The Medicare Wellness Exam

I was working full time when I turned 65 and became eligible for Medicare (the American health system for seniors).  When I first enrolled in Medicare, I became eligible for an annual "wellness exam" fully paid for by Medicare  I got the first one, then skipped the next couple. 

This year, I decided to get it.

The good news is, I don't have dementia.

The nurse said I scored 100% overall.

But the questions...This was a trip down memory lane and a peak into my future.  And, perhaps, yours.

The reason for this exam is to have a personalized care plan based on your risk factors for various conditions.

The questions the nurse asked brought back the times I was a part time caregiver for my late mother in law.  I remember when they tested her for dementia and other conditions.  Some of the questions were too familiar.

When she had her tests, they asked her if she did her own cooking and housework.  She said "yes". But she could do neither.  She was speaking her truth, though. In the world of her mind she was still fully independent at a time where she needed home health care.

"Have you fallen in the past year?"  My mother in law fell....too many times.

Meanwhile, back in the present, the nurse read down the list of questions mandated by Medicare for this type exam.

"What day of the week is it?"  (I don't know why they ask this; every retired person I know has a problem with this.  As a part timer, I have to know when I report to work and when I don't, so I always know.)

"Do you need help eating, toileting, dressing, bathing?" (but if you do, I pondered later, what then?  Medicare doesn't pay for most home health care and getting the same is a nightmare for every caregiver I know.  And I do know a couple right now.)

"Do you have trouble managing your money or your medication?" Back came the memory of the day my mother in law denied she needed any of her many prescriptions, even when we showed her the bottles with her name on them.

"What year is it?" (My mother in law couldn't handle this one, nor did she know who the President was, given that she watched a news channel most of the day).

"What town are we in?"  With all the doctor visits I had this month I actually had to think about that for a minute.  They are all in different places.

"Write a sentence with a noun and a verb in it." (Don't they know I'm not the best with grammar?)

I passed the three word test, where the nurse tells you three words and you have to remember them a few minutes later.

Then came, for me, the stumper. The nurse said:  "You have a choice between spelling "world" backwards, or counting backwards from 100 by sevens."

"By sevens, is that what you want?", I said, disbelieving.  "Yes", she said.

I chose spelling a word  backwards.  I've always had trouble with spacial concepts and I'm surprised I could do it.  (Later, at home, my spouse, who loves numbers, did the "count backwards by sevens" without any hesitation.  Showoff.)  I did manage "world", to my surprise.

There were, though, the questions they don't ask during this exam.  The answers many in the United States would give are all too familiar.

"Can you afford your prescription medication?"

"If we order tests today, will you be able to afford them?"

"How hard is it for your caregivers to provide care for you, and how many times do people they hire to help out never show up, quit without warning or interview and then ghost your family?"

"Do the programs we are referring you to have a long wait list, not enough funding, or have an income maximum that is just low enough for everyone to be ineligible?"

I can't help thinking back to when I was a caregiver for my mother in law, and ahead to when I will need help, if I live long enough.

Our system is broken.  Ask the woman I know whose mother has dementia and other health issues and needs someone with her 24 hours a day.  Ask the woman trying to take care of her 100 year old father and help out her only sibling, who has a serious and possibly fatal illness?  I know both those people.

There are millions more.

It's nice to have a Medicare wellness exam, but our country must ask itself:  How much longer will we fail our most vulnerable?