Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts,  Part A (Hospital Insurance) and  Part B (Medicare Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
• You or your spouse had Medicare-covered government employment.

To find out if you are eligible, go the Medicare.gov eligibility tool.

If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:

• You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig’s disease, your Medicare benefits begin the first month you get disability benefits.)
• You are a kidney dialysis or kidney transplant patient.

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.

If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration or visit their web site. The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing impaired is 1-800-325-0778. You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A. See also Medicare.gov FAQ on how to enroll in Medicare.

Prescription Drug Coverage

Since January 1, 2006, everyone with Medicare, regardless of income, health status, or prescription drug usage has had access to prescription drug coverage. For more information, you may wish to visit the Prescription Drug Coverage site at: http://www.medicare.gov/pdphome.asp.

www.MedicareInteractive.org/aarp
Medicare Interactive provides Medicare-related information on topics such as eligibility and enrollment, coverage, rights and protections, health plan options, prescription drugs, and programs for people with lower income.

Medication Basics for Caregivers

•    Keep a record of all medications taken.

Make a list of all the medicines that the person you are caring for takes. Include prescription and nonprescription medicines. (Personal medicine record books, sometimes called “medication passports” are available at no cost at some pharmacies.)

Write the name of each medicine, the doctor who prescribed it, what it is for, the amount taken, the possible side effects, and the times of day it is taken.

The person you are caring for should keep a copy of the list in the medicine cabinet and in his or her wallet or pocketbook. You should keep a copy, too. This record should be reviewed with the doctor at every visit and whenever a doctor prescribes a new medicine by phone.
•    Ask about drug allergy bracelets and necklaces.

Drug allergy bracelets can be bought in many pharmacies. These are small metal bracelets that can be worn over the wrist or hung on a necklace. For example, a bracelet might say “Allergic to penicillin.” Custom medical identification bracelets or necklaces are also available by mail for a fee. Some pharmacies have the application forms.

Customized bracelets can tell medical personnel, such as ambulance workers, about a person’s medical condition, allergies, medicines, and special needs, such as blood type and if the person has a living will. In some instances this information will be provided to health care workers when they call a telephone number imprinted on the bracelet.

•    Ask the doctor or the doctor’s staff to review all medicines and explain the reason for each medicine at least once a year.

As new medical problems occur, new medicines may be prescribed and it is important for the doctor to know what medicines the person you are caring for is already taking. Also, new information about side effects may become available about these drugs. Therefore, it is important that medicines be reviewed regularly.

•    Use only one pharmacy, if possible This way, the pharmacy will have all of your prescription medicines and drug allergy information on a computer. This will be helpful when the pharmacist checks for drug interactions as new prescriptions are filled.

Tell the pharmacist the medical problems that the older person has. Medicines taken for one problem may make another problem worse, and the pharmacist may notice this if it has escaped the doctor’s attention.

•    Labels can be hard to read and difficult to understand. Ask the pharmacist to explain the information on the label including expiration date, number of refills (if any), and directions for use. If the information is not clear, ask for an explanation.

For example, if a label says “Take three times a day,” what does that mean?
Does that mean every eight hours?
Does the patient need to be awakened promptly to take the medicine?
Should the medicine be taken with meals or an hour before meals?
What should you do if a dose is skipped?
Can it be taken with other medicines?

•    If there are no children in the home, refuse child safety caps on bottles

Child safety caps have helped prevent child poisonings, but they can be difficult for an older person to open. If it is too much of a struggle to open the bottle, an older person may not take the medicine. If children sometimes visit, keep medicines locked up or on a shelf they cannot reach or work on some other solution that both helps an older person get his or her medicines easily but also keeps the medicine away from children.

•    Store medicines in a cool, dry place

Although many people keep their medicines in the bathroom, its high moisture content makes it a poor place to keep them. Many tablets and capsules lose their strength if exposed to moisture or strong heat or light. The bedroom is usually a better location. Store medicines in the refrigerator only if told to do so by the pharmacist or if they are labeled “Refrigerate.” If you do not know how to store the medicine, ask a pharmacist.

•    Keep medicines in their original containers

Mixing different pills in one bottle can be confusing and even dangerous. Since many medicines look alike, this can confuse the patient, caregivers, or people who may be called on to help in an emergency.

•    Do not keep medicines at an older person’s bedside

An older person can wake up in the middle of the night and take an additional dose of medicine without realizing it.

•    Have the older person sit up or stand when taking pills, and use a half cup of water to wash them down.

Use water-not milk or other drinks-to help wash down a medicine. Some medicines are less effective when taken with milk. Water will help prevent the medicine from sticking in the throat and causing irritation. If the person you are caring for has difficulty swallowing, ask your pharmacist if the medicine is available in liquid form, or ask if it is all right to crush the tablet and mix it with applesauce or other soft food. Some tablets or capsules should not be crushed or chewed.

•    Use a pillbox.

You can buy a pillbox with many sections at your pharmacy. Some pillboxes have compartment sections for seven consecutive days and for times of day the medicine must be taken: early morning, noon, evening, and bedtime. Mediset(tm) is a popular brand of this type of pillbox.

There are also pillboxes with alarms to notify the user when the next dose should be taken. (These are useful for medicines that require precise timing, such as medicines for Parkinson’s disease.)

For medicines that cannot be placed in a pillbox-such as liquids, cream, and patches-a reminder note placed on the refrigerator may be helpful. Keeping medicines on the kitchen table with a note saying when to use them may also be helpful.

•    Use reminders.

A checklist or marking on a calendar may be helpful to show when medicine should be taken and when it was last taken. Alarm clocks can be helpful or you may have to remind the person you are caring for when to take medicines.

•   Ask about other ways to take medicines.

Most people have trouble remembering to take a medicine three or four times a day. If the person you care for has trouble taking the prescribed medicine, or has trouble remembering to take the medicine, tell the doctor or pharmacist. He or she may know of a similar medicine that is easier to take, or one that needs to be taken only once a day.

Some medicines are available in the form of patches that are placed on the skin and need to be changed only every few days; however, they are usually more expensive than the same medicine in pill form.

•    Throw away old medicines.

Check the expiration days on medicine bottles, and throw medicines away if the date has passed. It is usually a good rule of thumb to discard medicines after a year.

It is natural to want to hold onto unused medicines (“just in case”), but stockpiles of medicines can be confusing and even dangerous. Some pharmacists highlight the expiration date with a yellow marker; you can do the same thing at home.

Highlighting the expiration date on nitroglycerin tablets is especially important for they may keep their strength for only six months once opened.

Some communities have laws about how drugs can be disposed of. For example, in these communities it is illegal to flush medicines down the toilet. Ask your pharmacist if it is OK to flush medicine down the toilet or if you can return the expired medicines to the pharmacy for disposal.

• Hallucinations (hearing or seeing things that are not there)
• Palpitations or rapid heart beat
• Great trouble waking up, especially when others try to wake the person
• Severe nausea or vomiting
• Dizziness , falling, trouble with balance
• Unusual bruising or bleeding from minor cuts or blood in the stool
• Severe confusion
• Severe fatigue
• Impaired or blurred vision, or seeing gold “halos” around objects
• Hives, itching, skin rash, or swelling of the face.

It is especially important that if a person has difficulty breathing or if there is swelling in the throat, call 911 or take the person to an emergency room immediately.
Call the doctor or nurse during office hours to discuss the following problems
While some side effects from medicines happen immediately, others happen slowly over a period of days or weeks, or even months. What may seem to be a new health problem or a worsening of an existing condition may be a reaction to a medicine.

• Shortness of breath (If sudden or severe, call the doctor immediately.)
• Fatigue (If sudden or severe, call the doctor immediately.)
• Confusion or being “out of it” (If sudden or severe, call the doctor immediately.)
• Incontinence (If sudden or severe, call the doctor immediately.)
• Depression, feeling “down,” or taking no interest in activities previously found enjoyable
• Constipation
• Persistent cough
• Insomnia
• Sexual problems
• Feeling jittery or fearful
• Sensitivity to sunlight
• Black, tarry stool

Know the answers to the following questions before calling the doctor
Symptoms

• What is the symptom? (Try to be accurate and specific.)
• When did the symptom start?
• Is it a new symptom or an ongoing problem that is now worse?
• How severe is the symptom? Does it interfere with usual activities (such as preparing meals or dressing)?

Medicines

• What medicines are being taken? (Include prescription and non-prescription.)
• Is the older person following instructions for prescription medicines? If not, what is being taken and how much?
• Has a day or two been skipped in taking prescription medicine?
• Does the older person have any allergies?

Here is an example of what you might say when calling for help
“Hello. This is Ellen Smith. My mother is Ann Smith and she is Dr. Miller’s patient. My mother has been throwing up for the past 12 hours. Two days ago she started taking Indocin(TM) for her arthritis. Dr. Miller prescribed it. Do you think it could be causing the nausea?”

• All prescription drugs from any doctor, including eye drops, creams, and ointments.
• Nonprescription medicines, including vitamins, minerals, antihistamines, sleeping pills, laxatives, cold medicines, and antacids.
• Folk remedies, nontraditional products, or “alternative medicines,” such as plant compounds, herbs, special teas, or nutritional supplements.
• “Social” drugs such as alcohol, tobacco, or caffeine.

It will be helpful to the doctor, in making diagnoses, to know all the medicines that the patient is taking. The doctor needs this information because nonprescription medicines can interact with each other as well as with prescribed medicines in ways that could be harmful to the patient. Nonprescription medicines can also cause side effects that the doctor may have to treat.
Pharmacists are able to give you information about side effects of medicines and even how they can interact with each other. Ask the pharmacist for this information and ask any other questions you have about the medicines when you have prescriptions filled or refilled. Doing so may prevent a serious problem.
Your goals are to:

• Follow the doctor and pharmacist’s instructions. If you don’t understand their instructions, ask for clarification
• Know all medicines that are being taken and their side effects
• Know if the medicines being taken by the patient are safe to use together
• Ask for generic brands in order to keep costs lower
• Watch for side effects from the medicines and report them in a timely manner

A far too large number of medicine mishaps happen simply because some basic steps weren’t taken to ensure a senior properly understood the regimen or instructions for a medication. Though some of these questions may seem obvious, reviewing them with your parent or printing out a copy for them, will refresh their appreciation for proper medicine safety.

Who is responsible for your medicines?

A lot of people—including you!

• Doctors check all of your medicines to make sure they are OK to take together. They will also check your vitamins, herbs, diet supplements or natural remedies.

• Pharmacists will check your new medicines to see if there are other medicines, foods or drinks you should not take with your new medicines. This helps to avoid a bad reaction.

• Nurses and other caregivers may prepare medicines or give them to you.

• You need to give your doctors, pharmacists and other caregivers a list of your medicines. This list should have your prescription medicines over-the-counter medicines (for example, aspirin) vitamins herbs diet supplements natural remedies amount of alcohol you drink each day or week recreational drugs

What should you know about your medicines?

• Make sure you can read the handwriting on the prescription. If you can’t read it, the pharmacist may not be able to read it either. You can ask to have the prescription printed.

• Read the label. Make sure it has your name on it and the right medicine name.

• Make sure that you understand all of the instructions for your medicines.

• If you have doubts about a medicine, ask your doctor, pharmacist or caregiver about it.

What if you forget the instructions for taking a medicine or are not sure about taking it?

Call your doctor or pharmacist. Don’t be afraid to ask questions about any of your medicines.

What can you do at the hospital or clinic to help avoid mistakes with your medicines?

• Make sure your doctors, nurses and other caregivers check your wristband and ask your name before giving you medicine. Some patients get a medicine that was supposed to go to another patient.

• Don’t be afraid to tell a caregiver if you think you are about to get the wrong medicine.

• Know what time you should get a medicine. If you don’t get it then, speak up.

• Tell your caregiver if you don’t feel well after taking a medicine. Ask for help immediately if you think you are having a side effect or reaction.

• You may be given IV (intravenous) fluids. Read the bag to find out what is in it. Ask the caregiver how long it should take for the liquid to run out. Tell the caregiver if it’s dripping too fast or too slow.

• Get a list of your medicines—including your new ones.

Read the list carefully. Make sure it lists everything you are taking. If you’re not well enough to do this, ask a friend or relative to help.

Questions to ask your doctor or pharmacist

• How will this new medicine help you?

• Are there other names for this medicine? For example, does it have a brand or generic name?

• Is there any written information about the medicine?

• Can you take this medicine with your allergy? Remind your doctor about your allergies and reactions you have had to medicines.

• Is it safe to take this medicine with your other medicines? Is it safe to take it with your vitamins, herbs and supplements?

• Are there any side effects of the medicine? For example, upset stomach. Who can you call if you have side effects or a bad reaction? Can they be reached 24 hours a day, seven days a week?

• Are there specific instructions for your medicines?

For example, are there any foods or drinks you should avoid while taking it?

• Can you stop taking the medicine as soon as you feel better? Or do you need to take it until it’s gone?

• Do you need to swallow or chew the medicine?

· Can you cut or crush it if you need to?

• Is it safe to drink alcohol with the medicine?

~Ella Haimoff