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Expanding Medicare needed to ease cost of long term care

Viji Sundaram | 11/28/2012, 6:49 a.m.

ALBANY, Calif. — The long and hard-fought battle Eileen Hadidian has been waging against bone cancer for more than 10 years seems to be drawing to a close. Doctors earlier this month said she is probably just a few days, or maybe even just a few hours, away from death.

When that happens, the 64-year-old Lebanese American woman will become just another statistic in a health care system that fails to provide frail seniors and people with disabilities like her the long-term care they need — a situation that is sending many families into bankruptcy.

“I am so close to becoming eligible for Medi-Cal,” Hadidian said a couple of months ago, as she lay in a hospital bed near the window in the living room of her two-bedroom rental home here.

She said the monthly in-home support care of $5,000 she has to pay is fast depleting her family’s savings to a level that will allow her to qualify for the state-run program for low-income people whose financial assets fall below $2,000.

Bone cancer, one of the most painful forms of the disease, has eaten away at Hadidian’s body, causing her arms and legs to turn to matchsticks, and the outline of her collarbones to become visible under her nightgown. On her bedside table are bottles of medicines and a sipping cup.

She’s heavily medicated to numb the pain that has been her constant companion for years now. Even though her body is ravaged by the disease, until about a couple of months ago her mind was razor sharp and her sense of humor intact.

Hospice care

Hadidian was put in hospice care in September 2011, after cancer made her bones so brittle she began experiencing what doctors called “spontaneous pathological fractures.”

They determined that the fractured bones in her upper right arm and right thigh were never going to knit, and the mere act of standing on her legs could lead to more fractures. They told her she had no curative options and that she could either check into a skilled nursing facility or stay at home. She chose the latter.

“Both cost about the same, and I wanted be in quiet surroundings and close to family,” she said.

Since she was placed in hospice care, Hadidian has been in need of around-the-clock professional care, which her 70-year-old husband, Peter Tichenor, a part-time psychotherapist, cannot provide. She needs help turning in bed. Lying on her back is out of the question because of the widespread cancerous lesions all over it.

Medicare barely covers any of the in-home care she needs. And it only pays for biweekly visits by a hospice nurse.

“When you are on hospice for an extended time, they have to stretch their Medicare dollars,” observed Jodie Reid, executive director of the California Alliance for Retired Americans, noting that her late mother had had the “best hospice care,” possibly because she was on it for no more than a week.

Unfortunately, the hospice care system “doesn’t have enough resources,” asserted Wendy Peterson, director of the Senior Services Coalition of Alameda County. “That’s why the CLASS program was set up in the health care reform law.”