Sample Articles: October - December 2005

Is Understanding Medicare Part D Giving You a Headache?

By D. Marlane Porter, Attorney at Law

There are several reasons to become knowledgeable about the program.

First, although enrollment is purely voluntary, there is an escalating financial penalty for many Medicare recipients who don't sign up during the initial enrollment period.

Second, Medicare beneficiaries with low-incomes stand to gain significantly from the program because they receive “gap” coverage free of charge.

Third, if you do decide to enroll, choosing the right drug plan is crucial because most recipients will have to wait a year to switch plans.

Although space doesn’t allow for a complete explanation of the new plan, here are a couple of highlights: Medicare recipients who elect to be covered by the new drug benefit will pay premiums averaging $32.20 a month in 2006. Some plans will charge more, some less. After meeting a $250 deductible, you will pay 25 percent of drug costs up to $2,250 in a year, with Medicare paying the other 75 percent. The plan will pay $1,500 and you will pay $500. Coverage will then stop completely until your payments for covered drugs reach $5,100 (this… is sometimes called the "doughnut hole".)

In other words, after you reach the $2,250 limit noted above, you will be responsible for covering the next $2,850 in drug costs yourself. If your costs for covered drugs exceed $5,100, coverage will kick back in, with Medicare paying about 95 percent of costs above $5,100 (called "catastrophic coverage").

The rules are complicated, and can be confusing. Before you make a decision about future benefits, make sure you have as much information as possible.

For more information about who, when and how to enroll, an excellent source of information is Medicare’s website: www.medicare.gov or explore the wealth of information at www.aarp.com.

D. Marlane Porter is an elder law attorney and member of NAELA (National Academy of Elder Law Attorneys).

For more information about this article or specific elder law issues, call 480.464.7024.

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Can You Hear Me Now?

The Arizona Commission for the Deaf & Hard of Hearing Can Help!

By Dee Ann Deaton

What? Say Again? If you find it increasingly difficult to hear phone conversations, you are not alone. Hearing loss is the most common disability in America.

More than 27 million Americans presently have a hearing loss, representing almost 10% of the nation's population. The Arizona Commission for the Deaf and Hard of Hearing (ACDHH) provides numerous free programs that can assist you.

ACDHH's primary responsibility is that of an information and referral state agency. However, due to statutory delegation, ACDHH has seen its scope of responsibility greatly increased over the last decade to include providing telecommunications equipment and overseeing the states 711 Arizona Relay Service and licensure of interpreters.

In the past, Arizona residents with a hearing loss could not simply buy an accessible receiver and make phone calls. Telephone access was limited (and equipment was – and remains – expensive).

Thanks to The Arizona Telecommunications Equipment Distribution Program (AzTEDP), Arizonans with hearing loss can now obtain, through this voucher program, the necessary telecommunications equipment needed to communicate with the outside world.

Choices of telecommunication equipment available through the AzTEDP program vary from a TTY (Teletype), VCO (Voice Carry Over) phones to Volume control telephones. If you are unsure of the best fit for you, a number of demonstration sites are located around the state. The demonstration sites provide training on equipment use.

Who Qualifies?
People who are deaf, hard of hearing, deaf-blind, and speech-impaired qualify for the program. Equipment is completely free of charge. To qualify, you must be an Arizona resident, and submit an application form signed by a physician, audiologist, hearing aid dispenser, or speech pathologist who certifies your hearing loss or impairment. Once the application is processed, you will receive a voucher that pays for the equipment of your choice from a participating vendor. The equipment is then loaned to you free of charge for five years!

7-1-1 AZRS
Arizona Relay Service (AZRS) is another public service provided by the state, which can be accessed by dialing 7-1-1 anywhere in Arizona. AZRS is a “human” wire, with relay operators facilitating telephone conversations between the hearing and deaf, speech disabled, and/or hard of hearing individuals.

To find out more about ACDHH’s services and programs, and to make an appointment at a demonstration site near you, call 602-542-3323 (voice) or 602-364-0990 (TTY) in Phoenix, (800) 352-8161 outside Phoenix, or visit www.acdhh.org.

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Mouse Talk

By Amy C. Lowenstein

GREETING CARDS ONLINE

Your computer is a wonderful source for greeting cards for all occasions. Some web sites provide e-mail greetings. Others offer cards for sale. Most allow you to customize your choice. You can also purchase software to use to design your own cards on the computer. You will never have to go to a card store again! And, in some cases, to the post office either! There are so many greeting card web sites, it is hard to pick which ones to highlight.

CARDSTORE.COM

Cardstore.com offers a complete online card service. The site offers a wide assortment of cards printed on art museum shop quality paper. Select from their collection or provide your own artwork and photos to create 5x7 cards or postcards. If you use cards from CardStore’s collection, you can personalize the text. You can even attach a plastic gift certificate for whatever amount you choose from any of the national retailers listed on CardStore’s site. CardStore provides a variety of mailing options, including immediate or scheduled mailing. They will send a box of cards for you to address or mail you a box of stamped and pre-addressed cards made from your address list. Credit cards are accepted on a secure site. To get started, click on the Help file, which offers a detail explanation of all the services offered.

ANIMATED ELECTRONIC GREETING CARDS

There are a great number of companies that provide free animated greeting cards that are sent via e-mail. Most offer personalized messages, a choice of music and even a choice of pictures. Among the most popular are Bluemountain.com, e-greetingz.com, and regards.com. To find more sites, search Google using the term “free email greeting cards” and browse through the long list, which appears.

GREETING CARDS SOFTWARE PROGRAMS

Relatively inexpensive software programs are available for purchase online, which enable you to make your own cards. They offer templates, clip art and special fonts, as well as other things to enable you to make your own cards or invitations. Two of the more popular sites to find software are Hallmark.com (which sells Hallmark Card Studio), and AmericanGreetings.com (which sells Create & Print).

Amy C. Lowenstein is the author of For Grandmas Who Do Windows, Dithridge Press, 2005, available at Barnes & Noble, most other book stores and online.
Contact Amy at Grandmawindows@aol.com.

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Live Without Limits

By Barbara Feth - HEALTHSOUTH

New Hope for Wrist and Hand Spasticity

Spasticity is excessive muscle contraction that results from injury to the brain or spinal cord. Spasticity is involuntary, and affects muscles that control movement in only one direction at a joint. Spasticity in one’s hand may result in the hand remaining clenched in a fist, with the wrist bent down at an awkward angle. Hand/wrist spasticity will prevent use of an affected hand, and eventually leads to shortening of muscles, tendons, and ligaments.

The purpose of most movements of the shoulder, elbow and wrist are to position the hand for function—so one can reach for, lift, control and move objects. Therefore a spastic wrist and hand not only leads to increasing problems at the wrist and hand, but leads to deterioration of muscles at the shoulder and elbow too. Unfortunately, the brain reacts to this situation by ignoring the affected arm. This is what researchers call “learned disuse.” As I’ve mentioned in prior articles, recovery from stroke depends on a tremendous amount of practice. Below are the elements of practice required to allow recovery of function following a stroke.

1. There has to be a lot of practice; hours and hours a day.
2. The affected limb needs to be “forced” to be used.
3. The practiced movement needs to have meaning—something one WANTS to do.

This kind of practice is nearly impossible for a person with wrist and hand spasticity. Fortunately, a local company, Kinetic Muscle, Incorporated (KMI), is helping people recovering from stroke and spinal cord injury address this problem with their robotic device called the Hand Mentor©. KMI’s Hand Mentor© uses “air muscles” to gently lift the wrist and hand into an extended (open) position.

The motion is gentle and repetitive, allowing the spastic muscles to gradually loosen and relax. Once the hand can be opened, the device has an “active” mode, where patients can work with the device, and gradually learn to use the muscles that lift the wrist and open the hand.

There are several components of the Hand Mentor© that help patients comply with needed practice sessions. There are biofeedback sensors that let patients know when they are using their weak muscles. There is a viewing screen that “tells” patients when to lift and when to relax. Additionally, a recording mechanism provides information to the patient’s therapist regarding time and effectiveness of practice sessions.

The Hand Mentor© works best when used in a clinic situation, combined with exercise and functional tasks. Occupational therapists help patients with device set-up, and establish the most effective program for the patient. Following such training, the patient may purchase a device for home use, and continue to report periodically to their clinic therapist.

Sharon Buchanan and Terri Strelish are two occupational therapists who utilize the Hand Mentor© for inpatients and outpatients recovering from stroke. They utilize the Hand Mentor© as a primary tool to help stroke patients control stasticity, improve flexibility and range of motion and begin to regain control of functional movement.

KMI is continuing to develop practical robotics to assist patients suffering from paralysis and spasticity. They are currently developing a device similar to the Hand Mentor© to be used to help with foot/ankle spasticity, and RUPERT, a robotic device for shoulder, elbow, wrist and hand.

For more information about the contents of this column or rehabilitation technology available at HealthSouth Scottsdale Rehabilitation Hospital, please call 480-551-5471. Barbara Feth, PT, MBA, is the Director of Clinical and Marketing Services at HealthSouth Scottsdale Rehabilitation Hospital.