Expert: Michalene Peticca - 8/17/2007

Question
My mother is 83 years old and was diagnosed with Alzheimer's 6 months ago.  She lives in an nice Alzheimer's group home which is close to my sister and me.  Her diagnosis came after she "flipped out" while living with my sister.  One night she became paranoid and violent and my sister called for an ambulance.  She was transported to a hospital and eventually was transferred to another hospital about 20 miles away.  While in the psych unit there she was diagnosed and put on medication.  Her psychiatrist there told my sister that she would need to find another doctor to monitor her meds since he is not really taking on new patients.  My sister is my mother's legal guardian and medical guardian.  My sister tried to find a psych. in the area that would take medicare + supplemental insurance, but gave up after a few tries.  My mother's caregiver at her group home had been telling my sister that my mom needs her meds adjusted because she was getting aggressive and nasty with the 3 other residents that lived there.  My sister never called anyone and 2 nights ago my mother became very violent and paranoid and started hitting the other ladies.  I OK'd them calling an ambulance and they took my mom back to the hospital where she was diagnosed.  I'm afraid that my sister was reactive rather than proactive with getting my mom's meds regulated, waiting for this to happen as opposed to preventing a very upsetting situation for everyone, including my mom.  Once my mom is discharged she will need a local psych to regulate her meds, but we can't find one that takes medicare.  I've tried every resource available in our community and on the Internet, but cannot find someone to help me locate a doctor that will take Medicare for any Alzheimer's medical after care.  When I ask the receptionist why they don't take medicare for a disease that effects the elderly they say it's because they don't have to. This is very sad to me.  My sister has been paying for the group home from my mother's savings so she is trying to avoid large Dr bills if possible.  I told my sister if we cannot locate a medicare provider it is worth it to pay full price, but she refuses that option.  So finally, how can I find a psych that specializes in Alzheimer's care that accepts medicare?  Do they even exist?  I have been in contact with every Alzheimer's and elderly association I can find and all they tell me to do is call each doctor's office and ask if they take medicare!
Thank you for your time

Answer
Janet,
Thank you for writing.  I am sure this is a very  frustrating situation for your family and your mom.

It is true that doctors are starting to refuse Medicare reimbursements and can "hand pick" their patient clientele.
This shift in care is coming due to the expanding elderly population and the strains on the insurance and medicaid systems.   

However, i would expect some local Neurologist Would be willing to accept Medicare?  

Three options come to mind with your mother:  1. You take her to her primary physician and have that individual regulate her medications.    2.  You contact your local chapter of the Alzheimer's association and see if they can provide any help.    3. Contact your local Office of Aging and see if they can make any recomendations.

I am not sure what State you are in...but Johns Hopkins in Maryland has an excellent in-patient stay program for evaluation at their center called CopperRidge.  You might want to check out their website.

Don't give up...Keep trying to get the best medication for your mother...it does take trial and errors at time.

Best Regards,
Michalene Peticca M.A.