Because the future is imprecise, every adult, regardless of their age or health situation, needs to write down the exit plan they want implemented for themselves. If it is not written down, how can anyone be sure they are fulfilling your health care choices? This plan or advanced directive allows you to make your health care choices known before an accident happens or an incapacitating illness affects you. An advance directive is a legal document that states how you want to be treated if you become very ill and there is no reasonable hope for your recovery. Laws vary from state to state but there are basically two kinds of advance directives. They are living wills and durable powers of attorney.

An advanced directive can help establish what life choices are right for you. Do you want mechanical respiration or cardiac resuscitation? These are personal decisions that no one else should make for you. You can have your end-of-life decisions be a matter of record.

You can register an advanced directive with or without the help of an attorney. There are many websites that will help you do this. Terminally ill patients have another option for establishing their end-of-life path which is called POLST. It stands for physician’s order for life-sustaining treatment. It is a simple document that converts a patient’s treatment goals into medical orders. It can complement an already existing advance directive by addressing more specific preferences for end-of-life options such as transference from a hospital to a nursing home.

Marcy Cox, BS Gerontology

With an aging “Boomer” population and with many of the “Boomers” themselves facing the responsibility of caring for their parents, several challenges are presented. Meeting long term care challenges is complicated and often expensive. Two possible forms of help include assisted living and home health care. Assisted living is a long term care alternative housing arrangement for older adults who need help dressing, eating, bathing and toileting, but don’t need intense medical or nursing care. In-home companion care is a long term care concept that can encompass many social and personalized services. These services are provided at home to recovering, disabled, chronically or terminally ill persons who need help with various essential activities of daily living. The problem is that neither of these long term care options qualifies for any financial assistance from Medicare. They have to be paid for with the personal finances of the family involved. Some health or long-term insurance policies may cover some of the costs connected to assisted living.

Even though most of the elder population wants to live the remainder of their lives in the comfort and familiarity of their own homes, particularly when facing health issues, this may be an unfulfilled dream. Unless they have saved a considerable amount of money or get creative, like getting a reverse home mortgage, long term care services they most need or want like assisted living or in-home companion care may elude them. Medicare has not yet and probably never will be able to address the need for these kinds of services. Medicare is in as much or more financial turmoil as Social Security. It is plagued by rising health care costs and an aging population. The system is paying out more benefits than it is receiving in taxes. Failure seems certain if it doesn’t soon get a major overhaul. It is a not a government-run health insurance program but rather a government-funded health insurance program. As long as private insurers and providers are involved, the motivation will be to raise prices–not to evaluate, expand, and improve programs.

Medicare has not done well in explaining or managing the implementation of its new drug prescription system. In addition to that debacle, there are other flaws in its daily operation, one of which I can speak to personally. My father recently had back surgery. When he was released from the hospital, he had visiting nurses assigned to him for several weeks. He was also given a prescription for physical therapy. Months later, the physical therapy center told him that he owed them several hundred dollars because Medicare would not pay for both a visiting nurse and physical therapy at the same time. How would the average person know this? At this juncture, theoretically, he does not have to pay as the transgression was determined not to be his. He spent a lot of time, however, worrying about the outcome of this. It seems that Medicare is facing perilous times ahead, both financially and logistically. Will it be up to the challenge?

Gerri Tyber, Operations Manager
Barton Home Care

One of the most difficult tasks facing people today is decision-making about their own healthcare or that of a family member. While the current trends in health care toward patient empowerment, personal health records, patient advocacy, internet research and resources, electronic medical records, and other such tools have brought about much needed change in health care, these concepts also bring about much confusion.

When enough understandable information is made available, people can usually see their way very clearly toward a course of action. This process eliminates the anxiety, fear, and turmoil around complicated problems and complicated decisions.

The process we use at Lynxcare to assist people with their medical decision-making most often begins with a gathering of the person’s entire historical medical record. This is easily accomplished by a signed Medical Release of Information and can be collected by the person themselves, or by Lynx.

The records are then reviewed by the Lynx physician consultant on the case, and are then sent to a registered nurse trained in records abstraction. This Review-By-Two method assures that, as much as possible, errors, inconsistencies, omissions, dangling tasks and unanswered questions are recognized and resolved in the process of creating a very comprehensive, detailed, yet brief and efficient Health Record Summary.

The beauty of this process is that is allows for an ongoing “virtual” case management process to begin that is inclusive of the patient, all their practitioners, the Lynxcare medical consultants, and any other specialists, practitioners, or subspecialists whose expertise may be necessary, but whose time is too short to allow a thorough review of the original records.

Using this method of medical advocacy, Lynx has enabled participants to:
•access the wisdom of renowned medical experts to clarify questions about diagnoses
•qualify for specialized treatment previously considered inappropriate due to sufficient historical information
•have more effective and well-understood communication with their doctors, practitioners, and specialists
•successfully appeal health insurance denials
•move through complex health conditions and difficult times with clarity and peace of mind

As a personalized medical advocacy service, Lynx uses our solid foundations of medical practice, health care systems management, and personal experience to help fill the gaps in individuals’ health care experiences.

Sharon Feder
President, CEO, and Founder of Lynxcare

www.lynxcare.net