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Many Alzheimer’s patients are in denial, which prevents them from getting their legal and financial affairs in order until it’s too late. But there are ways to minimize the damage and ensure their well-being

KNOW THE WARNING SIGNS
If your mom calls three times a day to ask the same question, something may be wrong. The inability to learn new information is a red flag. Additionally, you can ask her what day of the week it is or when she was born, data that should be very familiar to her. When you visit, be concerned if you spot mystery dings on her car or if she’s getting lost driving familiar roads.

BUY A LONG-TERM-CARE POLICY
Alzheimer’s care costs up to $75,000 per year, and regular health insurance covers nothing beyond doctor visits, lab tests, and some prescription drugs. If your parent is still healthy, look into buying long-term-care insurance ($4,000 to $8,000 per year), which cannot be purchased once a diagnosis is made. Purchase a policy for your parent at age 55; if there is a family history of early-onset Alzheimer’s, consider earlier coverage.

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Tamoxifen is a hormonal therapy that blocks the effects of oestrogen in breast tissue. Developed more than 20 years ago, it is widely used to treat breast cancer, both after the initial surgery and if the cancer has come back following treatment. Tamoxifen may also be used to help prevent breast cancer in some women who are at very high risk of developing the disease.

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Recently I asked my doctor to prescribe for me by generic name, but he gave me an argument. What am I to make of this?

answer:
Federal Drug Administration and Senate investigations have clearly proved that brand name drugs are more expensive—and, in some cases, outrageously higher—than the same drugs under their generic names. However, many doctors sincerely feel that there is more to it than price. They argue that there is better quality control by large companies producing drugs under a brand name. They feel, then, that brand name medicines are safer. In addition, hard-pressed doctors on busy schedules say it’s hard to keep up with names of the many new drugs. The highly advertised brands stick in their minds and make it easier to prescribe.

Well-meant as these arguments may be, there is no proof that drugs made by small firms are inferior to brand name medicines in either quality or safety factors. In fact, some of the worst scandals on unsafe drugs have involved huge medical companies— usually when they release new drugs that have not been tested enough. Neither is it surprising that doctors remember brand names easier than generic names. Big pharmaceutical companies spend about $800 million a year in advertising directly to doctors—advertising that the general public isn’t aware of.

You can’t force your doctor to prescribe by generic name—and, of course, you shouldn’t try if you trust him or her, and have a good relationship. However, you might talk the matter over again, and ask the doctor to consider the importance of the money savings to you.

I have heard that it is cheaper to buy drugs by their generic name. What does this mean?

answer:
The generic name of drugs, like the generic name of anything else, is the common name given to all drugs of one kind. For example, aspirin is the generic name of one of the most commonly used nonprescription pain killers in the world. You can go into any drugstore and probably find aspirin at prices ranging from 29 to 89 cents for the same size of container. Similarly, prednisone, a drug now widely used in treating arthritis, costs six times more if bought by brand name rather than its generic name. Almost as startling is the fact that the often-prescribed antibiotic tetracycline costs one-half less under the generic name. Many tranquilizers run from one-fourth to one-third cheaper if you avoid buying them by their brand names.

Both the hospitalization and medical plans of Medicare provide for home care, and both cover up to 1oo visits by nurses or other health workers. However, hospital insurance pays for home care only if it comes after, and is connected with, a hospital stay.

In general terms, the medical plan pays for 80 per cent of doctor bills and certain medical services over the first $50 of expenses in any one year. The doctor will be paid for his treatment in or out of the hospital, and some of the tests covered may be done in a hospital. Out-of-hospital psychiatric care is met up to $250 a year.

A benefit period, which is sometimes also called a spell of illness, goes from the day you enter the hospital to the day you have been out of the hospital for 60 days running. For example, if you are in the hospital for 10 days, and out for 60, the benefit period is 70 days. If you return to the hospital even on the 71st day, a new benefit period starts.

The lifetime reserve comes to your aid if you need more than 90 days in the hospital during one benefit period. Each day used from this reserve is irreplaceable, and reduces the total number of reserve days due you. Thus, if you are in the hospital for 107 days, your lifetime reserve becomes 43 days—that is, the 17 days above 90 are subtracted from the 60-day reserve.