Your Aging Advocate
Helpful tips for family caregivers

Is the house too cold?

The dangers of cold, icy weather are obvious outdoors. But there are dangers indoors, too, most often because the house thermostat is set too low. People can die from being too cold. Older adults are especially at risk.

Signs of low body temperature. Shivering is the body’s first response to cold. Later symptoms include stiff or slowed movement, slurred speech, sleepiness, mental confusion, or a weak pulse. If your loved one’s temperature is 96 degrees or less, call 911 for emergency assistance. While you wait, make sure the person you care for is dry. Cover him or her with a dry blanket and offer a warm, nonalcoholic beverage.

The key risk factors

• Health conditions that affect blood flow, such as heart disease, diabetes, and stroke
• Medications such as sleep aids and major tranquilizers
• Lack of physical activity
• Alcohol consumption and/or inadequate intake of liquids (dehydration)
• Concern about finances and the cost of heating

The key preventives

• A warm-enough house. Set the thermostat to at least 68 degrees. Even a home temperature of 60–65 degrees can set off hypothermia in an older person.
• Appropriate clothing. Many layers of light clothing trap body heat better than one heavy coat. If your family member is sedentary, consider adding a hat, mittens, or socks with fleecy slippers.

Options to reduce energy costs

• Insulate windows and unused glass sliding doors with sheets of clear plastic. Add weather stripping around windows and doors.
• Provide a personal heat source such as a hot water bottle or a warming bag that can be reheated in the microwave.
• For help with utility bills, contact your state’s branch of the national Low Income Home Energy Assistance Program, or call the National Energy Assistance Referral (NEAR) project toll-free at 1-866-674-6327 for a referral.
• For help with making a home more energy efficient, contact the Weatherization Assistance Program.

Saving money on meds

Medicare’s prescription program feels a bit like Russian roulette: You are never quite sure when your loved one is going to hit the “doughnut hole” and have to pay the full cost of each medication. The doughnut hole calculator sponsored by the American Association of Retired Persons eliminates the suspense. Better yet, it identifies possible options to avoid the coverage gap altogether.

First, here are the rules of the game. If your loved one has Medicare Part D, he or she has signed up for a prescription drug plan with the following benefits:

• Initial coverage. The insured individual pays an annual deductible, and a per-prescription co-pay. The plan pays the rest, up to a specific amount. For 2009 this amount is $2700.
• Gap in coverage (the doughnut hole). The insured pays 100% of prescription costs until his or her total out-of-pocket expense reaches a specific limit. For 2009, this limit is $4350.
• Catastrophic coverage. The insured pays only 5% of prescription costs for the remainder of the calendar year. The plan pays the rest.

The doughnut hole calculator shows how your loved one’s costs accumulate over the months. It is quick and simple to use. Pull-down menus help you identify your family member’s plan, medications, and dosages. The calculator:
Presents a bar graph showing drug costs by month and if/when you’ll hit the doughnut hole.
Offers options of comparable lower cost drugs.
Prepares a letter to your doctor requesting consideration of the lower cost options.
Provides a printable wallet-size copy of your drug list.

If your loved one has limited income and resources, check to see if he or she qualifies for Medicare’s “Rx Extra Help” program.

Don’t forget: If you are considering switching your family member to a different prescription plan, the annual open enrollment period is November 15 to December 31.