Question of the Day on ElderCareMatters.com: "What exactly is Medication Therapy Management? Mom’s primary care physician mentioned this briefly at our last doctor’s appointment as an option for my mom who has had several “close calls” recently with overdosing on prescription drugs. Please advise."

Answer:  Medication Therapy Management (MTM) is a process that reviews and evaluates how each senior is responding to their unique group of medications—prescription, non-prescriptions, over the counter and natural medications, supplements, vitamins, minerals…any item that is in use to improve health.  It also evaluates food intake, how the medications are taken or used.   

Families, caregivers and other loved ones also share their insights about how the senior is responding to the “medications”, as many of them are with the senior at various time of the day.  An action plan is developed to address these issues or concerns.  There are many things that the senior and/or their family can do to improve the benefits of the “medications” in use and to minimize the side effects or other problems.  Prescribers are also contacted for changes in medications orders, provided with information about the use of multiple medications and changes made in medication dosage, and frequency of dose. 

Having one person organize such reviews and provide information to other members of the healthcare team can be very successful in avoiding the “close calls” that cause seniors end up in the emergency room, admitted to the hospital or even subsequently moved to the nursing facility. 

Medication Therapy Management may also be known by another name…Comprehensive Medication Review (CMR) which is defined as a systematic process of collecting patient-specific information, assessing medication therapies to identify medication-related problems, developing a prioritized list of medication-related problems, and creating a plan to resolve them with the patient, caregiver and/or prescriber. A CMR is an interactive person-to-person consultation conducted between the patient and/or caregiver and the pharmacist and is designed to improve patients’ knowledge of their prescription, over-the-counter (OTC) medications, herbal therapies and dietary supplements, identify and address problems or concerns that patients may have, and empower patients to self-manage their medications and their health condition(s).  

I hope this helps…

To find other competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Lynn Harrelson, R.Ph., FASCP, Senior Care Pharmacist
8302 Cheshire Way
Louisville, Kentucky  40222
502-425-8642
Member of the national ElderCare Matters Alliance, Kentucky chapter 


Question of the Day on ElderCareMatters.com: "My husband and I are both in our 80s and take a lot of prescription medicines. My question is whether there are any programs in place (nationally or in our state of Kentucky) that help seniors get their prescription drugs at a discount. We are spending far too much of our monthly income paying for prescription medicine. Please help."

Answer:  The first option is to always ask your prescriber for samples.  While this may work earlier in the year, as many seniors enter the donut hole, the demand for certain medications may far exceed the supply that prescribers have to share with their patients.   Always have your “next option” underway. 

In my locale, we have KIPDA (Kentuckiana Regional Planning and Development Agency) and similar regional agencies can be found throughout the country.   Many offer community outreach programs covering qualified Medicare beneficiaries under the “Extra Help with Prescription Drug Costs.”  This program is funded by the Social Security Administration, the Extra Help program provides premium, deductible, and co-payment subsidies for Medicare Part D using new 2011 Federal higher income levels.

Qualified individuals must meet the specific criteria to receive a full or partial subsidy:  they must be entitled to, or enrolled in, Medicare Part D; reside in one of the 50 states or the District of Columbia; and meet annual income guidelines.  I would suggest that you contact the Social Security office; they should be able to provide a phone number for a similar agency in your region.  Ask that office if they provide a similar service. Also, you can go online to www.socialsecurity.gov and click on “Get extra help with Medicare prescription drug costs” located in the left hand column; or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).  

Rx Help at 1-800-760-7616 is an organization that provides drug discount cards services.  Share the following with your pharmacy (most national pharmacies participate) and this organization offers 10-85% on all FDA approved brand-name and generic medications (ID# National 001/RX Bin# 014582, Grp NDC707).  Another option is Rx Assist (www.rxassist.org or 401-729-3284) that also has information about patient assistance programs and drug discount cards. 

Benefits Check Up Rx is sponsored by the non-profit National Council on the Aging.  This web site checks the potential eligibility of adults age 55 and over for more than 260 public and private prescription drug programs. After completing a questionnaire, the user receives a confidential, personalized report. The entire process typically takes five to seven minutes to complete.  (http://www.benefitscheckup.org/before_you_start.cfm?screen=BenefitsCheckUpRx) 

Pharmaceutical Patient Assistance Programs where several pharmaceutical companies feature programs to help eligible applicants reduce their medication costs. These programs are usually limited to the company’s brand-name medications, and will most likely have specific requirements including age and income. 

Partnership for Prescription Assistance (info@pparx.org or 800-477-2669) is an organization that researches the various drug assistance programs currently available and provides access to more than 275 public and private patient assistance programs, including more than 150 programs offered by pharmaceutical companies.  

NeedyMeds (www.needymeds.org) is a web-based service that shares information on cost saving ideas and includes drug coupon programs, disease-specific assistance programs, information about discount drug cards and more. 

TogetherRx (www.togetherrxAccess.com or 800-444-4106) is a pharmaceutical sponsored program offers a 40-60 percent discount on certain brand name and generic medications for those who do not have prescription coverage. 

I hope that this helps….

To find other competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Lynn Harrelson, R.Ph., FASCP, Senior Care Pharmacist
8302 Cheshire Way
Louisville, Kentucky  40222
502-425-8642
Member of the national ElderCare Matters Alliance, Kentucky chapter 


Question of the Day on ElderCareMatters.com: "What are the training requirements for the staff of Assisted Living Facilities as it relates to administering medications to residents?"

Answer:   Training requirements  for Assisted Living Facilities (ALFs) are regulated by each state, and educational and training requirements vary among the states to address the specific requirements of the state. Additionally, not all ALFs allow staff to administer medications, these facilities are often referred to as a social model, there are 5 or 6 in this classification. 

To better understand the regulations for an individual state, you may find the specifics on each state’s ALF association website, or staff within that association may assist you or clarify your questions.  Also, ALFs may develop their own training that may exceed state requirement to address the special needs of the residents within the facility.

To find other competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Lynn Harrelson, R.Ph., FASCP, Senior Care Pharmacist
8302 Cheshire Way
Louisville, Kentucky  40222
502-425-8642
Member of the national ElderCare Matters Alliance, Kentucky chapter 


Question of the Day on ElderCareMatters.com:"What is the first step in preventing my mother from having problems with her medications?"

Answer:  Make a list of all the medications that she uses, prescriptions, non-prescriptions, over the counters, supplements, and nutritionals. 

Keep the list updated, make copies and share with other caregivers.  Take the up-to-date list to all healthcare appointments and share with all healthcare providers.

I encourage you to go to my web site and download the Health ICE (In Case of Emergency).  This form provides an area to list this information and much more. 

Copies of this should be placed in 2 envelops, marked “Health ICE” and with your mother’s name. Place one on the refrigerator and one in the car. Emergency personnel are trained to look for such lists on the refrigerator and in the glove compartment of the car.

To find other competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Lynn Harrelson, R.Ph., FASCP, Senior Care Pharmacist
8302 Cheshire Way
Louisville, Kentucky  40222
502-425-8642
Member of the national ElderCare Matters Alliance, Kentucky chapter


This week’s featured Elder Care Expert on ElderCareMatters.com is Lynn Harrelson, R.Ph., Senior Care Pharmacist

Lynn Harrelson, R.Ph., FASCP, Senior Care Pharmacist
8302 Cheshire Way
Louisville, Kentucky  40222
502-425-8642
www.SeniorPharmacySolutions.com

Member of the national ElderCare Matters Alliance, Kentucky chapter

This week’s Featured Elder Care Expert is Lynn Harrelson, R.Ph., FASCP, Senior Care Pharmacist, Member of the Kentucky chapter of the national ElderCare Matters Alliance (a network of  1,500 elder care experts across America). 

Ms. Harrelson has over 30 years of experience helping patients, families, caregivers, physicians and other health care providers with questions and concerns that arise when multiple prescriptions and other medications are used.

Ms. Harrelson provides guidance for those who are overwhelmed and confused about drug reactions, interactions, and side effects of taking multiple medications.

Every day this week (M-F), Ms. Harrelson will answer one of your questions about her area of expertise (Medication Management), and this selected question along with Ms. Harrelson’s answer will be posted on the Featured Elder Care Question of the Day section of ElderCareMatters.com.

So if you would like to ask Ms. Harrelson a question about your elder care matter, just send a short email (a few sentences only please) to: questions@ElderCareMatters. com.  

And remember to bookmark ElderCareMatters.com and check back often to see if your question is our Featured Elder Care Question of the Day.


Question of the Day on ElderCareMatters.com: "My elderly parents are failing. It's a complicated situation, but I got a Durable POA to protect my mom's assets if my dad passes before my mom. My dad is named as the primary POA, in case my mom passes before my dad. I am named as the secondary. My question is if my dad passes before my mom, and since I am named as secondary on the POA forms, does that mean I automatically become the primary POA for my mother? Will I have the authority to make decisions regarding her estate? What other things should I know about being name "secondary" POA?. Also, I live in a different state than my parents, but the POA forms were created using the laws of their home state. Does living in another state have any impact on transferring authority from the primary to the secondary POA?"

Answer:  If the power of attorney (POA) is valid in the state in which it was written, it should be valid in any state even if you are the secondary agent. You may have to prove that the primary has died through a death certificate. Assuming the POA grants you the right to make decisions regarding your mother’s assets such as the power to write checks, to pay bills and deposit checks payable to your mother, living in another state should have no impact on a transfer of authority. One note of caution: The bank may view and make a copy of the original POA, but under no circumstances should they keep the original document. You will need the original document in the event your mother has assets with more than one financial institution.

To find competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

William “Bill” Brown, Attorney at Law
2999 E. Dublin-Granville Road
Suite 217
Columbus, Ohio  43231-4030
614-890-9099
Member of the national ElderCare Matters Alliance, Ohio chapter


Question of the Day on ElderCareMatters.com: "Husband and wife are both 85 and live in Massachusetts. Wife has early stages of Alzheimer's (possible Nursing Home admission in the future). If an income annuity is set up in the Husband's name, since it is income is this now a non-countable asset? Can a trust be named as primary beneficiary, in case he pre-deceases his wife, or do we have to name the State of Massachusetts as primary beneficiary up to the extent of benefits received? This annuity would be set up for income to be received for a period less than his life expectancy."

Answer:  Yes, a trust can be named the beneficiary of an income annuity; however, it must be done 5 years (60 months) prior to eligibility for Medicaid in order to be a non-countable resource for Medicaid purposes. The spouse could be the primary beneficiary with the state the ultimate beneficiary.

To find competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

William “Bill” Brown, Attorney at Law
2999 E. Dublin-Granville Road
Suite 217
Columbus, Ohio  43231-4030
614-890-9099
Member of the national ElderCare Matters Alliance, Ohio chapter


Question of the Day on ElderCareMatters.com: "My family doesn’t have the money to hire an attorney but yet we need help with applying for VA assistance for my parents since my father served in World War II. Can you recommend where we could perhaps get this help without hiring a private elder law attorney?"

Answer:  My suggestion is that you call the Dept. of Veteran’s Affairs, Benefits Information Claims. The toll free number is 1-800-827-1000.  Hope this helps.

To find other competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

William “Bill” Brown, Attorney at Law
2999 E. Dublin-Granville Road
Suite 217
Columbus, Ohio  43231-4030
614-890-9099
Member of the national ElderCare Matters Alliance, Ohio chapter


Question of the Day on ElderCareMatters.com: "My brother has a severe handicap due to a birth defect. He has been receiving disability benefits through social security, as well as some state aid. When my parents die, if my brother inherits from my parent’s estate, will he be denied benefits due to the inheritance?"

Answer:  In most cases I have recommended that the parents set up a living trust using “handicapped” language for the disabled child. This provides the disabled child supplemental care without loss of federal or state benefits and provides a better lifestyle. In addition, other children that are not disabled or handicapped can inherit their shares in a normal manner. There is no need to “disinherit” the disabled or handicapped individual. 

In some cases a “Medicaid payback” trust may be used where the disability is the result of an injury or an accident and there is a sizeable insurance settlement that might reduce or eliminate Medicaid benefits. The theory is that the settlement dollars will be invested and the “payback” to Medicaid upon the death of the beneficiary will still leave a significant amount for the beneficiary’s heirs, siblings or others.

To find competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

William “Bill” Brown, Attorney at Law
2999 E. Dublin-Granville Road
Suite 217
Columbus, Ohio  43231-4030
614-890-9099
Member of the national ElderCare Matters Alliance, Ohio chapter


Question of the Day on ElderCareMatters.com: "How long does the Guardianship process take?"

Answer:  Temporary guardianship can be obtained quickly; it is possible to have a temporary guardian appointed the same day the petition is filed. The length of time required for the guardianship process when an emergency does not exist depends upon the availability of information necessary for preparation of court papers, the availability of a judge, the type of notice required to satisfy the Constitution under the circumstances of the case, and the existence of complicating factors, such as disagreement among interested parties, controversial issues, etc. In routine cases the most time-consuming process is preparing the documents and gathering the information for the presentation of the case. It is important to thoroughly investigate the case before filing it, because it cannot be withdrawn later without the court’s permission. One is not permitted to file a frivolous court case and, if the case is filed and later investigation reveals that there is no justification for the case, there can be serious consequences for the petitioner and also for the petitioning attorney.

Once the case is filed, it usually takes from 14 days to two months for a decision to be reached by the court. The fact that a temporary guardian may have been appointed does not determine whether a permanent guardian will be appointed.

To find competent elder care professionals who are located near You and can help you with this type of elder care matter, go to: www.ElderCareMatters.com – A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.

Janna Dutton, Attorney at Law
Founding Partner
Dutton & Casey, P.C.

Chicago, Illinois  60603
312-899-0950
Member of the national ElderCare Matters Alliance, Illinois chapter


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