Anthony Ozella was in a panic. Standing in a Cape Cod pharmacy this past September, the Dennis resident realized that he couldn't afford his blood pressure medication. And he didn't know where to go or what to do to get help. 

"I kept checking my blood pressure in the drug store, and it kept going higher and higher. It was 197/110, which is just disastrous. I could have had a stroke at any time. But I didn't have the money to buy the medication," he said. 

Ozella said he knew he needed to change his prescription drug plan. The problem was, he didn't know how to begin. All the information -- all the sign-up forms and the details about various Medicare plans and coverage options -- it was all inside a computer.

"I didn't know how to even start one. And then we heard about the SHINE program up here. It gave us new hope."

It was SHINE counselor Ronnie Gullette who sat with Anthony and his wife Kathleen at the Dennis Senior Center, answering their questions and helping them navigate the complex maze of healthcare options. Gullette worked the computer keyboard as the couple signed up for prescription plans that lowered their monthly drug costs from hundreds of dollars to a just few dozen. 

Kathleen said it was an unexpected blessing. And she doubts she could have done it alone.

"I wouldn't be able to," she said. "I think I would make mistakes. It's very difficult."

The state has about 500 of these volunteer counselors. They receive intensive training and retraining about all aspects of medical insurance, and they work out of senior centers and hospitals to assist patients and their caregivers. 

Gullette began volunteering with Shine eight years ago, and she said it's common for people to arrive in panic mode. That's where the counseling comes in.

"First thing I say to them is, 'If you are overwhelmed, you are normal. If you don't understand this, you are normal. It's just the way the system is.'

We spend weeks studying this. We have monthly meetings to keep up with this. We have websites that guide us. So we know more than you do. But the population is overwhelmed by this. Not everybody, but on the whole. And they need guidance," Gullette said.

Sheila Curtis is the regional SHINE director on the Cape and Islands. She said counselors can assist caregivers and their loved ones with questions that go beyond health insurance.  

"Hopefully, if they come to us than we can help them as far as the insurance end of it, but we can also send them to another agency that can help with additional programs that are out there, such as the adult foster care program, which is a state program that will pay you for caregiving in the home," she said. "There's the personal care attendant program, where you can hire someone to come in and care for your loved one. So, at least we're aware of the program out there and perhaps we can send them on to more programs to help them."


Ira Wilson is a former teacher who has worked as a SHINE counselor for 15 years. He's also a former caregiver to his father. So he said he understands just how overwhelmed and alone caregivers can feel.

"One of the things that's very difficult is caregivers are often by themselves," he said. "You're providing the care, and you have to navigate the system. Because there isn't always a central place to go to where you can get all the information you need. And sometimes you don't know the questions to ask."

To illustrate his point, Wilson holds up a complex chart of all the Medicare Part D plans being sold in Massachusetts. 

"We help people through this maze," he said. "I would be remiss in just giving you a chart and saying, 'Figure it out yourself.' So we help people navigate this system."

Wilson said caregivers often want to discuss alternatives to nursing homes. Although he said the reality is that people often return when the level of care required is bigger than what people can do at home.

And we try to help them in the process," he said. "We know the various agencies to refer to help them. But the main issue we have with caregivers is, 'How do I do this application? How do I get my mom or dad in a nursing home? What type of nursing home is available?' So we get a lot of that."

Shine counselors also do their work for free. The only reward is a good feeling and the occasional priceless thank you card. Wilson talks about one card in particular, which he received from a caregiver and her loved one -- a couple he grew to know over time.

"I was able to be very helpful to them," Wilson said. "They were lovely people. They were the kind of people who you would want to do the extra for. He died. And I got a letter in the mail from his widow, who thanked me for the things that I did for him. And that while he was on his death bed, he asked his wife to write this letter. So it was very moving. And, a lot of us do this work because we want to actually help people." 

This is the busiest time of year for the SHINE program. It's open enrollment for Medicare, which means it's a good opportunity for caregivers to gather up their loved one's list of medications, compile any questions, and go see a counselor. They're there to help.

To learn more about the SHINE program, click here.

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