Susan Jacoby, New York Times
I RECENTLY turned 65, just ahead of the millions in the baby boom generation who will begin to cross the same symbolically fraught threshold in the new year to a chorus of well-intended assurances that “age is just a number.” But my family album tells a different story. I am descended from a long line of women who lived into their 90s, and their last years suggest that my generation’s vision of an ageless old age bears about as much resemblance to real old age as our earlier idealization of painless childbirth without drugs did to real labor.
In the album is a snapshot of my mother and me, smiling in front of the Rockefeller Center Christmas tree when she was 75 and I was 50. She did seem ageless just 15 years ago. But now, as she prepares to turn 90 next week, she knows there will be no more holiday adventures in her future. Her mind is as acute as ever, but her body has failed. Chronic pain from a variety of age-related illnesses has turned the smallest errand into an excruciating effort.
Read full article...
Friday, December 31, 2010
Wednesday, December 29, 2010
Congress Passes National Alzheimer's Bill
Congress has voted unanimously to create, for the first time, a national plan to combat Alzheimer’s disease with the same intensity as the attacks on AIDS and cancer.
The bill, expected to be signed by President Obama, would establish a National Alzheimer’s Project within the Department of Health and Human Services, to coordinate the country’s approach to research, treatment and caregiving.
Its goal, the legislation says, is to “accelerate the development of treatments that would prevent, halt or reverse the course of Alzheimer’s” and “improve the early diagnosis of Alzheimer’s disease and coordination of the care and treatment of citizens with Alzheimer’s.”
The project would include an advisory council of representatives from agencies like the Centers for Disease Control and Prevention, the National Institutes of Health, the Department of Veterans Affairs, the Food and Drug Administration, the Indian Health Service and the Centers for Medicare and Medicaid Services. Scientific experts, health care providers and people caring for relatives with Alzheimer’s would also be included.
“If you go to war, you have planning, planning, planning,” said Representative Christopher H. Smith, Republican of New Jersey, who co-sponsored the bill. “Well, this is a war on a dreaded disease. We need to bring all the disparate elements together for the greatest possible result.”
While the act itself does not authorize more money, one of the recommendations of the national plan “is likely to be for an increase in research money for Alzheimer’s,” said another co-sponsor of the bill, Senator Susan Collins, Republican of Maine.
“We spend one penny on research for every dollar the federal government spends on care for patients with Alzheimer’s,” she said. “That just doesn’t make sense. We really need to step up the investment.”
The legislation was driven by the rapidly rising number of people with Alzheimer’s — about 5.3 million now, and expected to triple by 2050. The cost of their care to Medicare and Medicaid was about $170 billion last year. By 2050, Ms. Collins said, it will grow to $800 billion a year, more than the military budget.
One can only hope that the good intentions of this bill will not become buried in bureaucracy and red tape.
The bill, expected to be signed by President Obama, would establish a National Alzheimer’s Project within the Department of Health and Human Services, to coordinate the country’s approach to research, treatment and caregiving.
Its goal, the legislation says, is to “accelerate the development of treatments that would prevent, halt or reverse the course of Alzheimer’s” and “improve the early diagnosis of Alzheimer’s disease and coordination of the care and treatment of citizens with Alzheimer’s.”
The project would include an advisory council of representatives from agencies like the Centers for Disease Control and Prevention, the National Institutes of Health, the Department of Veterans Affairs, the Food and Drug Administration, the Indian Health Service and the Centers for Medicare and Medicaid Services. Scientific experts, health care providers and people caring for relatives with Alzheimer’s would also be included.
“If you go to war, you have planning, planning, planning,” said Representative Christopher H. Smith, Republican of New Jersey, who co-sponsored the bill. “Well, this is a war on a dreaded disease. We need to bring all the disparate elements together for the greatest possible result.”
While the act itself does not authorize more money, one of the recommendations of the national plan “is likely to be for an increase in research money for Alzheimer’s,” said another co-sponsor of the bill, Senator Susan Collins, Republican of Maine.
“We spend one penny on research for every dollar the federal government spends on care for patients with Alzheimer’s,” she said. “That just doesn’t make sense. We really need to step up the investment.”
The legislation was driven by the rapidly rising number of people with Alzheimer’s — about 5.3 million now, and expected to triple by 2050. The cost of their care to Medicare and Medicaid was about $170 billion last year. By 2050, Ms. Collins said, it will grow to $800 billion a year, more than the military budget.
One can only hope that the good intentions of this bill will not become buried in bureaucracy and red tape.
Tuesday, December 28, 2010
How to Prevent Medication Errors in the Elderly
Every year there are countless deaths and hospitalizations resulting from the mismanagement of medication usage. These deaths occur from multiple factors including administration of the incorrect medication, taking drugs improperly and the wrong dose to name a few. We can help reduce these medications accidents and deaths, by implementing some safety precautions. Follow these steps to help your elders...
1. List all the medications prescription medications, over-the-counter drugs and any vitamin and herbal supplements they take.
2. Educate the elderly person about their medications including the desired effects and be familiar with the instructions on how and when to take the medication, possible side effects and drug interactions.
3. Develop a medication usage sheet. Below is one example of how you can list all the medications. A medication list should include the following:
• Name of the medication, color and shape.
• Dosage and frequency
• Reason they are taking the medication
• The date they started taking the medication
• The prescribing physician's name and contact information
• Any special instructions and/or side effects about the medication
4. It is important to have all the medications filled at only one pharmacy. It can be very helpful to develop a relationship with one of the pharmacist' s where the elder picks up their medications. Pharmacists are well trained and can answer your questions about possible drug interactions, side effects and contraindications that your health care provider may not tell you.
5. Keep a list of all the medications the elderly are taking on the refrigerator or by the main telephone they use in a brightly colored folder
clearly marked.
6. Ensure that the medications are stored properly [away from the heat or in the refrigerator] and discard any drugs that have expired or have no labels.
7. Instruct the elderly to put on a light when taking medications and never take their drugs in the dark.
8. If the elderly person utilizes a pill box, always have them keep at least one pill in the original medication container for identification purposes.
9. Never have the elderly mix more than one medication in a pill container, especially when traveling.
10. Always have the elderly bring a list of all of the medications they are currently taking when going to a physician appointment.
Linda Winkler Garvin, R.N., M.S.N., of Alameda, California, is a Health Advocate/Consultant & Educator in the Bay Area and Director of Health Management Associates. With advanced training in gerontology, Linda has expertise in chronic pain management.She is the author of several articles on Pain Management, Healthy Lifestyles, Nutrition and Travel. Learn more at www.healthmanagerbayarea.com.
Monday, December 20, 2010
A simple apology goes a long way...
When eldercare providers tell families about a medication error or some other slip up that happened under their care, the family or resident is twice as likely to recommend that provider to someone else than if they had not been told about the mistake. However, the disclosure does open the door for legal action.
Admitting a mistake goes along way, says Patricia Grace, CEO, Aging with Grace.
"One is that you made a mistake, and the other is that you are prepared to disclose it to the family,” says Grace. “The eldercare provider is always fearful that any admission of error will lead to a lawsuit, however there is no evidence that residents or families would be any more likely to sue if this was disclosed to them.”
Most kids growing up hearing that "honesty is the best policy," and that is certainly the case when dealing with family members that entrust their elderly loved ones to a providers care.
Remember it's not the crime that gets most people in trouble...it's the lie and the cover up!
Admitting a mistake goes along way, says Patricia Grace, CEO, Aging with Grace.
"One is that you made a mistake, and the other is that you are prepared to disclose it to the family,” says Grace. “The eldercare provider is always fearful that any admission of error will lead to a lawsuit, however there is no evidence that residents or families would be any more likely to sue if this was disclosed to them.”
Most kids growing up hearing that "honesty is the best policy," and that is certainly the case when dealing with family members that entrust their elderly loved ones to a providers care.
Remember it's not the crime that gets most people in trouble...it's the lie and the cover up!
Thursday, December 16, 2010
Study finds that narcotic painkillers pose danger to the elderly
written by Barry Meier
Older patients with arthritis who take narcotic-based drugs to relieve pain face a higher risk of bone fracture, heart attack and death when compared to those taking non-narcotic drugs, according to a government-financed study published Monday.
The study, in The Archives of Internal Medicine, appears to be the first large-scale effort to look at the comparative safety risks for the elderly taking different classes of painkillers. The use of narcotic painkillers has increased in recent years because of a prevailing belief that such drugs were safer for older patients than non-narcotic drugs like Advil and Motrin.
The review, financed by the federal Agency for Healthcare Quality and Research, appears to undercut that assumption. The report, which was based on an analysis of patient health care records, was conducted by researchers at Brigham and Womens Hospital in Boston.
Read full article
Older patients with arthritis who take narcotic-based drugs to relieve pain face a higher risk of bone fracture, heart attack and death when compared to those taking non-narcotic drugs, according to a government-financed study published Monday.
The study, in The Archives of Internal Medicine, appears to be the first large-scale effort to look at the comparative safety risks for the elderly taking different classes of painkillers. The use of narcotic painkillers has increased in recent years because of a prevailing belief that such drugs were safer for older patients than non-narcotic drugs like Advil and Motrin.
The review, financed by the federal Agency for Healthcare Quality and Research, appears to undercut that assumption. The report, which was based on an analysis of patient health care records, was conducted by researchers at Brigham and Womens Hospital in Boston.
Read full article
Seniors lose out with payment cuts to primary-care doctors
The temporary fix that Congress has passed to stave off the looming 23 percent reduction in Medicare reimbursements to physicians is better than nothing - but the long-term problem remains unsolved. Lawmakers have for years kicked down the road tough choices on a critical issue - and those who stand to suffer the most should physician pay be cut are elderly Americans.
Dr. Jerald Winakur has been a private practice geriatrician for 35 years. He has managed to keep his office doors open despite the edicts that have come down from Medicare year after year.
He is not against all payment cuts for physicians' services. There is growing recognition among doctors that many of the services at issue - primarily technical procedures - are over-compensated. We can thank the American Medical Association and its subspecialty-stacked "Resource Utilization Committee" for this state of affairs.
The implement that is needed to make these payment cuts, however, is a scalpel, not the meat cleaver that has hung menacingly over the program since Congress set a plan in motion in the 1990s to keep Medicare spending in line.
Here are some simple facts:
Those who practice primary care for the oldest among us are a vanishing breed. More geriatricians retire each year than are trained - and this at a time when every eight seconds, one of our countrymen turns 65.
Geriatrics is the lowest-paying specialty in all of adult medicine. Meanwhile, medical students graduate with six-figure debt loads. Is it any wonder why they choose to practice in other areas of medicine?
Geriatricians derive their incomes from actually seeing patients - at their office, in hospitals, nursing homes and even home visits - not from doing things to patients. We minister to them, face to face, and bring our cognitive skills and experience, not procedural wares, to aid in decision-making. Medicare has, from the inception of the program, undervalued these cognitive services. When an ear, nose and throat specialist receives significantly more for cleaning wax out of a senior's ear than a geriatrician receives for a "complex office visit" to evaluate that same senior's many medical problems, something is seriously out of balance.
Overhead costs for those in private practice range from 55 percent to 60 percent of collections. By necessity expenses have already been trimmed to the bone for rent, employee salaries, malpractice insurance and so on, because Medicare payments to doctors have, in essence, gone unchanged since 2001.
Given all this, Winakur believes it is fair to say that should Medicare proceed with its planned 23 percent cut in reimbursements for physician services, the current system of privately rendered, office-based primary care for seniors is in danger of becoming extinct.
"My patients realize this, even if our legislators and bureaucrats do not. It is increasingly common for primary-care doctors in my community to decline new Medicare patients or to restrict the number of Medicare patients in their practices. Not a day goes by when one of my aging patients inquire about my retiring", states Dr. Winakur.
For years he has said, "Of course not. I'll be here for as long as you need me." And he really means that!
But for him and other primary-care doctors around the country - especially geriatricians - this is a critical time. Congress must act to fix this unfair and ailing system for the long term. It must find an equitable substitute for Medicare's flawed "sustainable growth rate formula" that caused this problem in the first place.
Unfortunately the day is approaching that he can no longer promise his patients that he will be there when they need him most. If Congress allows these unkindest of cuts to occur, the already-fragile health-care system serving our seniors will bleed.
Jerald Winakur is the author of "Memory Lessons: A Doctor's Story" and a clinical professor of medicine and an associate faculty member at the Center for Medical Humanities and Ethics at the University of Texas Health Science Center in San Antonio.
Dr. Jerald Winakur has been a private practice geriatrician for 35 years. He has managed to keep his office doors open despite the edicts that have come down from Medicare year after year.
He is not against all payment cuts for physicians' services. There is growing recognition among doctors that many of the services at issue - primarily technical procedures - are over-compensated. We can thank the American Medical Association and its subspecialty-stacked "Resource Utilization Committee" for this state of affairs.
The implement that is needed to make these payment cuts, however, is a scalpel, not the meat cleaver that has hung menacingly over the program since Congress set a plan in motion in the 1990s to keep Medicare spending in line.
Here are some simple facts:
Those who practice primary care for the oldest among us are a vanishing breed. More geriatricians retire each year than are trained - and this at a time when every eight seconds, one of our countrymen turns 65.
Geriatrics is the lowest-paying specialty in all of adult medicine. Meanwhile, medical students graduate with six-figure debt loads. Is it any wonder why they choose to practice in other areas of medicine?
Geriatricians derive their incomes from actually seeing patients - at their office, in hospitals, nursing homes and even home visits - not from doing things to patients. We minister to them, face to face, and bring our cognitive skills and experience, not procedural wares, to aid in decision-making. Medicare has, from the inception of the program, undervalued these cognitive services. When an ear, nose and throat specialist receives significantly more for cleaning wax out of a senior's ear than a geriatrician receives for a "complex office visit" to evaluate that same senior's many medical problems, something is seriously out of balance.
Overhead costs for those in private practice range from 55 percent to 60 percent of collections. By necessity expenses have already been trimmed to the bone for rent, employee salaries, malpractice insurance and so on, because Medicare payments to doctors have, in essence, gone unchanged since 2001.
Given all this, Winakur believes it is fair to say that should Medicare proceed with its planned 23 percent cut in reimbursements for physician services, the current system of privately rendered, office-based primary care for seniors is in danger of becoming extinct.
"My patients realize this, even if our legislators and bureaucrats do not. It is increasingly common for primary-care doctors in my community to decline new Medicare patients or to restrict the number of Medicare patients in their practices. Not a day goes by when one of my aging patients inquire about my retiring", states Dr. Winakur.
For years he has said, "Of course not. I'll be here for as long as you need me." And he really means that!
But for him and other primary-care doctors around the country - especially geriatricians - this is a critical time. Congress must act to fix this unfair and ailing system for the long term. It must find an equitable substitute for Medicare's flawed "sustainable growth rate formula" that caused this problem in the first place.
Unfortunately the day is approaching that he can no longer promise his patients that he will be there when they need him most. If Congress allows these unkindest of cuts to occur, the already-fragile health-care system serving our seniors will bleed.
Jerald Winakur is the author of "Memory Lessons: A Doctor's Story" and a clinical professor of medicine and an associate faculty member at the Center for Medical Humanities and Ethics at the University of Texas Health Science Center in San Antonio.
Monday, December 06, 2010
HOLIDAY BLUES – OR SERIOUS DEPRESSION?
TIPS FOR ASSESSING THE EMOTIONAL STATE OF ELDERLY LOVED ONES, by Patricia Grace
For the elderly, the holiday season can trigger a mourning period for the spouses, siblings and friends who are no longer here. When should you be concerned about an elderly loved one’s emotional state? How can you tell the difference between “holiday blues” and serious depression?
“Recognizing depression in older individuals is not easy,” says Patricia Grace, CEO of Aging with Grace, “but at the same time, depression is a matter that should be taken seriously.” Grace offers these tips for recognizing depression in the elderly:
1. Blues are normal – and temporary. It is normal to feel subdued, reflective and sad this time of the year. A person who is sad or anxious around the holidays can, in most cases, continue to carry on with regular activities. Such feelings are generally temporary and the individual eventually returns to his or her normal state of mind.
2. Depression interferes with every day activities. A clinically depressed person suffers from symptoms that interfere with his or her ability to function in everyday life. There are often feelings of diminished self-esteem or excessive feelings of guilt. The person may show little interest in his or her own welfare and little interest in doing things that in the past-brought pleasure. “If a person is very sad for more than a month and starts having problems with sleep, normal activities, appetite, maintaining their weight, then they might be clinically depressed and should see a physician for treatment,” advises Grace.
3. Understand the generational differences. The current population of older Americans came of age at a time when depression was not recognized as a biological illness and may be unwilling to discuss their feelings. “Those who are depressed may fear their illness will be seen as a character flaw,” says Grace.
4. Take symptoms as seriously you would any other health issue. The signs of depression – increased tiredness, loss of appetite, mood swings – are often seen as a normal part of aging. They aren’t. “Depression is not a natural part of aging,” says Grace, “When clinically depressed, an elderly person may lose the will to live, complicating existing health conditions.”
5. You can help. Spending time with a loved one, listening to their stories, and sharing family memories are the best gifts you can give an older individual. Use holiday time together to keep your eyes and ears open for signs of depression in older relatives.
Friday, December 03, 2010
Retirees need more than $100K to cover health costs
by Alicia Caramenico
Despite health reform, retirees will need hundreds of thousands of dollars in savings to cover medical expenses when they retire, according to a report by the Employee Benefit Research Institute (EBRI). Uncertainty related to healthcare use, prescription drug use, and longevity may push those costs even higher.
Men aged 65 retiring this year will need between $124,000 and $211,000 if they want a 90 percent chance of covering health insurance premiums and out-of-pocket expenses. Women that age will need between $143,000 and $242,000 to have enough money because they tend to live longer, according to EBRI. Anyone retiring before age 65 will need even more, notes the Washington DC-based nonprofit research institute.
"Because employers are continuing to scale back retiree health benefits, and policymakers may soon begin to address Medicare's funding shortfall, more of the financial costs of healthcare will be shifted to Medicare beneficiaries in the future," said Paul Fronstin, director of EBRI's Health Research and Education Program and co-author of the report.
The future is just as grim. Men retiring in 2020 will need between $111,000 and $354,000 in savings, while women will need anywhere from $147,000 to $406,000 (in 2020 dollars), according to the report.
"Many workers are generally unprepared for both healthcare expenses in retirement and retirement expenses," said EBRI CEO and co-author Dallas Salisbury. In fact, many retirees will need more money than the amounts cited, since the report doesn't factor in long-term care expenses or the fact that many people retire prior to Medicare eligibility, he added.
But the study also shows that individuals can reduce their retirement healthcare costs 40 percent or more by avoiding expensive prescription drugs, notes CBS Money Watch.
Despite health reform, retirees will need hundreds of thousands of dollars in savings to cover medical expenses when they retire, according to a report by the Employee Benefit Research Institute (EBRI). Uncertainty related to healthcare use, prescription drug use, and longevity may push those costs even higher.
Men aged 65 retiring this year will need between $124,000 and $211,000 if they want a 90 percent chance of covering health insurance premiums and out-of-pocket expenses. Women that age will need between $143,000 and $242,000 to have enough money because they tend to live longer, according to EBRI. Anyone retiring before age 65 will need even more, notes the Washington DC-based nonprofit research institute.
"Because employers are continuing to scale back retiree health benefits, and policymakers may soon begin to address Medicare's funding shortfall, more of the financial costs of healthcare will be shifted to Medicare beneficiaries in the future," said Paul Fronstin, director of EBRI's Health Research and Education Program and co-author of the report.
The future is just as grim. Men retiring in 2020 will need between $111,000 and $354,000 in savings, while women will need anywhere from $147,000 to $406,000 (in 2020 dollars), according to the report.
"Many workers are generally unprepared for both healthcare expenses in retirement and retirement expenses," said EBRI CEO and co-author Dallas Salisbury. In fact, many retirees will need more money than the amounts cited, since the report doesn't factor in long-term care expenses or the fact that many people retire prior to Medicare eligibility, he added.
But the study also shows that individuals can reduce their retirement healthcare costs 40 percent or more by avoiding expensive prescription drugs, notes CBS Money Watch.
Thursday, December 02, 2010
We need your support
Aging with Grace has been nominated to the SeniorHomes.com Best of the Web.
Category: Best Senior Living Blogs
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Category: Best Senior Living Blogs
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