Medicaid Tampa Elder Care Law Firm Rosenkranz Law Firm Since 1991

Author: Jack M. Rosenkranz

  • Parent Care – Self Care

    By Jack M. Rosenkranz, J.D.

    How do we imagine the aging experience? What will it be like for us and how will we know what to do when our aging parent requires our help? Howard Gleckman attempts to answer these questions in his new book, Caring for our Parents, published this year (2009) by St. Martin’s Press. Gleckman collects stories of aging adults and their families who are navigating their way through the complicated and fragmented long-term care system. Most of the aging adults in Gleckman’s text suffer from Alzheimer’s; their children find themselves caregiving and searching for care and services that are difficult to organize even when family members have the ability to pay for them. The loved ones of these aging adults do not know where to turn as they are faced with the challenges of choosing appropriate care and of having multiple insurers, providers and funding sources.
    As the population ages, more Americans will be faced with taking care of their aging parents and making sure that they themselves will be taken care of in their twilight years. While the book provides numerous important references for adults taking care of an aging parent, it illustrates that caring for our parents is complicated and often requires an insider’s knowledge of the health care system. Gleckman’s illustrations are cautionary tales about the importance of getting help when maneuvering through the long-term care system. None of the families in his text seem to know beforehand that the aging process can be tailor-made with the help of individuals experienced in the health care process.

  • “Too Old for Hip Surgery”

    This headline ran over a Wall Street Journal article about rationing of health care in Canada. It offers a sad outlook if the US Health Care System follows the Canadian “Too Old for Hip Surgery” model. Preventive care will be the focus of the future. Quality of Life depends on having a supportive and conscientious environment within which to age. Recognizing the risks in the American system, scholars and policymakers have begun to differentiate between the fundamental causes of healthcare disparities – access, education, poverty – and patient level disparities. Scholars Peter Franks, MD and Kevin Fiscella, MD use the term “downstream reforms” in an effort to describe the disparities that occur at the patient level. In the January 2008 edition of The Journal of Internal General Medicine, they highlight downstream reforms that are important to improving the health care for the chronically ill.
    These Doctors argue that disparities can be addressed by examining both the provider-patient interaction and the manner in which clinical decisions are made. Much of their discussion centers on what individual doctors and patients can do to change their own biases and actions. The Baby Boomers are moving to individualize health care where personal preferences, desires and comfort are often just as important as clinical factors.
    Until widespread reforms are made that affect physician and clinical decision-making, elders and their families will need to implement their own downstream reforms through self-education and advocacy to improve care and prevent disparities. The Rosenrkanz law firm may be able to help build a supportive care environment that does not financially exhaust the family.

  • Disparities in Healthcare

    Many elders are concerned about the existing and potential disparities in the American health care system. One’s quality of life depends on having a supportive and conscientious environment within which to age. Recognizing the danger that healthcare disparities represent in the American system, scholars and policymakers have begun to differentiate between the fundamental causes of healthcare disparities – access, education, poverty – and the disparities that occur at the patient level. Scholars Peter Franks, MD and Kevin Fiscella, MD use the term “downstream reforms” in an effort to describe the disparities that occur at the patient level. In the January 2008 edition of The Journal of Internal General Medicine, they highlight downstream reforms that are important to improving the health care for the chronically ill – something that is of disproportionate importance to elders.
    Franks and Fiscella argue that disparities can be addressed by examining both the provider-patient interaction and the manner in which clinical decisions are made. Much of their discussion centers on what individual doctors and patients can do to relieve their own biases and actions that result in healthcare disparities. They explain what is part of a larger effort to individualize health care where personal preferences, desires and comfort are often just as important as clinical factors.
    While elders experiencing a chronic illness find themselves in difficult situations because health care knowledge and information are often limited, physicians are not always able to individualize care to patient needs because their information about patient preferences and lifestyle are also limited. Until widespread reforms are made that affect physician and clinical decision-making, elders and their families will need to implement their own downstream reforms through self-education and advocacy to improve care and prevent disparities. With Health Care Advocacy, the Rosenkranz law firm is dedicated to helping elders and families in this process.

  • Being Heard and Understood

    What do individuals in all health care environments desire: to live comfortably without pain. This is of particular concern to aging adults who suffer from conditions with chronic care more than any other population. A recent study in the journal of Pain Medicine examined the nature of patient-directed care and the patient-provider relationship for aging adults seeking treatment for chronic pain. Conducted by Dr. Carrie Teh and her cohorts, the study examined the experiences and desires of fifteen older adults in the Pittsburgh area. Researchers found that while some patients wanted to be told what to do by their physicians, others wanted to actively participate in efforts to manage their pain. These participation efforts included refusing specific undesirable treatments and demanding quality care. Regardless of the degree of control patients wanted in their pain decisions, all patients described the importance of being both “heard” and “understood” by their health care providers.
    There are two crucial implications of this study. First, patient-centered care is becoming the norm. Second, aging adults, regardless of the role they want to play in health care decision-making, want to feel connected and heard in the health care process. What the study also indicated was that, some patients may not be entirely ready for this but still want quality care. Nonetheless, the ability to be involved represents an important opportunity for elders and their families.
    Elders and their families have the ability to be the first generation to actively participate in the health care process. This will pave the way for other generations to become partners rather than their observers in their health care. The Rosenkranz law firm is dedicated to provide resources wherein families can get help and manage the care process. Building a supportive care environment that does not financially exhaust the families resources may be a result that could be obtained. What are your families goals and preferences. Contact Jack Rosenkranz for more information on this topic. to assist individuals, to determine for themselves, elder goals and preferences. For more information, please contact Informed Elder Institute, Inc. at 813-223-04195

  • Care Coaching + Technological Innovation

                Technological innovations are changing the way that patients, particularly the chronically ill, receive health care.  Patients are becoming responsible for coordinating more of their own care.  One example of this increase in responsibility is the use of remote patient management technologies – video conferencing between physicians and patients – by the Veteran’s Health Administration (VHA).  Veterans with chronic illnesses can now consult with their physicians remotely, which makes care less expensive and allows patients to individualize their care with less reliance on medicine and more focus on non-medical assistance.  The VHA’s use of remote patient technologies has been so successful that the Centers for Medicare and Medicaid implemented remote patient management for a portion of the Medicare fee-for-service population.

                As internet, audio and video conferencing and other technological innovations become more frequently used, patients will have to change their behavior and become educated on how to play a greater role in their care.  A recent study of the strengths and weaknesses of remote patient management suggests that one of the core tools are becoming available to patients require in this new era of health care delivery non-medical coaches.  In their recent Health Affairs article, Molly Cote, Ateret Haselkorn and Steven DeMello recommend coaching, what they describe as “motivational interviewing and other techniques to encourage patient behavioral change and self-care.”  The Rosenkranz Law Firm works with 3rd party vendors to help our clients build a supportive care environment that meets their families needs. This may result with families are receiving the individualized health care that they require at an affordable cost.  Many elders and their families have found Brook Crumrine our care coach to be of great help.  Clients of the firm report be able to meet the expectations of a health care system that is requiring that patients take more responsibility for the quality and coordination of their own health care.

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