Equipment and Supplies

People with dementia often have a need for supplies. Durable Medical Equipment  (“DME”)  is equipment and supplies ordered by a medical provider for every day or extended use which may be covered by Medicare. 

1. DME

Some examples of DME that are covered by Medicare Part B when prescribed by your doctor for use in your home include: 

Blood sugar meters 

Blood sugar test strips

Canes 

Commode chairs

Continuous passive motion devices 

Continuous Positive Airway Pressure (CPAP) devices

Crutches

Hospital beds

Home infusion services

Infusion pumps & supplies

Lancet devices & lancets

Nebulizers & nebulizer medications

Oxygen equipment & accessories

Patient lifts 

Pressure-reducing support surfaces

Suction pumps

Traction equipment

Walkers

Wheelchairs & scooters

These products will only be covered by Medicare if your provider and the goods supplier are both enrolled in Medicare. Sometimes they will only cover if you rent the product, others times only if you buy and other times you will have a choice.

Always ask if they are covered first before you buy. If they are enrolled, you will only have to pay the Part B deductible and co-pay which might be covered by other insurance you have. See https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage

Note that some supplies are not covered by Medicare such as incontinence supplies or hearing aids. Neither does Medicare pay for eye exams, eyeglasses or lenses with a very narrow exception for glasses or lenses after a certain cataract surgery. There are some Medicare Advantage Plans, known as Part C plans that do cover things like hearing, dental and vision. For more information on these plans go to https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans/how-to-join-a-medicare-advantage-plan

Be careful not to subject yourself to fraud when seeking out a plan! As Medicare notes on its website, above:

Medicare plans aren't allowed to call you to enroll you in a plan, unless you specifically ask to be called. Also, plans should never ask you for financial information, including credit card or bank account numbers, over the phone.

No one should call you without your permission, or come to your home uninvited to sell Medicare products. Call 1-800-MEDICARE to report a plan that does this.

2. Incontinence Supplies.

I especially address these because for many with dementia, incontinence becomes an issue. Incontinence products are very expensive, often 50 cents to more than a dollar a piece depending on brand, size, type, quantity and quality purchased. My mom had occasionally been using these when living with her companion. I repeatedly expressed my disapproval of their use for most occasions other than long plane rides because I thought she was fully capable of using the bathroom and honestly saw their use as one of convenience for the caretaker in not having to deal with an occasional mishap vs her dignity. I felt the more she used them, the more she would simply become reliant.

She stayed with us for three and a half weeks and we did not use them on her and she had two minor accidents, one in the bathroom itself. Yet, from the minute she was put into an assisted living facility I was told she needed these. I fought the facilities a lot at the beginning, trying pads for the bed and smaller pads and eventually just gave in.

Indeed, at my apartment she had ready access to the bathroom and in fact she regularly went on her own many times a day. The facilities often had the residents in common areas where the bathrooms were not as accessible or not known by her. Her inability to talk, obviously would have made it tougher to communicate her needs. When she was with us, she was still talking.

Both facilities gave you the option of using their service for these supplies where you paid a set monthly fee. While it may be convenient, I found the quality of the ones they used to be subpar (when she ran out, they would occasionally use one of theirs) and their monthly prices far exceeded buying them at the local drugstore or online.

I do wish that both of her facilities gave better advice and kept better track of her supplies. Often at 10:00 on a Friday night I would get a call, would fear the worst, and would be told they were calling because she needed more of these products. I never had a firm handle on how many she needed. I honestly do believe often I would be unaware that she was low, that they would use others and then when I would purchase a whole new bundle of them that many would go to “making up” for the ones she had already used! Other times, she would have 2 or 3 boxes there. Part of the problem at the second facility is that they kept each person’s locked up in a room, so even when I visited I couldn’t figure out whether she had any! Sometimes I would get a call that she needed them, when I knew I had some delivered a day or two before!

My hints on these are simply as follows:

1. Consider something like Amazon auto ship delivery once you have an idea on their general needs.

2. I am big on generics, yet this is one area where I truly found generics to be of inferior quality.

3. Realize that they may need different ones for day and night.

4. Carefully check the sizing of each brand as they differ.

5. Check out manufacturers and other services for coupons as they have them often.

6. Consider pads for their beds, and definitely invest in mattress pads and covers.

7. Carefully figure out the per pad price when you are buying them and look for sales. Often with certain in store sales the hugest box was not the best price.

3. Hearing Aids.

As noted above, these generally are not covered by Medicare but may be covered by other insurance. Early on we thought some of my mom’s behaviors could simply be attributed to hearing and promptly had her tested where slight loss was noted and obtained hearing aids for her. She was very good with charging them, yet she did lose track of them often and sometimes would lose one which couldn’t be found. They cost thousands of dollars and were limited as to their replacement.

When she entered the first facility, they promptly put them in the safe and advised against her wearing them. I understand how it would be nearly impossible to keep track of them in a large facility, yet felt the situation was unfortunate. 

I do not know if there is any real solution for those with advanced dementia at a large facility. I note there are comments like keeping them at the nurses’ station, painting them bright colors, products are mentioned like ones that are a cord that attaches to a blouse (although this might be a hazard to many with dementia), some can be tracked with a gps device, and other suggestions. 

4. Glasses.

Glasses, again, are generally not covered by Medicare Part B, but might be by a supplemental policy. Glasses would appear to present a little less difficulty than hearing aids in a facility setting. Again, a name or some bright colored nail polish could more easily identify them. Earlier stages of dementia might make cords a safe option.