One night I was awakened the by a crashing noise then the sounds of a screaming woman in the hall outside my apartment. I struggled into my clothes and sandals as fast as I could and went to see what was going on. Only one of my 5 close neighbors is capable of responding appropriately in an emergency. I rolled out sleepily with my walker-go-mobile and trusty phone for the 911 call.
The woman who lives across the hall from me was on the floor in front of her door in obvious pain. She is usually fairly lucid and I asked what happened and if she needed me to call 911. She didn’t want 911, but needed help getting up. I did call the security guard who came up and between us, managed to get her vertical, leaning on my walker then into her apartment.
It was clear that she was still shaken up and I decided to spend a few minutes talking to her just to make sure she was still alright once the adrenaline wore off. I went through the “Kitty Greeting Ceremony” with her tuxedoed fuzzy companion. It didn’t take long for her to begin telling me the story behind the fall she just took.
She needed a hip replacement, a routine procedure with a good track record for success. There is one complication that prevented her from having the surgery…Bad teeth. Like me, she is on Medicare, combined with a disability, don’t even ask, Medicaid is nearly guaranteed with an SSI/SSD income. Medicare/Medicaid does not cover hearing, vision or dental.
We forget in these times that dental problems can kill. My neighbor has been disabled most of her life; she has never had the benefit of regular dental care. She had a mouth full of gums and 6 teeth. Her remaining teeth were too badly decayed to risk the surgery. A completely preventable need stood between her and continued independent living. She was on some fairly substantial pain medication for her hip and was fortifying that with what beer she could afford, thus the fall in the hall.
Case workers are spread thin in Oregon. My understanding is that any one case worker will be overwhelmed if more that 20% of their case load needs close monitoring and/or support. It took six weeks for my neighbor’s caseworker to line up the help she needed to solve the tooth problem so she could have the hip surgery. She now has a shiny new hip, a mouth full of healthy gums...and a new addiction to deal with. New dentures are on the way, but, those will take time. Meanwhile she maintains the liquid diet.
I was very happy to see that new legislation was introduced in Washington to add hearing, vision and dental to Medicare. Medicare patients are whole people in need of holistic care. How will my neighbor's addiction be dealt with? Who is to blame? She may have been predisposed, but state policy put her in a position where addiction may have been inevitable. A little more attention, care and rational policy may very well have gotten her through her health crisis without the lingering aftereffect that may be with her a very long time and cost society so much more.