Q. My mother’s doctor gave a recent diagnosis of “failure to thrive.” My mom has always been petite and we haven’t noticed significant weight loss in her. What does this mean?
A. In general, Failure to Thrive (FTT) happens when an older adult has a loss of appetite, eats and drinks less than usual, loses weight, and is less active than normal. But a FTT diagnosis can be from more than just weight loss and your mother’s physician should be able to provide you with the specific causes for her diagnosis.
Often, a physician will measure against a patient’s previous baseline to see if there are noticeable changes in appearance, abilities and cognition. Is the patient noticeably less alert or active? Are they dehydrated or malnourished – which might or might not be reflected through weight loss. They will also ask the patient questions as to whether he or she is still able to do certain activities, such as showering, dressing, getting in and out of bed, and preparing meals and whether the patient has noticed any changes in their abilities. Sometimes these can be traced to changes in medication, loss of hearing or vision, or increased pain. The doctor will likely screen for mental health and cognitive changes and might order blood or urine tests to check for infection, test kidney and liver function, and check alcohol levels. Another cause of FTT can be depression and social isolation. Clearly, the pandemic is impacting everyone in these ways and older adults who live alone are even more susceptible to these effects.
How an individual’s FTT is treated depends on the results of the above tests. Medications might need adjusting, physical therapy could be ordered to help build strength, and more help in the home might be needed. A variety of approaches can be utilized so it is best to seek the specific advice of the physician and get additional medical opinions if needed.
Q: Can your agency help us get the Medicare plans we see advertised on TV that have no premium and offer dental coverage?
A. The best thing to remember is the old adage “there is no such thing as a free lunch.” For a select number of low-income individuals, there are Medicare plans that might have zero premium and zero or very low co-pays. This is because the individual qualifies for some form of Medicaid as well as Medicare. If you are not low-income or you have a decent amount of assets in the form of savings, property, or investments, you likely will not qualify for these plans. Additionally, most of the plans being offered are Advantage plans. You must switch from having Original Medicare parts A & B, with a Part D drug plan, in order to have a Medicare Advantage plan. If you have a supplemental insurance, or Medigap plan, you must give this up in order to enroll in an Advantage plan. Most Advantage plans are either HMOs or PPOs and combine the medical and drug coverage. Some of the plans can offer very basic hearing or dental coverage or might have a benefit for a fitness facility or a certain amount of over-the-counter products “for free.” Advantage plans work well for some people, but all plan benefits need to be weighed against what might be given up by switching to an Advantage plan. Sometimes the lower premiums of these plans are offset by higher deductibles or higher fees for different services within the plan, which brings up another adage “the devil is in the details.”
Medicare Open Enrollment runs until December 7, 2020. In most cases this is the only time you can pick a new Medicare Advantage or Part D plan. Changes you make during Fall Open Enrollment will take effect January 1, 2021. Although in-person appointments aren’t an option this year, Region IV Area Agency on Aging (RIVAAA) and the Michigan Medicare/Medicaid Assistance Program (MMAP) are here to help during Medicare Open Enrollment. RIVAAA is offering Medicare Open Enrollment Telephone and Zoom appointments.
To get a screening packet and sign up for an appointment, contact Mistelle Sleigh at 269-408-4354 or by email at mistellesleigh@areaagencyonaging.org To learn more about Open Enrollment, to access vital information, and to download documents, visit https://areaagencyonaging.org/medicare-medicaid. Information can also be provided from our Info Line for Aging and Disability staff at 800-654-2810.