This month is National Home Care and National Hospice Month!  This month's newsletter contains our celebratory announcement and recent health care news.  We have included an informative article to help explain the complex set of new rules for the Medicare drug benefit; a new study about what really causes colds, some recent studies concerning cardiovascular health and a feature on aphasia, a language disability. 

Scroll through our newsletter or click on a specific article title below to skip ahead:

Holiday Gift Certificates

Feature: Living Without Language

November is National Home Care and National Hospice Month

The New Medicare Prescription Drug Benefit

Newsbrief: Scientists Concede – Grandma Was Right About Colds

Newsbrief: New Studies on Heart Disease and Stroke

Give Yourself, a Loved One or a Friend a Break for the Holidays
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The holidays are a time to gather family and dear friends together to share in good times, presents and mirth, but it is also a time of stress.  As the holidays approach, dinner preparations, greeting cards and shopping for gifts all compete for time.  In families with a loved one who needs help with housekeeping and personal assistance, this can present a serious time crunch.

 Home Services Unlimited offers gift certificates to help families during the holiday season.  Consider these gift ideas: 

·                     Everyone likes to get his or her home in order for the holidays, but some people need extra help doing so.  Get a gift certificate for someone close to you who needs personal assistance, housekeeping or companion services. 

·                     If you have friends who are caretakers, they have extra time constraints around the holidays.  A gift certificate for respite care for their loved one makes a perfect early present.

·                     If you are a caretaker, treat yourself to some free time this season, by ordering respite care from Home Services Unlimited.

·                     Think about getting gift certificates for yourself, your loved ones or a caretaker friend for use throughout the year.  When giving a gift certificate for our services, you can be certain that your present is useful and unique. 

Feature: Living Without Language
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            “I did not have the ability to think about the future, to worry, to anticipate, or to perceive it. . . I simply existed."  These are the words of clinical psychologist Scott Moss, describing being temporarily struck without the power of language after suffering a stroke.  According to Moss, being without the power of speech effectively destroyed his power to think in abstract terms: essentially, he was unable to communicate not only with others, but also with himself. 

            Scott Moss was suffering global aphasia.  Aphasia, which afflicts one million people nationwide, according to the National Aphasia Association, is an impairment of language skills, usually caused by a stroke or head trauma.  Receptive aphasia is an inability to comprehend language, whereas expressive aphasia is an inability to use language to communicate.  Global aphasia is a combination of receptive and expressive ahpasia.  The conventional wisdom is that severe aphasia destroys a person's sense of self, often requiring that the person be institutionalized for the rest of his or her life.

            Case studies show, however, that aphasia is not, necessarily, the end to an individual's personality or social life.  Nor do all people suffering from even severe, global aphasia need to be institutionalized.  In fact, a long-term care facility may be counter-productive to making progress.  Dr. Oliver Sacks writes, in The New Yorker, of aphasics in nursing homes and long-term hospitals: "a vital social dimension of their lives is missing, and aphasics frequently feel intensely isolated and cut off."  He further describes the feeling of entering a hospital for the chronically ill, full of "incurable" people and how demoralizing that must be for a new "inmate."

            Instead of placing a loved one with aphasia into a long-term care facility, a more appropriate alternative may be home health care.  The good news is that, in a proper setting like the home, many aphasics have been able to regain their former, fulfilling lives.  Though recent studies show that the brain can repair itself better than previously thought and that different areas of the brain can take over some functions lost by other areas, improvement is mostly through learned compensation for lost language skills.  With intensive speech therapy and, in some situations, physical and occupational therapy, many can get around aphasia by learning new ways to communicate.

            Those with receptive aphasia compensate by learning to read the subtleties of peoples' tones, facial expressions and body language to interpret what the person is saying.  In fact, a study at Massachusetts General Hospital showed that aphasics tend to be much more capable of detecting lies about emotion.  Compensating for expressive aphasia is most commonly achieved through adept use of gestures.  Some people with aphasia can still recognize single words and use categorized phrasebooks to communicate.  Others can sing along with recordings of songs and then regain use of some of the words.

            Speech therapists are not only able to help aphasics learn all of these new skills, but can teach family members how to help.  Families affected by aphasia can be coached in how to best help their new relative get around this challenge at home.  Keeping someone with aphasia involved in social settings, and active in general, can help tremendously in keeping their mood up and, possibly, in learning to compensate for lost language skills.  Many activities, like playing cards, going shopping, going out to eat, visiting a beauty salon, playing sports and visiting art galleries require little or no language, especially when a companion comes along.  If progress in understanding language is made, then even movies and theatres are an option for an afternoon outing.  Many people, however, are often too busy to keep an aphasic family member or friend active.  Home health care agencies can provide staff to fill in on a regular or temporary basis.  With all the care options available, no one with aphasia should be left feeling alone or unable to continue leading a fulfilling life.

November Is National Home Care and National Hospice Month
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Home Services Unlimited joins the National Association for Home Care and Hospice in celebrating National Home Care and National Hospice Month.  We applaud NAHC's national campaign - "Home Care: When You Are Well, and Especially When You Are Sick, There Is No Place Like Home."  Home Services Unlimited salutes all those in the home health care industry who dedicate their lives to caring for others in the comfort of their own homes, where they can be surrounded by their loved ones. 

As part of National Home Care and National Hospice Month, Home Services Unlimited and the National Association for Home Care and Hospice have designated the second full week of November, (the 13 - 19th), as a week to honor the home health aides who make home-based care the preferred method of care for those in need.  Home care aides play an integral role in providing more care than their family or friends can provide in their own homes or a residential care facility, instead of a health facility.  We are proud to join the NAHC in congratulating this nation's home care aides  for their commitment to quality care.

The New Medicare Prescription Drug Benefit
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Since the legislation creating the new drug benefit for Medicare was passed, there has been much controversy surrounding the new plan.  For your benefit, we have broken down the basics of the plan.  Many of the larger pharmacy chains have trained their staff to be able to help you further and sources for further information can be found at the end of this article.

GENERAL COVERAGE

As of January 1, 2006, prescription drug coverage will be added to Medicare.  Those on Medicare will be able to sign up for a prescription drug program in addition to the fee-for-service program that most people covered by Medicare are currently a part of.  Alternatively, Medicare recipients can join a Medicare Advantage program, like an HMO, that covers all Medicare benefits, include medications.  Their is a monthly premium that will average at around $32 per month, depending on the recipient's plan and location.  This premium is expected to rise by approximately $4 per month.  Except for low-income assistance beneficiaries, enrollment is voluntary.  However, for those with coverage that is less extensive than the new plan, there will be a penalty of 1% of the monthly premium for every month that enrollment is delayed after the original enrollment eligibility period.  The new plan is complicated, so we have included some quick references for your benefit. 

Here is a breakdown of typical benefits: 

• Partial Coverage: Recipients with $2,250 or less of drug costs will have 75% of the cost covered by the new plan. 
• Catastrophic Coverage: Beneficiaries with more than $5,100 will have 95% of their prescription drug costs covered under the new plan.
• The Doughnut Hole: Those whose drug benefits are between $2,250 and $5,100 will receive no drug coverage.  If you fall into this category, it is vital that you check to see how any drug benefits you currently receive are effected.

 LOW-INCOME ASSISTANCE

Medicare beneficiaries who qualify for Medicaid drug coverage and certain other programs already in place will qualify for additional assistance.  A beneficiary can also qualify if his or her income is less than 50% above the poverty line and their assets fall below the eligibility threshold.  If you do qualify for this coverage, check what category you are in to know what your benefits are: 

• Indigent: Recipients who are below the poverty line, and already qualify for Medicare and Medicaid, will have co-payments of $1 per generic prescription filled and $3 for brand-name drugs, up to a total cost of $5,100.  Any costs above $5,100 will be completely covered.  There are no premiums or deductibles for this coverage.
• Institutionalized: Those who already qualify for Medicare and Medicaid and are institutionalized, will have all drugs completely covered with no co-pays, premiums or deductibles.
• Other Dual-Eligibles: Beneficiaries who are eligible for both Medicare and Medicaid, but are not below the poverty line will have $2 co-pays for generic drugs and $5 for brand-name drugs, up to a total cost of $5,200.  Any costs above this threshold will be fully covered.  There are no premiums or deductibles for this coverage.
• Less Than 35% Above the Poverty Line: This applies to individuals who have no more than $12,920 of yearly income and less than $6,000 in assets or couples with less than $17,321 in income and $9,000 in assets.  Those in this category will have the same benefits of those in the category above (Other Dual-Eligibles).
• Between 35% to 50% Above the Poverty Line: This includes individuals with between $12,920 and $14,355 of income and less than $10,000 in assets.  Couples qualify if their income is between $17,321 and $19,245  and they have less than $20,000 in assets.  Beneficiaries in this category will be required to pay the regular monthly premium (about $32) and a $50 annual deductible.  Drug costs of up to $5,100 will be 85% covered.  After that they will have a co-pay of $2 for generic drugs and $5 for brand-name drugs.

IMPACT ON OTHER PROGRAMS

Other drug benefit programs will be affected in different ways by the new plan.  Some will be completely eliminated. 

Employer-Sponsored Plans: To encourage employers to continue offering drug coverage for retired employees, the new drug plan will provide tax-free subsidies of 28%.

Medicaid Drug Coverage: Medicaid will no longer offer drug coverage.  Those eligible for Medicaid drug coverage will be given coverage and guaranteed premiums no higher than the regional average.

Medicare Advantage: Medicare Advantage plans will now offer drug coverage, except for those with certain private components, like FFS or Medicare Savings Account plans.

Medigap:Medigap will stop offering drug benefits when the new plan comes into effect.

State Pharmacy Assistance Programs: These plans will still be able to offer coverage.

 If you believe that the new plan effects you, please be sure that you understand the new rules for drug coverage and how it effects you.  If you plan to enroll, keep in mind the penalty for postponing your enrollment.  The best source for more complete information on the coverage, enrollment, Medicare providers and other issues is www.medicare.gov or call 1-800-MEDICARE.

Newsbrief: Scientists Concede - Grandma Was Right About Colds
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For years, scientists have said that the idea that cold weather caused colds was an old wives' tale.  Well, they were wrong and your grandmother was right: if you want to prevent a cold, bundle up and stay dry.  In a study at Cardiff University's Common Cold Center, half of 180 volunteers soaked their feet in cold water for 20 minutes, while the rest kept their feet warm and dry.  Those who had soaked their feet in cold water suffered from colds at a rate over three times that of those who did not. 

According to Professor Ron Eccles, who conducted the study, the cold water causes the body to constrict blood vessels, in order to keep warm.  When blood vessels in the nose are constricted, fewer white blood cells, which combat infection, are available to the area.  This allows dormant infections to come to life.  "Mothers can now be confident in their advice to children to wrap up well in winter," says Eccles, in a major vindication of motherly advice over scientific folly.  So bundle up and make sure to cover your nose with a scarf.

Newsbrief: New Studies on Heart Disease and Stroke
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A few studies about heart disease, blood pressure and stroke were released this month.  The studies are a mixed bag, but there is some good news for those worried about their cardiovascular health.  

In an important study, involving almost 46,000 heart attack patients, researchers found that Plavix (clopidgrel) can save the lives of people who have had heart attacks.  The study, published in the medical journal The Lancet, showed that Plavix, which thins the blood, reduces the risk of stroke, second heart attack and death, by 9% when taken with aspirin.   

Also in The Lancet, was a report that a popular method for determining obesity is not the best way to calculate heart attack risk.  This method, known as body mass index, is based on the ratio between a person's weight and height.  Instead, say researchers from McMaster University, the size of one's waist as compared to one's hips is a better indicator.  Simply said: A big bottom is not a problem, but a beer belly could get you. 

Finally, the Nurses' Health Study, with 156,000 participants, studied the supposed link between coffee and acute, high blood pressure.  Good news for nurses and other coffee drinkers: the study, conducted through Brigham and Women's Hospital in Boston, has concluded that coffee does not contribute to long-term high blood pressure.

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