Tag Archives: aging well

Bridging the Gap Between Generations

Since 2018, I’ve been deeply involved with Age Friendly Teaneck’s (www.agefriendlyteaneck.org)  four-week summer internship program for high school students, known as Exploring Careers in Aging. The program has two main goals: to give students the opportunity to learn about a variety of careers in aging (ranging from health care to architecture and construction) that they might not have been aware of; and to combat the many stereotypes about aging that are still far too prevalent in our culture. We encourage intergenerational connections with visits to a variety of venues where interns and elders can find common ground; and we aim to combat the isolation and loneliness that can arise in part because of the culture’s misconceptions about aging. 

            One of my roles throughout the internship is showing films that center on some aspect of aging, and conducting discussions with the students after each screening. One of my favorite films – and the one we show first – is “Lives Well Lived,” a documentary by filmmaker Sky Bergman. I love this film because in the process of interviewing 75 people between the ages of 75 and 100, we get to know so many women and men living active, productive and meaningful lives, talking about what, exactly, makes for a life well lived. They are all positive, they have a sense of purpose in their lives, and they are clearly resilient. It is inspirational. And it offers plenty of food for thought for our interns.

            Sky embarked on the documentary by interviewing her then-99-year-old grandmother, to show how active and engaged in the world she was: cooking, socializing, going to the gym and reflecting on her life and what has made it so meaningful. Sky then broadened her lens to include many other elders to learn about their lives too. These were not people who had lived a life free of hardship or heartache.

Many recalled the traumas of World War II: one being separated from a parent in fleeing a country; one being forced to live in an internment camp (and becoming a widow with two young children as her husband fought for this country), for example; the challenge of starting a new life in the U.S.  Others were active in the civil rights movement; or 

overcame hurdles to complete their education years after early education was interrupted. And yet their positivity remained intact. And they had plenty of great advice for all of us.

Creating a Movement

           I admire Sky greatly because her own story didn’t end after she had done this documentary. It has evolved into a movement that connects elders and members of younger generations, to share their experiences and outlooks, which has enriched the participants. And she is determined to encourage others to find ways to bridge the gap between generations and to understand “the transformative power of listening to and learning from each other,” Sky says. “Ageism diminishes when generations connect.”

            And so she has published a book, “Lives Well Lived: Generations — Resilience, Positivity and Purpose at Every Age” to spread that message. The book is divided into several sections that roughly mirror Sky’s own evolution: why she decided to do her documentary; glimpses of many of the people she features in the documentary, quoting their observations; and how the movement to connect generations has grown. Of great value are the roughly three dozen chapters written by intergenerational program directors from all across the country – with links to their websites – about what they do, how they do it and what the benefits have been.

Programs range from the social (such as sponsoring intergenerational dinners) to such pressing issues as housing affordability and voter registration. The book also includes considerable guidance for those who are interested in either screening the film and starting a discussion about it; or starting an intergenerational program of their own. There is more guidance on the website www.skybergmanproductions.com. The book is available on Amazon at  https://a.co/d/aBvvbaG

            Two years ago, one of our Age Friendly Teaneck interns was so taken with the film that she decided to do her end-of-internship project about a few people in our town who had embarked on their second chapters. And we also arranged for her to interview Sky by phone. I can tell you that it was hard to tell who was more enthusiastic about this interview, our intern or Sky herself. Which to me proved the essential wisdom of this intergenerational movement. 

AMAZON: bit.ly/LWLAmazon

iTUNES: apple.co/2YpODcI

PBS Passport: pbs.org/show/lives-well-lived

KANOPY: kanopy.com/en/product/12391561

3 Steps to Peace of Mind: Or, Thinking About Advance Care Planning

Happy National Healthcare Decisions Day (NHDD)! The Day’s purpose, according to the Conversation Project (www.theconversationproject.org), the organization that promotes and manages it, is to “demystify healthcare decision-making and make the topic of advance care planning inescapable.”

In short, it’s a way to get us all talking about what we normally would prefer not to talk about at all, which is mortality; as well as our preferences for the kind of care and treatment we would want for ourselves if we were gravely ill and couldn’t speak for ourselves.

If you don’t already have an advance care plan (also known as a living will), or if you haven’t decided who will be speaking for you (your health care proxy), the best present you can give yourself and your loved ones for NHDD is to create one and designate a proxy. And if you are caring for elder parents or relatives, now would be a good time to ask them about their advance care plans too. Your proxy needn’t be your spouse, significant other, son or daughter. It does need to be someone who can be tough-minded if necessary, and dedicated to carrying out your wishes, even if they wouldn’t make those same choices for themselves.

Where to begin? First and foremost, get better educated about some of the kinds of treatments you may or may not want, like CPR, feeding tubes, pain control and mechanical ventilation (about which we’ve all seen way more than we might have expected to during the pandemic).

Second, think deeply about your own values:  If you had a limited amount of time left to live, or were limited in how you could communicate if you had dementia, for example, what would be most important to you? What are your hopes for the future? What would make life continue to be worth living? Be aware that your feelings may change over time and circumstances may change too, so keep revisiting the subject. It’s not a one-time conversation, either with yourself or with your loved ones.

Don’t Keep It a Secret

Third, don’t keep your preferences a secret.  Document your wishes — put it in writing. There are plenty of examples to follow. One of my favorite advance care directive templates is Five Wishes, (http://www.agingwithdignity.org/forms/5wishes.pdf) mainly because it’s very clear, written in plain English, and covers the important bases. Another useful source for advance directive templates is Caring Connections, a program of the National Hospice and Palliative Care Organization (NHPCO).  You can find advance directive forms (free) for each state on its web site:  http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289.

You can also record yourself on video, keep it in your phone, or on a thumb drive, and send a copy to your health care proxy.

And of course, now there are apps for advance care directives too. The American Bar Association has a My Health Care Wishes app https://www.americanbarfoundation.org/uploads/cms/documents/flyer_for_smart_phone.pdf  It can be stored in pdf or word form on your smartphone or tablet. To find other apps, try https://www.caringinfo.org/planning/advance-directives/digital-video-advance-directives/

Advance directives are not set in stone. You can change your mind, and your directive, at any time, depending on changes in circumstances. Bear in mind, too that it’s possible for these documents to fall between the cracks in our fragmented health system. Even if your primary care physician has a copy, for example, the specialists who may be tending to you may not. So you or your proxy should not be shy about reminding physicians, administrators or whoever is in charge of your care, that your directive exists.

For NHDD 2023, give your loved ones the gift of eliminating the burden of guessing what path to pursue if you’re seriously ill. Spare them the guilt over second-guessing their decisions. Short-circuit a toxic brew of family dissension that could poison family relationships for years to come, as can happen when family members disagree about how best to manage your care.

Mortality, loss, grief – it’s all tough enough to bear under the best of circumstances for the people who love you. You can ease their pain when you speak for yourself through a directive.

And on a personal note…Although I haven’t blogged since pre-Covid days, it’s nice to be back! If there’s anything you want to read about here, let me know!

Why It Matters to Talk About Values with Dementia Patients

As relieved as we are about finally seeing the awful year 2020 in the rearview mirror, I’d say that one useful thing the pandemic has given us is an in-your-face awareness of mortality and the gravity of serious illness. And it’s given us permission to talk about it more freely.

But what about loved ones who may be newly diagnosed with dementia? As caregivers know only too well, dementia progresses to the point where ultimately those afflicted may not be able to think clearly, reason well or speak. They become increasingly dependent on others for their care. So, to honor these loved ones, to support them in the way they’d want to care for themselves and to make sure that medical professionals understand the best way to respect what matters to them, it is vital to ask the questions regarding future care when loved ones are still able to articulate their answers.

How do you even begin to discuss these life-and-death issues? Especially if loved ones are anxious about their health and their future, or resistant to the idea that anything is wrong at all? Before trying to talk about the pros and cons of specifics of what I’d call “the Big Three” — CPR, mechanical ventilation and feeding tubes – it’s important to talk about values first. One great source of advice for this is the <a href="http://(https://theconversationproject.org/wp-content/uploads/2017/02/ConversationProject-StarterKit-Alzheimers-English.pdf) which offers a “starter kit” for those caring for people with dementia, at various stages.

The starter kit stresses the importance of beginning with exploring what matters to loved ones, what they fear, what kind of setting they envision if they were at the end of life, how involved they want to be in their medical care and who they’d like to have around them. It also emphasizes the importance of keeping the talk simple. Its questions are clear and straightforward. Finally, it stresses how important it is that you convey that this process is an act of love and that you will be there to support your loved one, no matter what.

Understanding loved ones’ values provides the framework for future decisions as dementia progresses. Advance directives, and health care proxies (those who will be responsible for speaking for loved ones) should reflect these values.

Some Points to Consider About Artificial Nutrition

Of the “Big Three,” let’s focus here just on artificial nutrition (feeding tubes): Sadly, people in the final stages of dementia may not remember how to eat, or be able to chew and swallow. Artificial nutrition is one solution to this issue, but it is not without its own problems According to the American Academy of Hospice and Palliative Medicine, for patients near the end of life, artificial nutrition and hydration is unlikely to prolong life and can potentially lead to medical complications and increased suffering. How? For starters, it makes people feel bloated, nauseated, and/or develop diarrhea.

Experts say it’s better to offer a little food or something to drink, and if your loved one wants it, even a minimal amount, fine. If not, don’t force it. There are other ways to continue to nourish your loved one, if food and fluids are no longer an option.

A useful template of an advance directive for people with dementia, published by End of Life Washington, addresses the feeding-by-hand issue. It states, “If I accept food and drink (comfort feeding) when they’re offered to me, I want them. I request that oral food and fluids be stopped if, because of dementia, any of the following conditions occur:

• I appear to be indifferent to being fed.
• I no longer appear to desire to eat or drink.
• I do not willingly open my mouth
• I turn my head away or try to avoid being fed or given fluids in any other way.
• I spit out food or fluids.
• I begin a pattern of coughing, gagging or choking on or aspirating (inhaling) food or fluids.
• The negative medical consequences of symptoms of continued feeding and drinking, as determined by a qualified medical provider, outweigh the benefits.”

No doubt this is all a lot of food for thought (pardon the pun) for caregivers and loved ones alike. But it’s the hard work of discussing and documenting loved ones’ values and wishes that will be the foundation for the compassionate and appropriate care that loved ones deserve later on in the course of illness.

Wishing everyone a safe, healthy and happy 2021.

Having ‘The Talk’ With Mom and Dad

Editor’s note: Did you know that April 16th is National Health Care Decisions Day? Of course, the pandemic has made us all just that much more aware of our mortality, so it’s an excellent time to think about the kind of care we’d want if we couldn’t speak for ourselves. Or: to learn what our parents would want. Not an easy talk to have, certainly! This guest blog, by systems engineer William Donaldson, explains how he had multiple such conversations with his parents — and why they proved so valuable. He’s also writing a book about it, available this summer, “Estimated Time of Departure: How I Talked to My Parents to Death: A Love Story.”

For reasons I still do not fully understand, I wanted to know what my parents wanted for their end of life. What I learned in shepherding my parents on their journeys is that the discussions, while hard and sad, are also incredibly liberating and rewarding. The feeling of control and certainty were ironically comforting since I was certain I was going to be losing my parents. But knowing precisely what each of my parents wanted and sharing that with my siblings long before we needed to face the event became a wonderful, loving gift. When the time came (Dad died in August 2009 and Mom died in March 2011) there were no questions or regrets; we all knew exactly what needed to be done.

When I first started pressing the issue, probably 10-12 years before the events, my parents were dismissive of the need. As time moved on, they became evasive and would change the subject. Finally, after many aborted attempts, we broke through and started to talk in earnest. But why did it take so long?

Here is why I believe they resisted. My parents were fiercely independent and had a work ethic that required one to “buck up” and fight through whatever the issue they were facing. They did not want to be reliant on or a burden to anyone. Finally, I think they didn’t want to burden their children, or anyone else, with their issues. They were very private, and they did not wish to have anyone intruding into their space. I believe all these feelings are normal and caused avoidance and deflection. Only when it became apparent that some things were going to have to change due to physical limitations, and when my siblings and I told my parents that we needed to know how the movie ended, that we began to have the productive end of life discussions.

My parents had raised five children and, while we had our differences and spats, we all loved one another and got along well. We talked and visited often. As my parents aged, they named me and my brother, Alec, executors of their estate. My parents did all the right things concerning wills, powers-of-attorney, DNRs, and all the legal, rational, and biological decisions. In that regard, we were blessed.

However, as their lives wound down, it became clear to me that the emotional and biographical elements of their end of life were still unknown to us. As I was living in the same town, I had access to my parents, and I took it upon myself to explore those aspects of their end of life. I kept my brothers and sister informed at every step, and they helped encourage my parents to open up about their wishes. I believe my parents needed to hear from all of us that we were okay with them having these discussions. We all became very philosophical that we had to have these discussions. This openness and resolve paved the way for genuinely heartfelt, loving, liberating discussions.

These hard, emotional discussions paid off handsomely at my parents’ end of life. When those times came, there were no surprises. None of us had to wonder what our parents wanted. Our parents knew that we were comfortable with the inevitability. Both of my parents were able to identify the right time and circumstance for their deaths. They were ready to accept hospice services, and we all had beautiful long, loving goodbyes, without regret for what hadn’t been said. They both died peacefully. I believe their knowing that they had prepared themselves and their children for the inevitability changed everyone’s experience for the better.

So, don’t wait until it is too late. Don’t miss the opportunity to take control of this event. Have the discussions you need to have. Make these declarations ahead of time. You can do it.

Here are some thoughts from my siblings and my journey to help with yours.

Don’t wait – Since death is inevitable, why not talk about what you think and feel about that inevitability?
Talk early – Dealing with these discussions at the last minute, during highly stressful episodes, does not help matters at all. As morbid as it sounds, the best time to have these discussions is when you feel the most alive. Being reasonably sure the specter of death is some time off relieves some of the stress the topic inevitably brings.
Talk often – People can change their minds. Don’t feel pressured only to talk once and resolve all the issues.
Write it down – Whatever decisions you come to, as parent or child of parents, write them down.
Share it – Share these thoughts with everyone who needs to know.

My experience of shepherding my parents to the end of their lives turned out to be one of the most loving and rewarding chapters in my life. I hope hearing that will give you the courage to have these most important conversations.

Looking Ahead with Resilience & Purpose

Having recently celebrated a birthday — not a “big” one, but big enough, thanks — I felt in need of a little inspiration. And found it in a documentary on DVD called “Lives Well Lived.” The filmmaker interviewed some 40 people, in their 70s through 100, about their lives, about what gives their lives meaning, and what advice they might have for younger people.

Besides being a great antidote to the often-stereotypical portrayals of older adults in the media, it’s also an excellent history lesson from a variety of vantage points. Lots of food for thought, for all generations.

I wrote about it for SixtyandMe.com. Here’s the link.

‘Elderhood’: A Necessary Look at Embracing Aging in All its Stages

I wonder if Madonna, 60, thinks of herself as old.

I’m guessing probably not, but maybe she should. Think of how much she might contribute to the discussion about what it means to age, to grow older well, and how we can facilitate that for all of us, not just for a privileged few.

This thought might never have crossed my mind except for having read Louise Aronson’s extraordinary new book, “Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life,” and having the opportunity to interview her about it. Aronson is a geriatrician and professor of geriatrics at the University of California San Francisco.

In the book, an amalgam of facts, patient stories, tales of Aronson’s own education and medical experience — as well as references to history, anthropology, literature and scientific studies — combine to shine a light on the necessity to rethink aging itself. Bonus: reading it also provides the great pleasure of following the path of a unique and invaluable mind and heart.

In some ways the book is an indictment of our medical system, which recognizes that chronic illness and aging are a major health challenge, but often treats those who experience it or the specialists who treat it as second class citizens. And she has a number of recommendations for changing the system. Among the many reasons why the need for change is so compelling: People who are 65 or older represent 16 percent of the U.S. population, but nearly 40 percent of hospitalized adults; with a few notable exceptions, hospitals as they are designed and operated currently present a great many challenges for elders.

“Elderhood” is also a road map for those of us who are aging to tap back into our boomer activist genes and insist on better care as we go forward, not only from the health care system, but also from policymakers who have a big impact on how that care is provided and paid for. As for ourselves individually, it’s time to discard the clichés and stereotypes of aging we may have internalized over the years.

“Elderhood is life’s third and final act; what it looks like is up to us,” Aronson writes. “This third act is not a repeat of the first or second. More often it is in life what it is in drama: the site of our story’s climax, denouement and resolution.”

The book dispels a number of myths about what aging looks like. “Old age is only partially determined by biology. It’s long, varied, relative and relational,” she writes, noting that “a good part of the suffering in old age is manufactured by our policies and attitudes.”

Owning Our Elderhood, in All Its Substages

Elderhood comprises a number of substages and in Aronson’s view we need better language for those substages. As an example: at 55, she has taken to referring to herself as old when she teaches her medical students at UCSF (who, she said, amused, most likely consider her “old” anyway).

“The more we own it, the better. We reform it,” she said. Much as the LGBTQ community has taken back the word “queer” and succeeded in taking the awful sting out of it, we can “reclaim, create or repurpose simple words to redefine themselves and their place in society,” she writes.

Aronson stresses that the numbers of elders who find satisfaction and purpose in their lives and consider their health excellent – despite having to contend with a variety of ills – are legion. Studies have shown, for example, that anxiety rates fall around 60. In their 80s, she has found, for the most part people are quite satisfied, more so than in their 40s and 50s.

“Adaptability is a huge defining characteristic of elderhood,” she told me.

In her elderhood clinic at the University of California San Francisco, Aronson treats people ranging in age from 60 to 102. (Fun fact: The World Health Organization, among others, defines people aged 60 and up as old.) So, she points out, there are at least two generations within this group.

“It’s time for elderhood to take its rightful place alongside childhood and adulthood,” she writes. That includes the “young-old” and the “old-old” and all the stages in between, under the umbrella of elderhood.

Aronson explained that in her clinic, dealing with the “whole human being” is of first and foremost importance. She focuses on functional status because “that’s a better predictor of whether [patients] will wind up in the hospital or not.” Together, she and her patients discuss preferences and goals – not just medical, but goals of life. She also wants to know about “who’s in their world?” In other words, how does the person live, who is available to be supportive, what obstacles or barriers lie in the path to a better quality of life and how does the person actually feel about aging. “That impacts recovery,” she said. The clinic practices what she calls the four “P’s”: prevention, purpose, priorities and perspective.

“Failing to fully acknowledge the ongoing human development and diversity of older Americans is bad medicine and flawed public health,” she says, noting that “we can only make aging good if we make it good for all of us.”

I could go on quoting Aronson, but I won’t. Instead, I encourage you to read it to discover the many gems to be found.

Maybe Madonna should read it too.

What’s Your Mountain?

A year before Isabella de la Houssaye reached the summit of a 22,840-foot-high mountain peak in the Andes with her daughter Bella, she had been diagnosed with stage 4 lung cancer.

The 55-year-old, an outdoors enthusiast, and her husband David Crane had five children, aged 16 to 25, all of whom had conquered outdoor adventures together with the family and as individuals. So after recovering sufficiently from grueling cancer treatment and feeling stronger, Isabella was determined to have other adventures with each of her children, individually, in large part to impart life lessons to them.

The climb to the top of Aconcagua in Argentina with college-junior Bella, with a team that included a New York Times reporter and photographer, is a remarkable story of almost unimaginable challenges, courage, grit and determination. It was featured in a lengthy article in the Times that you can read here.

One passage in the story that I found especially moving – and thankfully its lesson is not dependent on climbing a mountain to learn from – records Isabella’s attitude about illness:

“So much of who I was was defined by my physical strength,” she said. “It’s definitely hard being sick and saying goodbye to the person you were before. You have to redefine yourself, and you don’t want to define yourself as a sick person. I’m learning that you have to find acceptance with the decline.”

Facing Mortality Head-On

Her story is inspiring, to say the least. But I must admit that after I read it, I knew that if at some point I am diagnosed with a life-threatening illness, my first thought would not be: let me call my son and propose that we climb a 22,840-foot-high mountain together. As I kept thinking about Isabella’s ultimately successful ordeal, though, I wondered: what would I do (after emerging from a period of hiding and mourning my life under the covers)?

It’s an important question, one that many of us don’t think about much. How do I know that? For the past several months, I’ve been giving “Conversation of Your Life” talks to various groups. It’s all about advance care planning: having the conversation with loved ones about your treatment preferences if you cannot speak for yourself; choosing a health care proxy; preparing an advance directive; and communicating with your doctors about what you want and what you don’t want. Essential issues.

What I try to stress, though, is that the first and most important part of this process of communication is to communicate with yourself. That is, to confront your mortality head-on. So much flows from that. It isn’t all about medical treatments, just as serious illness itself isn’t just a medical issue. It’s about what you feel you want and need to do before you can no longer do it. It’s about how you want to live the rest of your life – honoring your sense of what gives your life meaning and purpose. It’s about the kind of legacy you want to leave. It’s about who you want to surround yourself with. And unfinished business to attend to.

When I talk about this fundamental part of communication, I sometimes ask my audience, who has given some thought to this? What are you envisioning? The response? Crickets, typically. Either no one has given this any thought, or people feel too shy or embarrassed to share.

Sharing Your Values

So I’ll share some of what I’d like. If I am gravely ill and still have my wits about me, I’d like a big good-bye party, with lots of food and lots to drink. I’d like to hear from family and friends about what I’ve meant to them, what they’ll remember, how I’ve affected them and funny stories they can tell. All the wonderful and moving things that people say at funerals that the deceased don’t get to hear. (At least we don’t have any evidence that they do.) I want to hear it before I go.

And, speaking of food: We’ve been hosting Thanksgiving and Passover for decades and in recent years our small family has happily grown to include seven grandchildren and cousins’ grandchildren, aged six and under. As you might imagine, these events are like organized chaos, but always seem too short. One reason I love to keep doing this is that I am hoping that all the younger-generation cousins and their children will continue to recognize how precious these times are and will keep the tradition going.

Clearly, Isabella had grander things in mind, but fundamentally she wanted to impart her values and wishes to her family. She succeeded in accomplishing what she set out to do. After reaching the summit, Isabella said, “It was so important to me that Bella and I have this experience together. I really wanted her to see that when things get hard, you can find a place inside yourself to keep going.”

An important lesson for all of us.

What’s your mountain?

A Senior’s Guide to Navigating Medicare for Mental Health Treatment

(Note: This is a guest blog, from Teresa Greenhill, co-creator of MentalHealthForSeniors.com, a website dedicated to providing information on physical and mental fitness.)

Mental health is a serious issue among seniors. In fact, depression affects about 5% of people over 65 as well as up to 13.5% of older adults who require home healthcare. While depression is a common problem, it’s not a normal side effect of growing older. Depression should not be something we simply endure as part of the aging process. If you’re experiencing depression, keep reading to find out how Medicare can help you cover your treatment and support your mental health in the long run.

Mental Health Services Covered by Original Medicare

Original Medicare—also called Medicare Parts A and B—covers a variety of mental health services. Medicare Part A covers the costs of mental health care for hospital inpatients, including therapy and medications administered in a hospital setting. When it comes to outpatient mental health services, Medicare Part B covers one depression screening every year. In addition, it covers psychiatric evaluations, diagnostic tests, medication management, family counseling, and therapy with licensed mental health professionals such as psychiatrists, psychologists, and social workers. However, seniors using these services should be aware of deductibles and copays. After you reach the deductible for Medicare Part B, you will have to pay 20% of the cost for each mental health service.

Unfortunately, Original Medicare alone does not cover prescription drugs or other essential services that can support your mental health treatment. This is why many seniors opt for a Medicare Advantage plan. Medicare Advantage plans offer all the same benefits included in Original Medicare, plus coverage for services like vision, dental, hearing and prescription drugs to help improve your quality of life.

Finding the Right Medicare Plan

There are over 3,700 Medicare Advantage plans available across the United States, so how are you supposed to choose one? Start by making a list of services that you need covered. For example, you may need prescription drug coverage if you’re prescribed medications to treat your depression. If you have vision or hearing problems, make sure your plan covers these services as well—taking care of your physical health is crucial to good mental health. Untreated hearing loss, for instance, can lead to cognitive impairment! Additionally, many Medicare Advantage plans have in-home support services which can significantly improve quality of life for people facing mobility limitations.

Medicare Advantage plans that provide access to wellness programs may also be a good choice for people with depression. Research from McMaster University a public research university in Hamilton, Ontario, Canada, shows that staying active plays an important role in treating and preventing depression. Additionally, any senior with Medicare can also take advantage of a free annual wellness visit. During this visit, seniors can discuss prevention strategies with their doctor and develop a personalized plan for avoiding mental illness in the future.

Ensure Your Mental Health Provider Accepts Medicare

Since many psychiatrists opt out of Medicare, you may have trouble finding a mental health professional that accepts your health coverage. Fortunately, U.S. News recommends a few steps patients can take to find the mental health care they need. Start by talking to your primary care provider about your mental health concerns. Your doctor may be able to prescribe medication for your condition and refer you to professionals who they know accept Medicare. If you enroll in a Medicare Advantage plan, ask for a list of covered providers. For seniors who live in rural communities, telepsychiatry is a superior option to forgoing mental health care altogether. This service may be covered by Medicare, depending on where you live.

Is Your Mental Health Service Recognized?

On the other hand, you also need to ensure that your Medicare plan recognizes the mental health services you intend to use. CMS (the Centers for Medicaid and Medicare) recognizes mental health care provided by clinical psychologists, clinical social workers, clinical nurse specialists, psychiatrists, physicians assistants, nurse practitioners, and general practitioners. Non-medical doctors—like social workers and psychologists—must be Medicare-certified. Also, ensure your mental health care provider accepts Medicare’s approved amount for the services they’re providing to you.

Along the same lines, make sure that your Medicare plan will cover your prescription drugs. If you opt to stick with Original Medicare, you can add a prescription drug plan with Medicare Part D. Alternatively, you can choose a Medicare Advantage plan that includes drug coverage—most plans do. Either way, be sure to choose a drug plan that covers your prescriptions. If you cannot find a plan that covers all of your medication, consider choosing a plan that covers your most expensive drugs. It’s also important to check that your plan covers the pharmacy that you would like to get your medications from.

Depression is a serious problem that can accelerate aging and exacerbate age-related physical issues. Fortunately, seniors have several avenues for treatment. And, thanks to Medicare, you don’t have to spend a fortune to receive treatment for depression or any other mental health problems. Don’t hesitate to seek the treatment you need now.

Talking About….Life, Ageism, Death and Everything in Between

Had a wide-ranging conversation about how the media portrays (or doesn’t) elders, serious illness; how people misunderstand palliative and hospice care; and lots more on Barry Lynn’s “Culture Shocks” podcast.

You can listen to our half-hour conversation in the second half of the podcast.