How Geriatricians Can Help Their Patients Address Incontinence
By Cheryl Williams
As the American population continues to live longer with improvements in modern medicine and better understanding about their own health, many are concerned about facing the rising costs associated with managing long-term conditions such as geriatric incontinence.
More than 25 million people in the United States suffer from some form of bladder leakage, and one-half of nursing home residents struggle with incontinence and require toileting assistance.
Unless they reside in skilled nursing facilities, residents are responsible for acquiring their own protective undergarments. Seniors often have difficulty paying for their own supplies, and their families may struggle to provide financial assistance.
Due to the sensitive and private nature of the condition, many patients take on the cost without looking into all of the available options. As a result, they may overpay for geriatric incontinence supplies without realizing that Medicaid will provide monthly payments toward adult disposable briefs, pull-ups, underpads, and more.
Caregivers are often a trusted resource for patients and can help by discussing alternative payment methods. In addition to directly helping patients while caring for them, geriatricians also can share information regarding Medicaid and insurance to help patients cope with incontinence on their own.
Insurance Coverage for Geriatric Incontinence Supplies
Patients can save money by having insurance cover their incontinence products. To do so, they must be covered by Medicaid by successfully meeting their individual state's qualification requirements, which are based on family income and size. In some cases, incontinence can be cured or significantly reduced. However, in many circumstances the symptoms can only be managed. Some patients need to manage their condition for decades or even a lifetime—often with the help of a caregiver—which is why Medicaid coverage for these expensive supplies is crucial.
Generally, state Medicaid plans cover as many as 200 disposable geriatric incontinence supplies, but Medicare does not provide for incontinence products. Coverage varies based on the patient's incontinence type, the severity, and of course, their individual and specific needs.
For example, a patient with severe incontinence may receive more supplies than another patient with stress incontinence. Coverage also varies depending on where the patient is located. For instance, to qualify in North Carolina, patients must be diagnosed with incontinence by a qualifying physician.
Receiving Supplies Through a Medical Supplier
Once patients qualify for incontinence supplies, they'll often purchase them through a medical supplier that's been recommended by their geriatricians or found online. Most suppliers ask patients to fill out a basic qualification form to determine their insurance coverage and then determine whether the patient will be fully or partially reimbursed for the cost of the supplies. Once that determination is made, the supplier will then bill Medicaid for reimbursement.
Once a patient has qualified to receive supplies, the medical supplier ships the products directly to his or her residence on a monthly basis.
The process may sound simple enough, but a team of qualified continence care specialists, skilled geriatricians, and caregivers are needed to keep patients comfortable.
Caregivers and geriatricians should act as trusted resources to reduce anxiety and make necessary care changes. Incontinence can be emotional, so these professionals must be trained about how best to approach the situation. They need the ability to calmly diffuse emotional escalations with empathy, support, and understanding.
Continence specialists at supply companies are responsible for maintaining client relationships, providing education, and guiding patients toward appropriate resources. Many people find a diagnosis of incontinence difficult to discuss, which is why it's so important that they work with a company that places a priority on building trust with patients by making available customer service representatives who are experts on the subject.
Geriatricians can help patients choose a company by directing them to a compassionate and proactive supplier that actively helps patients navigate their insurance coverage options and find correctly fitting protective undergarments. They should allow access to a variety of quality products that will conform to a patient's unique needs, condition, and lifestyle with excellent customer service to help products be discreetly delivered.
In some cases, caregivers are able to assist their patients with determining their specific needs, but expert specialists are also able to assist patients in managing their monthly supply schedules and should contact clients on a monthly basis to verify coverage and supply quantities. The exchange of information and planning are key to the long-term health and comfort of the patient.
Geriatricians can educate patients on incontinence care. The more equipped patients feel to deal with it on their own, the more comfortable they will be between care sessions.
— Cheryl Williams is urology team leader at Aeroflow Healthcare.