • In 2018, home care providers will travel about 8 billion miles to deliver the best health care in the world’
  • Ninety percent of Americans want to age in place, and home care is the preferred method of health care delivery among the disabled, elderly, and chronically ill; and
  • Home care provides high-quality, compassionate care to more than 5 million Americans annually.

As we approach the giving season, November is the perfect time to recognize their efforts.

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Financial planning and Medicare

By Steven Merrell, Financial Planning: Let’s talk Medicare

If you are one of the 44 million Americans currently covered by Medicare, you probably know that Medicare’s annual open enrollment period just started. Between now and Dec. 7, you have the opportunity to make adjustments to your Medicare coverage.

Paying for health care is one of the biggest financial challenges many people face in retirement. If you are 65 or older, Medicare is probably an important part of your financial picture. However, if you are new to Medicare, you may be surprised by Medicare’s complexity and the gaps in your coverage.

You can choose between two general directions for your Medicare coverage: Original Medicare and Medicare Advantage plans. Original Medicare, in turn, is divided into two parts. Part A covers inpatient hospital care, skilled nursing facilities (when medically necessary), hospice care and home health care. Part B covers doctor visits and outpatient care and other medically necessary services like ambulance services, clinical research and durable medical equipment. Optional Part D covers prescription drugs and is purchased from private insurance companies.

Original Medicare does not cover everything. For example, while Part A covers hospitalization and skilled nursing facilities, it only covers acute care. If you need long-term care, also known as custodial care, Medicare will not cover it. Medicare also excludes most dental care, eye exams for prescription glasses, dentures, hearing aids and exams for fitting them, acupuncture and routine foot care. If you want to find out if your particular need is covered by Original Medicare, you can search for your item or service on the Medicare coverage website: www.medicare.gov/coverage.

Most people do not pay a premium for Part A, but they do pay a deductible of $1,340 for each benefit period and coinsurance for hospitalization. Part B premiums start at $134 per month but can be higher depending on your income. In addition, for Part B you will pay a deductible of $183 per year and coinsurance above that amount equal to 20 percent of the Medicare-approved charge for most doctor services, including the services provided by your doctors while you are in the hospital.

In a catastrophic scenario, there is no limit to the amount you can owe under Original Medicare. Consequently, many people purchase a supplemental policy, also known as Medigap insurance. Medigap insurance is issued by private companies, but the policies are standardized by law to comply with Medicare requirements. There are 10 standard Medigap policies available each with different coverage limits.

If you find this confusing, you are not alone. In fact, this confusion is why Medicare Advantage plans have become so popular in recent years. By law, Medicare Advantage plans are required to provide everything that is covered by Original Medicare. The only exception is hospice care, which continues to be provided by Original Medicare Part A.

Steven C. Merrell is an investment adviser and partner at Monterey Private Wealth Inc. in Monterey, CA. 

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