Despite Medicare drug confusion, many elderly people don't seek kids' help


Monday, February 20th 2006, 12:23 pm
By: News On 6


ATLANTA (AP) _ This month the federal government placed a Valentine-themed ad in People magazine that shows a smiling young woman being hugged by a grateful-looking elderly woman.

An attached card for readers to send to their parents listed ``5 ways to say I love you.'' Among them: ``I love you,'' ``I love you like kids love cookies,'' and ``Let's talk about Medicare prescription drug coverage.''

The idea: The elderly will turn to their children for help in evaluating the program's complicated coverage options, and thus open a conversation about health and medication needs.

``I've heard a lot of people say, 'I had no clue my parents took these meds!''' said Kathleen Harrington, who leads prescription program outreach for the federal Centers for Medicare & Medicaid Services.

She and other federal officials point to the mind-numbing array of drug coverage options as an opportunity for family bonding. However, plenty of other people question how often the program is triggering the kind of Hallmark moments that Medicare officials are talking about.

Family relationships are complicated, and many parents don't feel comfortable sharing personal medical information with their children. The new Medicare benefit does not seem to be changing that, said Dr. Jeff Lesesne, medical director for two Emory Healthcare nursing facilities in Atlanta.

Indeed, most of the dozen seniors interviewed in Atlanta recently said they didn't turn to their kids for help. Some felt they didn't need help. Some said it made more sense to ask a pharmacist or social worker. Some said they weren't close to their children. And some didn't want to be a burden.

Luanna Miller, 84, said she ``didn't want to bother'' her daughter, whose husband just had surgery.

Medicare is the federal health insurance program for the elderly and disabled. It's paid hospital and doctor bills for decades, but traditionally did not pay for beneficiaries' prescription drugs _ a crushing cost for many older Americans.

A 2003 law added a prescription benefit, called Medicare Part D, to be operated by companies with Medicare contracts. Sign-up for the benefit began in November, and seniors have until May 15 to pick a plan without facing a late penalty.

The program went into effect Jan. 1 for those who signed up early and for millions who previously were covered by state Medicaid programs.

The start-up did not go smoothly. Pharmacies and patients complained about jammed phone lines, inaccurate computer lists of who was eligible for the program, and patients being charged hundreds of dollars for prescriptions instead of the set co-payments of $1 to $5.

The program's complexity and well-documented problems have undoubtedly caused some anxious seniors to turn to their children, and led children to better understand their parents' health status, said Andrew Scharlach, a University of California-Berkeley professor of social welfare and a member of the California Commission on Aging.

But Scharlach, a critic of the benefit, said that doesn't mean the new program should be celebrated as some kind of transforming agent improving familial bonding.

``If an asteroid was going to fall in the middle of downtown Atlanta tomorrow, one side effect is people would get to know their neighbors and have a lot of improved relationships. But I don't know that that's a positive thing, overall,'' Scharlach said.

For seniors still considering the program, many have found the options overwhelming. Most states have dozens of Medicare drug plans, each with its own list of covered drugs, prior authorization rules, premiums, co-pays and deductibles.

Experts say the easiest way for seniors to compare options and sign up for a plan is through an Internet service offered by Medicare, at http://www.medicare.gov. But surveys show that only about a fifth of people 65 and older have access to the Internet.

Medicare officials knew that, and expected many seniors would turn to their adult children for computer help. ``We're trying to get the adult children engaged,'' Harrington said, adding that the $325,000 People ad was part of that effort.

Medicare also has done outreach with financial planners, who are advising families on retirement planning and may see Part D as an opening to doing other business with beneficiaries' children, Harrington said.

Federal officials say they have no data on how often the elderly are turning to their children for help. A small Kaiser Family Foundation telephone survey of U.S. seniors earlier this month found that only 8 percent said they turned to family or friends to help them choose plans through the Medicare Web site. About 75 percent said hadn't used the site.

Nearly two-thirds of those surveyed said they trust a doctor or pharmacist most to help them make decisions.

U.S. Secretary of Health and Human Services Mike Leavitt has talked about helping his own parents enroll. Both in their 70s, they brought their prescription drugs with them.

``As I picked up each bottle, we had a conversation about what the purpose of that one was,'' Leavitt said. ``I learned things I didn't know before. It was an important conversation.''

Dr. Truddie Darden of Atlanta said her mother, Alma Edwards, called her for help in November after receiving a mailing about Part D. Darden already knew about her mother's diabetes and other health conditions, but she hadn't realized what her mother was paying out-of-pocket each month.

``It was $50 to $60 more than I thought,'' said Darden, a pediatrician at the Morehouse School of Medicine.

In some families, like Darden's, children are their parents' caretakers and already know their prescriptions, said Lesesne, the Emory geriatrician.

In other families, kids are not involved, and elderly parents want to keep it that way. ``The fear is, 'If I say to my doctor _ in front of my child _ that I'm having trouble bathing or driving or dressing, they (children) may try to make me move or take away my independence,''' Lesesne said.

At an Atlanta senior center, eight elderly people who gave interviews said they didn't ask their children to help them with Part D.

``I've studied this. My children would not understand it as well as I do,'' said Helene Mills, 78, a senior activist and the center's namesake.

Lucinda Smith, 60, in December chose a plan for her 75-year-old husband, Eddie, whose drugs were previously covered by Medicaid. They're unhappy that his prescription co-pays rose and concerned because the plan never sent him a prescription card. But they said there biggest question was simply, ``What is the Part D?''

They haven't consulted the retired construction worker's children. ``I don't know his kids,'' Smith said.

Similar stories could be found at Wesley Woods Towers, a seniors apartment complex in northeast Atlanta.

Martita Van Ness, 88, didn't consider talking to her child. ``My son is not close to me,'' said Van Ness, who turned instead to a social worker.

Even in cases where beneficiaries did work with their kids, family members were nonplussed by the experience.

``I don't think anything I learned was like, 'Oh, wow, it brought me closer to them,''' said Parthiv Parekh, 39, editor of a monthly magazine that serves the Atlanta area's Indian and South Asian communities.

``I just learned a couple more prescriptions that they take,'' he said. ``If anything, it was just one more headache.''