If you are among the four of five older Americans who buy medi-gap health-insurance policies to supplement Medicare, take heed: A recent report by the American Association of Retired Persons (AARP), with the National Association of Attorneys General, found that some insurance agents lure older people into purchasing costly and excessive policies.
The report cautions consumers to be on the lookout for the following sales abuses:-"Deceptive advertising": Some medigap companies exploit fears of health and financial disaster while glossing over policy limitations.
-"Loading up": Consumers are often sold more insurance than they reasonably need. Many policies offer variations in coverage, making it easy for agents to convince confused consumers they need more than one policy.
-"Twisting": Some agents urge older people to cancel current policies and replace them with new, comparable ones, which can cause a temporary lapse in coverage. (Commissions paid to agents are generally higher for new policies.)
Older Americans lost an estimated $3 billion in 1987 because of unscrupulous Medicare supplemental-insurance sales practices.
Consumers are advised to buy only one medigap policy, check waiting periods and clauses limiting coverage for pre-existing conditions, and carefully review coverage before purchasing a plan. Medigap plans can usually be canceled within 30 days and should never be paid for in cash.
For a free copy of the AARP report, send a postcard to Consumer Alert: Medigap (D13572), AARP Fulfillment (EE046), 1909 K St. NW, Washington, DC 20049.
QUESTION: Very often when my 80-year-old, diabetic husband gets up from bed or rises from the table after a meal, he gets lightheaded and feels dizzy. Frequently he has to sit down immediately to avoid falling. Although his doctor says his heart is fine, I'm worried that he might have a stroke or fall and injure himself. What is the problem and is there anything we can do about it?
ANSWER: What you are describing is called orthostatic hypotension, or low blood pressure on standing. The dizziness is caused by a decrease in blood circulation to the brain.
On standing, circulating blood shifts downward to the legs and temporarily lowers the amount of blood available to circulate to the head. In older people (especially those with diabetes, Parkinson's disease or those taking certain medications that can lower blood pressure), normal body reflexes that compensate for the shift do not function properly.
Also, it has recently been shown that, following a meal, blood pressure is reduced and sometimes cause such symptoms.
Your husband should be examined by a physician for any treatable reason for these symptoms. Adjusting a medication or starting a specific medical treatment may eliminate them.
If the cause itself cannot be cured, then the symptoms may be alleviated by changing the way in which the patient sleeps or gets up. Sleeping with the head of the bed elevated can prevent the sudden drop in blood pressure on arising. Or special elastic support stockings covering both legs up to midthigh can minimize pooling of blood in the legs and eliminate the dizziness. Often, sitting on the bed for a few minutes before getting up is effective.
These symptoms may or may not relate to a serious condition, but they should not be ignored. Postural hypotension is a common cause of falls in older people, and falls cause a tremendous amount of injury. Your husband's physician needs to be made aware of the problem.
QUESTION: After many years of living on the opposite side of the country, I recently moved within 15 miles of my aunt. When I was a child we lived in the same town, and she brought gifts on my birthday and at Christmas.
Now that she's 78 years old and living alone, I planned to offer her support by visiting regularly. However, the visits are difficult because she is crotchety and complains a lot. I don't remember her being that way when I was little. Why does this happen to people when they age?
ANSWER: The personality traits you describe are not part of the "normal" aging process. The Baltimore Longitudinal Study of Aging being conducted at the National Institute on Aging confirms what other experts have found: that the personality is stable from young adulthood on. Neither aging nor events associated with aging, such as the "empty nest" or retirement, appear to cause significant personality change. A person who is warm, sociable and outgoing at 20 is likely to be warm, sociable and outgoing at 80, according to Dr. James Fozard, study director.
Although these findings are a general rule for healthy people, you shouldn't ignore your aunt's complaints without first checking them out. Since your childhood memories focus primarily on her generosity, check with others who knew your aunt as a younger woman to see whether their observations about her personality are consistent with yours. If her tendency to complain appears to be lifelong, you may want to visit for short periods and focus on the positive aspects of her life and her feelings.
Significant changes in personality may signal other problems. If that appears to be the case, a thorough evaluation by a geriatrician is in order.
Send questions about growing older to On Aging, P.O. Box 84256, Los Angeles, CA 90073. Questions of general interest will be answered in the column; individual answers cannot be provided.