Ryan:
Welcome everybody to another podcast of The Caregiver’s Toolbox. My name is Ryan and I’m here with Janet, and today we’re going to be talking about DME equipment or durable medical equipment. What’s going on, Janet? How are you?

Janet:
I’m doing well. Things are going really busy and it’s not snowing yet.

Ryan:
Always a good thing up in New England when it doesn’t snow. As I mentioned, we’re talking about durable medical equipment and a lot of people don’t know about it, don’t really understand where to get it, all of the things that come into discharging home and needing supplies when you get home. What is DME (durable medical equipment) and what does it consist of and what is it used for?

What Is Durable Medical Equipment

Janet:
Durable medical equipment are things that are most familiar as hospital beds, commodes, wheelchairs, items like that that are needed for a patient or client to help them function with their daily living. There are some things that we all see in the hospital that you can have at home. Some things you need to have, and some things are just a convenience.

Ryan:
All right, and so what is it used for in the sense of what can the average person expect to start needing when they are discharged going home?

Janet:
Okay. When someone’s going home, usually the number one thing that people think about is their sleeping, and is the bed that they have at home appropriate or not. It depends on their hospitalization. It depends on their ability to get in and out of bed. Some beds too high, too low, or a variety of other things.

Another item is their ability to get around in the home. Can they walk freely? Do they need a cane, a walker? Do they need a wheelchair, and will this fit through your doorways, things like that. Also, in terms of needing to use the bathroom, can they get to the bathroom or do you have to make arrangements to have a commode or a bedside ability to toilet, things like that. Those are the biggies.

Ryan:
People can’t walk, then they’re not going to be making it downstairs to the bathroom or upstairs to the bedroom, so they might have to make the new bedroom in the living room, and that’s where …

Janet:
Exactly.

What Durable Medical Equipment Costs

Ryan:
The always fun topic that everybody’s interested in are the costs associated with this because you do have reimbursement versus out of pocket, so can you go into that a little bit on what people can expect with those two differences?

Janet:
Basically, what happens on the reimbursement side through insurance of medical equipment it is determined by what the doctor fills out as a medical necessity. That’s where maybe the person does need a hospital bed, but their particular diagnosis doesn’t qualify for a fully electric bed. It’s just something they can raise or lower their head or their feet, and that’s needed because of their heart condition or whatever that case may be.

Some folks need a walker to get around, and a lot of people think, “Well, maybe they can borrow the neighbor’s walker.” Well, it depends on the height and the shape and the weight and there’s lots of things that go into that. Some things you can get at a medical equipment supply store or other people, and other things have to be ordered and you have to get the physician involved in getting the right equipment, the right size.

 

Bariatric Medical Equipment

One thing that’s far more common today than just a few years ago is a category of equipment called bariatric, and what that’s referring to is larger equipment. Those are larger than a standard width hospital bed. It’s a little bigger. They could be called big boy beds to some folks.

Ryan:
You mean people that are overweight.

Janet:
Yes.

Ryan:
Got you.

Janet:
The same is true of wheelchairs, so some of those things that are now available, but it can take a little extra effort to make sure you’re getting the right thing.

Ryan:
Absolutely. You need to make sure they’re sturdy enough for everybody. We were talking about the reimbursement versus the out of pocket. What are some of the items that you suggest that people get that though it might be out of pocket, it’s still worth its weight in gold to purchase because it makes life easier and it can save backs and things like that?

 

Most Important Medical Equipment Devices

Janet:
I think one of the number one things really is bedside commodes. A lot of people, even if they can get up and walk, getting up in the middle of the night because of medication or whatever, it’s not a safe walk down the hall to the bathroom or they just can’t get that far. You might want something right near the bed, and that’s something that people really don’t like to think they need, but oftentimes that’s one of the most helpful and safest things that you can have.

Another issue is often if there’s any unsteadiness, grab bars, and a lot of grab bars or safety bars, those are out of pocket, but those are worth their weight in gold when they’re properly installed. That’s something you should have somebody that knows what they’re doing because they’ll know where to put them and there are some, just for a simple example, there are some that work like suction cups and those are a problem if you have a shower that’s tile. Because of the cracks, the suction cup doesn’t adhere properly, so those are out of pocket things. They save lives, but you need to get the right thing.

Ryan:
Yes. Without a doubt, there are certain small changes that people can make that we’ve talked about in other episodes. Pick up throw rugs so that if somebody is walking down the hallway at night, that they don’t trip over things, so absolutely a bedside commode is a great idea to have. I haven’t had experience with this, but I can tell that you have. These recliners, what are some of these recliners? What are we looking at right here?

Janet:
Well, a lot of people are familiar with the Lay-Z Boy recliners that your grandpa leans back in or you do and read a book. Well, they also make recliners that also move in the opposite direction, so they’re actually helping push the person up to stand up. A case manager affectionately referred to them and it stuck in my head as granny launchers because all of a sudden they’re up on their feet, and that’s something that can be very useful to someone whose legs aren’t that strong or someone that may have had some type of abdominal surgery and it’s harder for them to stand up. That’s something that is an out-of-pocket type of thing, but they really are very, very useful, and for people that can afford it, it’s something that really does give someone independence.

Ryan:
Yes, absolutely. It also can help people that are used to helping somebody get out of a chair or out of a bed or out of a sitting stance, I guess if you will, that it saves their back, as well. It helps the caregiver as well, wouldn’t you say?

Janet:
Absolutely, and there are other things. Some people have the old Craftmatic beds and I guess there’s a whole bunch of new ones out there now, but those are things that can help someone sit up, or even if it just increases the angle so that they either don’t snore or more importantly, it’s easier for them to breathe, or someone with those kinds of issues.

Ryan:
Yes. I know that when my mom was sick, picking her up, and obviously people can’t see me, but I’m a big, strong guy. I’m 6’6″, so I’ve got some muscle to me, but picking her up just by myself four, five, six times a day started to wear on my back even after just a month of doing it. Obviously, I was happy to do it, but I could see where family caregivers can get really hurt from doing something like this.

Though the cost might be relatively expensive, we’re looking at the sheet of anywhere between $500 and $700, being able to walk upright for the rest of your life is worth that amount of money, so I certainly think that you need to not just look at the cost, but look at the quality of the product that you’re getting, as well.

Janet:
Absolutely, and even things like if you’re trying to be the sole caregiver in your house, things like if the person has a double bed, it’s a whole lot more difficult to help someone turn or whatnot in a double bed than it is in a twin bed, and that’s probably the way your back is at the greatest amount of strain, so the height of the bed, the height of the person, all those things can matter, and where you can have devices that can save your back, it’s worth its weight.

Ryan:
I guess I’m really in trouble if I ever need caregivers in my life. I’m going to need three of them.

Janet:
I’m not going to be able to pick you up. That’s for sure.

Ryan:
Absolutely.

 

Finding Medical Equipment Companies Online

Janet:
Okay. Ryan, you’re the one who is much more computer savvy than I am, and a lot of times people don’t know where to begin to look for resources of products in the area or people to talk to. What’s available either online or where can people go?

Ryan:
Well, we actually have a really long article on our website that’s the 50 plus best caregiving tools online, and one of those items thats on there is Medicare.gov, and Medicare.gov is a very big website, as we all imagine. There’s a lot of information on there that you can spend hours figuring out, but what we think is great is two sites. We’ll down into the article in the transcription, is if you go to Medicare.gov there is your Medicare coverage and you can look up durable medical equipment and see what is covered and what is not covered so that if you are tight for money and you really need to find out what is going to be covered under Medicare insurance, you can find out.

Then, depending on what your financial status is, you can then look at what isn’t covered and see what makes life a lot easier. Maybe you can’t afford the recliner that helps somebody get up, but you can afford the bed [inaudible 00:10:11] and alarm system that beeps off when mom, who has a leg problem and dementia, tries to get out of bed at 2:00 in the morning, so you can make a determination on what is most important and practical for your financial situation.

 

Finding A Durable Medical Equipment Supplier

Additionally, a lot of people don’t know, and I don’t blame them, where a durable medical equipment company is. They’re usually not in downtown in the most expensive real estate lot. They’re usually a little bit out of the way because they don’t need retail space like somebody else does, so you can go onto Medicare.gov as well and find where your closest suppliers are and then you can start making calls and setting things up if that’s not already being done for you by a discharge planner.

I would always recommend people to look at that article, which just continues to get added. It’s not 50 anymore. It’s like 60 different really great tools online, but it really helps with caregivers start finding solutions to their problems using online resources that we found, so that’s where I’d recommend to go is those two different tools on Medicare.gov.

Janet:
Now, when you go and look at some of these suppliers, do they have reviews do you think, like you do with other businesses? I know from a consumer standpoint, I can get equipment from someplace, but if something breaks and if something’s electric, I want to know that I’ve got a company that’s going to stand by their product.

Ryan:
Yes. With reviews, I can’t imagine there’s a lot of Yelp reviews for durable medical equipment companies like there are for restaurants, but you also want to talk to people in the industry that maybe know and make recommendations for different people. If you’re talking to your discharge planner, your social worker, where do they recommend for durable medical equipment companies? Also, Google will have reviews, so you might find them, you might not, but there isn’t a resource that I know of that just reviews durable medical equipment companies up and down.

Obviously when you’re paying out of pocket for something, you’re going to want to talk to them about what the warranty is on this item, what happens if something breaks down, how do we get it repaired or does it need to be replaced or what is covered under this so that you’re protected in case you’re spending thousands of dollars on extra equipment to make your life easier or your loved one’s life easier, you want to make sure you’re protected.

I would find out all about that on the different DME companies, but obviously if somebody’s been in business for a very long time and you’re hearing from, whether it’s a private home care company or a hospital or nursing home that these people are really good, then that’s a really good starting point, and then do your own investigative research on it, as well.

Janet:
Okay. Well, that makes a lot of sense, because a lot of times people just don’t know where to go and where to start. I’ve been to some of the retail DME companies, and if you’re a medical equipment geek, it’s like a candy store. There is something to help you do everything, and if you get a good company that you can feel comfortable with, they can give you some very helpful suggestions and you don’t always have to buy the biggest and the best thing that’s there, especially given the budget that you may be trying to live with.

Ryan:
Absolutely. A starting point for everything for everybody in the United States is to talk to your senior center, your counseling agent. Their whole job is to know about what’s going on in that town and the different resources that are available, and if you don’t feel comfortable doing that, talk to either family or friends.

If somebody called us up, even if they didn’t need private home care services, I wouldn’t hang up the phone when they ask, “Hey, listen, I don’t need your services, but I just need a recommendation for a DME company.” Sure, I can recommend two or three that I know of that have been good in the past. I hope it helps your day and spread the word that [inaudible 00:13:52] just in case, so I think only good things and good karma can come back from helping people out that can call it, so you shouldn’t be too afraid to do that either if you don’t have a really good starting point.

Janet:
Yes, because I think the hardest thing is someone’s excited to get the loved one home, but it’s the little details. It’s like getting a new puppy and you didn’t get a dog dish or a leash, and now what do you do?

Ryan:
Absolutely.

Janet:
I think that could really be helpful, and it’s a daunting task. It’s good to know specifically what your doctor feels the person needs, because there are things you’re not even going to think of.

Ryan:
There are always going to be things that you don’t think of that in the heat of the moment, you go, “That might be good,” and then you call up your durable medical equipment company and you see if they have a solution to help with that problem, and you’d be surprised how often that might be the case that there might be a tool or technology out there to make your job easier as a caregiver.

Janet:
Yes, and especially the high priced items, because it’s like the dentist. If you get a crown, it has to last you for so many years before your insurance is going to replace that. The same is true of wheelchairs. You can’t decide next year you want a different one, so you want to make sure you’re getting some good support in picking out the right medical equipment.

 

Wrapping It Up with Medical Equipment

Ryan:
Absolutely. Well, excellent. That wraps up our episode on durable medical equipment. We appreciate all your insight, Janet, and thank you to our listeners. Our podcasts come out every Tuesday, so you can expect to hear from us then. Thank you very much and have a great day.

Thank you very much for listening to our durable medical equipment podcast. For any feedback please reach out to us on Twitter @mwhomecare. New episodes come out on Tuesday.