By Betty Berry, Tuesday, Sept. 7, 2010  Q: I am a caregiver for a relative who is in the beginning stages of dementia. I also hold down a full-time job. I would very much like to attend a support group but have not found one that meets in the evening. Do you know of one that does?

A: Yes, I know of two caregiver support groups that hold their meetings in the evening, including a new one offered by the Central Coast chapter of the Alzheimer’s Association.

This new support group will hold its meetings from 7-8:30 p.m. on the first and third Tuesdays of each month at the OakView assisted-living facility at University Village, 3557 Campus Drive, Thousand Oaks. For more information, call 380-4264.

Also, Senior Concerns facilitates an evening support group for caregivers of dementia patients on the second Wednesday of each month from 7-8:30 p.m. at the Simi Valley Senior Center, 3900 Avenida Simi. For more information, call Senior Concerns at 497-0189.

These groups are designed to provide emotional, educational and social support for caregivers. The meetings help participants develop methods and skills to solve problems and encourage caregivers to maintain their own personal, physical and emotional health as well as optimally care for the person with dementia.

Q: My dad might need to go into a skilled nursing facility, and I’ve been told that Medicare might pay the costs. Do you know under what conditions this would occur?

A: The reason for your dad’s stay in a skilled nursing facility will determine whether or not Medicare will cover some of the cost. There are three types of care an individual can receive in a skilled nursing facility: skilled care, rehabilitation therapy and custodial care. Medicare coverage only applies to skilled care or therapy.

If your dad needs only custodial care, Medicare will not cover any of the costs. However, if your dad needs continued skilled care or therapy after having been in an acute care hospital for at least three days, Medicare coverage is available for a limited period of time.

Custodial care does not require the skills or knowledge of a doctor or registered health personnel. Care is normally provided by an attendant who assists or supervises such activities as walking, bathing, dressing, eating, toileting or moving from bed to chair, etc.

Medicare defines skilled care as a nursing or rehabilitation therapy service that requires the special skills of technical or professional health care personnel such as registered nurses, licensed practical or vocational nurses, physical therapists, occupational therapists, speech therapists and audiologists.

Examples of skilled care services include, but are not limited to, intravenous feeding, care of catheters, application of dressings involving prescription medications, and treatment of bedsores and other widespread skin disorders.

Skilled rehabilitation services include therapeutic exercises or activities, gait evaluation and training, ongoing assessment of rehabilitation needs and potential, and maintenance therapy. Both skilled care and rehabilitation services must be required seven days a week to qualify for Medicare coverage in a facility.

There may be some crossover of coverage. A patient who needs both skilled or therapy care as well as custodial care will likely be considered a Medicare patient.

Also, a service that is ordinarily considered custodial may at times qualify as skilled if the overall condition of the patient requires the expertise of skilled personnel.

— Betty Berry is a senior advocate for Senior Concerns. The advocates are at the Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks, CA 91362; call 495-6250 or e-mail (please include your telephone number). You are invited to submit questions on senior issues.

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