ParentCare » Vol. 27

Caregiving NOW!

By Angela Penny

holytrinityMany people wonder whether choosing hospice care means that they are giving up hope. They may be concerned that choosing comfort care means choosing death. In actuality, people who choose hospice are not giving up hope; they are in fact redefining it. Though there may no longer be a possibility of curing their illness, they redirect their hope into mending and restoring relationships, spending quality time with those they love, and finding peace and comfort. Choosing hospice doesn’t mean choosing death, it means choosing to live life to the fullest. Usually once someone has chosen hospice, he/she has been through a lot already. Multiple hospital admissions, chemotherapy and radiation, and invasive tests and treatments can leave patients feeling sick and tired. By choosing hospice, they have decided to focus on the quality of their lives rather than on the quantity/. Many patients choose hospice to use their time that was once consumed by doctor’s appointments and hospital stays, to take family vacations, travel to places they’ve always wanted to see, and enjoy the company of loved ones. These are not patients who have given up hope or given up on life. These are patients who are living life to the fullest.

There comes a time for some families that caring for a loved one in their own home becomes too difficult.  The Ichabod Washburn Hospice Residence is a place that your loved one can have their care provided and be in a home setting.  The benefit for the family is that the staff can become the provider of care and the family can return to being a husband, wife, son, daughter or friend.  The unique part about the Ichabod Washburn Hospice Residence is the partnerships with other Hospice Providers.  In order to prevent patients from having to leave their nurses, CNAs and volunteer staff that they have in their home, Ichabod Washburn Hospice Residence has partnered with other Non-Profit hospice providers that continue to see them at the Residence.  This is especially important to patients and families at the end of a life journey.  The comfort and peace you have with your nurse for example, is very important.  If you had to move to another nurse and other staff, it would be very disruptive to that comfort and peace.

Hospice philosophy is to provide comfort and quality of life and also believes that it includes caring for the families.

Angela Penny is the Director of Admissions & Marketing at Ichabod Washburn Hospice Residence, 1183 Main Street at Webster Square, Worcester.  She can be reached at 508-341-7170


evv-1If your elder is having difficulty with mobility or you feel that he or she isn’t able to get around safely, there are mobility products available to help. A mobility aid will allow your elder to maintain independence and will help prevent falls and injuries.

These aids range from canes and walkers for people who are fairly mobile to electric scooters, manual wheelchairs, and power wheelchairs for those with significantly decreased mobility. If your senior falls into the last category, an evaluation is necessary to determine if a scooter, manual wheelchair, or electric wheelchair is best for your needs.

Get an Evaluation

The first step in getting a mobility aid is to have your senior evaluated by his or her doctor. An occupational therapist may conduct your evaluation, but the doctor must first write a prescription if you are using your Medicare coverage. The doctor or therapist uses certain criteria to decide which mobility product is best.

The following will be checked during the evaluation:

• Overall strength: If upper body and legs are weak, an individual may not have the strength to use an electric scooter or manual wheelchair. To use a scooter, you have to be able to hold yourself upright without assistance or support.

• Upper-body strength: Even if someone has sufficient body strength, he/she must have enough strength in the upper body, arms, and hands in order to operate a mobility scooter. Upper-body strength will also determine if he/she is able to operate a manual wheelchair or if an electric wheelchair is necessary.

• Balance: If someone’s balance is impaired and posture is poor, he/she may not be able to remain upright to use a manual wheelchair or stay on a scooter.

Choosing an Electric Scooter

If the evaluation has established that an electric scooter is the mobility product that best fits your requirements, you can begin to decide what type of scooter your elder needs. There are many styles of scooters with a wide variety of options and accessories.

All scooter models have the same basic features. They have a seat on top of a wheeled platform and a column (called the tiller) at the front with controls or hand-rests. The base unit offers support for feet and contains the drive system and battery.

The doctor or therapist will have specific results that will help determine your choice. For instance, if someone has less hand strength, that means he/she would have difficulty using hand controls; fortunately, other types of controls are available. The following are other factors to consider:

• Where will your senior be using the scooter? Electric scooters are available in 3- and 4-wheeled models. If he/she will be using your scooter primarily outdoors, the 4-wheeled model will offer more stability and is easier to use on rough terrain. The three-wheeled model works well inside since it is easier to maneuver in smaller spaces.

• Will you need to transport the scooter in your vehicle or will your senior need to transport it in his/her vehicle? There are both full-size electric scooters and portable scooters. The portable scooter can be folded and placed in a vehicle and is thus a good choice if you are still driving and don’t want to purchase the additional scooter lift that is necessary for a full-size scooter.

Medicare Coverage for Electric Mobility Scooters

Medicare Part B will cover most of the cost of electric mobility scooters, but only if the doctor determines that it is medically necessary. The scooter must also be used primarily for moving about the home and not as a “recreational” vehicle. Your senior may have to pay up to 20% of the cost after meeting his/her Part B deductible.

Other requirements for Medicare coverage include:

• The evaluation must be with a doctor or other qualified health provider

• The evaluation must be documented and say that your senior needs a mobility aid for a medical condition (called a “Certificate of Medical Necessity”)

• You must present the order or prescription to the Medicare-approved electric scooter supplier before Medicare can be billed

• The “driver” must be able to get on and get off of the scooter  and safely operate it

• He/she must have good vision

• He/she must have a health condition that makes it difficult for him/her to move around at home

Changes to Medicare Coverage

There have been changes to Medicare coverage for “Durable Medical Equipment,” which includes things like medical supplies and electric mobility scooters. It’s important that you are aware of the changes.  The ones listed below apply through the end of 2011; if you have questions about covered suppliers, go to where Medicare-approved suppliers are listed or call 1-800-MEDICARE (1-800-633-4227). If your elder has a Medicare Advantage Plan, be sure to check with the individual plan to be sure you follow their guidelines for obtaining an electric mobility scooter.

In an effort to cut costs, Medicare began to implement what is called “Competitive Bidding” at the end of 2010. This meant that Medicare-approved providers and suppliers of durable medical equipment were required to submit competitive bids for their products. There is a selection process in which the “winning” bids and those suppliers become Medicare-approved.

Also, there are now much stricter guidelines for doctors and providers who evaluate the need for a mobility aid. These evaluations have always been face-to-face for Medicare to approve a wheelchair or scooter, but now these evaluations are even lengthier and more detailed.


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