Medicare covers an annual "wellness visit." The focus of a "wellness visit" is to create a prevention plan. The topics addressed in a "wellness visit" include health status, injury risks, risky behaviors, urgent health needs, risk factors for depression, functional ability, level of safety and cognitive function.

With that background and understanding...

Elderly woman in her 80s shows up for a Medicare "wellness visit." Her gait is steady and she is mentally intact. She plops herself down on the exam table, and we talk.

I review her history and medications. We discuss the support network she has in her life. I ask her about her appetite and activities of daily living. She claims it takes her a long time to bathe, otherwise she feels comfortable with everything, including shopping and cooking.

I notice her hair tied up in neat buns. Her clothes are clean and color-coordinated. Her nails are painted orange with silver sparkle. I notice abrasions across her legs.

Concerned about falls or, even worse, abuse, I casually ask her about the scrapes I her legs. She looks up at me sheepishly. She looks around the way a child would when caught with a hand in a candy jar.

Finally, she looks me in the eye. And confesses that she acquired the injury when she fell off her bike.

Of course, I am worried about her frail, osteoporotic bones...but in my book, she's a:



  1. My 85 year old MIL went for her annual medicare wellness exam. Ignored were a lung mass that 4 months later tests as stage 3 lung cancer; her swollen ankles and SOB that required to ER trips and hospitalizations for CHF. To date no one has counseled her on sodium intake or prescribed a diuretic. She is so forgetful that she drives to her doctors' offices just to confirm appointments. No one has screened her for dementia. Her cardiologist only prescribed a NOAC for her afib but otherwise it went untreated until a pulmonologist in the hospital prescribed a CCB when her cardiologist failed to show up 2 days in a row. None of her doctors talk to the other. What's the point of a wellness exam?

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