HOORAY & HALLELUJAH !!!

" Medicare said Friday it will pay doctors to help patients plan what kind of care they want at the end of life, an idea more broadly accepted than six years ago when it touched off a political uproar about "death panels."
The policy change was urged by numerous physician and health groups. Some doctors provide this "advance care planning" to their patients without getting paid for the counseling time, and some private insurers already reimburse for it.

"But the Obama administration's policy change could make the talks more common among about 55 million Medicare beneficiaries.

"The rule, proposed last summer and finalized Friday as part of broader doctor-payment regulations, takes effect Jan. 1. The counseling is entirely voluntary, and could take place during seniors' annual wellness visit or during regular office visits."

About time!!

Importance of elder advocates

A recent situation brought home to me the importance of having an elder advocates present in conversations about an older person's care, especially when proposed changes are afoot.  Unless that is so instilled as to be automatic, the older person & their loved ones can find themselves at a disadvantabe & the staff who cares for the elder - whether as medical staff or as staff at his or her senior residence - at a disadvantage. 

The graphic says "Supporting patient power," but an elder advocate does so much more.  Ideally, he or she advocates on behalf of ALL parties, for the benefit of the elder.  Many times, what the staff wants to do is resisted by the elder & need to be discussed in ways that resonate with the older patient or resident.  Ditto with the family.  It helps to have someone not personally emeshed in the situation - not a family member, not a direct care provider - part of discussions. 

More on this as thoughts get sufficiently mulled in my mind!

 

Game daze

A cherished grannie client just fully entered her "senior full care" community's Personal Care unit.  As of the other day, she's having all her meals there & virtually all of her activities will center around her PC neighborhood.  

Our prayers are the change is even more a gain for her than it's certain to be for the PC staff, who will no longer have to deal with her admittedly errant schedule that included frequent meals OUT, fun treks, late nights (out until 9:00 p.m. several nights a week, even the occasional 10:30 p.m. when we headed down to Philadelphia for her beloved jazz). 

In thanks - especially the remarkable Activities Director - am making up a couple games I've specifically designed for folks with memory challenges.  One is a riff on the iconic Concentration (the traditional, not the t.v., version), using archive photos & fun facts about PC "neighbors" as game cards to turn over & match into pairs. Easy to do by photocopying photos of  PC "neighbors" & staff, cutting & pasting onto cards, or writing out matching pairs of fun facts about them.  Simple to do AND simple for the Activities Director to update & expand.  

The other game I'm designing & making for the PC Activity Room uses a traditional flat game board, playing pieces, dice & fun fact cards.  Each contestant rolls the dice to see who goes first.  The first player takes a card, the player (or a moderator) reads the fun fact out loud, then the player rolls the dice & takes his or her turn.  The board is laid out similar to Candy Land, with straight forward squares but also a couple that move players ahead or sends them back.  First player to reach the end wins!  

In addition to helping by contributing photos & fun facts to use with both games, PC "neighbors" can be involved in designing the game board, adding a layer of personal investment in the game.  Maybe some of them can come up with new twists on the games, taking it in directions I'd never think about.  

Hmmm....  What sort of games could be developed using a big spinning wheel, like in The Price is Right or Wheel of Fortune?  The possibilities for all we can develop around games that build memory banks & reinforce skills  leaves me in a daze!