ProAging Information Network

Researchers and the general public have a new resource for information on the health and intimate relationships of older people, thanks to a new supplemental issue of The Journals of Gerontology Series B: Psychological and Social Sciences.

Based on the groundbreaking National Social Life, Health, and Aging Project  (NSHAP), the supplement’s 14 articles focus on demographic characteristics; social networks; social and cultural activity; physical and mental health, including cognition, well-being, illness, medications, and alternative therapies; history of sexual and intimate partnerships; and patient-physician communication.

"The NSHAP represents an extraordinary contribution to the study of aging, and published findings from it have already shed new light on critical issues in social gerontology — from abuse to sexuality, said Journal of Gerontology: Social Sciences Editor Kenneth F. Ferraro, PhD, of Purdue University. “A truly distinctive feature of the study is the collection of several biomeasures on a national sample.”

The NSHAP is a unique, interdisciplinary effort to collect social data alongside biological indicators in a population-based sample of older adults. The study collected 13 biomeasures, including the assessment of respondents’ weight, waist circumference, height, blood pressure, distance vision, smell, touch, and mobility. NSHAP also collected blood spots, saliva, oral fluid for HIV testing, and, from female respondents, a self-administered vaginal swab.

Sexuality among older adults tended to vary with age and gender. At all ages in the study, men were more likely than women to have a partner, more likely to be sexually active with that partner, and tend to have more positive and permissive attitudes toward sex.

Similarly, men were more likely than women to report alcohol use, potential problem drinking, and ever having smoked. Alcohol use and smoking were also lower among older age groups.

This information can provide physicians and public health policy makers with a scientific base of knowledge for advising older people about positive social and intimate relationships, as well as designing health programs to capitalize on and promote these relationships.

The NSHAP is based on data gathered from interviews of 3,005 community-dwelling older adults (aged 57 to 85) across the U.S. between July 2005 and March 2006. Blacks and Hispanics were oversampled, as were the oldest old, providing adequate cases for analyses by age, gender, and race/ethnicity. This study was supported by the National Institutes of Health, including the National Institute on Aging, the Office of Research on Women’s Health, the Office of AIDS Research, and the Office of Behavioral and Social Sciences Research.

For more information

 

Noted author and journalist Paula Span wrote an insteresting piece on Assisted Living at the New York Times website recently. She explores the concept of small residential assisted living options and makes the statement:

"Among other advantages, they often cost less. At about $4,000 a month, Horizon Manor is still cheaper, unbelievably enough, than most assisted living in this pricey precinct of northern New Jersey."

Those of us working with seniors are well aware of the costs, and even more well aware of the look on our clients faces when we tell them how much these options costs. The reader comments at the end of the article definately validate this.

Read complete article

Congrats to our friends at the Beacon Institute for the recent award, lets hope that this is a trend that will be replicated throughout the region and the country!

The Maryland Office of Health Care Quality (OHCQ) has awarded a $150,000 grant to LifeSpan and its education affiliate, The Beacon Institute, to improve clinical outcomes and enhance the quality of life for residents in 20 challenged nursing homes in the state.  Beginning in January 2010, the grant will apply nursing home culture change principles to facilities with limited resources.  Funds for the grant derive from a fund comprised of civil penalty monies paid by nursing homes and other entities resulting from a variety of Medicare and/or Medicaid infractions. The Office of Health Care Quality is committed to seeking additional funds to support a second year of the project.  LifeSpan is also seeking additional funds from major foundations to support full implementation. 

More info at www.lifespan.org

 

A recent podcast reports some interesting statistics and tips that we can be helpful to share with your clients and staff, here are a few elements detailed in the podcast:

• caregiving consumes approx. 19 hours per week


• communicate with your employer and ask for help


• family gatherings during the holidays are a great opportunity to start a dialogue


• average caregiver is a woment over 50-64


• person they are caring for is over 75

Listen to podcast

Unfortunately the term "geriatric jail" is used all too often when describing nursing homes or senior living settings. It’s hardly a "fair" statement to blanket on the industry, especially with all the innovations and efforts around person-centered care.

A recent article in the Chicago Tribune, reports:

Federal, state and county officials swept two Chicago-area nursing homes Tuesday for felons with outstanding arrest warrants and identified 18 residents wanted on charges ranging from disorderly conduct to burglary to assault.

 

It’s clear that "aging" does not make people immune to the long arm of the law!

Read article here

BALTIMORE (December 23, 2009)—Erickson Retirement Communities, a leading developer and manager of communities that enable seniors to live life to the fullest, today announced that it has selected Redwood Capital Investments LLC as the successful bidder to acquire substantially all the assets of the company, subject to court approval.  Terms of the transaction were not disclosed.

Erickson signed a definitive agreement with Redwood Capital, a Baltimore-based company, in October because the organization was a particularly strong candidate.  As its continued interest in Erickson indicates, Redwood recognizes that Erickson has tremendous strengths, including a strong brand that is recognized for quality, value and the enhanced lifestyle residents experience every day.

“We are pleased that the interests of Redwood Capital are well aligned with Erickson’s long-term growth strategy and the interests of all community residents,” said John C. Erickson, founder and executive chairman of Erickson. “Redwood Capital has the capital resources to address Erickson’s long-term needs and has assured us they support the actions Erickson feels are necessary to strengthen the company immediately and for the future. This sale marks a company milestone that creates numerous benefits for all members of the Erickson Community.”

Jim Davis, who controls Redwood Capital, said, “Erickson Retirement Communities has a noble mission, a time-tested product, industry-leading customer satisfaction and tremendous opportunities for growth.  Redwood Capital shares Erickson’s vision for improving the lives of seniors and we are excited to build on the legacy and success of this venerable brand.”

“The transition of Erickson’s ownership to Redwood Capital will promote the long-term stability of the developing communities National Senior Campuses sponsors,” said Ron Walker, Chairman of NSC.  “We look forward to working with Erickson, under new ownership and with restructured finances, reorganized businesses and fresh capital to fulfill NSC’s mission of providing the highest quality service and lifestyle to our residents.”

Erickson Retirement Communities received two qualified bids for the purchase of the company when the bidding process closed on December 14, 2009, a testament to the fact that Erickson has tremendous strengths, including a strong brand that is recognized for quality, value and the enhanced lifestyle residents experience every day. Qualified bidders were permitted to participate in an auction that occurred on December 22, 2009. 

Erickson and Redwood Capital will submit to the U.S. Bankruptcy Court in Dallas on December 23, 2009 an amended Plan and Disclosure Statement, and request that the court schedule hearings to approve a revised disclosure statement and to confirm any plan of reorganization (“confirmation hearing”).  Once that hearing has concluded, Erickson and Redwood Capital can begin the process of completing all necessary actions to finalize the sale.

The New York Times recently published an article titled, For Elderly in Rural Areas, Times Are Distinctly Harder that are key to looking at where and how we define "community".

The article states, "Growing old has never been easy. But in isolated, rural spots like this, it is harder still, especially as the battering ram of recession and budget cuts to programs for the elderly sweep through many local and state governments."

Transportation is a key issue, one of George Burgess’s main concerns is that he will loose his drivers license, which is definately a lifeline in a rural environment, but even in a more suburban environment.

Read article here

ORLANDO, Fla., Dec. 3 /PRNewswire-USNewswire/ – Many seniors and their families will at some point struggle with a difficult decision about an older adult’s driving ability.

Is it safe for them to continue driving?

Are there tools to help them be safer?

How do we know when it’s time to hang up the keys?

What options exist when they can no longer drive?

To address this growing concern among families across the country, AAA provides expert advice, research-based tools and resources through its safety and mobility web site – AAASeniors.com.  The information and tools on the site are designed to aid in prompting conversations, assessing abilities and improving the comfort and safety of older drivers.

"Many people do not know where to turn for help to address the safety and mobility challenges often faced by older drivers and their families. AAASeniors.com provides the tools needed to create an action plan to help manage the inevitable consequences of aging, and the effects of aging on driving ability," said Jake Nelson, director, AAA Traffic Safety Advocacy and Research.

According to the U.S. Census Bureau, one in five people will be age 65 or older by 2030, with an estimated 90 percent licensed to drive. In support of Older Driver Safety Awareness Week, Dec. 6-12, AAA encourages seniors and their families to take the first step in addressing this difficult issue by having a conversation about driving and aging.

"People age 65 and older represent the fastest growing segment of the country’s population, which makes their safe driving ability an issue that millions of families are facing. AAA encourages seniors and their families to use Older Driver Safety Awareness Week as an opportunity to begin a conversation about safe mobility. AAA can provide the resources needed to help guide them through this process," said Nelson.

For many seniors, conversations about continued safe driving can easily spark strong emotional reactions such as concerns about personal independence and managing other day-to-day activities. Fortunately, these conversations also can serve as opportunities for constructive communication and problem solving.

Talking with an older driver is just the first step. AAA also provides guidance and tools to help develop and implement an action plan.

AAA Roadwise Review is a computer-based tool designed to assess a driver’s functional abilities important to safe driving.

CarFit and AAA’s Smart Features for Mature Drivers help to enhance seniors’ comfort and safety while driving.

Safe Driving for Mature Operators classroom and online courses provide driver training to help address the changes caused by aging and how a driver may compensate.

For more information about Older Driver Safety Awareness Week, please visit www.AAA.com/PublicAffairs.

As North America’s largest motoring and leisure travel organization, AAA provides more than 51 million members with travel, insurance, financial and automotive-related services. Since its founding in 1902, the not-for-profit, fully tax-paying AAA has been a leader and advocate for the safety and security of all travelers. AAA clubs can be visited on the Internet at AAA.com.

MIAMI – Lawmakers have wooed seniors skeptical of the health care overhaul by emphasizing the plan would close the "doughnut hole" — a gap in Medicare drug coverage that can cost thousands of dollars a year.

But getting support for the entire overhaul from this powerful voting bloc has been difficult, despite Democrats repeated town hall meetings, interviews and congressional hearings.

Janet Cohen, 75, would like to see the doughnut hole closed, but like many, she still is uncertain about the health bills.

Cohen and her 97-year-old mother are both in the doughnut hole because their out-of-pocket drug costs exceeded $2,700 this year. Rather than just a copay, each one now must foot the entire cost of their medications for the rest of the year, or until their annual spending reaches $4,350, which isn’t likely to happen. If it does, the government will again subsidize the costs.

The Cohens, who live just north of Miami, are both on Social Security and eating through savings. Janet Cohen just learned she was in the doughnut hole when she went to pick up her supply of Aricept, which she takes for memory loss. Instead of the copay, she was charged nearly $200.

"I can’t afford my medicine, is it OK if I miss like one month?" she asked the pharmacist.

He suggested taking the drug every other day, but said the effectiveness could be compromised.

Medicare Part D established a new prescription drug benefit in 2006. The doughnut hole was designed to reduce the overall cost of the program. An estimated 3.4 million seniors fall into it each year.

Most people never see the other side of the doughnut hole. They simply wait for New Year’s Day. The House health care bill would close the gap gradually until it’s eliminated in 2022.

There are about 39 million people aged 65 and older in the U.S. and they voted at a higher rate than any other age group in the 2008 election, according to the Census Bureau. The 40-million-member AARP has endorsed the House’s version of the bill, but voters aren’t yet sold on the plan.

The latest Kaiser Health Tracking Poll, released last month, found just 32 percent of those 65 and older believed passage of a health bill would leave them and their families better off, compared with 44 percent of respondents under the age of 65.

When asked about elements of the health overhaul plan that are "extremely" or "very" important, the doughnut hole was the No. 3 issue for Republicans, and No. 4 for both Democrats and independents.

Rep. Kathy Castor, D-Fla., saw a summer town hall meeting become a shouting match. In subsequent visits to senior centers, constituents expressed worry their Medicare costs would increase with or that they would no longer be able to see their doctors.

The doughnut hole, she said, has helped garner support for the overhaul.

"It’s easily understood that eliminating the Part D doughnut hole will put cash back into the pockets of seniors who need it desperately," she said.

Some will grovel to avoid the doughnut hole. Maida Genser meticulously keeps track of her 72-year-old husband Morton’s drug costs, trying to determine when he’ll hit the threshold for his numerous pills to control diabetes, blood pressure and other problems.

As the limit approached in October, 66-year-old Maida had a strategy: "I just kept begging different doctors for samples."

Others aren’t sure what to do. Evodkia Kresch, 83, takes pills for glaucoma, diabetes and heart problems and has been in the doughnut hole for several months. She grew up in Ukraine and lost her parents and six siblings in the Holocaust. Her husband died two years ago and she lives off a Social Security check of about $1,300 a month. She doesn’t have much hope things will change in Washington.

"They talk, they talk," she said. "But I need to live. And they just talk."

A recent round of refills cost her $412. She paid for them with her meager savings.

"I never asked the government for a penny. I came and I worked every day and I don’t know what to do," she said, slipping into a soft sob. "It’s terrible. I don’t know what to do. I come back and I cry."

 

Source: http://news.yahoo.com/s/ap/20091204/ap_on_he_me/us_health_overhaul_prescription_drugs

WASHINGTON – Talk about unnecessary misery: One in five Medicare patients winds up back in the hospital within a month — even worse, one in four patients with heart failure.

A major push is under way around the country to cut rehospitalizations, in part by arming patients with simple steps to keep their recovery on track — like getting past harried receptionists for quicker follow-up doctor visits, and reducing medication confusion.

Less than a year into a Medicare-sponsored "Care Transitions" project in 14 states, participating hospitals already are seeing readmissions start to inch down, says Dr. Barry Straube, chief medical officer of the Centers for Medicare & Medicaid Services.

One of those projects, in Baton Rouge, La., sends health coaches to five area hospitals to guide high-risk patients through discharge and check how they’re faring through that critical first month. Of the first 145 patients coached so far, only seven had to be rehospitalized.

The key: Support, so that weakened seniors don’t backslide merely because they couldn’t get a timely doctor’s appointment or had no ride to the drugstore to pick up a prescription, says coach DeeAnn Broussard with Louisiana Health Care Review, a quality-improvement company leading the project.

Consider her heart failure patient who sought a doctor’s appointment, saying he couldn’t sleep. The doctor’s booked all month and his receptionist doesn’t realize the man has heart failure and really was describing shortness of breath when he laid down, due to worsening fluid build up.

"He needs to say, ‘I can’t sleep because I can’t breathe,’" explains Broussard, teaching a phrase that cues receptionists to squeeze patients in. A quick drug change might get rid of that fluid and avert a rehospitalization.

"This generation tends to be very obedient and does not want to be pushy," she says. "No, it’s your body, it’s your life, let’s be a little pushy. That’s what the doctors are there for."

Rehospitalizations ought to be handled with the same urgency as an epidemic, says Dr. Harlan Krumholz of Yale University. He helped the American College of Cardiology begin a "Hospital to Home" program this fall, signing up hundreds of hospitals to share solutions with the goal of cutting heart patients’ readmissions by 20 percent within three years.

"Somehow this idea of one in four people landing back in the hospital in a month is treated as business as usual, that it’s part of being sick in America. It doesn’t have to be that way," he says.

The top risks:

_Medication problems. Patients on a dozen or more drugs forget which ones they’re supposed to toss when given new ones in the hospital, or can’t afford the new ones, or have no way to pick them up.

_Not getting a follow-up doctor’s visit within a week of discharge. Waiting longer is proven to increase rehospitalization. Yet even if patients have a primary care doctor, getting a rapid appointment can be tough.

_Not realizing early signs of trouble and knowing what to do about them.

Rehospitalizations aren’t just bad for patients, but for taxpayers, too. They’re costing Medicare $17 billion a year, a recent study estimated. Hospitals make more money when patients have to return.

Last summer, Medicare started posting hospital readmission rates for the three worst conditions — heart failure, heart attack and pneumonia — on its Web site, peer pressure for hospitals to improve. And either as part of Congress’ pending overhaul of the health care system or its own regulations, Medicare eventually hopes to cut payments for rehospitalizations in ways that encourage better upfront care.

"Even the best hospitals have room for improvement," says Straube, who hopes to expand the Care Transitions program to all states in a few years.

As for the payment debate: "Shame on us for paying you for things that should really in many cases not have happened," he says.

Not every rehospitalization is preventable, says Yale’s Krumholz, and there’s no one solution that will help every hospital lower the rate.

When discharging heart patients, "you hold your breath a little bit," he says. "They’re vulnerable, they’re tired, they heard messages from a bunch of different people."

Nor is it an issue just for Medicare. At Duke University Medical Center, trauma nurse Jo Ellen Holt takes photos with patients’ own cell phones to guide them through the home care required to avoid infection and rehospitalization.

It started with a man in his 50s whose arm was rebuilt with muscle and skin from elsewhere on his body after a machine accident. The discharge nurse cleared the man to leave, assuming his wife could clean his arm and change his bandages — only to have Holt discover right before the couple left that the woman couldn’t stomach the task. So Holt snapped a photo of each step, helping the man remember the order of each solution and ointment and type of gauze. One-armed, he cleaned his own wound fine.

"I want to help them be independent," Holt says.

Source: http://news.yahoo.com/s/ap/20091208/ap_on_he_me/us_med_healthbeat_hospital_returns