I have infinite regard for healthcare/medical professionals. Working with the in-firmed in some very challenging situations, day-in-day-out, dealing with hundreds of people and inquiries each day is not easy. But, just as you are picky about purchases you make and negotiating in other aspects of your life, be picky and stand firm in your negotiations when it comes to health. No amount of money in the world can bring you happiness, but without good health can anyone be truly happy?
For those of you who are caring for a senior citizen, remember to fight for their care as you would, for a child. Don't buckle under pressure. Be a soldier in their healthcare advocacy.
Background/The Scene Behind the Scene:
My mother used to prepare her pill boxes every weekend for the following week, but as her Parkinson's progressed and she got older her ability to open jars, handle small pills, and sort them into the morning, noon, evening, bedtime slots, has dulled. What used to take minutes could now take an hour. Coupled with bouts of forgetfulness and confusion this was a cocktail for disaster. Overdosing or under-dosing prescription medications by senior citizens can cause serious health complications requiring hospitalization, so for the last few years I prep them.
Prep Pill Boxes Together
If your loved one is insistent on having a role in managing their pill box prep, then try to make it a fun task that you can do together. Like a nurse in an operating room passing equipment to a surgeon, let them hand you the amber prescription jars, and you fill the boxes. Either you or your loved one can call out the name of the medicine. That will be a way to boost their memory too.
Don't stress, or argue, no one benefits from that.
CAREGIVER TIP / CALLING FOR PRESCRIPTION REFILLS:
Call Way in Advance
Don't wait until the last minute. Call 7 to 5 days before a refill is needed.
Get Automatic Refills
Ask the pharmacy if they can set up automatic refills for medications that are taken on a regular basis. You can always have it cancelled if there should be some change.
Ask for Insurance Overrides
If you will be out of town when prescriptions will be needing a refill and you do not have someone who can take over the task of preparing the pill boxes. Speak with your pharmacist and your loved one's health insurance provider if necessary. Let them know no one else prepares your loved ones pill boxes and that you must have the medications before you travel. Most of the time you will get cooperation from both parties. The insurer may be able to override authorization for a refill if it is too soon to approve one so you do not have to pay full price just the regular co-pay. Be sure to let the pharmacy staff know that this may be necessary. So, they ask for this when contacting the insurer.
Set Deadlines for Having the Pill Boxes Prepared
Set the deadline to have all the pill boxes filled at least 2 days before your trip. You will need this additional buffer in the event that an issue occurs that causes delay. Such as the pharmacy needing to order the drugs, contact the doctor, insurance carrier, computer system/software failures, changes to policy and/or healthcare regulations, etc.
I have needed to do this on several occasions. Most of the time without a glitch. Once I was not able to get a medication until a day before a trip. I cannot imagine what would have happened if I waited too long to request the refills and did not press on for getting them.
Act I:
Although my mother has been taking the same medications for the last year the pharmacy claims it cannot fill the medication I called for. Apparently it has side effects with another medication she is taken. Why the change in refilling it all of a sudden? The pharmacist says it is a new policy of the insurer and she just needs to speak with the doctor to get an override. The next day the pharmacist says she is still trying to reach the doctor.
The following day a letter from the insurer arrives saying the refill is approved. I assume this means the pharmacy has filled it as well. I wait until my mother sees her neurologist 2 days later, in case he makes a change to her medications, so I just have to make one trip to the pharmacy.
When I go to the pharmacy to drop off the new prescription and inquire about the other I am told it is out of stock and needs to be ordered. It will be ready in 2 days. I leave with one medication.
Act II:
I return in 2 days for the medication. The clerk says it is not ready. Why? Because it now has high side effects with the new medication that was picked up. My mother has enough of the medication for 3 days. The pharmacy follows the same routine of calling the doctor. Pharmacy staff are great about calling doctors and insurers most times, but they are filling prescriptions for many people and making calls all day. They cannot just focus on one client. I understand this. So, I also reach out to the doctor with an email and call.
CAREGIVER TIP / REQUEST AN ADVANCE ON MEDICATIONS IF NECESSARY: There is no need for your loved one to miss taking a medication(s) if there is a pending issue the pharmacy needs to resolve with a doctor or health insurer. Most pharmacists can and will advance 2 to 4 days of medications for refills depending on the issue and how much time they think it will take to resolve. Let them know that you are going to need them to do this! Be polite, but resolute.
Act III:
The pharmacist calls and leaves a message apologizing for the inconvenience and let's me know I can pickup the refill. I go the next morning.
The clerk brings out the white bag, rings up the charge noted on its label and asks me for over 100 dollars. I ask her to repeat the amount, thinking I am hearing incorrectly. She repeats the same number. Why so much? She claims the insurance will not cover it. I note that it was always covered before and ask why the change? She does not know. That is what the insurer says. She asks, do I still want it? Of course I want it, but I will not pay the amount they claim I should, will call the insurer myself and get back to them. She returns the package to its nest. I head to the office.
After contacting the insurer I find out that the pharmacy entered the request too many times and with the wrong code. The issue could be resolved by 1) I could have the insurer complete a paper request for an investigation to the pharmacy, but that could take up to 3 days. Or, 2) The pharmacy just needs to call the insurer's pharmacy line and they can take care of the issue right away. The representative recommends doing both. The paper as a backup in case the pharmacy does not call them back in time.
I call and speak with the pharmacist and repeat what I was told. She admits to the staffs mistake. I get another apology. The medication is ready in the evening.
End:
There can be no greater cause worth advocating and fighting for than your and your loved one's health.
When things are not smooth sailing, take notes and be persistent with follow ups. Learn from the events that present obstacles in your healthcare journey so you can avoid repeat performances.
For More Tips on Medication Management for Senior Citizens go to:
http://www.agingcare.com/Medications
For Caregiver Tips for Loved Ones with Parkinson's Disease go to:
On Support & Caregiving by Lonnie Ali / Micheal J. Fox Foundation for Parkinson's Research
No comments:
Post a Comment