Aging in America

Boomer Lit Friday: Guest Post from Boomer Lit Author Angil Tarach-Ritchey

noreply@blogger.com (Angil Tarach RN) — Tue, 5 Nov 2013 13:34:00 -0500

I typically write about things related to aging, eldercare, and chronic illness, but wrote an article about publishing choices for a blog that focuses on Baby Boomers literature for their BoomerLit Fridays.

Boomer Lit Friday: Guest Post from Boomer Lit Author Angil Tarach-Rit...: Your Intention as an Author Can Help Determine Your Publishing Choice I find it interesting to hear about how people started doing what...

Hope you enjoy this change of pace!

Pedagogy - Pedagogy Author Angil Tarach Ritchey Makes the Best Seller List

noreply@blogger.com (Angil Tarach RN) — Tue, 26 Feb 2013 11:33:00 -0500

Pedagogy - Pedagogy Author Angil Tarach Ritchey Makes the Best Seller List

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Contest in honor of my Grandma on January 31st only!

noreply@blogger.com (Angil Tarach RN) — Thu, 31 Jan 2013 20:24:00 -0500

See this link on my website for details. Contest Time is running out, enter now! Good Luck and enjoy the book!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Behind the Old Face: Aging in America and the Coming Elder Boom has been released!

noreply@blogger.com (Angil Tarach RN) — Tue, 13 Nov 2012 12:18:00 -0500

I am very happy to announce my book, "Behind the Old Face: Aging in America and the Coming Elder Boom", is now available!

This book comes from my 30+ years experience spending time with seniors, listening, chatting, caring, laughing, crying, helping, observing, and advocating. I have been amazed, empathetic, sympathetic, joyful, filled with deep laughter, love, sadness, anger, grief, respect, sadness, compassion, understanding, disbelief, happiness, and a host of other emotions throughout the decades I have spent time with aging adults, family caregivers, and healthcare professionals. I have witnessed the best in care, the worst in "care"and everything in between.

I believe God put "Behind the Old Face" on my heart several years ago, which I have written about in more detail in the book. I am extremely grateful for the blessings, people and opportunities that have enabled the book to be written and published. It has been a difficult, yet wonderful journey to get to the place I am now, sitting here announcing the release of the book. Never having wrote a book like this before, I now understand what it takes to write and publish a book, and couldn't be happier with my publisher, Jared Rosen at Dreamsculpt!

There have been too many people who have contributed to my life and this book to name them here. I have been humbled by the immense encouragement, support and contributions so many have made to me along this journey and throughout my life and career. I feel my heart is overflowing with gratitude as person after person comes to mind.

I am excited to share my heart and work with you and hope you will read the book and share it with your family, friends, co-workers, groups you are involved with and on social media. You can read a bit from the book and/or purchase it here. Behind the Old Face: Aging in America and the Coming Elder Boom

I would love to hear what you think about the book. Please go to my website to post your thoughts on my "Comment" page http://www.elderboom.org and sign up for news, updates and a free download, 19 tips to save on prescription drug costs

Remember....Together we can do more!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Writing "Behind the Old Face"

noreply@blogger.com (Angil Tarach RN) — Wed, 17 Oct 2012 19:32:00 -0400

If you have followed my blog you know I haven't posted much in the last few months. I have been very busy and I am happy to announce the release of my book "Behind the Old Face: Aging in America and the Coming Elder Boom" is scheduled for November 12th!

This book has been on my heart and in my mind for 8 years or so. Maybe it has been there since I began in eldercare in 1977, but didn't surface until 8 years ago. Either way I will be sharing it with the world in 26 days and that is exciting! I won't get into any details about how this book came about, because it's included in the book. I will say however, that God put the book and title on my heart. I am extremely grateful I have been given the passion, experience and talent to do the work I have and finally see the book become a reality.

So many wonderful people have been a part of this process, my heart is filled with joy and sincere gratitude for what each person has and continues to do. From pushing me to get the book done, to cheering for me on Facebook, to allowing me to be privileged enough to be privy to their life stories, to giving financial gifts to pay publishing costs, to helping me get the word out, to praying for me and my family, to encouraging and supporting me, to guiding me through the entire process, to editing and helping create what the book has become, I am so thankful to each person who has helped me along the way. There really aren't words to describe how blessed I feel by the love and generosity I have been given.

I have been working with my publisher, Jared Rosen from Dreamsculpt, since last year and it has been an awesome experience! He had belief in the intention of my book from the first email I sent him and he responded with "when can we talk, I like what you're doing". From our first conversation I knew I wanted to work with him, and it has been great since. I have learned a lot from Jared and grown as a writer and visionary for the future of aging. Jared has the ability to bring forth more than some words that end up in a book. His process expanded my thoughts, ideas, and the possibilities of what can be. I really don't know how I would be here, ready to release the book, without him. I know eldercare and the difficulties and beauty of aging, but other than some research I'd done, I didn't know squat about publishing!

The book is getting wonderful feedback and has already been endorsed by 2 nursing organizations, NurseTogether and Nurse Talk, which is a true honor. Even my husband said "I knew it would be good, but not this good!" That meant a lot too. I know he is a fan of my work and probably a little partial to me, but for him to express that I even impressed him, was a very heartfelt moment for me. My brother Joe, who has always been my biggest cheerleader but hasn't picked up a book in years said he couldn't put it down.
What makes me happy is to know the the intention of the book is coming through.

Authors write with intention. Whether the intention is to entertain you, make you laugh, cause a stir in your emotions, or keep you on the edge of your seat, there is intention. Since my passion and focus is to improve the treatment, living and care of aging adults, the book's intention supports that focus.

Now the real work begins to get my book in as many hands as possible. It's not about how many book's I sell or where my book ranks, it's about the intention. I'm not going to try and tell you that sales and good rankings don't matter at all, because that would be a lie. If I want to continue my advocacy work and get the message heard I need an income and rankings matter for future books and attention to the matters at hand, but that has never been the purpose or focus of this book. If readers receive the intention of the book good things will happen for the elderly now and into the future and that is why spreading the news is so important. I have put an enormous amount of time, effort, knowledge, research, experience, money and thought into the 178 pages that come from my heart. I kept every senior I have met, cared and advocated for, laughed with and cried over in my thoughts as I wrote every word. They all matter to me and are the driving force behind my advocacy work and Behind the Old Face.

I invite you to see a preview of the book in my M2E Book "The Aging Question: A Vision for the Coming Elder Boom", which is a mini-media Ebook that includes text, photos and video clips of 2 of the wonderful seniors I interviewed for Behind the Old Face.

I hope you will read the book to better understand aging, now and into the future. If you find it worthy, please tell your family, friends, co-workers and business associates about it so together we can see better treatment, living and care for aging adults!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.elderboom.org

Pedagogy - I Am Voting for CLEAN HANDS

noreply@blogger.com (Angil Tarach RN) — Mon, 15 Oct 2012 17:45:00 -0400

As we get into Cold and Flu season I highly recommend Pedagogy - I Am Voting for CLEAN HANDS!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.elderboom.org

Let's set an advocacy record today!

noreply@blogger.com (Angil Tarach RN) — Tue, 3 Apr 2012 13:10:00 -0400

I'm excited to once again be a guest on Marla Martindale's radio show "Winning Life Through Pain", today April 3rd at 2pm EST! Marla and her assistant Meg, are great lady's with big friendly hearts!

We will be discussing Behind the Old Face and the advocacy project and rallying for support as we get down to the wire in our funding goal on Kickstarter. Please join us to listen, chat in the chatroom, or call in with any questions or comments. I'm asking listeners to please just pledge $1 in support of the elder advocacy project on Kickstarter. I am hoping to set a record for the most $1 pledges on any single Kickstarter project and draw attention to the care needs of the elderly and, chronically ill and disabled adults.
Come join in the conversation!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.elderboom.org

Thank You Nurse Talk for Your Support!

noreply@blogger.com (Angil Tarach RN) — Fri, 30 Mar 2012 11:34:00 -0400

Thank You Nurse Talk for your public support of my/our senior advocacy project! Thank you for the post
Going to Be Old Someday? Invest in Behind the Old Face; The Current Climate and Future of Aging
I am so honored by being supported by my peers in this way! I have always been proud to be a nurse and I know that nurses are the heart of healthcare and only support things they truly believe are worthy so thank you from the bottom of my heart for believing in this project and the effort to improve the treatment, care and living of aging adults!

Nurse Talk ROCKS! I invite you to check out their radio show and blog so hear what nurses have to say, and get some laughs too!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.elderboom.org

Please join the efforts to advocate for the elderly

noreply@blogger.com (Angil Tarach RN) — Fri, 9 Mar 2012 12:36:00 -0500

As you probably know, I have been working on a book to change the perception of seniors for quite some time. Over the last year I have worked with Jared Rosen, the Founder of Dreamsculpt in LA, to help me with the book’s publishing etc. The book has turned into a bigger project to improve the treatment, living and care of the elderly, and I am very happy to say the book was sent to the publisher last week! Here is a small sample of the full print book in a M2 Ebook that I wrote and was developed by Dreamsculpt. The Aging Question; A Vision for the Coming Elder Boom You will see video clips of 2 of the ladies I interviewed for the full book, “Behind the Old Face; The Current Climate and Future of Aging”.

I am sure you would agree that our system is failing the elderly population. Elder abuse and neglect are on the rise, care costs are skyrocketing and resources are shrinking. Our older generation deserves much more! As we stare down the impending growth of the aging Baby Boomer population we are headed for a crisis like no other and we MUST make changes now to avoid what’s expected.
Book publishing is very expensive and after putting $5000 into it I am falling short of the funds to complete the publishing and marketing of this book to long term care facilities, homecare agencies, nursing and medical schools, and other groups in the field of aging. This book is a compilation of some of my experiences over the last 34 years that led to my belief that we will not improve care until we evoke empathy in care providers and the public in general, several stories, thoughts, and opinions of wonderful seniors who were interviewed for the book, and a detailed description of a vision for senior living and care that is the answer to the serious issues seniors and caregivers face now and in the future, while reducing healthcare costs. I will be developing a training program following the book to bring care providers to a place of empathy so treatment and care will improve.

I am humbly coming to you to ask for your support in this project. It has been accepted and was posted on Kickstarter today in an effort to raise awareness and funds. Please help in any way you can, whether that is forwarding this email to your family, friends, co-workers, posting on social media sites or your website, or financially backing the project. I am not looking for individuals who will support this project with large donations, as nice as that would be. It is going to take many people who believe in this project and improving life and care for the elderly by donating anything from $5 up to $50 that will make this project happen.. You will see details on the site, but know levels of donations come with rewards and if the total funding goal is not met you will not be charged any pledge you offer and I will receive nothing towards this project. Whether you can or want to donate, I ask you to please share and promote this project. Any support in any form is very much appreciated! It’s all or nothing so every single email, post, and penny count! I have 30 days to meet my goal so time is of the essence.

Project link http://www.kickstarter.com/projects/angiltarachrn/behind-the-old-face-the-current-climate-and-future
I thank you for your time and consideration to join in this advocacy effort! It is my hope that we join together to make the changes necessary for now and in the future. Nothing good happens alone. This is not my project, this is our project. A vision is not just a picture of what could be; it is an appeal to our better selves, a call to become something more. - Rosabeth Moss Kanter

Together we can improve the treatment, living and care of aging adults!

If you have any questions please don’t hesitate to contact me. Project updates will be posted on the Kickstarter website and to all financial backers by email.

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

The Elder Boom Foundation Daily

noreply@blogger.com (Angil Tarach RN) — Wed, 4 Jan 2012 20:52:00 -0500

I recently developed an online newspaper called The Elder Boom Foundation Daily. It is compiled of the top stories and news for Baby Boomers, Seniors, and Caregivers. As the name states, it is a daily Enewspaper that anyone can subscribe to.

Whether you are a caregiver, healthcare professional, aging adult or Baby Boomer being on top of the latest news in the field of aging is important since it affects us all. We are just in the 1st year of a 19 year growth period of Baby Boomers turning 65, so whether you're 20 years old or 60 years old the unprecedented growth of the aging population will affect you.

The Elder Boom Foundation is a nonprofit (pending 501c3 status) to offer family caregiver's education and training for free or at a reduced cost, and to develop a vision of senior living and care which will solve many of the current problems our elder population are currently facing, the shortage of professional caregivers, and reduce healthcare costs. The Elder Boom Foundation is part of a larger project that is in development. The sole intention of the foundation is to improve the treatment, living and care of the elderly. This will be accomplished in a varietuy of way, so stay tuned!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com

Homecare Scheduling and the Mobile Phone Market

noreply@blogger.com (Angil Tarach RN) — Tue, 29 Nov 2011 09:00:00 -0500

By Tom Voiles
Cell phones have certainly transformed our lives. The family phone is going away, replaced with individual, direct lines of communication. As a parent, I've seen the change from conversations with friends dominating the home telephone to most of the kids' friends not even knowing that number. In some ways it's a problem I miss: it used to be that a boyfriend would have to run the gauntlet of speaking to us parents before getting through. Now, we have to ask "who's that texting you during dinner?".

The next big transformation in this area is the proliferation of smartphones. These web devices are really tiny, powerful computers that can do most of what their desktop and laptop cousins can do, plus you can make a phone call!

In the Home Care setting, where mobility is a fact of life, mobile devices are increasingly changing the way staff and caregivers interact, but it's not happening uniformly. There are still many markets where significant numbers of caregivers do not have a cell phone, while others where everyone has a cell phone and many (if not most) have smartphones.

A recent article in Business Insider shows the trends of smartphone penetration in the United States. It reveals that there is still a huge part of the populace that doesn't have a smartphone. The trend is heading strongly upward but it's uncertain how fast or how complete that transformation will be in the next few years.

For home care scheduling providers like Shoshana Technologies, this represents a big unknown. The promise of caregivers using their smartphones to provide information from the field is great, but it takes a critical mass of caregivers having them before it becomes something that home care agencies can make use of in large numbers.

For many (if not most) agencies, the additional cost of providing these devices to caregivers is out of the question. The real transformation will happen when ownership of smartphones among caregivers is so prevalent that it can be made a condition for employment without scaring away good caregivers.

As smartphones become the norm, look for lots of additional options in terms of what caregivers can do in the home. The possibilities are truly exciting! Entering care notes, attendance tracking, scheduling and documentation operations, location tracking, route management, avenues for training and education, etc.\

These changes are coming in any case. The main question is how broadly they will be available to our customers (home care agencies). These tools will make it possible for small and medium sized agencies to compete and continue to provide excellent care to their clients, a crucial element in a future with great care for all.

About the author: Tom Voiles is the president of Shoshana Technologies. He has been working with Home Care professionals providing technology and business support for over 20 years. Shoshana Technologies' Rosemark System is the premier online software for home care agency management.

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

How Do you see the elderly?

noreply@blogger.com (Angil Tarach RN) — Fri, 4 Nov 2011 19:25:00 -0400

For More Information on Advocacy go to The Elder Boom Foundation

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Announcing my Quick Guide to Understanding Medicare, Medicaid and other payer sources

noreply@blogger.com (Angil Tarach RN) — Wed, 12 Oct 2011 17:10:00 -0400

If you follow my blog you haven't seen any recent articles or posts, and that's because I have been very busy working on 2 recently released book's and another book expected to be published by March 2012!

Today my very 1st book on Amazon came out! "Quick Guide to Understanding Medicare, Medicaid and other payer sources" was released for sale on Kindle Ebooks. This is a very exciting time for me! I have done a ton of writing for free over the last 2.5 years. If you have read my story and history you know why I started writing and what my intention was and is, but just as anyone who reads this, I need to make an income too. If I were independently wealthy I would continue to give it all away, but I am not. If you haven't read my story and are interested, I wrote about it for NurseTogether.com in an article titled "What Happens when a nurse gets sick?" After reading my story you will also see why I would like to help others save money on healthcare costs!

I understand the confusion seniors, family caregiver's and folks just entering the Medicare years have. Heck my head was spinning with the research I did for the book, even though I had a good basic knowledge! I have met many families who have been strapped with huge medical bills because providers did not inform them of the insurance "rules" prior to treatment, ordering equipment, or sending their loved one off to rehab. This is crazy!

My quick guide offers simplified explanations of who pays for what, who qualifies, what the benefits are with particular insurances, and how to make sure you're not unknowingly being charged for equipment, procedures or rehab stays you would've not approved had you of known.

Quick Guide to Understanding Medicare, Medicaid and other payer sources is available on the Amazon Kindle Bookstore for the very reasonable price of $9.99. Don't have to worry if you don't have a Kindle because Amazon offers a Free Kindle Reader for PC's, Mac's, smartphones and IPad's. I've also allowed free sharing for up to 14 days, hoping you will share with someone who finds the guide so indispensable they'll want their own!

This guide is just in time for Open Enrollment for private Medicare Plans which is October 15 through December 7 in 2011.

Please share my book with anyone confused about senior insurance plans, or nearing their 65th birthday. You and I could help them save thousands in medical expenses!

If you purchase my book and find it helpful., please leave leave a review on the Amazon site. It is only through reviews the book will gain popularity so it can be found by others looking for information on senior insurance plans.

I'll be posting about my other recently released book soon or you can find it through my Products and Services page.

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Would You Like to Be Forced Into a Nursing Home?

noreply@blogger.com (Angil Tarach RN) — Fri, 16 Sep 2011 13:24:00 -0400

How would you feel if you are 80 years old and forced into a nursing home because you needed some care and there were no family near to help you and you couldn't afford to pay for homecare? What if the nursing home you were being sent to from the hospital had a bad reputation but you could no longer stay at the hospital and it was the only one that had a Medicaid bed open? What if you refused but were told you were not safe to go home alone and sent anyway?

This is the state of the current system when a senior needs care and can't afford to pay for it. They are basically forced into nursing homes on Medicaid. Imagine being forced from the home you love, all your belongings, and comforts to begin living in a 10x10 space that allows 1 chair, and a few small possessions? What if you had a room mate that screamed throughout the night, rumbled through your belongings and you had no real privacy? The fact is this happens to countless seniors on a daily basis.

It's not the fault of the hospital, physician, adult protective services, or even the nursing home, as many many think. The truth is hospitals, physicians, nurses, and discharge planners are almost always looking out for the well being of the patient. They have concluded that the patient needs care and is unsafe alone, but the state of our current system doesn't allow a choice.

In this economic climate we all see how quickly anyone can go from wealthy to middle class, or even broke. How middle class is edging more towards poverty every day, and no matter how hard you worked your whole life, or what you were promised for retirement, you can find yourself in a very different and difficult financial situation. Prior to retirement or a devastating illness or injury there is opportunity to work at regaining wealth or going back to a higher income level, but what about those who are too old or too disabled to work? People have lost their entire nest eggs in the stock market, scams, or through devastating illnesses, injuries or acts of God.

Should hard working citizens who have contributed their whole lives be forced into nursing homes because their personal income doesn't allow choice? I say NO! Our current system does not allow choice. Yes there are some programs that allow minimal homecare benefits through Medicaid, but the truth is it is very minimal, it is often closed to new applicants and is often provides services from agencies who are less than satisfactory. That is not to say that every program in every state only contracts with poor service providers, but in the State of Michigan, where I live and provide services, the Medicaid Waiver program which it's called here, reimburses so little we would be in the red for every single hour we would contract.

For agencies that spend the money to hire great caregivers, provide a thorough training program, pay a decent wage on hire and raise wages with loyal and committed caregivers to retain them, they cannot afford to participate in these Medicaid programs. The retention rate in my Visiting Angels agency is excellent. I have several caregivers who have been on our care team for between 3 and 8 years. Our long term caregivers make more in their hourly wage than the Medicaid Waiver program even pays. Then you add the Medicare and Social Security taxes we have to match, the costly Workmen's Compensation and liability insurance that we pay for each caregiver and we would be in the hole $4-$5 an hour for every hour we provided care as a vendor for the waiver program.

I have been to advocacy meetings with State Representatives and the Administration over the waiver program expressing my opinion and concerns about their low reimbursement rates and they have no answers. They seemed to understand the points about poorly trained care providers, excessive turnover and the lack of choice in providers for waiver recipients. My agency has received several calls over the last 9 years from Medicaid Waiver clients who tell us about the horrible care they're receiving, asking us to be the provider. Its heartbreaking to tell them "we're sorry, we don't participate in the program." This doesn't even take into account the amount of calls we receive from individuals or family members who need care for themselves or a loved one and can't afford it, or are saddened and lost to find out health insurance and Medicare don't pay for private duty homecare services.

Our system is a mess! There is a heavy threat looming over the state of Medicare, Medicaid, and Social Security, and equal concerns about rising healthcare and drug costs, yet the government is yet to recognize the savings from allowing private duty services as a choice.

Most seniors who are in need of care or services could get by with a few hours a day. They don't require the 24 hour care which is provided in the nursing homes they're paying for now. Facility care also comes with some very expensive risks that remaining home doesn't. Things like community acquired infections, bedsores, decreased mobility, falls, dehydration, poor med compliance, poor nutritional status, and depression all cost millions of dollars. According to a 2010 article in Medline The cost to heal a single full-thickness pressure sore may be as high as 70,000 dollars.[1] The overall annual cost has recently been estimated to be between 5 billion and 8.5 billion dollars.

The Agency for Healthcare Research and Quality released a study in 2009 of falls in the elderly from 2006 statistical information. As you can see by the chart below the costs are outstanding.

According to the Family Caregiver Alliance expenditures for skilled nursing facility (SNF) care are much greater than care provided in other settings. Average expenses per older adult in a skilled nursing facility can be four times greater than average expenditures for that individual receiving paid care in the community.

I don't think I need to go on about the statistical costs.(click on the Family Caregiver Alliance for more statistical evidence). The evidence is there, yet the ability to choose private duty services is not a viable option.

I have started a petition that demand choice. Unless we advocate and push for the ability to choose it will not happen in the near future, if it happens at all. If you would like to have a voice for your loved ones and/or yourself I urge you to sign the petition and pass it on. I am Currently looking for a minimum of 10,000 signatures. Together we can make a difference! Thank you!

Petitions by Change.org|Start a Petition »

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Angil Tarach-Ritchey on Blog Talk Radio

noreply@blogger.com (Angil Tarach RN) — Sat, 20 Aug 2011 07:50:00 -0400

I was recently a guest on Marla Martindale's Blog Talk radio show, "Winning Life Through Pain." Marla is a wonderful lady and RSD Coach. I have been invited to come back twice a year to advocate for the elderly!

This interview had over 38,000 live listeners, and was downloaded over 750 times. I am thrilled that I was able to advocate for aging adults and encourage listeners to be kinder, and more respectful to seniors and join in our advocacy efforts.

Here is the audio. Please pass it on and repost on Twitter, Facebook, and Google+ so more people may join in advocating for the elderly.

http://m.blogtalkradio.com/winninglifethroughpain/2011/08/09/aging-in-america-how-would-you-improve-elder-care

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Aging in America: Who's protecting the elderly?

noreply@blogger.com (Angil Tarach RN) — Mon, 8 Aug 2011 20:05:00 -0400

Aging in America: Who's protecting the elderly?: "I recently met a woman on a social media website who reached out to me because of the advocacy I do for seniors. Her story is unfortunately ..."

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Who's protecting the elderly?

noreply@blogger.com (Angil Tarach RN) — Mon, 8 Aug 2011 20:03:00 -0400

I recently met a woman on a social media website who reached out to me because of the advocacy I do for seniors. Her story is unfortunately common.

A family member financially abused her mother so much so that she was being kicked out of her home, an assisted living facility, because her rent wasn't paid by the family member who was in charge and took advantage of her. She is also without dental insurance because the policy was cancelled as well. Her savings have been exhausted, her credit cards have been charged up, and now she is left with a monthly social security check, and a daughter that is so exhausted and stressed out by what has happened to her mother, and the fact that it was a family member, that her own health is at risk.

So what's being done? Who is protecting seniors from this type of abuse, and going after the evil ones doing it? Unfortunately not much is being done and it's very difficult to find an authority who will pursue the perpetrator. This daughter is exhausting herself trying to care for her mom, get authorities to listen and pursue having the family member made accountable. She has hit resistance because not a lot of people want to pursue damages from what they see as a family matter. .Others don't find this a crime of any urgency, and it gets tossed aside.

Adult Protective Services (APS) is supposed to be the agency that helps protect seniors, but my experience, and others I've spoken to, have had very little positive interaction and response from them. Typically they drill the person forming the complaint, as if the complaint is not legitimate or serious enough. If they decide to make a report or investigate, it usually only takes one person telling APS what they want to hear and the case is closed.

We've all heard the news stories about how Child Protective Services let a child fall through the cracks, such as the case with Jaycee Duggard. They heard and saw what they wanted to and walked away while that poor girl suffered for years. The same happens with seniors every single day.

I have called APS on several occasions throughout my 30+ year career, and I never call them lightly. I exhaust all possible solutions prior to calling, yet in all the times I've called I have seen them actually act and do something 1 time. Yes, you heard it, 1 time!

Many times when an elderly person is being abused, neglected, or taken advantage of, they are fearful of the aftermath if they are questioned by APS. The investigator walks away from the case without ever considering the fear behind the answers. The abuser may, and often does, threaten the victim when they find out APS has been called.

Just as an example. Many years ago I had a home health patient, who after a few weeks of visiting, finally confided in me that her daughter was physically and emotionally abusing her. She was a pretty sick lady and her daughter was an alcoholic that smelled so bad of alcohol in the morning it nearly gagged me when I made my nursing visits. The patient and I talked and I told her it needed to be reported because she should not have to live in such horrible conditions, being abused. This took a few visits of talking before she finally agreed to allow me to report it. I only wanted her approval because she'd finally developed enough trust in me to tell me what was happening to her. I did not want to break her trust or for her to feel she had no one she could go to.

APS made a home visit, in which I was not present. They saw the conditions of the home, and spoke with my patient. They began by telling her they could move her to a nursing home. She told APS it really wasn't that bad and she did NOT want to move. For her the known surroundings and daily threats and physical attacks were better than going to an unknown nursing home. They also had called her home and spoke with her daughter before the home visit. APS reported to me on a follow up call I made that she is an adult and because she refuses to move, there is nothing they can do. They said she is an adult and has rights. I still think about this lady, and wonder what ever happened to her after she was discharged from Home Health. I drive by the home which is not too far from my home and think about her. I think about how quaint and beautiful the home looks like from the outside, yet no one really knows the conditions and horrible treatment an elderly woman lived with inside that home.

One thing I do have to say in defense of APS is they have 2 case workers to handle the entire county, which is absurd! I understand they're understaffed and overworked but the lack of compassion tells me that the 2 individuals they have shouldn't be in those positions. Anyone with any sense knows that abused individuals are fearful of the repercussions if they report or tell the real truth of what is happening to them. APS seems to want to take the easiest way out of following through with a report so their caseload is less.

Just writing this I sit here in anger and sadness. Angry that we can't count on any agency to protect seniors, and sad for those who have been victimized by the abusers. Sad that no authority seems to care enough to do anything.

This is where advocacy is so very important. We need to write our state representatives about the lack of real protection by Adult Protective Services, and to enact stiffer laws that will seek and prosecute the evil abusers. You can find your State representatives under the advocacy tab on this site. Take a moment to advocate on behalf of those too scared to advocate for themselves and have fallen prey because of their vulnerable state.

Put yourself in the place of either of these 2 women I mentioned. Being left with nothing but a social security check as you're being evicted from your home because a family member took your money, or living in dirty smelly conditions, while the one you count on for support is yelling, threatening, calling you names, withholding food, and smacking you around. Let these women be your motivation for advocacy. Let their lives be worth the 10 minutes it'll take to write your representative an email imploring APS to be accountable for every single complaint they receive and having more evidence to make a case decision than the answers a fearful and vulnerable aging adult gives them.

Thousands if not millions advocate for animals, endangered species, and civil rights. Aren't our elderly citizens who have spent decades upholding the laws of our country and contributing to society worth more than a dog, or a right to personal freedom?

For more information on recognizing financial abuse check out ths article
http://larkkirkwood.wordpress.com/2011/05/26/when-elders-are-financially-exploited-by-friends-family-and-caregivers/

Angil Tarach-Ritchey can be reached for questions or comments at visitingangelswvc@comcast.net or other contact options at http://www.behindtheoldface.com/

Aging in America: How would you improve eldercare in the US?

noreply@blogger.com (Angil Tarach RN) — Thu, 4 Aug 2011 13:37:00 -0400

Aging in America: How would you improve eldercare in the US?: "I think most of us who are over 40 think senior treatment and care in the US is less than excellent. We talk a lot about how bad things are ..."

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

How would you improve eldercare in the US?

noreply@blogger.com (Angil Tarach RN) — Thu, 4 Aug 2011 13:35:00 -0400

I think most of us who are over 40 think senior treatment and care in the US is less than excellent. We talk a lot about how bad things are but don't do much talking about how to improve things with concrete ideas and examples.

As I work on my book, "Behind the Old Face", I am interested in hearing from folks who have ideas on how to improve how we treat and care for seniors in America in oarticular, but definitely welcome input from other countries.

Please add your ideas, and suggestions in the comment boxes, and I will repost the answers I received in a couple weeks, and post a follow up question at that time.

Looking forward to hearing from you!

Angil Tarach-Ritchey can be reached for questions or comments at Angilc@comcast.net or other contact options at http://www.behindtheoldface.com/

Government leaves no choice for a hard working senior

noreply@blogger.com (Angil Tarach RN) — Mon, 20 Jun 2011 10:26:00 -0400

I just finished reading an article written by a senior woman who is being forced into a nursing home because her savings is being exhausted following a stroke. This lady worked hard her whole life, built up a savings, but is not allowed to make a choice between remaining in her home or going to a nursing home because the government system doesn't allow a choice.

You can read the whole article here;
Forced to leave home by broken health system | CapeCodOnline.com

Currently, if a senior runs out of money and cannot pay for care out of pocket or doesn't have a big long term care insurance policy, the only option is Medicaid. Medicaid is available throughout the country but is a state insurance, not federal. Medicaid will not pay for someone to remain home with care, but will pay for a nursing home. Not any nursing home either. They will pay for a nursing home that has Medicaid beds, which not all do. Some states have homecare benefits under state run programs but only a very small percentage are able to receive those benefits and they are typically less than 12 hours a week. Michigan's program is often closed to new applicants, as an example.

I sit here very sad for this lady, who just wants to remain in her home, and very angry at an ineffective and poorly run system that doesn't allow choice. Our government has yet to understand and recognize the savings in healthcare dollars by paying for Homecare services, rather than nursing homes. Most seniors could remain home with a few hours a day, yet Medicaid pays for 24 hour care in a facility. Seniors remain healthier and safe at home than in nursing homes. Depression, urinary tract and other infections, falls, dehydration, and failure to thrive are all common in nursing homes. Nutrition and fluid intake is poor in those who need assistance to eat. Poor care in incontinent and immobile patients results in urinary tract infections and bed sores which are very costly to treat. Staffing levels are low and those who are at risk for falls are unsafe because there is no possible way to have a aide with them continuously, and restraining patients is against the law.

A good homecare company, like Visiting Angels, provides 1:1, or 1:2 care if a couple is in need, which allows for more individualized care, and monitoring. Homecare clients continue to have choices of when they wake up, eat meals, shower, and spend their time. They remain healthier and safer because their caregivers provide meals, hygiene assistance, help with ambulation or transferring, fluid intake, medications, and monitor their health and safety. If a client has a change in health status they are able to get the client seen by the physician early so complications are prevented. Seniors who remain at home are much less likely to suffer from depression, and injuries.

As Barbara Waas, the lady in this article explains, she was very depressed in the nursing home despite good care. She improved after returning home. Just because she had a stroke early in her senior years, should she have to reduce her life to what can fit in an 10x10 space and live her days out without any choice of when she eats, when she showers, what activities she can participate in, when she's expected to go to bed and wake up? Should she have to go live in a place she doesn't even like because it's the only facility with an open Medicaid bed? I have heard many describe nursing home living as feeling like being on prison. Is this the way we should treat citizens who worked hard, contributed to society and lived upstanding ethical lives?

Do you see how easily her story could be your story, your spouses story? How would you feel if you were forced into a nursing home because your savings ran out? This is the reality of thousands of seniors every single day, and will continue to be the reality unless we work to advocate together for better solutions. Would writing your State Representatives, which would take less than an hour out of your time be worth the effort if it kept you from living in a nursing home? We MUST advocate for choice. We MUST be willing to get involved and discuss better solutions and put better solutions in place if we want to have choices as we age.

Here is the link to find and write your State Representative online. https://writerep.house.gov/writerep/welcome.shtml I have written my Representatives on several occasions in my advocacy for the elderly. I have always received a response. I recommend copying and pasting the link to the original article from the lady being forced to move, or to this article. I also ask that you share this article with everyone you know, and ask them to write their Representatives. The ONLY way we are going to create change is to stand together and send a huge message to our government leaders that says this system is unacceptable!

Let's all stand up for Barbara Waas, and the thousands of seniors that have been forced into nursing homes. Let's show Barbara and others we do care, and believe in choice.

Waiting for the day

noreply@blogger.com (Angil Tarach RN) — Tue, 7 Jun 2011 09:15:00 -0400

Every morning I receive an email with the latest medical research and discoveries. It isn't abnormal to have something appear at least once a week related to Alzheimer's. As I've said before there are a lot of what if's, a lot of puzzle pieces, but no real answers yet.

Today was no different when I read "New Direction in Alzheimer's Research.". A new finding, yes. An answer? No, not yet.
New direction in Alzheimer's research

As an eldercare professional and advocate I look for the discoveries and answers to devastating diseases like Alzheimer's, Parkinson's, Macular Degeneration. All diseases that typically target aging adults, but as a chronically sick woman I also look for the discoveries and answers to Sjogren's Syndrome, and Chronic Fatigue, the 2 illnesses that have changed my life. I wish there was a list of the companies, universities, and scientists that are leading research in a particular disease, so I could keep up to date with each, but there is no such list. I just subscribe to Science Daily Health and count on them to forward the latest news.

If I know someone in particular who is suffering with some illness and some relatively good information in the way of research comes up on my Science Daily Health email, I will forward it on. I also post a lot of the news on Twitter, so maybe it can help someone find an area of the country, a hospital, research team, or physician that they may find answers. I subscribe to a couple different chronic illness message boards, where many subscribers are desperate for answers. I know that feeling of desperation when I spent 5 years trying to get diagnosed with the mystery illnesses that stole my life as I knew it. I can only imagine the desperation from an adoring husband or wife whose spouse's life is slipping away to Alzheimer's disease. I also know the feeling of being filled with hope, only to be entirely disappointed, by what I call the crash. The hope/crash cycle.

I went through the hope/crash cycle many times while I spent 5 years going from doctor to doctor to try and figure out what was causing me to be so sick. I would meet a doctor who was pretty sure he had the answer, filling me with hope, only to send me from their office saying "I don't know what's wrong with you." After my diagnosis I not only was relieved to know what I had but I was then able to accept the fact that I would remain sick and my life would be very different from my life before illness. I decided to accept the fact that I would most likely remain sick the rest of my life. Truthfully that is easier than not knowing what I was dealing with or would face.

When I was able to accept the diagnosis and life change I stopped searching for answers. I stopped hanging hope on every little thing that appeared to be a possible answer. I found the hope
/crash cycle to be too much for me to continue to put myself through. I wonder how many families and patients are out there going through the hope/crash cycle that wears away at themselves and their happiness? I certainly don't propose to have all the answers, or believe what works for one, works for everyone, but I do believe we can do a lot of damage to ourselves by constantly hoping for answers that won't necessarily come. Not saying we should be without hope, just saying we need a very realistic balance.

Just as anyone who is sick with an incurable illness, I would love to see an effective treatment or cure for what I have, but I don't expect it. I do hope to one day be very surprised if an answer comes. If the breakthrough of all breakthroughs happens and I can return to my once active, healthy life, I would be thrilled. Until then I just concentrate on living my life the best I can, and as happy as I can. The energy spent on happiness is much more beneficial to my daily life than spending the energy waiting for something that may never come.

All of us have a choice in how we handle any chronic illness within ourselves or a family member. We can watch our lives pass us by while we become stagnant in hope, or we can live. Really live with what we have to deal with, to the best of our ability. You can go to any chronic message board or even chronic illness group on Facebook and quickly pick out those who are miserable
and waiting for the cure, and the ones who have decided to be happy in their circumstances. If you haven't made your choice, or the choice you have made thus far isn't working for you or your life, just review the 2 groups on a couple message boards, and decide which group you want to be in.

Don't wait for the day to be happy. Today is the only day we have, tomorrow is not promised. Be happy today.

Smile & Move®: A reminder to happily serve

noreply@blogger.com (Angil Tarach RN) — Wed, 18 May 2011 19:28:00 -0400

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

Is a blood test for Alzheimer's coming?

noreply@blogger.com (Angil Tarach RN) — Thu, 5 May 2011 09:14:00 -0400

I do my best to keep up on the latest research and answers in Alzheimer's and other diseases that frequently are found in aging adults. Frequently I read about research and findings related to Alzheimer's disease, but they seem to be tiny pieces of a very large puzzle that hasn't come together yet.

When I read about things researchers have found in relation to Alzheimer's I am careful not to post every single finding because many are still in the "We Think" stage. That's what I call it because it's nothing really concrete that will either diagnose, treat, prevent, or cure Alzheimer's. Researchers believe (same as "We Think") that certain supplements, or actions will prevent or delay Alzheimer's. Do those things really help? There are no concrete facts and to make people believe that there is a true way to prevent Alzheimer's is very misleading, because there is no confirmed way to prevent the illness.

As a chronically sick person myself I understand waiting for the research to finally find the cause, treatment or cure. I also understand the desperation of trying anything to get better. The problem with that is twofold. One is the emotional roller coaster of having new and exciting hope only to discover whatever we are hanging our hope on is of no benefit. Second is the incredible amount of time and expense we go to, to have access to the latest treatment, or hopeful cure.

My own experience chasing and using hopeful treatments left me broke, depressed and disillusioned, after spending 8 months and thousands of dollars on IV's, injections, supplements and physician consultations, only to be left at the starting point, again. I am much more careful about jumping on the latest "treatment" or "cure".

My experience helps me discern which research findings I post and which I don't. With all that said, they may be onto something good here with a new diagnostic blood test for Alzheimer's. This doesn't help those who have already contracted the disease, but it may clarify the cause of those with undiagnosed dementia.

What most of us don't understand is that diagnostic tests are done to diagnose and/or treat a symptomatic health condition. Right now the use of a diagnostic blood test for Alzheimer's can only let us know if we are likely to develop Alzheimer's Disease, are in the early stages, or that Alzheimer's is in fact the cause of undiagnosed dementia. It still doesn't have a treatment or cure based on the results of the test.

The blood test is specifically looking for hormone production of the DHEA hormone, which was found different in person's with Alzheimer's. Basically if oxygen is added to DHEA in healthy individuals it is able to reproduce, and it doesn't reproduce in person's with Alzheimer's. This doesn't give any information about the cause of AD, it is only a finding that can help tell if someone is in early to late stages of AD.

This is improvement even though it doesn't indicate the cause or any treatments or cures, simply because there are lots of causes of dementia and Alzheimer's has been diagnosed as the cause when all other possible causes that can be found are not present. It helps individuals know early on whether the dementia is irreversible or possibly reversible. It rules out Alzheimer's in those who have dementia from another cause.

Keep in mind as you look for answers, preventative treatments, and cures, if there is a real concrete treatment or cure it will be BIG news. I believe the puzzle pieces currently found are moving us to answers that will either prevent, treat, or cure the disease, but when that will come, who's to know?

To access the full article on the research and findings of this new diagnostic blood test, go to;
Blood test for Alzheimer's: Study identifies procedure that detects early stages

Can we get back to being neighborly?

noreply@blogger.com (Angil Tarach RN) — Sun, 1 May 2011 17:19:00 -0400

This past week my Visiting Angels agency received a few calls for care. There are different reasons seniors, families, or friends call, but its always because someone is in need or someone is worried.

More times than not the calls come from a concerned family member. The concerns are typically around safety issues, but sometimes they are from family members who live a long distance away from the person they are worried about.

I remember growing up in Detroit when neighbors knew each other, and looked out for one another. The neighborhood was a busy place. Neighbors took a walk to one another's house's for coffee, talked over fences, sat on porches conversing with neighbors who walked by, and kids were playing in the streets, each other's yards and homes. People actually did borrow a cup of sugar, an egg, or the 1 missing ingredient for the dinner recipe, already in progress. Everyone came out of their homes to help a neighbor whose car was stuck in the snow, and came to each others aid with dinner's and support if a family was in need. We knew everyone's name and their living situation. Not because people were nosey, although a neighborhood always had at least one nosey neighbor, but because it was normal to know your neighbors and look out for their well being.

Today most neighborhoods are quiet, lives are busier, and many don't even know the person next door. If you lived in the 1960's and even a bit into the 1970's or before that time, you also probably miss the friendlier and more social times, because you know the difference.

One of the phone calls we received for care this week was from a family who lives out of state and has concern for an elderly family member who lives here alone. I met with her, and had the best time getting to know her! I found out she has very little socialization. An occasional visit from an old friend and the visits from her family when they are able to travel here, but that is pretty much the only socialization she has. She is a very pretty, sweet woman with a good sense of humor. We enjoyed our visit, I ran an errand for her and returned. I helped her put some groceries away, gave her a hug, and anticipating the next time I would get to visit with her. I really can't wait to spend more time with this lovely lady, she was the bright spot at the end of a long week!

Meeting and spending time with her gave me a great amount of joy, and I wondered why her neighbors don't take the time to know her, visit with her, or check on her. She has lived there for over 60 years, so it's not because SHE is knew to the neighborhood. I think the neighbors are missing out. They're missing out on knowing and spending time with a wonderful woman, missing out on the blessing that comes from helping another, and missing out on the joy of living in a friendly, caring neighborhood.

After I hugged my new elderly friend I wondered when she last had a hug, when she experienced human touch? I would suspect it was the last time her family was able to visit. They come every couple months, but is that enough socialization or human interaction? For most of us who live with spouses and/or kids, or even have friends we spend time with, that isn't something we think about, because we have social interaction, and human touch.

Her family wants her to move to their home, so it isn't a lack of family caring for and about her. She doesn't want to lose her independence or leave the home she has been in all these years. As an outsider looking in, it appears choosing would be a trade-off. I wonder if I would trade my independence for being with extended family? Would you? It shouldn't even have to be a choice.
The only thing I see lacking in this lady's life is friendship, which wouldn't even be an issue if we actually took time to be neighborly.

Take a moment to think what it would be like to live alone without any socialization for months at a time, except for a few phone calls. Think about losing your spouse, and 1 friend after another as you age. Think about living without hugs, the touch of a hand, or seeing a friendly face. Although my new friend doesn't appear lonely, her appreciation of our visit and conversation was evident. Not only could I see the joy in her eyes, she thanked me several times. The funny thing is, I think I left with more joy and gratitude than I brought.

Have we gotten so focused on ourselves that we can't take the time to meet a neighbor, check on an elderly person, or extend a hand or a hug? Although we believe we have to attend to ourselves and our lives, we are depriving ourselves of some of the greatest joy's in life. The dishes, laundry, TV shows, or another hour tending to our careers will never fulfill us like being a good neighbor will. When our last days are upon us, it is the moments we spent with each other and the memories of our lives, that we will think about and cherish. It will never be the work we didn't do.

Some of my best memories are the times my family and I spent with our neighbors back in the 60's in Detroit. Neighbors were always in and out of our home. I recall lots of laughter, love, and friendship. Even the darkest times were shared by lots of caring people.

Take time this month, even this week, to meet a neighbor, share some coffee and conversation. Ask around if there's an elderly person or couple in the neighborhood that may need to see a friendly face or help with something they are no longer able to do. Visit an aging family member, invite their neighbors over to get to know one another. I promise you when you extend yourself to another, the blessing will be yours. It just may be the best hours of your day, week, month, or year.

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.behindtheoldface.com

18 tips to save on prescription drugs

noreply@blogger.com (Angil Tarach RN) — Fri, 25 Mar 2011 11:16:00 -0400

According to a report written in 2000 from Families USA they estimated seniors would spend $2810 a year in prescription drug costs, an increase of 133% from 2000 to 2010. It’s difficult finding updated statistical information, or whether their projections were correct in 2010, but I would venture to guess it wasn’t too far off. Many seniors are forgoing important medications due to the rising costs. These tips may help prevent significant health consequences for those struggling to pay for medications.

1. Physicians often have samples of a variety of drugs in their offices, given to them free of charge. Ask your physician for samples. Especially if the physician is prescribing something new and you don't know if the drug will work, or cause adverse reactions or have intolerable side effects. A previous patient of mine did just that and came home with a huge bag full!

2. Physicians order medications without cost consideration. Their focus is treating the problem at hand with the drug they feel will work best, without thinking about cost. Newer drugs always cost more because generics are often unavailable. Ask if a generic is available for the drug they want to order. If not, ask for an alternate order for something a generic is available.
3. Price check! The prices can vary a significant amount from pharmacy to pharmacy. If the medication is too expensive, call the physicians office and ask for a cheaper alternate drug. The pharmacists can also give you that information before you call the physicians office, so you can request a replacement order of a specific drug.

4. Check with buying clubs such as Costco and Sam's Club. You do not need a membership to utilize the pharmacy. Just tell the person at the door checking cards that you're only using the pharmacy. As an incentive to purchase a membership these Clubs typically will offer drug discounts on some drugs with specific membership levels, only if you’re uninsured. The discount can't be used for all medications, so check with the club pharmacist about your specific medications, and see if the discounts are worth spending money on a membership. Remember you do not need a membership to utilize the pharmacy.

5. Insurance companies allow you to refill your medications 1 week prior to being out of the current prescription. Filling prescriptions one week early will allow you to save 4-6 weeks of medications in a year if you refill monthly.

6. Ask your physician if there is a higher dose of the medication you can split in half to save money. Check with the pharmacy on both dosages, because higher dosages may come with higher costs.

7. Mail order through your insurance companies approved mail order pharmacy may be cheaper, especially if you order medications for 3 months. Again check prices.

8. If you are prescribed a new medication you haven’t taken before and your physician doesn't have samples, see if your pharmacist will allow a partial fill of the order, until you see if the medication will work, or how you react to it. Some medications cannot be partially filled by law. This is especially true for individuals with previous sensitivities to medications. Lots of money is wasted on prescriptions that cause a reaction or intolerable side effects after a dose or two.

9. If you do not have insurance, small independent pharmacies may have discounted prices for uninsured. Let all pharmacies know when you price check that you are uninsured.

10. Many states now have drug discount cards for the uninsured. Price check and tell them you have the discount card. Using a drug discount card may even be less expensive than your cost with health insurance prescription coverage. Have the pharmacist check the cost using health insurance and off insurance using the discount card. You can find several discount drug card companies, or go to Free USA Drug Plan and check the cost of your medications from your local pharmacies right on the site.

11. Drug companies offer discounted or free medications for individuals who fall below a specific amount of income. Check their individual websites for programs offered. Seniors can often qualify for these programs.

12. Canada Drugs can fill and mail prescriptions often at prices far below US prices. A medication I was prescribed was over $1200.00 a month at CVS, $950.00 a month at Sam's Club, and $450.00 at Canada Drugs. Less than 1/2 the cost of the lowest US price I found. You can enter the drug you are inquiring about on their website and find the price right there. If you are insured, chances are your insurance company will not cover drugs from foreign pharmacies, but if you have a prescription cost limit, or need to fulfill a deductible at the beginning of the year, or are in the donut hole of Medicare, purchasing at Canada drugs may be beneficial, even without insurance covering.

13. If you are uninsured and have regular and costly medications, shop for insurance. Now that the health reform went through you may have access to insurance you didn't have before. If you can find a plan that is only major medical with the option for a prescription rider, you could end up insured and saving money.

14. If you set up a Health Savings Account (HSA) prior to being a Medicare beneficiary you can spend the money contributed to an HSA prior to enrollment in Medicare. Medicare beneficiaries are not elligible to open an account.

15. Check your state government website for a list of programs, or discounts available for low income patients, children and seniors. They often have a list of government and nongovernmental healthcare options and choices that may reduce healthcare costs, particularly for the uninsured.

16. Utilize a bank credit or debit card that offers points for purchases, to pay for prescriptions. My debit card collects purchase points that I can exchange for products, travel, services, Visa gift cards, and cash deposits into my checking account. Utilizing the card for prescriptions as well as other products, and services can result in a few hundred dollars in merchandise, gift cards, or cash deposits.

17. Know your insurance companies limit on yearly medication coverage. Even though they may cover the costs over your copayment, the total drug costs are being applied to your yearly limit, potentially leaving you without coverage before year end. When I was prescribed the very expensive drug I ended up buying at Canada Drugs, my prescription limit was $2500.00 a month. If I would have purchased that medication at CVS, I would have surpassed my limit in less than 3 months. So if your prescription coverage has a yearly limit, it does pay to price shop even when you only have a small co-pay. Watching the total drug costs can delay, or help you from getting in the “Donut Hole” before year’s end.

18. If you are a Veteran, you are eligible for medication purchases through Veterans Administration. Co-pays are very low for Veterans. The VA negotiates drug prices with the manufacturers keeping costs much lower for Veterans. Depending on eligibility, Veterans can obtain prescriptions from a zero co-pay to a $9 co-pay, and possibly have a cap of not paying more than $960 a year, far less than non-veterans are paying.

Angil Tarach can be reached for questions or comments at Angil@BehindtheOldFace.com or www.visitingangels.com/annarbor