Health and medicine
Doctors, pharmacy, therapy, and the specialists nobody tells you exist — a geriatrician is not the same as a family doctor who has older patients.
Official source the real list is public and we send you to it
Start with the appointment she has already paid for
Medicare Part B covers a yearly “Wellness” visit, once every 12 months, and you pay nothing for it if the provider accepts assignment. It is not a physical. It is a conversation, and the things it is required to include are precisely the things families spend years failing to get done:
- The provider reviews her current prescriptions.
- The provider performs a cognitive assessment to look for signs of dementia — and if they think there may be impairment, Medicare covers a separate, more thorough visit to check for dementia, depression, anxiety or delirium.
- The provider offers to talk about advance directives.
- You leave with a written plan of the screenings and vaccines she is due.
Read that list again with your own situation in mind. The memory question that your family has been having at Christmas for two years is a standard part of a free annual appointment, asked by a doctor, on the record. Book it. If you want to raise something specific, book a separate appointment for that, because the wellness visit is meant to stay on prevention and gets crowded out otherwise.
A geriatrician is not a family doctor with older patients
Geriatrics is its own specialty, and the difference that matters day to day is what they do with the whole medicine list at once. A parent at 82 is often being treated by four people who each prescribed sensibly and none of whom has seen the full set. Ask whether one practises near her, and whether her plan needs a referral.
If there is no geriatrician within reach — common outside cities — the substitute is not nothing. Ask her existing doctor directly for a full medication review and take everything to it.
The most valuable hour: one pharmacy and every bottle
- Use one pharmacy for everything. The interaction checking only works on the medicines that pharmacy can see.
- Take every bottle to the review — prescriptions, anything bought off the shelf, vitamins, herbal supplements, the eye drops, the cream. The ones nobody counts as medicine are the ones that interact.
- For each one ask: what is this for, is it still doing that, and what happens if we stop it? A medicine that was right in 2014 is not automatically right now.
- Ask the pharmacy to synchronise the refills to a single date. One collection a month instead of five is a different life.
- Ask whether they will blister-pack by day and time, and whether they deliver. Many do both, often at no charge, and neither is advertised.
If the failure is forgetting rather than organising, that is a device problem — see safety, monitoring and devices for dispensers, and match the machine to the actual failure.
What Original Medicare does not cover, and everyone assumes it does
| Original Medicare | |
|---|---|
| Dental | In most cases not covered — including routine cleanings, fillings, extractions, dentures and implants. Narrow exceptions exist, mostly dental work tied to a covered medical treatment such as a transplant, cancer treatment or dialysis. |
| Hearing aids | Not covered — and neither are the exams for fitting them. You pay all costs. |
| Glasses | Not usually covered. Part B pays for one pair of standard-frame glasses, or one set of contact lenses, after each cataract surgery that implants an intraocular lens. |
Hearing aids without an audiologist, since 2022
The FDA created a category of over-the-counter hearing aids that took effect on 17 October 2022. Adults 18 and over with perceived mild to moderate hearing loss can buy them in a shop or online with no medical exam, no prescription and no fitting appointment.
Two limits worth being straight about. They are not for severe or profound hearing loss — their maximum output is capped, and someone with worse hearing should see a licensed professional. And self-fitting means somebody has to do the fitting; if that will not be her, it needs to be you.
Why it belongs on a page about a parent rather than a gadget page: the FDA notes that only about one-fifth of people who could benefit from a hearing aid get one, and that using hearing aids may reduce the frequency or severity of cognitive decline and depression. A mother who cannot follow the conversation at the table looks withdrawn and looks confused, and sometimes that is all it is.
The official list, and what it is good for
There is one national register worth knowing, and it is free: Medicare's Care Compare. It covers doctors and clinicians, hospitals, home health agencies, hospices, dialysis facilities and nursing homes, with inspection findings and star ratings.
Use it to check a specific name and to read the inspection detail. Do not use the star alone to pick: a star is a summary of measures chosen for a national programme, and the question you actually have — is this the right person for my mother — is not one of those measures.
What to ask at the next appointment
- Ask for a full medication review, with every bottle in the bag.
- Ask to be added to the release so the practice may speak to you. Doing this in the waiting room takes two minutes; doing it during a crisis takes days.
- Ask what the plan is if she falls, and who to call that is not the emergency room.
- Ask whether routine follow-ups can be done by telehealth — for someone with no easy ride, that is the difference between attending and not.
- Ask for the after-hours number, and write it somewhere other than your phone.
If the obstacle is the journey rather than the appointment, that is its own problem with its own free answers — see getting around.