Frequently Asked Questions

Question 1: Difference between Medicare and Medicaid

Answer 1: Medicare and Medicaid are two separate, government-run programs. They are operated and funded by different parts of the government and primarily serve different groups.

Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income.

Medicaid is a state and federal program that provides health coverage if you have a very low income.

If you are eligible for both Medicare and Medicaid (dually eligible), you can have both. They will work together to provide you with health coverage and lower your costs.

Also know that while Medicare and Medicaid are both health insurance programs administered by the government, there are differences in covered services and cost-sharing. Make sure to call 1-800-MEDICARE or contact your local Medicaid office to learn more about Medicare and Medicaid costs and coverage, especially if you are
dual-eligible.

Question 2: WHAT IS ADL AND IADL?

Answer 2: ADLs = activities of daily living:

One way to think about basic ADLs is that they are the things many people do when they get up in the morning and get ready to go out of the house, i.e. get out of bed, go to the toilet, bathe, dress, groom, and eat. Generally, there are six basic ADLs: eating, bathing, getting dressed, toileting, transferring and continence.

Bathing

Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)

Personal hygiene and grooming (including brushing/combing/styling hair)

Dressing

self-feeding (not including cooking or chewing and swallowing)

Functional mobility, often referred to as "transferring", as measured by the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition (moving from one place to another while performing activities) is useful for people with different physical abilities who are still able to get around independently

Continence Care
There is a hierarchy to the ADLs: The early loss function is hygiene, The mid-loss functions are toilet use and locomotion, and The late loss function is eating.

IADLs = Instrumental activities of daily living:

Things like using a telephone, etc. not necessary for fundamental living, but if you have these, you can live independently in a community.

Meal preparation

Homemaking, housekeeping, household management or Cleaning and maintaining the house (act of overseeing the organizational, day-to-day operations of a house or estate

Managing money

Moving within the community

Shopping for groceries and necessities

Taking prescribed medications (Medication reminder, set-up or administration)

Using the telephone or other form of communication

Care of pets

Religious observances

Laundry
Here are warning signs that your parents may need help (sooner than you thought):

Your Mom or Dad claim that they eat three meals a day, but their refrigerator is filled with spoiled food and their pantry remains stocked with food that you purchased for them two weeks ago.

You observe that your parents are eating only frozen food dinners or canned soup, and not any fresh fruit or produce.

You notice that they're having more difficulty climbing up and down stairs.

You see that the dust seems to be accumulating, and you know that your parents have always been meticulous when it came to the maintenance of their home.

Your parents' loss of vision or their arthritis makes it difficult for them to drive, even short distances.

If you see that your loved one is having trouble with their IADL's, you have some options to help them out.

One option is home care agencies. Home care agencies can employ companions and caregivers to assist Mom or Dad with tasks that they may have difficulty completing, such as meal preparation, grocery shopping, light housekeeping, laundry, and driving.

In addition, independent personal assistants and concierges can also assist with the tasks above, while also taking the extra step to schedule your doctors' appointments and escorting you to these appointments.

As a caregiver, you want to be proactive in anticipating your loved one's needs and preventing any future risks for injuries or falls. Noticing that your loved one needs assistance with their IADL's should be the first indication to start putting measures in place to help them.

Editorial content provided by Janie De Leon-Male, M.S.S., LSW, Director of Care Coordination, Law Offices of Jerold E. Rothkoff