The Press Newspaper

Toledo, Ohio & Lake Erie

The Press Newspaper

The Press Newspaper


I have had a unique opportunity to have spent the past few years observing someone close to me function in the ever-expanding role of caregiver and advocate for the elderly.

Like the title says; “It’s a jungle out there” in terms of navigating the health care system on behalf of another, especially one who is elderly and/or ailing.

According to statistics from the CDC (Centers for Disease Control) in Washington D.C., in 2007 the percentage of the U.S. population that was 65-74 years of age was 12 percent. By 2050, this percentage is expected to rise to a whopping 20 percent! This will translate in to a substantial increase in health care dollars spent and increased skilled and assisted living populations. The people will also be in need of caregivers to provide help with daily activities, medications and help with providing a safe environment.

There are many levels on which to perform as a caregiver of an elderly person. Some people function on a direct physical care level. If you are one of these people, it is critical you become well educated on the multitude of physical and mental/emotional changes that the elderly go through, and how you will interact during these changes.

Elderly people are at higher risk for falls. According to studies published by the CDC, more than one third of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001). The older we get, the higher the incidence of osteoporosis in the elderly person, which translates into risks of spontaneous, pathologic fractures of the vertebrae as well and hips.

It has been shown that, as we age, our world tends to “shrink.” We feel more comfortable in surroundings that are familiar and easy to control. Many elderly persons do better in apartments than large houses because the large spaces become confusing. As a caregiver in these situations, providing a safe, familiar environment can go a long way in reducing stress and confusion.

For those of you who also function as advocates for an elderly person, it is imperative that you become well educated and familiar with such things as community resources, physicians routinely seen by the individual, pharmacies and pharmacists and also drug companies. Many elderly people, as a result of multiple health issues, are taking different medications. Which ones have a generic? Which ones can I get samples for? How does the Medicare “doughnut hole” affect this person?

Elderly people who live in assisted living or skilled nursing environments face tremendous financial challenges. It is up to the caregiver/advocate to understand how this works in terms of what money the individual is entitled to (usually only $40-50/month after pensions are relinquished). How does “mom‘s” medication get paid for? What about hearing aids, glasses and doctor visits? If the individual is a candidate for skilled facility care, has he/she been accepted into Medicaid yet?

Here’s something many of you may not know. We certainly didn’t.

If you have a loved one living in an assisted-living facility that also has a skilled unit on premises, he/she may be eligible for what is called a “Medicaid Waiver” provided certain criteria are met. For example, if Mom lives in assisted living, and because her condition or medical issues are such that she can have at least two of her “activities of daily living” (i.e. medication administration, baths) performed by nursing home staff, the criteria would be satisfied for a “Medicaid Waiver”

What this does, is place the individual in the same Medicaid scenario as those who reside in the skilled unit, thus clearing the way such things as payment of medications, elimination of the “doughnut hole” debacle and other benefits not available to assisted living residents all with the ability to continue residing in the assisted living environment.

As the caregiver/advocate, are you also the P.O.A. (power of attorney) for health and financial matters? If so, get your hands on important papers such as the Living Will and Advanced Directives and know what each means in case the time comes where critical life-sustaining or life-ending decisions have to be made.

Overwhelmed? It’s easy to get that way. Just take a deep breath and put one foot in front of the other. The information is out there and plenty of professionals to help you get it.

For more information on Medicaid Waivers, contact your local Area Office on Aging ( or social worker at the local assisted living or skilled facility. That’s a good place to start.

Chisholm’s expertise in nursing, orthopedics and surgery spans more than 30 years. For more information on orthopedic-related topics, visit Submit questions or comments to Ken at This e-mail address is being protected from spambots. You need JavaScript enabled to view it.

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