Ramona Talks

Ramona VNA & Hospice - Changing Lives, One Patient at a Time

2010-02-17T17:57:00.000-08:00

Dr. Cochrane- Medical Director for Ramona VNA & Hospice treats Haitian Child

On Tuesday January 12th, a 7.0 magnitude earthquake hit Haiti near the capital city of Port au Prince. To date 212,000 people are estimated dead, with another 300,000 injured and over 1.2 million living in temporary shelters. On January 23rd I had the privilege of joining a medical team from my church and the Haiti Endowment Fund (www.haitiendowmentfund.org ); a Temecula based missions organization which has been ministering to the people of Haiti for over 25 years. Our team consisted of surgeons, an anesthesiologist, physicians, nurses, and a variety of construction and other support personnel. One of our biggest challenges was getting our team and over 40 cases of relief supplies from the States to the town of Hinche which is located about 40 miles north of Port au Prince.

Because the Port au Prince airport was only allowing military aircraft to land, we boarded a small charter plane from Ft. Lauderdale Florida and flew to Cap Haitien, a city on the North Coast of Haiti. From there we received a UN security escort and took a 4 hour trip over a rugged dirt road to reach the town of Hinche. Because many of the hospitals in Port au Prince were destroyed, thousands of patients evacuated to Hinche where the hospital was still standing. Once there we worked quickly to help as many people as possible. Some of our team provided much needed surgical care at the local hospital along with physical therapy and post operative wound care. I was able to help by seeing patients in various clinics set up at the mission compound as well as some of the outlying villages. Our team treated an estimated 2,000 patients while we were there in addition to securing 20,000 pounds of rice and beans for emergency food relief. When it was time to leave we were spared the bumpy dirt road thanks to an organization called Mission Aviation Fellowship ( www.maf.org ), who made several trips in a small plane which landed on the dirt runway in Hinche (after we chased the goats off the runway). I was sad to say goodbye to my new Haitian friends; but sense that I will be back again.

I would like to thank all the folks at Ramona VNA & Hospice and Hemet Hospice Volunteers for their whole hearted support. I would also encourage anyone interested in helping the earthquake victims in Haiti to consider supporting the above listed organizations, there is still much work to be done.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

Antibiotics for Colds?

2010-01-12T01:32:00.000-08:00

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director

Ramona Visiting Nurse Association and Hospice

Question: I am having a cold that has lasted for over a week. I want to see my doctor and get an antibiotic so I can get better soon, what antibiotic would you suggest?

Don’t take antibiotics for colds because they won’t help. During the winter season, I see many patients with cold and flu symptoms who ask the same question and are convinced that they need an antibiotic to get better. Antibiotics are one of the wonders of modern medicine; but they must be used judiciously or patients run the risk of serious side-effects or worse yet, patients can develop drug resistant infections such as MRSA (methicillin resistant staph aureus); which can lead serious complications.

Where did I get this cold from?
Cold symptoms including fever, runny/stuffy nose, sore throat, and coughing are nearly always caused by a virus infection. When an infected person coughs or sneezes, small droplets of saliva and mucus containing the virus float through the air and ultimately land on doors, counters and other objects. When you touch these objects, some of the microscopic particles end up on your hands. Later when you rub your eyes, face or nose those particles infect you with symptoms usually beginning 2-3 days later. Because of this delay, it is often not possible to tell exactly where your cold came from.

Why won’t antibiotics help?
Although there are a few anti-viral medications that can slow down some of the more aggressive influenza viruses, there are no medications effective against most of the over 200 different viruses which cause the common cold. Antibiotics, which can help the body fight against bacteria such as strep throat, are completely powerless against viruses. When your body is infected with a virus, your immune system must make antibodies to attack the virus which is why the average cold lasts about 7 – 10 days.

What can I do for my cold?
Rest, and drink lots of fluids (you knew that was coming, didn’t you!). Regularly washing your hands will decrease your chances of catching a cold by 20% and people who get less than 7 hours sleep per night are 3 times more likely to catch a cold as well. My final advice, take two cookies and call me in the morning.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

Banks and the Proper Use of Powers of Attorney

2009-11-30T11:06:00.000-08:00

LAW OFFICE OF GEORGE F. DICKERMAN

3879 Brockton Avenue
Riverside, California USA 92501
Tele: (951) 788-2156
Fax: (951) 788-0906

Elder Law Newsletter

A primary purpose in executing a power of attorney for financial matters, is to grant an “agent” (attorney-in-fact) the authority to conduct banking transactions if, and when, the elder (principal) is no longer able. However, sometimes a bank employee has a problem with recognizing the validity of the power of attorney. They hand the agent the bank’s own power of attorney form, and instruct the agent to have the elder’s signature notarized on it. Hmmm …

First, some clarification. Most powers of attorney are called “springing powers”. That term may not actually be included in the document itself, but the language of the document states that the power is effective only if the elder becomes mentally incapacitated and unable to make sound financial decisions. Most powers of attorney require the written declaration, under penalty of perjury, of at least one qualified medical doctor who states - for example: “The elder is my patient, she suffers from A, B, and C, and as a result, is no longer able to make sound financial decisions.”

The doctor’s declaration can then be stapled to the back of the power of attorney and has now “sprung” into being, so to speak.

Contrast that with a power of attorney that becomes effective immediately - without regard to incapacity (i.e., not a “springing power”). These should seldom be used. This immediate power of attorney may also state that, even if the elder becomes incapacitated, the authority will continue. This is known as a “durable” power of attorney.

Now back to the problem with the bank.

The purpose of the power of attorney was to have it executed by the elder while s/he still had the mental capacity to do so - that is, the ability to understand that by signing such a document, they were giving their financial authority to their agent in case of the elder’s subsequent incapacity. Now, when the elder is incapacitated, the bank says the original power of attorney is no good.

California Probate Code Section 4300, et seq., govern the use and authority of these financial powers of attorney. A third person (i.e., bank)must give an attorney-in-fact acting pursuant to a valid power of attorney the same rights and privileges that would be given the principal (elder) if the principal were personally present and able to act.

Of course, the bank wants to protect both itself and its elderly client from any improper use of the power of attorney by the agent. In so doing, the bank may first request that the agent provide proper identification, and even samples of signatures of both the agent and elder (principal) to confirm the identity of both. If the bank made this request, it would require that the agent locate other documents that contained the elder’s signature and present those to the bank as further evidence. The bank can also require the agent to provide the current and permanent residence addresses of the elder before agreeing to honor the power of attorney - and agree to transact any banking business with the agent.

The bank will not be held liable for relying, in good faith, upon the validity of a power of attorney so long as the following conditions are met:

1. The power of attorney is presented to the bank by the agent.

2. The power of attorney appears on its face to be valid.

3. The power of attorney includes a valid notary public’s certificate of acknowledgment or is signed by two witnesses.

If, after all this, the bank still refuses to honor the power of attorney, then the recourse is to petition the court and obtain an order that confirms the validity of the document and the agent’s authority.

Testamentary Capacity

2009-11-18T14:39:00.000-08:00

George F. Dickerman, Esq.
3879 Brockton Avenue
Riverside, California, USA 92501
(951) 788-2156

Elder Law Newsletter

In California, anyone who is at least 18 years old and of sound mind can make a will. However, the term “sound mind” means having testamentary capacity, and the law describes this as being “mentally competent”.

Mental competency means that, at the time the will was signed, the “testator” (person signing the will) was able to do all of the following:

(1) Understand the nature of the testamentary act. That is, they knew that they were giving specific instructions on who their beneficiaries would be and what property (real or personal) the beneficiaries would receive.

(2) Understand and recollect the nature and situation of their property. Did they know what their estate consisted of? A house? A bank account? Some stock certificates? They need not know, for example, the actual bank account numbers, or even the total number of accounts they have. But they must know that they have bank accounts, and a general understanding of the assets that make up their estate at the time the will is signed.

(3) Understand who their close relatives are and how they will be affected by the will. If the person cannot remember that s/he is married, or has children, then the will is likely to be determined invalid, because only a mentally incompetent testator could have forgotten that such relationships existed.

(4) The testator must not suffer from a mental disorder. This includes hallucinations or delusions that result in the testator leaving property to individuals or entities that, absent any such delusions, s/he would never have done.

An example would be where the testator suffered from a delusion that he was being visited by ghosts every night and believed that the only way to stop the haunting would be to name a paranormal group (like the ghostbusters) as a major beneficiary to the will.

Other circumstances exist, however, that would allow a will to be made even though a person has been declared mentally incompetent.

In a conservatorship (http://www.elder-law-advocate.com/conservatorships) case, where the court has appointed a conservator, a will can be executed on behalf of the conservatee. However, for the will to be valid, the conservator would have to first petition the court and obtain a court order for such authorization.

From the above rules, you can see that testamentary capacity is not a high bar to hurdle. When issues such as hallucinations and delusions appear, then a will may be challenged through a procedure known as a will contest ( http://www.elder-law-advocate.com/wills/will-contests).

Ask the Doctor - How can I save money on my prescriptions?

2009-10-27T11:11:00.000-07:00

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director
Ramona Visiting Nurse Association and Hospice

Question: I spend over $300 per month on prescriptions and I don’t know how much longer I can afford them. Is there anything I can do to save money on my prescriptions?

Despite all the talk about how expensive health care is and how we need to reform it; there are several things you can do right now to save money that don’t require an act of Congress. Here are a couple of ideas to get you started on your own personal “ economic stimulus” plan:

An ounce of prevention is worth a $100 of cure – See your doctor and dentist regularly for check ups. A cavity costs about $100 to repair; if neglected the root canal and crown will run you close to $2,000. Likewise, with early detection diabetes and hypertension can be controlled thus preventing expensive complications such as strokes, heart attacks, and renal failure.
Too many cooks (or pills) spoil the soup- Many patients take more medications than necessary. Unnecessary medications increase cost and multiply the risk of adverse reactions. The next time you see your doctor, take your medications with you and ask the doctor these three questions: What is this for? What are the side effects? And, do I really need to take this? Stop all unnecessary medications. For more information see my article on Polypharmacy at www.ramonavna.org under the community news section.
The buck stops here- Once you have eliminated unnecessary medications as described above you should ask your doctor or pharmacist if there is a generic or less expensive alternative available. Wal-Mart has over 300 prescription drugs and over 1,000 over the counter medications available for $4.00 per month. Call your pharmacist or check out http://www.walmart.com/4prescriptions for prices.
A penny saved is a penny earned- If you can use a pill cutter, chances are you can cut your prescription costs in half. Most drugs cost just about the same regardless of the dose. For example if you take Enalapril 10 mg twice daily, you could buy the 20 mg strength, cut them in half and take ½ pill twice daily thereby cutting your cost in half.

I hope these tips help you to pinch those pennies so hard that you hear ole Abe Lincoln squeal.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

Ask the Doctor - Polypharmacy

2009-10-13T00:15:00.000-07:00

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director
Ramona Visiting Nurse Association and Hospice

Question: My husband takes 8 different pills each day, I think that is not good but he tells me not to worry. How can you tell if you are taking too many medications?

The Pitfalls of Polypharmacy –

The term polypharmacy refers to the use of multiple medications and is a common problem in the elderly. Patients who take 5 or more drugs daily and those utilizing multiple physicians and/or multiple pharmacies are at greater risk of adverse effects. The potential for drug/drug interactions increases exponentially with the number of drugs used. In other words, taking 4 medicines is more than twice as likely to lead to problems as just taking two. Drugs can also interact with over the counter medicines, vitamins and nutritional products as well as certain foods.

When you see multiple doctors, or use multiple pharmacies, it becomes increasingly difficult to ensure that your providers have an accurate and up to date medication list. Without an accurate list, your doctor or pharmacist can not adequately review your medications to ensure you are on an optimal plan. Additionally, adverse reactions lead to increased hospitalizations not to mention the fact that taking multiple medications is just plain expensive.

There are several things you can do to reduce the risk of polypharmacy. First, place all of your medications in a bag including prescription, over the counter, and nutritional products. Take the bag with you on your next doctor visit and ask your doctor to explain why you take each medicine and to discuss the risks and benefits of discontinuing the medicine. For each medicine you keep, ask the doctor to include the indication for the medication on the prescription bottle: i.e. “Take one pill each morning for blood pressure”; this will help you better understand your medications.

Many patients find that they can safely reduce the number of medicines they take, thereby reducing risk and cost at the same time. Sharing the newly updated medication list with your pharmacist will enable them to run a drug safety profile and advise you of any interactions. Be sure your pharmacist is aware of all the over the counter medicines and vitamins/nutritional products you take as well. Educate yourself and remember: don’t be a Pollyanna when it comes to polypharmacy.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

Trust Contests - Litigation

2009-10-13T00:03:00.000-07:00

Law Office of George F. Dickerman
3879 Brockton Avenue
Riverside, California 92501
Tele: (951) 788-2156

ELDER LAW NEWSLETTER

Trust Contests - Litigation

A trust contest occurs when someone believes that the “trustor” (the deceased person that made the trust) was mentally incapacitated and/or unduly influenced when s/he signed the trust document.

A contest petition is filed in court, and requests that the improper trust instructions be stricken.

One BIG caveat: Most living trusts contain a clause that states that any beneficiary who challenges any of the terms of the trust will be automatically disinherited. This is called a “no contest” clause.

If a beneficiary files a petition that challenges the terms of a trust, then the court can rule that the filing violated the no contest clause. The proper approach (2009) is to first file with the court what is called a declaratory relief action under the California Probate Code’s “Safe Harbor” rules. This petition asks the court to render a ruling on whether the proposed filing of a trust contest petition would violate the no contest clause of the trust. if the court rules in favor of the “Safe Harbor” petition, then (only after the applicable appeal time has run) the actual trust contest petition can be filed.

Generally, most trust contest petitions are difficult to win. The policy of the legislature and courts is to honor the intent of the trustor. The court knows that, many times, trust contests are made simply because a family member or friend of the deceased thought that they would receive a portion of the estate. When they found out they were disinherited, they got upset and automatically concluded that the decedent must have been tricked or fooled into disinheriting them.

However, there are many cases where the trustor was susceptible to undue influence or lacked the mental capacity to understand what they were doing when they signed the trust document. When this occurs, a trust contest can be filed to challenge the document’s validity.

The evidence must be focused on proving the trustor’s mental state at the time the document was signed. This can be difficult, especially when the only witness present during the signing may be the person who unduly influenced the trustor.

The test for determining whether sufficient mental capacity existed to make a trust is not a high standard, but the test is greater than that required to simply create a will. As stated, the court will bend over backwards to honor the written instructions of the trustor and to presume this is what the trustor’s wishes were. It must be shown that the trustor knew what his/her estate consisted of (house, bank accounts, furniture, etc.) and was aware of the “natural objects of his bounty”. These natural objects would be a spouse, children, brothers, sisters, etc.

If the trust made no mention of these people and, instead, instructed that all estate assets were to be given to a person that the trustor had only met a few times, a red flag would raise indicating foul play and the liklihood of undue influence.

A successful trust challenge must prove that the trustor lacked legal mental capacity. Legal mental capacity is, in large part, determined by Probate Code Section 811, which identifies numerous mental/psychological categories that must be examined to determine whether the trustor possessed the required mental capacity.

Medical records are a great source of evidence, if they have discussed the trustor’s mental capacity at or near the time that the questionable trust document was signed. It’s unlikely that you’ll find a medical document that attests to the trustor’s lack of mental capacity, and was prepared on the same day the questioned trust document was signed. However, these records can be subpoenaed and then examined to determine whether they support the case of undue influence or lack of mental capacity.

Family members and friends can also be a valuable source of evidence, particularly if these people spent a great deal of time with the trustor and were intimately familiar with his or her beliefs, wishes, mental state, and relationships with family members and others. This personal knowledge can greatly assist the court in determining whether the trustor possessed the requisite mental capacity.

Expert witnesses can also assist. Great care needs to be exercised in the selection of such an expert. This person must be thoroughly qualified and reputable in order to provide a meaningful and persuasive opinion as to mental capacity.

Given these difficulties of sufficient evidence, the law does provide a remedy when the truth is that the trustor lacked mental capacity or was unduly influenced into signing the trust document.

ASK THE DOCTOR: Swine Flu

2009-09-18T16:32:00.000-07:00

Question: I am 66 years old and in good health. I usually get a flu shot each year just to be safe and was wondering if my annual flu shot will protect me from the swine flu?

The swine flu, now being referred to as the H1N1 flu, first began affecting people in North America in April 2009. By June 2009, the H1N1 virus had spread around the world and was declared a pandemic. The H1N1 flu is similar to the seasonal flu in that it is spread from person to person through coughing and sneezing; but thus far it seems to have primarily affected pregnant women and patients between the ages of 6 months and 24 years. As usual, people over age 65 are advised to receive a yearly “seasonal” flu shot; but the yearly flu shot will not be effective in preventing the H1N1 flu.

Each flu season an average of 36,000 people die from flu related complications in the United States, with over 90% of these deaths occurring in people over 65. What is unusual about the H1N1 virus is that it has mostly affected younger people including those with risk factors such as pregnancy, diabetes, heart disease and asthma. There have been very few cases of H1N1 flu reported in patients over 64, and studies have shown that about 1/3 of adults over age 60 have antibodies to the H1N1 virus.

A vaccine to protect against the 2009 H1N1 flu is expected to be available sometime this fall and will be able to be given in addition to the seasonal flu shot. At present, The Center for Disease Control (CDC) is recommending that the following groups receive the H1N1 flu shot:
Pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency personnel, people between the ages of 6 months and 24 years old, and people ages 24-64 who are at higher risk of infection due to chronic health conditions. At this time the CDC is not recommending patients over age 65 routinely receive the H1N1 flu shot. If you are 65 or better and have chronic medical conditions, please consult your physician for more specific advice.

For more information on the H1N1 flu, go to www.help4elders.info

ASK THE DOCTOR: Parkinson's Disease

2009-08-27T08:03:00.000-07:00

Ask the Doctor - Leslee Cochrane, MD

Question: I am 65 years old and have recently noticed a tremor in my hands and some increased difficulty with my balance. Does this mean I have Parkinson’s disease?

Answer: There are many potential causes of tremors including medications such as caffeine, strokes, multiple sclerosis, hypoglycemia, brain injury and Parkinson’s disease. Given your description, you see your doctor for further evaluation. Parkinson’s disease is named after the English physician, James Parkinson, who gave a detailed description of the condition in 1817. Although there have been many advances in radiological imaging of the brain, Parkinsons disease is still diagnosed by your doctor examining you for the typical signs including a resting tremor, muscle rigidity, slow movement (bradykinesia), and impaired balance. In order to confirm a diagnosis of Parkinson’s disease, patients must also respond favorably to a challenge of a medicine such as Sinemet® which contains Carbidopa and Levodopa.

Parkinson’s disease is caused by the loss of the dopamine producing cells in the brain which lead to the above mentioned symptoms. It usually affects people over the age of 50 and increases in frequency with age. As the dopamine production of the brain worsens over time, the symptoms of the disease become more severe. Over time other symptoms including depression, difficulty swallowing and dementia may occur as well. Many of the symptoms can be reduced or managed with the proper use of Parkinson’s medications.

Parkinson’s disease is a chronic persisting illness that may vary from mild to severe and may progress slowly over decades or rapidly. Many of the symptoms can be treated by judicious medication management and in rare cases, surgery might also be beneficial. If you feel that you may have Parkinson’s disease, please see your doctor. He or she may also want you to see a neurologist who specializes in Parkinson’s disease.

Special Powers of Attorney - How They Work

2009-08-27T07:34:00.000-07:00

Law Office of George F. Dickerman
3879 Brockton Avenue
Riverside, California USA 92501
(951) 788-2156

ELDER LAW NEWSLETTER

Special Powers of Attorney - How They Work

Special powers of attorney for financial management carry the same caveat as general powers of attorney: placed into the wrong hands, they can become a license to steal. Like all financial powers of attorney, you must be certain that the person you appoint to act as your agent is absolutely trustworthy. Here are some examples of special powers of attorney and how they work.

A special power limits your agent's authority and is generally used only in specific circumstances. For example, you may be in the process of purchasing a home but, nearly a year ago, you purchased a non-refundable European vacation and you won't be available to sign all of the real estate documents. A special power of attorney can authorize your agent to act on your behalf and sign all necessary papers to complete the purchase.

Under this scenario, your agent's authority is very limited.

Contrast this to a general power of attorney for financial matters. With this document, you are granting authority for someone else to handle all of your financial matters - opening and closing bank accounts, withdrawing money, purchasing or selling real property - essentially, your agent would have the ability to transact every type of financial business that you would. A very dangerous document if placed into the wrong hands.

Usually, a general power over finances should only be granted if it utilizes a "springing power". This means that your agent has no authority to act unless two qualified medical doctors provide written declarations, under penalty of perjury, that you are incapacitated and unable to make sound financial decisions. Then, and only then, does the power "spring into being", as it were, and allow your agent to act on your behalf.

A special power of attorney generally becomes effective immediately. It is granted to allow your agent the authority to handle one or more specific transactions and, again, is usually done out of convenience because you are unavailable to timely act.

Using a boilerplate form where you just fill-in the blanks to specify the exact authority you wish to grant can be a mistake. Sometimes the authority is too limited and could prevent your agent from being able to complete the particular financial transaction. For example, granting authority to "sign all documents required by my real estate broker" may not be acceptable to the lender or the escrow company. They may have different requirements and do not feel comfortable in recognizing your agent's authority under the special powers you have stated.

An attorney can assist with the creation of a special power of attorney for financial matters and, in doing so, should contact all of the companies and agencies involved to ensure that their requirements are met. The exact language used in the document can then be tailored to meet all of these needs.

Special powers of attorney can be very useful in completing certain transactions but should be tailored to meet very narrow and specific situations. If properly drafted, they are a valuable financial tool.

Ask The Doctor- Living Alone

2009-07-21T17:28:00.000-07:00

Question: I have a neighbor who is a widow and lives alone. Her family lives out of state; she is quite frail and has very limited finances. I am worried about her falling and not being able to call for help. What can I do to help her?

Answer: You are right to be concerned; falls are the leading cause of accidental death in persons over 65. More than 90% of all hip fractures occur as the result of a fall and 1 in 3 seniors living at home fall each year. Risk factors for falls include increasing age, cognitive impairment and medication use.

If at all possible your neighbor should see her doctor to have an evaluation done to assess her risk of falling and to take preventative measures. Numerous types of medications are associated with dizziness and falls, and any patient taking four or more medications is at increased risk of falling due to medication interactions.

I am excited to announce a new service that is available free of charge that will be of great help to your neighbor. Beginning July 13^th, Ramona Visiting Nurse Association and Hospice is sponsoring the HELP line. HELP is short for Healthy Elder Life Program, and the program will provide:

Toll Free Help Line: answered by a licensed nurse offering information on many services available to seniors, including county programs, advance directives, finance, insurance & low-income resources, transportation and mobile healthcare services, and much more.

Daily or Weekly Phone Calls: by a licensed nurse who will check in with elders by phone to ensure safety, or to remind them of physician or other appointments. This service is available by request of the senior or their family member.
Information resources: for low-income seniors, located on our website or available at the toll free line, including how to navigate the often confusing healthcare delivery system.

For more information go to www.help4elders.info or call 888-98ELDER (1-888-983-5337).

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

Elder Law Attorneys

2009-07-01T11:18:00.000-07:00

George F. Dickerman, Attorney

Elder law attorneys address the legal issues that arise as a consequence of the aging process. Elder law is a rather large umbrella and covers the areas that are most practical to the problems that seniors face. Here are the top five ways that these lawyers can assist the elderly:

- 1. Elder Financial Abuse. These are cases where financial predators use undue influence, manipulation and coercion to take property and money from elders who have diminished mental capacity. The perpetrators can by anybody, but are usually family members, caregivers or friends who have the most access to the elder and are least likely to be challenged by outsiders.
- 2. Nursing Home Abuse. Abuse or neglect of a nursing home patient generally results from inadequate staffing where there are too many patients and not enough nursing assistants. Sometimes, this is a conscious policy on the part of the nursing home owner who puts corporate profit ahead of patient care. Fortunately, there are many legal remediesavailable to stop these wrongful acts and to compensate the elderly victim for injuries suffered.
- 3. Conservatorships. When an elder is no longer able to make sound financial and healthcare decisions, and no other alternatives are available, then a request can be made for the court to establish a conservatorship and appoint someone to have the legal authority to make such decisions. This is an involved process but provides a solution to assist an elder who can no longer protect them self.
- 4. Estate Planning. "Living trusts", powers of attorney for financial and healthcare decisions, and wills are the primary documents that constitute a person's estate plan. These written instructions assist the elderly client both during their lifetime and afterwards. A proper estate plan can also avoid the need to establish a conservatorship if the elder becomes unable to make sound decisions. These documents grant all of the legal authority needed to carry on the elder's affairs - without having to seek court involvement.
- 5. Medi-Cal Planning. This term applies to California residents and involves the process of obtaining Medi-Cal benefits to pay the sky-rocketing costs of long term care in a skilled nursing facility. Planning involves three stages: (1) Thorough analysis of the client's financial status to develop a written strategy to obtain eligibility, reduce any share of cost, and avoid recovery claims; (2) Execution of the written strategy; and (3) Completion of the application process. Medi-Cal law is complicated and requires a lawyer experienced in the nuances of the various rules and regulations.
There are many other sub-fields that fall under the elder law umbrella. Each has its own peculiar application and importance as a piece of the elder law puzzle. This brief article has addressed only the top five ways that elder law attorneys can assist their clients.

Law Office of George F. Dickerman
3879 Brockton Avenue, Riverside, California 92501
(951) 788-2156
www.Elder-Law-Advocate.com

Stopping Financial Thefts

2009-06-26T08:38:00.000-07:00

George F. Dickerman, Attorney

Elder financial abuse is not only a crime, but invokes a civil cause of action as well. There are many remedies to stop financial thefts and this article will discuss a powerful law that protects elder victims through civil litigation.

Many states have laws that specifically protect seniors from such abuse. California, in particular, has enacted the Elder Abuse and Dependant Adult Civil Protection Act (EADACPA). The civil courts in Riverside County, for example, are now familiar with the remedies that EADACPA provides. One of the primary advantages of EADACPA is the right to recover postmortem pain and suffering damages (general damages). Prior to EADACPA, a lawyer might refuse to accept a financial abuse case because it was quite possible that his or her frail elderly client might pass away before the case got to trial. If so, the right to recover general damages died also.

Under EADACPA, this right continues even after death. Interestingly, one of the primary reasons the California legislature passed this set of laws was to encourage attorneys to take on such cases. The law requires that it be proven, by clear and convincing evidence, that the defendant committed acts of fraud, malice, oppression or recklessness. EADACPA claims involve intentional torts and, when proven by these higher standards, provide nearly every remedy that the elderly victim could hope for.

Out of pocket monetary losses are recoverable damages. These may include interest on money that was wrongfully taken by the defendant, or lost rent on a home that the defendant lived in without making any payments. As mentioned, general damages (pain and suffering) are recoverable. There is no measuring stick to determine the amount of money that would compensate the elder for this loss. A jury must put aside passion and sympathy and award only the amount that appears reasonable under the circumstances.

Exemplary, or punitive, damages are also recoverable. The purpose of such an award is to both punish the defendant and also to set an example that despicable acts of elder financial abuse will not be tolerated in a civilized society.

Enhanced remedies may also be available in which the court, under circumstances of particularly egregious acts, may double or triple the amount of certain damage claims. As mentioned, an award of attorney fees is another remedy for the elderly victim. Under certain circumstances, these fees are mandatory. Appropriate costs are also recoverable.

If an EADACPA lawsuit is brought on behalf of an elder who is under a conservatorship, then a jury verdict can include monetary compensation to the conservator for services rendered in furtherance of the civil lawsuit.

Imposition of constructive or resulting trusts can also be imposed against a defendant. If the defendant wrongfully acquired title to the elder's real or personal property, then the court can order that the defendant's interest was solely as a trustee and such property must be returned to the elder.

These are just some of the many remedies available to an elder who has been victimized by financial abuse.

Law Office of George F. Dickerman
3879 Brockton Avenue, Riverside, California 92501
(951) 788-2156
www.Elder-Law-Advocate.com
george@Elder-Law-Advocate.com

POLST Form Now Available In Spanish!

2009-06-17T21:32:00.000-07:00

The California POLST form has been translated into Spanish and is now available on the California Coalition for Compassionate Care website. The Spanish version is for educational purposes only and is not a valid POLST form. To be effective as a physician’s order that is honored across the continuum, the POLST form must be signed in English so that emergency personnel and other healthcare professionals can read and follow the orders.

The POLST form is the most powerful way to make your wishes known in an emergency situation. Traditional "Living Trusts" and Durable Power of Attorney forms are still important and good to have. However when an emergency happens and the form is too hard to locate or if your chosen spokes person is unavailable, the emergency physician is bound to provide life saving treatment, whatever that may entail.

With the POLST form, you sit down with your physician ahead of time, you discuss with him/her what your desires are concerning treatment, especially in an emergent situation. Then your physician signs the form, making it a legal order from a doctor.

We encourage you to go listen to our Podcast with our very own Dr. Cochrane as he spells out the need for this form and how to specifically use this invaluable form. You can listen HERE.

ASK THE DOCTOR - Memory Loss

2009-06-13T08:45:00.000-07:00

Question: I have noticed that my memory is getting worse with age, is that normal?

Most people experience changes in their memory with aging; but there are several other causes of memory loss. Medication side effects, alcohol use, depression and dementia are just a few of the causes of memory loss you may want to discuss with your doctor. In order to better understand normal “age related” memory changes, let me provide an overview on how your memory actually works (information adapted from FamilyDoctor.org).

The brain stores information in different areas that I will refer to as “compartments”. The three compartments are short term memory, recent memory, and remote memory. Information stored in the short term memory may include a phone number you were just given. Information stored in the recent memory may be what you ate for dinner yesterday. Childhood memories and details regarding last year’s family vacation are stored in the remote memory.

Your brain has over 100 billion neurons and an estimated 1 trillion additional structural cells. To better comprehend how vast 100 billion is, consider the human heart. The heart beats around 60 times per minute, 24 hours a day. At this rate, a person would have to live for over 3,000 years before the heart had beaten 100 billion times. Beginning at age 20, several thousand brain cells die each day. Alcohol use and head trauma accelerate this process. In addition to this loss of brain cells, the chemicals your body produces to store information decrease with age making it harder to recall the previously stored information.

Aging primarily affects the recent memory compartment which explains why you forget where you parked your car and why you can’t remember the name of the person you met earlier today. The short term memory and the remote memory are not as affected as much by age. Being unable to recall a particular persons name or struggling to find a word that later pops into your head are also examples of normal age related memory changes.

Memory changes that disrupt daily life such as misplacing things and being unable to find them, getting lost inside your house, or losing track of the day or season are not characteristic of age related memory loss. If you are experiencing any of these more serious memory changes, then write a note to yourself: “remember to tell the doctor what I am forgetting”. 

Elder Law - What Is It?

2009-06-11T17:06:00.000-07:00

George F. Dickerman, Attorney

Elder Law involves the legal issues that arise as a consequence of
the aging process. This is a rather narrow field and can be a
little confusing to some senior citizens.

Many seniors have legal problems that are similar to people in
their thirties and forties; for example, wrongful termination
(employment), bankruptcy, or real estate disputes. Sometimes a
potential client calls an elder law attorney to obtain, for
example, family law advice regarding a possible divorce. That
lawyer explains that family law and divorce issues do not fall
under the category of elder law. Elder law pertains to persons who
are 65 years of age or older. Nearly always, the client responds by
saying: "But I'm over 65 years old".

Elder law generally involves the following types of legal matters:

Elder financial abuse. Taking advantage of another person's weaker
state of mind and wrongfully obtaining their money and property
through undue influence, coercion and manipulation. A civil lawsuit
is usually filed to recover the property fraudulently taken.

Elder physical neglect. Most often, this concerns nursing homes
that fail to properly care for their elderly patients. It can also
be caused by in-home caregivers or anyone who has the primary
responsibility of caring for an elder.

Estate Planning. This involves the creation of trusts, wills and
powers of attorney for financial matters and healthcare decision
making. Although these tools should also be utilized by younger
people, they are most often created for elder adults at a time when
they seek to get their financial affairs in order.

Probate. The probate process enables a decedent's estate to be
distributed to loved ones after death. With the proper use of
trusts and wills, the probate process may not be necessary.
However, if no prior estate planning was accomplished, then it may
be necessary to utilize the probate court in order to complete the
distribution of assets.

Conservatorships. When proper estate planning documents have not
been put into place (for example, powers of attorney), then it may
be necessary to establish a conservatorship over the elder's person
and/or estate. Court intervention is sought to grant someone the
authority to make necessary healthcare and financial decisions for
the incapacitated elder.

Medi-Cal Planning. This area refers to the laws and regulations in
California that determine the guidelines to qualify an elder to
receive government benefits to pay the high cost of long term care
in a skilled nursing facility. Riverside County, for example, has
local Medi-Cal offices where the application process is begun and
an ultimate determination of eligibility is made. Medi-Cal is a
complicated area of law with the goal of having the state pay the
monthly nursing home bills and, at the same time, allowing the
elder and their spouse to keep as much of their assets as possible
so they can pass them on to their loved ones.

Although elder law is a narrow field, it is also a rather large
umbrella that encompasses the foregoing issues.

Law Office of George F. Dickerman
3879 Brockton Avenue, Riverside, California 92501
(951) 788-2156
www.Elder-Law-Advocate.com
george@Elder-Law-Advocate.com

ASK THE DOCTOR - Blood Pressure Meds & depression

2009-05-26T17:54:00.000-07:00

Question: “I feel like my blood pressure medicine is making me feel depressed, but my wife says I’m crazy to think that?”

Answer: Please allow me to offer some free advice: don’t ever argue with your wife. I say this for two reasons: first of all arguing will raise your blood pressure and, secondly, wives are usually right. 

High blood pressure is a condition well worth treating as it increases your risk for heart attack, stroke, kidney failure and heart failure. Diuretics (water pills) and medications known as “beta-blockers” are often used to treat hypertension.

Some examples of beta blockers include atenolol (Tenormin®), metoprolol (Lopressor®), and propranolol (Inderal®). These medications are commonly associated with side effects including depression. If you’re taking these medications and feel depressed or lethargic, you should discuss this with your doctor and consider alternative medications.

So, my answer is yes, blood pressure medications can cause depression. Just in case you are tempted to tell your wife: “see, I told you so!” …remember that she might ask the doctor for a new prescription that causes decreased libido. 

National Nurses Week

2009-05-18T15:23:00.000-07:00

Carol Wood, R.N., CEO

National Nurses Week is celebrated annually from May 6, also known as National Nurses Day, through May 12, the birthday of Florence Nightingale, the founder of modern nursing. National Nurses Week is one of the nation's largest health care events, recognizing the contributions and commitments nurses make and educating the public about the significant work they perform.

Often described as an art and a science, nursing is a profession that embraces dedicated people with varied interests, strengths and passions because of the many opportunities the profession offers. Nurses have many roles – from clinical nurse to educator to nurse practitioner and nurse researcher – and serve all of them with passion for the profession and with a strong commitment to patient safety.

ANA President Rebecca M. Patton, MSN, RN, CNOR said “Today’s nurses must have the strength to care for patients during times of disaster and crisis; the commitment to remain involved in continuing education throughout their careers; and the compassion to provide hands-on patient care at the bedside – as they have done throughout the centuries. Moreover, at 2.9 million strong, nurses represent the largest group of health care workers in America, and we have the power to achieve much-needed reform in nursing and in health care. That is why it is important to take time out during National Nurses Week to thank nurses for what they do and to remind the public just how vital our nation’s nurses are to patients, their families and society.”

Here at Ramona Visiting Nurse Association and Hospice, we are fortunate to have the highest compliment of the highest caliber nurses in our valley as part of our family. I am pleased to offer my thanks to each of our nurses for their contributions to the patients and their families.

ASK THE DOCTOR - Medicare or HMO?

2009-05-11T14:02:00.000-07:00

Question: I am about to retire and will be eligible for Medicare insurance; but I am very confused about all the choices. Could you explain the difference between Original Medicare and Medicare Health Plans?

Understanding Medicare is a lot like understanding the tax code; just when you think you are beginning to understand it they change the rules again. Here is some general Medicare information provided by Medicare :

Original Medicare- This fee-for-service plan covers many health care services. You can go to any doctor or supplier that is enrolled and accepts Medicare and is accepting new Medicare patients, or to any hospital or other facility.

Medicare Health Plans (like HMOs and PPOs) - These plans are approved by Medicare and run by private companies. When you join one of these plans, you are still in Medicare. Some of these plans require referrals to see specialists. They provide all of your Part A (hospital) and Part B (medical) coverage. They generally offer extra benefits, and many include prescription drug coverage. These plans often have networks, which mean you may have to see doctors who belong to the plan or go to certain hospitals to get covered services. In many cases, your costs for services can be lower than in Original Medicare, but it is important to check with the plan because the costs for services will vary.

Selecting the right Medicare plan is an important decision and I suggest that you go our homepage at Ramonavna.org and click on the “Podcasts” tab and listen to an extremely informative podcast by Ann Kasper from HICAP, the Health Insurance Counseling and Advocacy Program. HICAP is funded through grants provided by Riverside County and their services are free of charge. They are able to provide information and assistance with Medicare, managed care (HMOs), long-term care insurance and other related health insurance issues. Their trained volunteer counselors offer objective information to help seniors and other Medicare beneficiaries make good health care decisions. When you have insurance questions or problems, HICAP counselors can help resolve them. If you don’t have internet access, you can contact HICAP by calling 1-800-434-0222.

It is important to remember that Medicare allows the patient, not the doctor or health plan, to select the Hospice of their choice. This is true regardless of whether you select traditional Medicare, or a Medicare PPO or HMO Plan.

From the CEO: Update on Swine Flu

2009-04-28T06:51:00.000-07:00

Carol Wood, R.N., CEO

CDC Swine Flu website last updated April 27, 2009 1:00 PM ET

Human cases of swine influenza A (H1N1) virus infection have been identified in the United States. Human cases of swine influenza A (H1N1) virus infection also have been identified internationally. The current U.S. case count is provided below.

U.S. Human Cases of Swine Flu Infection (As of April 27, 2009 1:00 PM ET)
State	# of laboratory confirmed cases
California	7 cases
Kansas	2 cases
New York City	28 cases
Ohio	1 case
Texas	2 cases
TOTAL COUNT	40
International Human Cases of Swine Flu Infection See: World Health Organization

An investigation and response effort surrounding the outbreak of swine flu is ongoing.

CDC is working very closely with officials in states where human cases of swine influenza A (H1N1) have been identified, as well as with health officials in Mexico, Canada and the World Health Organization. This includes deploying staff domestically and internationally to provide guidance and technical support.

CDC activated its Emergency Operations Center to coordinate the agency's response to this emerging health threat and yesterday the Secretary of the Department Homeland Security, Janet Napolitano, declared a public health emergency in the United States. This will allow funds to be released to support the public health response. CDC's goals during this public health emergency are to reduce transmission and illness severity, and provide information to assist health care providers, public health officials and the public in addressing the challenges posed by this newly identified influenza virus.

To this end, CDC has issued a number of interim guidance documents in the past 24 hours. In addition, CDC's Division of the Strategic National Stockpile (SNS) is releasing one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak. Laboratory testing has found the swine influenza A (H1N1) virus susceptible to the prescription antiviral drugs oseltamivir and zanamivir. This is a rapidly evolving situation and CDC will provide updated guidance and new information as it becomes available.

What You Can Do to Stay Healthy

There are everyday actions people can take to stay healthy.

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.

Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

The CDC will continue to update its Website: www.cdc.gov/flu/swine and is answering questions via telephone at 800-CDC-INFO.

* The above was taken from the CDC website for your information.

Nursing Home Abuse & The Ombudsman

2009-04-15T11:01:00.000-07:00

George F. Dickerman, Elder Law Attorney

A nursing home ombudsman is a person who is trained to respond to
complaints of elder abuse and neglect that occur in a nursing home.
Ombudsmen are either paid for their services or volunteer their
time for this important task.

The ombudsman's assistance is critical as an impartial
investigator. Their task is not to advocate for the patient;
rather, it is to investigate the complaint to determine whether
abuse or neglect has occurred and then report the incident if
warranted. However, many patients have no family members who visit with any regularity, and no other interested person to assist when abuse or neglect is committed against this "forgotten population".

Typically, the ombudsman's office will receive a complaint from a
family member who reports that their elderly loved one is being
abused or neglected as a nursing home patient. The type of abuse or
neglect may arise from a variety of ways.

Often, the complaint is that the patient is suffering from
decubitis ulcers, or bed sores, that occur when a non-ambulatory
patient is not turned in their bed at regular intervals. This
condition can develop within weeks and may result in a deep wound
that extends down to the bone.

Other complaints may involve improper feeding. Some patients have
hands and arms that are too weak or shaky to allow them to use a
fork or spoon. It's not that they aren't hungry; rather, their
physical limitations simply prevent them from performing the
otherwise simple task of eating. Neglectful nursing home personnel
bring the patient their food, but leave it entirely to the patient
to eat. When the employee comes back to retrieve the food tray,
they simply note the patient's chart as "not hungry".

When an ombudsman receives a complaint, they then make an
unannounced inspection to investigate. During the investigation,
they will speak with the nursing home personnel - including the
director of nursing and the particular employees responsible for
the daily care of the patient. The ombudsman will also review the
patient's medical records to determine whether any notations are
made that support or refute the allegations of abuse or neglect.

If the ombudsman finds fault against the nursing home, then a
report can be made to the local county or state authorities who
monitor and also respond to such cases.

In California, the law requires that all 58 counties provide these
ombudsman services. Unfortunately, the state's budget crisis has
forced this program to be severely slashed - reducing state funding
by $3.8 million (2008). As a result, ombudsman programs are laying
off full-time employees or reducing hours to part-time, and relying
more than ever on volunteers.

The Riverside County, California program recently was forced to lay
off its three full-time employees, reduce a full-time employee to
part-time, and eliminate mileage reimbursement for 20 volunteers.

The bottom line: many complaints against nursing home abuse and
neglect will not be investigated and the "forgotten population" of
elderly patients will suffer without representation. However, the
ombudsman's role continues to be a valuable tool in combating elder
abuse and neglect.

George F. Dickerman, Esq.
3879 Brockton Avenue, Riverside, CA 92501

(951) 788-2156

www.Elder-Law-Advocate.com

A Note From The RVNA & Hospice CEO

2009-04-09T10:08:00.000-07:00

Carol Wood, R.N., CEO
As the only Not-for-Profit home health and hospice agency located in the Hemet-San Jacinto Valley, Ramona VNA & Hospice is committed to providing quality care to the patients we serve. One of the best indicators for someone evaluating a home health or hospice agency is whether or not the agency has achieved accreditation.

The Community Health Accreditation Program, Inc. (CHAP) is an independent, non-profit accrediting body. It was the first accrediting body for community-based health care organizations in the United States and was created in 1965 as a joint venture between the American Public Health Association (APHA) and the National League for Nursing (NLN). These organizations brought to fruition the futuristic view that accreditation was the needed mechanism for recognizing excellence in community health practice. In 1988, CHAP became a separately incorporated, non-profit subsidiary of the NLN under the CHAP name. In 2001, it was spun-off by the NLN and became an independent, non-profit corporation. CHAP was granted “deeming authority” by the Centers for Medicare and Medicaid Services (CMS) in 1992 for home health and in 1999, for hospice. This means that instead of state surveys, CHAP has regulatory authorization to survey agencies providing home health and hospice services, to determine whether they meet the Medicare Conditions of Participation (CoPs). In 2006, CMS granted CHAP full deeming authority for Home Medical Equipment (HME). Recently RVNA & Hospice received CHAP Accreditation following a very comprehensive review of the Agency, which objectively validates the excellence of community health care practice through a consistent measurement of the delivery of quality services.

As discussed in our Podcast with a CHAP surveyor following the survey process, few agencies in the country meet the National Standards as identified in the CHAP guidelines (Listen to the Podcast interview HERE). She commented that most people look for good quality of care but don’t know how to evaluate it. She said people should look for CHAP designation when selecting an agency; because CHAP accreditation means the agency provides high quality of care and meets National Standards. She further commented that many start up companies, new to communities, don’t provide good quality, which is bad for the community.

Comments during the survey by members of the survey team included… that our (Agency) was, “in the top 5% of Agencies I have surveyed in the country”; that “if I lived in this area I would want to work here”; and finally after evaluating our quality improvement process stated, “your patients and their families are very pleased about your agency and the quality you provide”.

Our agency success is directly related to the efforts of the entire staff. Leadership directs the orchestra, but it is the entire team that makes the music. Please join me in congratulating the staff and leadership for their excellence, and Ramona VNA & Hospice on their receipt of CHAP Accreditation.

ASK THE DOCTOR - Free Medication Samples?

2009-04-06T17:22:00.000-07:00

Question: “My doctor gave me free samples of a new medicine to take for my blood pressure; how can the drug companies afford to give away free samples?”

Answer: While necessity is the mother of invention; the price tag for “invention” of new drugs would not be a very nice Mother’s Day gift. The estimated cost of bringing a new drug to market is greater than $500 million dollars. Once the new drug is approved by the FDA, the manufacturer holds exclusive rights on the brand name drug for 5 to 7 years. During this time no generic products are allowed to compete against the brand name. This allows the drug company to set the price at a level to recoup their investment and hopefully make a profit.

Have you ever wondered why a brand name drug which costs $130.00/ month later sells for $4.00/month once it is available as a generic? The majority of the $500 million to develop a new drug is related to research and development expenses. The actual cost to manufacture a pill is only pennies per dose. Thus, it is cost-effective for the drug company to offer “free” samples of medicine to patients who they hope will continue using the new medication.

The development of new drugs is essential if we are to continue making progress against diseases such as diabetes, heart disease, and cancer. Newer is not always better however. When given a prescription by your physician you should always ask the doctor to explain what the medication is for and how it works, including the benefits and side effects. Because the newer medications are very expensive, I also suggest asking your physician if there are less expensive generic alternatives that might be equally effective. When a newer medication is indicated, using a free sample is a good way to try the new medicine and determine how well it works before buying it. Remember: Caveat emptor - "Let the buyer beware".

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

Hospice Providers and Patient’s Primary Physicians

2009-03-24T20:36:00.000-07:00

Study Finds that Dying Patients and Families Suffer from Lack of Continuity of Physician Care: NHPCO Stresses the Importance of Continued Involvement between Hospice Providers and Patient’s Primary Physicians

( Alexandria , Va ) – In study published in March 9 issue of Archives of Internal Medicine, researchers found that patients and families can suffer from feelings of abandonment when a physician who had been actively involved in care is no longer involved. Additionally, when there was no continuity between care providers, a lack of closure following the patient’s death was found among families as well as the referring physicians and their staff.

National Hospice and Palliative Care Organization wants to emphasize the importance of the primary physician’s ongoing involvement with a patient and family once a person has been referred and made the transition to hospice care.
“There are certainly challenges in maintaining ongoing communication between referring physicians and hospice providers, but this study demonstrates that there is a need,” said J. Donald Schumacher, NHPCO president/CEO NHPCO. “Having a process in place that enables all parties to stay connected and informed is critically important in keeping the patient at the heart of care. In fact, regulations require it.”

In the Centers for Medicare and Medicaid Services conditions of participation (CoPs) for Medicare certified hospice providers, involvement of the primary physician is indicated. Current CoPs require that the hospice interdisciplinary group complete the patient’s initial comprehensive assessment in consultation with the individual’s attending physician (if any) within five days of the election of hospice. And the care plan developed by the hospice team must be done in consultation with the patient’s attending physician.

As healthcare providers continue to work on creating a more seamless continuum of care from diagnosis through hospice, the need for patients and families to feel supported is critically important. “All physicians who have cared for a person during a life-limiting illness should continue to be a part of the patient’s journey at the end of life. While the primary physician’s role will change, his or her involvement should not stop when hospice starts,” Schumacher noted. Recognizing the importance of supporting families, hospices offer bereavement services to family members for a year after the death of their loved one.

For more information about hospice, palliative care and advance care planning, please visit NHPCO’s Caring Connections Web site or call the HelpLine at 800/658-8898.

Contact:
Jon Radulovic
NHPCO, Vice President of Communications
Ph: 703-837-3139

ASK THE DOCTOR - Pneumonia Vaccine

2009-03-22T21:50:00.000-07:00

My doctor told me that I should get a pneumonia shot, what is that and is it the same as the flu shot?

Viral pneumonia is a serious complication of Influenza (the flu). Taking the flu shot each season will help protect you from the most common flu strains for that year.

The adult pneumonia shot, Pneumovax, is different from the flu shot. It protects against 23 strains of pneumococcal bacteria. These bacteria commonly cause pneumonia, which can be life threatening in older adults. The bacteria can also cause serious infections in the blood, spinal cord and brain which life are threatening as well.
The vaccine does not prevent every type of pneumonia, but it's very effective at protecting people from these more dangerous pneumococcal diseases. The pneumococcal vaccine has been shown to be safe and effective at preventing illness for up to 10 years. Side effects include pain or redness at the injection site, fever and muscle aches. A booster is recommended after 10 years.
The shot is covered by Medicare and recommended for all patients over 65. The vaccine protects against 88 percent of the pneumococcal bacteria that cause pneumonia. No shot can protect you against all types of pneumonias but pneumococcal pneumonias are the leading cause of vaccine preventable deaths in the US. Just think - here is a great New Year’s resolution that Uncle Sam will even pick up the tab for.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.