Colorado Politics

Medicare questionnaire misses | NOONAN

Paula Noonan

As part of the medical shift to deeper patient inquiry done fast, elders on Medicare now complete a questionnaire to help providers understand their mental and physical health. Some people of conservative persuasion might label the questionnaire “woke.” Those on Medicare surely call the questionnaire wrong-headed as the health conditions described don’t fit to seniors’ actual circumstances.

For example, one question asks: Over the last two weeks, how often have you been bothered by any of the following problems: “little interest or pleasure in doing things” and “feeling down, depressed, or hopeless.” The selections are: not at all, several days, more than half the days, nearly every day.

For most seniors, these questions are framed incorrectly and the timelines are unrealistic. Seniors may feel down but the mood expresses itself as cranky and irritable. Seniors may feel hopeless but the mood expresses itself as frustration. The timeframe should not be over the last two weeks but over the last two hours.

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The correct questions should be: Over the last two hours, have you been bothered by any of the following: Losing your phone; losing your keys; losing your mind; forgetting why you went to the kitchen or bedroom or bathroom; getting into the car then getting out of the car and returning to your abode because you don’t have your wallet; showing up at an appointment in the wrong hour; not showing up for an appointment at all; forgetting your next door neighbor’s name; unable to remember the title of the streaming show you want to finish watching on Netflix.

Here’s another mood question on the survey: “In the past seven days how often were you bothered by the following: Feeling angry/feeling lonely – never, rarely, sometimes, often, always.”

A more truth revealing question would be: At what incident during the day do you feel angry or hostile: First thing in the morning when you wake up; when your spouse/partner/roommate asks a stupid question; when you can’t get the medicine bottle opened; when you watch the news; when someone ate the one thing in the refrigerator that you really wanted for yourself; when your spouse/partner/roommate doesn’t put the empty milk container in the recycling; when you always have to be the one to empty the dishwasher or make the salad.

Another question is: “In the past six months have you accidentally leaked urine? Yes/No.”

This question is a joke. The actual question should go like this: In the last day, did you miscalculate how long you could wait to use the bathroom, and as you walked your dog or returned from an errand, did you find yourself on approaching your home:

Dangerously racing to the bathroom; tearing your pants off; unzipping on the fly.

Here’s another joke, not woke, question: “Do you have a hearing problem, or do others think you have a hearing problem? Yes/No.”

What? What did you say?

Here is the correct question: Do you frequently ask or say the following: I’m sorry, could you repeat that; huh; why are you shouting at me; can you speak up or talk louder; turn on the subtitles, I can’t figure out what they’re saying; I can hear you, you don’t have to yell!

Here’s a question that doesn’t get to the heart of the matter: “How would you describe the condition of your mouth and teeth, including false teeth, crowns, and implants.” The suggested replies are: “excellent, good, average, poor.”

The survey should frame the teeth question this way: Have you experienced any of the following with your mouth or teeth: A crown pulled off when eating a tootsie roll; you lost your false teeth; you decided a hole from a missing tooth was better than paying to fix it; you broke a tooth on a popcorn kernel or ice cube; you decided to gum your food because you will die soon and why deprive your children of your inheritance.

“Do you often have problems related to your sleep?” That’s an obvious question, but the Yes/No choice doesn’t cover nearly enough options. The selections should be: Do you wake up 1, 2, 3, 4 or more times at night; do you have a conference call with friends at 3am most nights; do you say your prayers from childhood to go back to sleep; do you nod off 1, 2, 3, 4 or more times during the day?

The questions most likely to generate lies are these: “How many days during the week do you have a drink containing alcohol; how many drinks a day do you have on days you are drinking?”

Someone had fun with these questions: “Are you sexually active? And, if you are sexually active, do you have questions or are you interested in being tested for sexually transmitted diseases?”

Given our current medical health care insurance system, many people under 65 years can’t wait to get on Medicare. When you arrive at that miracle moment, don’t be offended when your health care insurance provider asks how many fruits and vegetables you eat every day, whether friends and family have concerns about your leaving your pots boiling on the stove, whether you forget to flush or, if you’re a male, whether you also forget to put the seat down.

Paula Noonan owns Colorado Capitol Watch, the state’s premier legislature tracking platform.

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