How to Live a Longer, Healthier Life

Back in 1946, when the first baby boomers were born, it was easy to imagine some sort of magic pill that would promise, if not immortality, at least a very long, happy, and healthy life.

Darn, another hoped dashed. We are living longer, but not always healthier and happier. Given that the ranks of Americans age 65 and older are soon to swell -- from 13 percent to 18 percent by 2030 -- geneticists, physicians, and psychologists are hard at work figuring out what it takes to thrive into old age.
Everyone is aware that they'll probably live longer if they exercise, eat right, and don't smoke. The trick is to get people to do what they know they should.
However, don't get your hopes up about living past 100, should you lack the right genes. Demographic experts had predicted that the proportion of U.S. centenarians would grow over the past decade, but they were wrong. Instead, from 2000 to 2010, the figure held steady: Only about one in 5,000 Americans reached age 100 or above.
For the other 99-plus percent of us, even the best genes will get you only so far. "Genes account for one-fourth to one-third of longevity," estimated Howard Friedman, a professor of psychology at the University of California (Riverside) and the coauthor of The Longevity Project, published this year. "That leaves well over half not accounted for."

Most of the rest, for better or worse, is up to you. "The importance of choices people make is in so many ways responsible for the quality of life in old age," said Charles Reynolds III, a professor of geriatric psychiatry, neurology, and neuroscience at the University of Pittsburgh medical school. "Many people think they should be entitled to a good-quality 25 years after age 60. Well, they're not necessarily entitled, but they can put the odds in their favor."

One way -- "the least speculative and the most obvious" -- is with exercise, according to Simon Melov, a Buck Institute biochemist. "More activity is better than no activity, and most people are not doing anything. They're just sitting there." Exercise, he said, reduces the risk of cardiovascular disease and perhaps even a decline in cognition. One needn't run a marathon. Gardening, walking, swimming, wood-working -- all of these are more active than just sitting.

Although physical fitness is important, so is psychological fitness. "The word I like to describe successful aging is active aging," said geriatric psychiatrist Reynolds. "That means socially, intellectually, and spiritually." Research has shown that people who maintain connections to others -- whether through family, friends, or work -- remain healthier in old age. A study of centenarians found that they had a purpose to their lives -- volunteer work or taking care of grandchildren and great-grandchildren.

But these rules aren't universal. "Everyone ages differently," the National Institute on Aging's Bernard pointed out. "If people who have been lonely and isolated their whole lives, and we say they need to be out and socializing -- but it's not in their nature -- it could be more stress than benefit."

She touts the advantage of preventive care as a larger part of the U.S. medical system, noting studies that show a greater incidence of cancer, heart attacks, strokes, diabetes, and lung disease in older Americans compared with Europeans. Preventive care can even ease depression, a serious problem among the elderly, albeit one that medical professionals often dismiss as natural and not worth treating. Not so, according to Reynolds. Depression can be treated with medication or psychotherapy, thereby improving a patient's physical health. The benefits -- and the downsides -- flow in both directions. "Disability can beget depression," Reynolds said, "and depression can beget disability."

But depression should be distinguished from garden-variety worrying -- and here's a provocative finding: People who fret about things may live longer. "[A] moderate amount of worrying can be good," particularly for men, said Leslie Martin, a psychology professor at La Sierra University in Riverside, California. Research has shown that men who think ahead and plan -- and, yes, worry -- tend to fare better after their wives die. In fact, men who were worriers faced a 50 percent lower risk of dying within the next few years after becoming widowers than men who weren't worriers, Martin reported.

Possibly the reason is that, in many marriages, "the wife is the protector -- telling the husband to get the doctor's checkup, to eat healthier, to wear a seat belt," she explained. "If a guy does more on his own, it may serve him well." This could also explain why men who are happily married tend to live longer than men who aren't, while wedded bliss seems to have no effect on women's longevity.
The role of dumb luck inspires experts to counsel: Don't be too hard on yourself. As federal administrator Bernard put it, "People shouldn't blame themselves if their aging isn't going exactly as they want."

Hey, relax (but not too much). Maybe you'll live longer.

Three ways to cut down on hospital re-admissions

Hospitals are taking a close look at care transitions in preparation for reimbursement changes that will penalize hospitals for high readmission rates. To avoid Medicare cuts and penalties, hospitals across the country are experimenting with how to better care for patients after discharge.

Offer transition coaches
According to a recent study published in the Archives of Internal Medicine, a Journal of the American of Medical Association, programs designed to help older patients transition from the hospital to home can cut readmission rates. Hospitals that provided a transition coach for patients had a 12.8 percent readmission rate, compared to 20 percent for those without coaches.

New Jersey's Robert Wood Johnson University Hospital Hamilton in October launched a similar program, in which a transition coach visits patients at home, reports NJ Spotlight. The coach provides patients with a daily health record to monitor weight gain, track medication, write down questions for providers and map out personal goals. Although that responsibility has traditionally been on the healthcare provider, the transitional coach program encourages patients to actively manage their own care.

Implement post-discharge clinics
Some hospitals, including Boston's Beth Israel Deaconess Medical Center, are identifying patients who are likely to be readmitted and directing them to post-discharge clinics. At Beth Israel, providers at the post-discharge clinic, located near the hospital, check on patients to make sure they are taking medications and making follow-up appointments, reports Kaiser Health News.

Similarly, Barnes-Jewish Hospital in St. Louis recently launched its post-discharge program, called the Stay Healthy Clinic, for Medicare-eligible patients with chronic obstructive pulmonary disease, pneumonia, heart attack and heart failure. The Stay Healthy Clinic even goes as far as offering patients transportation to the clinic. Still, the program isn't a cure-all for one persistent challenge: Only half of patients show up to their appointments.

"We'll continue to try to tweak" the program, Barnes-Jewish Hospital Chief Medical Officer John Lynch said in the article.

Keep patients out of hospital from the start
Hospitals in areas that have high admission rates also have a high propensity for readmission rates, according a study published last week in the New England Journal of Medicine. The study suggests that more can be done in the beginning of patient care, that is, keeping patients out of the hospital from the get-go.

"I think the notion that we can do better at the point of transition are pretty obvious, but I think what this is saying is that it's really just a start of what we have to do," Dr. Arnold Epstein, one of the researchers at the Harvard School of Public Health, said in a National Journal article.

Researchers of the study don't discourage improvements in discharge planning, but they do suggest that Medicare and other payers reward hospitals for keeping patients out of the hospital altogether, according to the article.

Thinner might not be better when it comes to Alzheimer's disease

New research suggests that the outer edges of the brain are thinner in older people who may be destined to develop Alzheimer's disease, but there's currently no way to use the information to help people fend off dementia.

Still, the findings could help researchers test Alzheimer's medications by allowing them to track the progression of the disease, said study co-author Dr. Brad Dickerson, an associate professor of neurology at Harvard Medical School.

Alzheimer's disease is the sixth leading cause of death in the United States, according to the Alzheimer's Association, and the number of deaths has risen in recent years. There's no cure for the disease.

In the new study, researchers focused on the thickness of the edges of the brain, known as the cortex. "We're looking at the parts of the cortex that are particularly vulnerable to Alzheimer's disease, parts that are important for memory, problem-solving skills and higher-language functions," Dickerson said.

Previous research found that several areas of the cortex were smaller in people with dementia from Alzheimer's. "It's like an orange that's shriveling. The thickness of the outer skin might get thinner as it dries out," Dickerson said.

In the new study, researchers examined the MRI brain scans of 159 people with an average age of 76; about half were men. Three years later, the participants took tests designed to measure how their brains were functioning.

The findings appear in the Dec. 21 online issue of the journal Neurology.

The 15 percent of participants with the thinnest brain areas performed the worst on the tests: About one in five of them experienced cognitive decline. They also showed increases in signs of abnormal spinal fluid, a possible sign of developing Alzheimer's disease.

"That suggests they may be developing symptoms," Dickerson said.

A lower number -- 7 percent -- of the participants in the middle range of brain thinness experienced cognitive decline. None of the people with the least thin brain areas developed problems.

So are the scans appropriate as tools to figure out whether patients are on the road to Alzheimer's?

Cost doesn't appear to be a major challenge at this point. It's not clear how much the MRI scans might cost at doctor's offices, Dickerson said. However, they're only a few hundred dollars each in the research world.

Also, many older people already receive MRI scans of the brain for other reasons, said Dr. Raj Shah, medical director of the Rush Memory Clinic, in Chicago.

But with no cure for Alzheimer's, the best use for the scans will be to help researchers figure out if medications work, Dickerson said.

Cathy Roe, an assistant professor of neurology at the Knight Alzheimer's Disease Research Center at Washington University School of Medicine, in St. Louis, said the findings could have value down the line. "Right now, there is not much we can do to delay the progression of dementia," said Roe, who's familiar with the findings. "But once effective treatments are identified, this research could help to identify which patients should receive that treatment and when they should receive it."

Calling all snowbirds...

Here are several tips that can help snowbirds protect their finances and homes while they're away from home for several months.

Prepare your home for winter. Everyone should take some key steps to prepare their home for cold weather and snowstorms, to help avoid expensive damage or homeowners insurance claims. But it's even more important to prepare your house if it will be vacant during the coldest months of the year and you won't be there to notice problems -- such as a small leak that can cause a lot of water damage by the time you return in the spring.

1. Before you leave for Florida, inspect your roof for any damage or worn shingles that can lead to leaks. Also clean gutters and downspouts and checking for clogs that can cause water damage to interior walls. Insulate any water lines that run along exterior walls and open cabinet doors to allow heat from the room to get into concealed spaces, which can make pipes less likely to freeze. Also drain and shut off outdoor water faucets.

2. Trim trees. Winter's high winds and snowstorms can cause a lot of damage from fallen tree limbs -- which can be very expensive and may not be covered by your homeowners insurance policy.Remove dead trees or large overhanging tree limbs before you leave town.

3. Ask someone to shovel snow. Arrange to have a neighbor clean snow from your driveway, sidewalk, hatch cover and dryer vent opening when you're gone, says Montgomery-Baisden. That can prevent melting snow from leaking into the home and causing damage. It can also reduce slip-and-fall liability losses, and prevent your home from looking vacant and becoming a target of thieves.

4. Secure your home. Home security is a big issue if you're away from your house for months. Stop your newspaper delivery and forward your mail to your winter address or have it picked up on a regular basis. Also have someone check the house at least weekly to make sure any flyers or packages that are delivered while you're gone don't build up and make the house look unoccupied. Secure doors and windows with deadbolt locks, and install slide locks or other security locks on sliding glass doors or French doors. You can also install variable light timers, which turn lights on and off at different times to make it look like someone is home.

5. Monitor your house from a distance. Install smoke detectors on at least every floor, preferably tied to a centrally monitored fire alarm system so the fire department will be notified automatically if the alarm goes off. Otherwise, nobody will be home to hear the alarm if it goes off only inside your house. You can get a discount on your homeowners insurance premiums if you have a centrally monitored home-security system. You may even be able to hook up a water-flow sensor or low-temperature sensor to that system, which can alert your security provider of problems that could lead to freezing pipes. But nothing replaces the human touch. Share your winter contact information with a neighbor who can be your eyes and ears while you're gone, forward important mail to you in Florida, check for any problems and take action in an emergency.

6. Notify your bank. Give your bank your temporary address and contact information before you leave, which is important so you can continue to receive your statements and to alert bank representatives about out-of-state debit and credit card charges, says Joe Bednarik, PNC Bank's regional manager of retail banking for Southern New Jersey. Bank fraud departments have become proactive about preventing theft by spotting and denying unusual charges. It's better to let them know of your travels ahead of time rather than run the risk that your account could be frozen temporarily if your financial institution is unable to reach you with questions about charges from an unexpected location.

7. Sign up for online banking. This can be a good time to sign up to receive your bills online, so you don't miss any payment deadlines while your mail catches up with you during your transition from north to south. Check your credit card due dates before you leave to avoid any missed payments.

Technology is playing a greater role in caregiving.

The senior care industry is increasingly relying on technology to better meet the needs of elders both in senior living facilities and at home. Here are some gadgets, applications, and systems that might be on caregivers’ Christmas lists this year:

1. Memo Touch: The iPad for Seniors

This tablet, a tech gadget similar to the iPad, is designed for seniors with short-term memory loss and provides reminders for to-do lists, taking medication, or keeping scheduled appointments. The Memo Touch also allows seniors or their caregivers to coordinate calendars and schedules, and is marketed as easy-to-use even for those without computer knowledge or skills.

2. Presto: Elder 911 & Elder 411 Applications for the iPhone

Developed by a gerontologist and Presto Services, Inc., these apps provide convenient mobile access to a variety of advice and insights for those who provide care and support to the elderly. Elder 411 is a resource for on-the-spot caregiving information and for planning ahead, covering a full spectrum of caregiving issues including managing financial and legal needs, considering housing options, and keeping the home safe. Elder 911 is for emergency situations like a fall or sudden illness, and provides important information for navigating a variety of crises.

3. eCaring: Home Health Care Management System

eCaring LLC recently launched a home health care management and monitoring system that coordinates seniors’ information about care, conditions, activities, and status among family members, home care providers, and doctors. The system utilizes digital media to allow home care providers to quickly and easily track a patient’s comprehensive information and share it with others outside of the home.

4. Virtual Health: Remotely Monitor Patients’ Vital Signs

Virtual Health now provides subscription-based services that are available nationwide to assist family members caring for seniors who are living independently at home. The platform works directly with an individual’s primary care physician, and allows for monitoring a patient’s vital signs such as blood pressure, weight, and glucose; it also includes video-conferencing technology capabilities.

5. Verizon Wireless: Digital Healthcare Suite for Mobile Care Management

Verizon Wireless has released a virtual care solution that uses smartphones, tablets, and video technology to provide a tool that virtualizes a healthcare visit, eliminating the need to physically visit a doctor’s office for routine consults. It allows healthcare professionals instant access to patient health records, images, and clinical reference information, leveraging high-speed mobile networks and devices to enable greater efficiency and productivity among clinicians.

Brain Changes May Be Tied to Parkinson's Dementia

Researchers say they've spotted brain abnormalities that may be linked to dementia in people with Parkinson's disease.

Many Parkinson's patients develop dementia and many of those who aren't diagnosed with dementia have mild cognitive impairment (a state that can precede dementia), according to background information in study.

The study used MRI scans of the brains of 84 Parkinson's patients -- 61 with normal mental abilities, 12 with mild cognitive impairment, and 11 with dementia as well as 23 healthy people.

The scans showed that the Parkinson's patients with dementia appeared to have more brain atrophy in the hippocampal, temporal and parietal lobes of the brain. People with Parkinson's and dementia also tended to have decreased prefrontal cortex volume compared to Parkinson's patients without dementia.

Parkinson's patients with mild cognitive impairment had a pattern of brain atrophy that was similar to those with dementia.

The study, which only found associations and cannot prove cause and effect, is published in the December issue of the journal Archives of Neurology.

As awareness of Parkinson's link to dementia grows, insights that can help further research and aid in the care of these patients will become increasingly important, Dr. Daniel Weintraub, of the University of Pennsylvania, Philadelphia, and colleagues said in the study.

Things to know about cold weather and heart disease

The fall and winter seasons will bring cooler temperatures, and for some, ice and snow. It’s important to know how cold weather can affect your heart, especially if you have cardiovascular disease. People who are outdoors in cold weather should avoid sudden exertion, like lifting a heavy shovel full of snow. Even walking through heavy, wet snow or snow drifts can strain a person's heart.

Many people aren't conditioned to the physical stress of outdoor activities and don't know the dangers of being outdoors in cold weather. Winter sports enthusiasts who don't take certain precautions can suffer accidental hypothermia.

Hypothermia means the body temperature has fallen below 95 degrees Fahrenheit. It occurs when your body can't produce enough energy to keep the internal body temperature warm enough. It can kill you. Heart failure causes most deaths in hypothermia. Symptoms include lack of coordination, mental confusion, slowed reactions, shivering and sleepiness.

The elderly and those with heart disease are at special risk. As people age, their ability to maintain a normal internal body temperature often decreases. Because elderly people seem to be relatively insensitive to moderately cold conditions, they can suffer hypothermia without knowing they're in danger.

People with coronary heart disease often suffer angina pectoris (chest pain or discomfort) when they're in cold weather. Some studies suggest that harsh winter weather may increase a person's risk of heart attack due to overexertion.

Besides cold temperatures, high winds, snow and rain also can steal body heat. Wind is especially dangerous, because it removes the layer of heated air from around your body. At 30 degrees Fahrenheit in a 30-mile wind, the cooling effect is equal to 15 degrees Fahrenheit. Similarly, dampness causes the body to lose heat faster than it would at the same temperature in drier conditions.

To keep warm, wear layers of clothing. This traps air between layers, forming a protective insulation. Also, wear a hat or head scarf. Heat can be lost through your head. And ears are especially prone to frostbite. Keep your hands and feet warm, too, as they tend to lose heat rapidly.

Don't drink alcoholic beverages before going outdoors or when outside. Alcohol gives an initial feeling of warmth, because blood vessels in the skin expand. Heat is then drawn away from the body's vital organs.

Older Driver Safety Awareness Week is Dec. 5 – 9

December 5 through 9 is Older Driver Safety Awareness Week and Aging with Grace wants to help keep older drivers and their families safe. The first of the baby boomers turn 65 this year, so the population of seniors will be increasing substantially over the next twenty years. According to the AAA most of us can expect to live 7-10 years past our safe driving ability, so safety is going to be a growing issue.

Matt Gurwell founder & CEO, Keeping us Safe, developed “Beyond Driving with Dignity” a workbook for the families of older drivers. It was specifically designed to help your family by providing you with a “road map to success” in your quest to overcome the challenges of an older driver’s safety. It can be used by families as a tool to meet the demands of a potential problem when you become suspect of the senior driver’s ability to remain a safe driver

Timely and appropriate use of this workbook and of all available resources will help keep families from making many of the common mistakes encountered by others as you move toward a possible driving retirement for your loved one.

Working through this instrument will help your family make driving-related decisions that are not only in the best interest of the older driver, but simultaneously find themselves in the best interest of highway safety in general. This workbook was designed to be used by your family in the confidence and comfort of your own home, most likely seated right at your family’s kitchen table.

Now you can give your hospital a check up...

A new online tool from Medicare can help you evaluate some of the care that hospitals in your area provide to patients.

The service – called, appropriately enough, Hospital Compare – is part of a burgeoning effort within healthcare to give patients, families and medical providers access to more data about treatments and outcomes. At the same time, the information, ideally, encourages hospitals to improve the quality of care they offer.

In specific, the Hospital Compare tool helps users see whether medical facilities are providing some of the care that is recommended for individuals receiving treatment in five categories: heart attack, heart failure, pneumonia, asthma (children only), or patients having surgery.

Read full article.

Is your power of attorney aware of HIPPA regulations?

With the New Year rapidly approaching now is the perfect time to start getting your financial and legal affairs in order. The following information will explain the differences between a Power of Attorney (POA) and a Durable Healthcare Power of Attorney; and how HIPPA affects both.

A power of attorney (POA) and a health care proxy are two of the most important estate planning documents you can have, but in some instances they may be useless if they don't comply with the federal privacy law.

A POA allows someone you designate (your "agent" or "attorney-in-fact") to make decisions for you if you become incapacitated. A health care proxy specifies who will make medical decisions for you. For these documents to be effective, your agents may need to be able to access your medical information. However, medical information is private. The Health Insurance Portability and Accountability Act (HIPAA) protects health care privacy and prevents disclosure of health care information to unauthorized people. HIPAA authorizes the release of medical information only to a patient's "personal representative."

HIPAA can be a problem especially if you have a durable healthcare power (also known as a "springing POA) attorney. A springing POA doesn't go into effect until you become incapacitated. This means your agent doesn't have any authority until you are declared incompetent, but, under HIPAA, the person won't be able to get the medical information necessary to determine incompetence until the agent has authority.

To make sure your agent doesn't get caught in this "Catch-22", your POA and health care proxy should contain a HIPAA clause that explains that the agent is also the personal representative for the purposes of health care disclosures under HIPAA. You should also sign separate HIPAA release forms that explain what medical information can be disclosed, who can make the disclosure, and to whom the disclosure can be made.

Contact your elder law attorney to make sure your POA and health care proxy do not conflict with HIPAA.

Can you prevent Alzheimer's?

If you’re like me, every time you forget your keys or the name of a favorite actor playing in an old movie, you start worrying that you’re starting down the long slide to dementia, if not Alzheimer’s disease.

Alzheimer’s and dementia are actually very different issues. Dementia refers to a set of symptoms that include memory loss, impairment of judgment, and difficulty with language. Alzheimer's is a brain disease that accounts for 60 to70 percent of the cases of dementia, but other disorders such as vascular disease and Parkinson’s can also cause dementia.

Over 5 million Americans suffer from Alzheimer’s. And experts estimate that with our aging population, the number of cases will more than triple to over 16 million by 2050.

It’s not surprising that the main risk factors for Alzheimer’s are the same ones that put you at risk for heart disease and overall poor health. The study named seven main pathways to Alzheimer’s: physical inactivity, depression, smoking, mid-life hypertension, mid-life obesity, low education, and diabetes.

Unfortunately, Alzheimer’s disease is still a mystery to medical science. Although there is clearly some genetic component, researchers do not understand what really causes the disease or even exactly what it is. Amyloid plaques are found in the brains of Alzheimer’s victims. But do the plaques cause the disease, or are they merely a symptom? Doctors are working on tests to predict whether or not you will develop Alzheimer’s, but so far there is nothing definitive.

So if you want to prevent Alzheimer’s, stop smoking, get treatment for depression or anxiety, and engage in some sort of physical activity like walking, biking, dancing, or swimming. Go take an adult education class at your community college, join a bridge club, or start doing crossword puzzles. And if you’re overweight, shed some of those extra pounds.

Aging in Place...still the option of choice.

Retirement communities may have their perks, but Beryl O'Connor says it would be tough to match the birthday surprise she got in her own backyard when she turned 80 this year.

She was tending her garden when two little girls from next door — "my buddies," she calls them — brought her a strawberry shortcake. It underscored why she wants to stay put in the house that she and her husband, who died 18 years ago, purchased in the late 1970s.

"I couldn't just be around old people — that's not my lifestyle," she said. "I'd go out of my mind."

Physically spry and socially active, O'Connor in many respects is the embodiment of "aging in place," growing old in one's own longtime home and remaining engaged in the community rather than moving to a retirement facility.

People have long wondered about the purpose of dreams. But scientists say they now know: they sooth the sting out of troubling memories. And when dreams don’t do their job, horrific memories can take over a person’s life, as they do with PTSD, a new study suggests.

According to surveys, aging in place is the overwhelming preference of Americans over 50. But doing it successfully requires both good fortune and support services — things that O'Connor's pleasant hometown of Verona has become increasingly capable of providing.

About 10 miles northwest of Newark, Verona has roughly 13,300 residents nestled into less than 3 square miles. There's a transportation network that takes older people on shopping trips and to medical appointments, and the town is benefiting from a $100,000 federal grant to put in place an aging-in-place program called Verona LIVE.

Administrated by United Jewish Communities of MetroWest New Jersey, the program strives to educate older people about available services to help them address problems and stay active in the community. Its partners include the health and police departments, the rescue squad, the public and public schools, and religious groups.

Among the support services are a home maintenance program with free safety checks and minor home repairs, access to a social worker and job counselor, a walking club and other social activities. In one program, a group of middle-school girls provided one-on-one computer training to about 20 older adults.

Social worker Connie Pifher, Verona's health coordinator, said a crucial part of the overall initiative is educating older people to plan ahead realistically and constantly reassess their prospects for successfully aging in place.

"There are some people who just can do it, especially if they have family support," said Pifher, "And then you run into people who think they can do it, yet really can't. You need to start educating people before a crisis hits."

There's no question that aging in place has broad appeal. According to an Associated Press - LifeGoesStrong.com poll conducted in October, 52 percent of baby boomers said they were unlikely to move someplace new in retirement. In a 2005 survey by AARP, 89 percent of people age 50 and older said they would prefer to remain in their home indefinitely as they age.

That yearning, coupled with a widespread dread of going to a nursing home, has led to a nationwide surge of programs aimed at helping people stay in their neighborhoods longer.

Verona LIVE is a version of one such concept: the Naturally Occurring Retirement Community, or NORC. That can be either a specific housing complex or a larger neighborhood in which many of the residents have aged in place over a long period of time and need a range of support services in order to continue living in their homes.

Verona is an apt setting. Roughly 20 percent of its residents are over 65, compared with 13 percent for New Jersey as a whole.

Another notable initiative is the "village" concept. Members of these nonprofit entities can access specialized programs and services, such as transportation to stores, home health care, or help with household chores, as well as a network of social activities with other members.

About 65 village organizations have formed in the U.S. in recent years, offering varying services and charging membership fees that generally range between $500 and $700 a year.

Read full article...

Guard your card

Identity theft affects about 9 million Americans every year — many of whom are seniors. Identity theft occurs when someone gets access to your Social Security number, bank or credit card account number, or other identifying information and uses it to steal from you. While there's no ironclad protection against identity theft, here are some things you can do to minimize your risks.

Guard your SSN: Treat you SSN like your most prized possession. Never carry your Social Security card in your wallet or purse, don't write your SSN on checks, and never give your SSN, credit card number, checking or savings account numbers to strangers who call, visit, text or send email to you even if they seem legitimate. And don't carry around your Medicare card unless you're going to the doctor.

Be wary of emails: Don't trust emails that claim to be from the Social Security Administration, the IRS or other government agencies. Be leery of emails that look like they're from your bank, telephone company or credit card company. Remember that only phony emails will ask for your credit card number or SSN. For more Internet fraud tips including a list of common online scams go to onguardonline.gov.

Secure your mail: Empty your mailbox quickly, or consider getting a P.O. box or buy a locked mailbox to deter thieves. Also, don't leave outgoing mail in your mailbox. To put a stop to prescreened credit-card offers that thieves look to intercept, use the consumer credit reporting industry opt-out service at optoutprescreen.com or call (888) 567-8688.

Destroy your trash: Buy a cross-cut paper shredder and shred all records, receipts, statements, preapproved credit offers, mail solicitations or other papers you throw out that has your financial or personal information.

Monitor your accounts: Review your monthly bank and credit card statements carefully; see whether your bank or credit-card issuer offers free alerts that will warn you of suspicious activity as soon as it's detected. If they do, sign up for them.

Watch your credit: Check your credit report at annualcreditreport.com or call (877) 322-8228. You can receive one free report a year from each of the three major credit bureaus (Equifax, Experian and TransUnion), so consider staggering your request so you can get one free copy every four months.

Set up security freezes: You can help protect yourself by setting up a security freeze on your credit reports at all three credit bureaus — Equifax (equifax.com, (800) 685-1111), Experian (experian.com, (888) 397-3742) and TransUnion (transunion.com, (877) 322-8228). With a freeze in place, no one, including you, can open new lines of credit in your name. This typically costs $5 to $10 per person per credit bureau each time you freeze or thaw your credit report. Some states offer free freezes for ID-theft victims.

Take action: If you think your identity's been stolen, immediately contact your creditors and financial institutions to report unauthorized charges or debts, and close any compromised accounts. Then place fraud alerts and security freezes with the three credit reporting agencies, and file a report with your local police and with the Federal Trade Commission online at ftccomplaintassistant.gov or (877) 438-4338.

For more tips on preventing identity theft, go to idtheftinfo.org and idtheftcenter.org.

More 90 year olds living in Amercia

The rolls of America's oldest old are surging: Nearly 2 million now are 90 or over, nearly triple their numbers of just three decades ago.

It's not all good news. They're more likely than the merely elderly to live in poverty and to have disabilities, creating a new challenge to already strained retiree income and health care programs.

First-ever census data on the 90-plus population highlight America's ever-increasing life spans, which are redefining what it means to be old.

Joined by graying baby boomers, the oldest old are projected to increase from 1.9 million to 8.7 million by midcentury -- making up 2 percent of the total U.S. population and one in 10 older Americans. That's a big change from over a century ago, when fewer than 100,000 people reached 90.

Demographers attribute the increases mostly to better nutrition and advances in medical care. Still, the longer life spans present additional risks for disabilities and chronic conditions such as arthritis, diabetes and Alzheimer's disease.

Read article...

Social Security Launches New Spanish Online Services

Michael J. Astrue, Commissioner of Social Security, announced that the agency’s most popular online services, the applications for retirement and Medicare and for Extra Help with Medicare prescription drug costs, are now available in Spanish. The new online services are available at www.segurosocial.gov, the robust Spanish version of Social Security’s award winning website,www.socialsecurity.gov.

“The Spanish online applications for retirement, Medicare, and Extra Help with Medicare prescription drug costs are so easy and can be completed in as little as 15 minutes,” said Commissioner Astrue. “I’m proud that Social Security is a leader in the Federal government in providing service in Spanish, and I thank Don Francisco for volunteering his time to help spread the word about these new online services.”

In addition to the new applications, Social Security has also recently made online estimates of retirement benefits available in Spanish. People interested in planning for retirement can get an immediate, personalized estimate of their Social Security benefit by using the Retirement Estimator at www.segurosocial.gov/calculador. Using people’s actual wages from their Social Security record, the Estimator gives a good idea of what to expect in retirement. Workers can enter in different dates and future wage projections to get estimates for different retirement scenarios, which is why this service is one of the most highly rated electronic services in the public or private sector.

Don Francisco, who will appear in several new public service announcements for Social Security, said, “I have good news to share with the millions of Americans who prefer to conduct business in Spanish. You can now apply online for Social Security retirement and Medicare benefits in Spanish, as well as take advantage of other online services offered in Spanish at www.segurosocial.gov. ¡Es tan fácil!”

Once people complete the online application and “sign” it with the click of a mouse, the application is complete and, in most cases, there are no documents to submit or additional paperwork to fill out. It’s the easiest way to apply, and now it’s available in Spanish.

iPads not just for the young

Researchers across the country are using Apple’s tablets for applications to engage the elderly.

Tony Marsh and Jack Rejeski, health and exercise-science professors at Wake Forest University in North Carolina, in 2010 helped develop the Mobility Assessment Tool for the iPad.

MAT consists of videos showing animated figures performing daily tasks such as climbing stairs and walking. The videos not only help senior citizens picture themselves doing these tasks, but they offer some insight of their clients’ limitations.

But tests subjects in pilot runs encountered obstacles such as those at the Winter Garden nursing home before they were evaluated on the iPad.

"People not accustomed to a mouse had trouble coordinating the cursor. It took them close to an hour to complete the video and questions," Rejeski said. "We tried the software on a computer with a touch screen, and it cut the time in half."

Marsh said that the iPad tablets have helped older people become more aware of their level of functioning - the first step to rehabilitation.
The pair is testing their iPad software in Canada, Brazil and Colombia as part of a multiyear project funded by the National Institutes of Health to assess the mobility of older adults.
"These devices have an increased potential to aid people preserve their memory," Marsh said. "They can monitor progress and, in a way, back you up."

Can happiness lead to living longer?

Being happy doesn't just improve the quality of your life. According to a new study, it may increase the quantity of your life as well.

Older people were up to 35% less likely to die during the five-year study if they reported feeling happy, excited, and content on a typical day. And this was true even though the researchers took factors such as chronic health problems, depression, and financial security out of the equation.
"We had expected that we might see a link between how happy people felt over the day and their future mortality, but we were struck by how strong the effect was," says Andrew Steptoe, Ph.D., the lead author of the study and a professor of psychology at University College London, in the United Kingdom.

It may seem far-fetched that a person's feelings on one particular day would be able to predict the likelihood of dying in the near future, but these emotional snapshots have proven to be a good indication of overall temperament in previous studies, says Sarah Pressman, Ph.D., a professor of psychology at the University of Kansas, in Lawrence.

"There is always room for error, of course; if I get a parking ticket or stub my toe on the way to the study, I'm not going to be particularly happy," says Pressman, who was not involved in the study but researches the impact of happiness on health. "But given that the study worked, it suggests that, on average, this day was fairly typical for the participants."

Unlike the happiness measures, depression symptoms were not associated with mortality rates once the researchers adjusted for overall health. According to the study, this finding suggests that the absence of happiness may be a more important measure of health in older people than the presence of negative emotions.

Positive emotions could contribute to better physical health in a number of ways. Regions of the brain involved in happiness are also involved in blood-vessel function and inflammation, for instance, and studies have shown that levels of the stress hormone cortisol tend to rise and fall with emotion.

The study doesn't prove that happiness (or unhappiness) directly affects lifespan, but the findings do imply that doctors and caregivers should pay close attention to the emotional well-being of older patients, the researchers say. "We would not advocate from this study that trying to be happier would have direct health benefits," Steptoe says.

However, this study and others like it should help establish happiness as a legitimate area of concern for health professionals, Pressman says. "There are still some people who see happiness as something fluffy and less scientific -- not something they should be worried about like, say, stress or depression," she says.

Happiness, she adds, "may be something for doctors to ask their patients about."

November is National Family Caregiver’s Month.

WANT TO HONOR VETERANS? HONOR THEIR CAREGIVERS

It’s no coincidence that November marks both Veterans Day and National Family Caregivers month. To truly honor veterans, we must also start honoring their caregivers.

Caregivers of veterans remain a largely invisible group. They are, at best, a footnote in debates about Medicare, veterans benefits, and budgets cuts to local services such as California’s recent decision to cut off Medi-Cal funding for adult day care centers.

Yet caregivers of veterans are not a voiceless bunch. As an advocate for caregivers of the elderly, I hear their stories every day. They speak loud and clear – if we choose to hear them. Take the words of Kathryn M. White, whose husband, a World War II veteran, is now battling Alzheimer’s disease: “I wish none of this ever happened. I wish that I had my wonderful, loving husband back but I know that is not possible.
We were the love of each others’ lives for 24 years and had a great marriage, but that Glenn has gone and I do not know this one.”

She included the following poem, written after assisting her husband through a recent doctor’s visit.

I am not just a Caregiver - I AM the Veteran

I asked the doctor, who was in a bad mood,
After I felt that he was being rude,

“Doctor have you ever put yourself in the shoes of the Vet?”

His answer made me want to shiver.

“Yes, but you’re not a Veteran…you’re just a Caregiver.”

I sat there a moment until I could find my voice.
I had to speak for all of us; he left me no choice.
With tears streaming down my face,
I had one goal: to put him in his place.

“I’m not just a caregiver and this I want you to know.
I’m the veteran and I hope it shows.
Alzheimer’s is taking his mind,
Moreover, I search for the items he can’t find.

“I am his mouth when he can’t speak.
I am his legs when his grow weak.
I am his ears when he can’t hear.
I am the one he counts on being there.

“I am his eyes when he can’t see.
I clean up the messes he makes, even his pee.
I lead him to bathe when he would rather not.
He totally depends on me; I am all he has got.

“I pick him up when he falls,
I lay awake listening for his call.

I pay the bills because he can’t think.
I prepare his meds and hand him a drink.

“We are on a journey into the unknown.
We’ll go together, as one, no, he won’t go alone.
So look into my eyes doctor, see my pain, lest you forget.
I am not just a Caregiver…I am the Vet

-- Patricia Grace, founder and CEO of Aging with Grace,

The best foods to control diabetes in the elderly

Eating healthy is important for everyone, but it's even more important for the nearly 26 million Americans who have diabetes — half of whom are older than 60. A healthy diet, coupled with regular exercise and medicine (if needed) are the keys to keeping your husband's blood sugar under control.

The American Diabetes Association offers a list of 10 superfoods for Type 1 and Type 2 diabetics. These foods contain nutrients that are vitally important to people with diabetes, such as calcium, potassium, magnesium and vitamins A, C and E. They're also high in fiber, which will help your husband feel full longer and keep his glycemic index low so his blood sugar won't spike. And they'll help keep his blood pressure and cholesterol in check, also critical for diabetics.

Beans: Kidney, pinto, navy, black and other types of beans are rich in nutrients and high in soluble fiber, which will keep blood sugar steady and can help lower cholesterol.

Dark green leafy vegetables: Spinach, collard greens, mustard greens, kale and other dark, leafy green veggies are nutrient-dense, low in calories and carbohydrates. A diabetic can't eat too much of these.

Citrus fruits: Grapefruit, oranges and other citrus fruits are rich in vitamin C, which helps heart health. Fiber in whole fruit slows sugar absorption so your husband will get the citrus fruit nutrients without sending his blood sugar soaring.

Sweet potatoes: High in vitamin A and fiber and low in glycemic index, sweet potatoes won't raise your husband's blood sugar at the same level as a regular potato.

Berries: Whole, unsweetened blueberries, strawberries and other berries are full of antioxidants, vitamins and fiber.

Tomatoes: Raw or cooked, this low-calorie food offers vital nutrients such as vitamin C, iron and vitamin E.

Fish with omega-3 fatty acids: Salmon, mackerel, herring, lake trout, sardines and albacore tuna are high in omega 3 fatty acids that help heart health and diabetes. But avoid the breaded and deep-fried variety.

Whole grains: Pearl barley, oatmeal, breads and other whole-grain foods are high in fiber and contain nutrients such as magnesium, chromium, folate and omega 3 fatty acids.

Nuts: An ounce of nuts provides important “healthy fats” along with hunger management. They also contain a nice dose of magnesium and fiber. Nuts are high in calories so a small handful each day is enough.

Fat-free milk and yogurt: These dairy foods provide the calcium and vitamin D your husband needs and can help curb cravings for snacks.

More information

For more details on healthy food choices for diabetics, including free recipes, go to diabetes.org or call (800) 342-2383.

Financial pressures driving some older Americans to drink...

Some older adults may turn to alcohol or cigarettes as a way to cope with financial stress, particularly men and people with less education, a new study suggests.

In the study, researchers surveyed 2,300 older Americans periodically between 1992 and 2006, and found that 16 percent reported growing financial strain over that time, 3 percent reported increases in heavy drinking (more than 30 drinks a month), and 1 percent said they'd started smoking more.

The youngest of the study participants were age 65 when the study began.

Older men who faced increasing financial stress were 30 percent more likely to become heavy drinkers than those who remained financially stable. This increased risk was similar for older adults with lower levels of education compared to those with more education.

Older women and seniors with higher levels of education tended to reduce their drinking when they encountered financial struggles, according to the study published in the November issue of the Journal of Studies on Alcohol and Drugs.

The findings don't actually show that financial problems were the reason for changes in smoking and drinking habits, but it is known that some people use alcohol and tobacco as a way of coping with stress, noted lead researcher Benjamin A. Shaw of the State University of New York at Albany.

"When you have a stressor that's not very controllable, people may focus on something to help control their emotional response to the stressor," he said in a journal news release.

Financial woes may be particularly stressful for older adults, Shaw added.

"They are out of the workforce, and they might feel like they have less time to recover or generally have less control over their financial situation," he explained

What every senior needs to know about hospital observation care.

How do I know the status of my hospitalization stay?

Ask your doctor or other hospital officials if you are in the hospital for observation or as a regular inpatient. If you are an observation patient, ask why. Even if you are admitted as an inpatient, the hospital can switch you to observation status; in that case, the hospital is required to notify you.

You may not be eligible for post hospitalization skilled Medicare benefits.

If you do not have three consecutive days of hospitalization as an inpatient -- excluding the day of discharge -- Medicare will not cover a subsequent stay in a nursing home. For those who do qualify, Medicare pays for up to 100 days of rehabilitation or skilled nursing care.

How long can the hospital keep me for observation?

Medicare expects patients to remain in observation status for no more than 24 to 48 hours. But there are no rules limiting the time; some patients spend several days in observation.

What can I do if the hospital won't change my observation status to inpatient?

"You cannot directly appeal the hospital's determination that you are or were an observation patient," says Ellen Griffith, a Medicare spokeswoman.

If you think you should be considered an inpatient, ask your personal physician to call the hospital and request a change in status, although your doctor cannot mandate this. If that is not successful, there are other steps you can take.

Flu shot hoping to "trick" the oldster's immune system

When it comes to getting flu shots, seniors are exceptional.

Yet despite their unusually high vaccination rates, they also account for an exceptional portion of flu-related hospitalizations: 90 percent, according to the Centers for Disease Control and Prevention (CDC).

It turns out their bodies are sluggish to react to the standard vaccines that easily rev up a younger person's immune system.

So doctors around the country are hoping to coax a better immune reaction from seniors this flu season by offering them a shot that packs four times the amount of dead flu virus to which the body can react.

This high-dose shot, manufactured by French pharmaceutical giant Sanofi Pasteur, has been proved in clinical trials to get a stronger immune response, the CDC said.

Whether a heightened immune response reduces the number of seniors contracting the flu has yet to be proved.

That clinical trial won't be completed until 2014.

But Dr. Larry Bush, an infectious-disease specialist in Atlantis, Fla., gives the shots to patients 65 and older.

So do many private physicians, supermarkets and pharmacies, including Bartell Drugs.

The elderly can choose the standard vaccine or the high-dose one. When his patients ask which he would pick, Bush tells them, "If I were over 65, I would get the high dose," he said.

Bush said that while we can't yet prove it is significantly more effective, it's certainly not less effective. And, Bush said, he's inclined to believe that a proven rise in immune response will translate to fewer cases of the flu.

"It makes sense," said Bush, a staff member at JFK Medical Center in Atlantis, Fla.

Though the CDC at one time advised only select vulnerable populations — including the elderly — to get vaccinated for the flu, that advice changed in 2008. The standing message now is that everyone 6 months and older should get a shot.

It's a message that is particularly important to older people.

"They're at much greater risk of complications and death," said Dr. David Greenberg, Sanofi Pasteur's senior director of scientific and medical affairs. "Influenza, we often say, is not just a bad cold; it's a terrible disease that can lead to hospitalizations and death."

The contagious respiratory virus can bring on a fever, headache, sore throat and runny nose. The flu can make existing chronic medical conditions such as asthma or diabetes worse. It also can cause complications such as sinus infections and bacterial pneumonia.

Flu and pneumonia are the seventh-leading cause of death in the United States among those 65 and older, according to the most recent data from the CDC.

The high-dose vaccine was licensed by the U.S. Food and Drug Administration in time for last flu season. Sanofi Pasteur estimates that 10 percent of the elderly population that was vaccinated last season opted for the high dose. The option is more widely available this year, company officials say.

Like the standard shot, the high-dose version is made of three flu strains deemed most likely to make people ill in that season.

But the high-dose shots pack more antigens, those elements that trigger a body's immune response.

Sanofi's Greenberg said the higher dose of antigens also results in more reactions from the shot.

"The downside is there are slightly more local side effects," Bush said. "A little bit more redness, a little bit more tenderness (around the shot area), a little bit more fever."

But when it comes to serious side effects, the high-dose vaccine is no different from the standard, the CDC said. "Most people had minimal or no adverse events after receiving the Fluzone High-Dose vaccine," it said.

Antidote for the Alzheimer's Epidemic: An Ounce of Will ad a Pound of Pragmatism

Surely, you’ve all read the grim reports about Alzheimer’s disease. The advancing age of the US population will usher forth an Alzheimer’s epidemic in the coming decade. The emotional toll of this epidemic will be immeasurable, and the financial impact could bankrupt the Medicare system.
That dire version of the story might sell newspapers, but it doesn’t really reflect the available options to a nation with a will to fight back. The good news is: we can manage this problem. And no elusive scientific discoveries are required to do so. We merely need to implement the medical knowledge that is already in hand.

This short summary outlines the pragmatic steps necessary to close the gap between the state of current medical knowledge and the lagging standard of care that is routinely practiced in primary care settings. We can avert this looming threat with an ounce of public will and a pound of pragmatism.

Read more...Brain Today

You're never too old to quit

Perhaps you’ve heard of the “damage is done” scenario. An elderly family member started smoking as a young person, maybe a teenager, tucking a pack of cigarettes into his rolled-up shirtsleeve or into her purse. Decades later, despite wall-to-wall anti-smoking ads, despite smoking being outlawed in nearly every public space, perhaps despite family pleas or doctors’ admonitions or even a heart attack, that person remains a smoker.

What’s the point of stopping now, he or she figures, when my body has already suffered the consequences of a lifetime of tobacco addiction? The damage is done, isn’t it?

So while the rate of smoking in those over age 65 is smaller — a bit over 8 percent — than it is in the younger population, more than 22 percent of whom smoke, older smokers are much less likely to try to stop. More than half of smokers ages 18 to 24 have tried to quit, the Centers for Disease Control and Prevention has reported, but only about a quarter of those over age 65 have. In the three decades following the first report by the surgeon general’s report on smoking and health in 1964, smoking rates dropped much more among younger adults than among older ones.

“They’ve been smoking longer, so they might be more nicotine-dependent,” said Bethea Kleykamp, a postdoctoral fellow in nicotine pharmacology at the National Institutes of Health, trying to explain those differences.

But in their article, “The Older Smoker,” recently published in The Journal of the American Medical Association, Dr. Kleykamp and Stephen Heishman, a nicotine researcher at the National Institute on Drug Abuse, argue that the damage isn’t done.

The good news for older smokers is that under the Affordable Care Act, Medicare now covers smoking-cessation counseling for any beneficiary who wants to stop. A quarter of older smokers have already made an attempt. (Previously, Medicare covered such programs only for those who already had a smoking-related disease.)

And Part D drug plans cover medications — patches, gum, pills — in most states. “We know that the best treatment is a combination of pharmacology and counseling,” Dr. Kleykamp said. You’d think that reducing smoking among the elderly population would save Medicare a boatload of money.

And the winner is...Sami Peterson, Caregiver of the Year

National Family Caregivers Association, announced Sami Peterson, 50, of Fort Collins, Colo., as the grand prize winner of the third annual National Family Caregiver of the Year award. As the winner, Peterson received $10,000 from Homewatch CareGivers, eight hours of respite care, and a scholarship to Homewatch CareGivers University, which offers courses geared to help caregivers increase their knowledge and skill sets.

Sami Peterson represents the spirit of this award, said Leann Reynolds, President of Homewatch CareGivers. The magnitude of care Sami provides for her son and her father is astounding. The fact that she can provide this level of care while holding down a career is an inspiration and a top reason why our judges voted Sami the National Family Caregiver of the Year.

The National Family Caregiver of the Year award was created by Homewatch CareGivers in 2009 to create awareness around the issues faced by family caregivers, and to nationally recognize one caregiver from the community each year whose story is judged the most compelling by a 10-member industry panel.

Caring for Will and Rob has provided me with many of life-enriching opportunities. It has touched those around me. While it is not always easy, it has truly enriched my life, says Peterson. I want to thank my sister, Lana, for her love and support – and for nominating me for this award. I owe this award to all the people who have been there for me along the way to help me not only survive, but to thrive. I am so very grateful to the National Family Caregivers Association and Homewatch CareGivers for this award and for all the work they do in helping family caregivers.

Peterson provides in-home care for her husband, Rob, 66, who has Huntington’s disease, as well as her developmentally disabled son, Will, who is 17. She also works full time and is active in the weekly Huntington’s Disease Support Group of Northern Colorado.

Reviewing Sami’s story was heartbreaking on the one hand and inspiring on the other, said Susan Lutz, Senior Project Manager, Health and Family Team for AARP. All of the finalists for the award faced intense caregiving situations, which made the final selection difficult, but Sami’s situation was perhaps the most intense. How she manages her husband’s Huntington’s disease while at the same time raising a developmentally challenged teenager is beyond most people’s threshold. She is a deserving winner.

Sami Peterson says that her quest to help her husband and son live better lives has been a challenge especially with regards to the relatively unknown Huntington’s disease. Huntington’s disease is a genetic disorder that affects muscle coordination and ultimately leads to cognitive decline and dementia. Rob Peterson, whose mother also had Huntington’s, is currently experiencing the full range of Huntington’s symptoms, including dementia. Sami Peterson is determined to find medical answers.

Sami is amazing, says sister Becci McCormack. She has had to fight the system of education, healthcare, insurance and employment to provide an affordable and viable situation for her family. And in doing so, she has tapped into resources others didn’t even know existed.

Best US Cities for Oldsters

Minneapolis is the best city in the United States for senior living, with Boston, Pittsburgh, Cleveland and Denver rounding out the top five, according to a new survey conducted for the Bankers Life and Casualty Company Center For a Secure RetirementSM.

Criteria in the areas of senior issues and gerontology identified the qualities for optimal senior living. Major categories were: healthcare, economy, health and longevity, social, environment, spiritual life, housing, transportation and crime. Each category was statistically weighted to reflect the needs of the senior population.

“Most surprising is that the survey results contain many cities we don’t often associate with senior living,” said Scott Perry, president of Bankers Life and Casualty Company, the national life and health insurer. “We weren’t interested in another study on where to enjoy your retirement, but instead wanted to find cities that did the best job in providing the services and support that seniors need. The top ranked cities aren’t what come to mind when you think about where to spend your golden years, but they scored high in the criteria most important to the 65 and up bracket.”

The Categories

The Healthcare category includes physicians per capita, gerontologist to senior ratio, hospitals per capita, hospitals with special care, nursing homes per capita, nursing home beds per capita, continuing care retirement communities per capita and average nursing home rating.

Economy includes consumer price index, sales tax rate, the unemployment rate and the stability index.

Health and Longevity includes life expectancy, age 85 expectancy, depression rate, heart mortality and cancer mortality.

Social includes percentage of seniors, social and emotional support, satisfaction with life rating, art and museums, education level, recreation, four-year colleges and libraries.

Environment includes number of sunny days, clean air levels, clean water measurement, natural disaster risk index, ocean coastline miles, river and lake square mileage, and local/state park number and size.

Spiritual Life includes percent of population belonging to organized religions and the number of religious congregations.

Housing includes cost of living index, housing price, property taxes and apartment rentals.

Transportation includes public transportation, special access and mass transit percentage.

Crime includes violent crime rate and property crime rate.

Methodology

The Bankers Life and Casualty Company Center for a Secure Retirement Best Cities for Seniors 2011 was conducted in July of 2011 by the independent survey administrator Sperling’s Best Places and identified the top 50 metro areas in the U.S. The complete report may be viewed at www.CenterForASecureRetirement.com.

Finally, a raise in social security.

Social Security retirement benefits for nearly 55 million people will rise 3.6% in 2012, the first cost of living increase since 2009 said the U.S. Social Security Administration on Wednesday.

Some other changes that take effect in January of each year are based on the increase in average wages. Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $110,100 from $106,800. Of the estimated 161 million workers who will pay Social Security taxes in 2012, about 10 million will pay higher taxes as a result of the increase in the taxable maximum.

“Over the past two years, costs for food, utilities and health care have continued to increase while Social Security benefits have not,” said Nancy LeaMond, AARP Executive Vice President. “This first increase in three years will provide much-needed relief to millions, and underscores the importance of Social Security as the only guaranteed, lifelong, and inflation-adjusted source of retirement income for most Americans.”

Monthly Social Security payments average $1,082, or about $13,000 a year. A 3.5 percent increase would amount to an additional $38 a month, or about $455 a year.

Most retirees rely on Social Security for a majority of their income, according to the Social Security Administration. Many rely on it for more than 90 percent of their income.

Even a mild stroke can cause serious side effects

Even mild strokes can result in serious but unrecognized disabilities, such as depression, vision problems and difficulty thinking, according to a new study.

The findings, released Monday at the Canadian Stroke Congress in Ottawa, suggest new guidelines are needed on the treatment and management of mild strokes, the researchers said.
"There is no such thing as a mild stroke," said study co-author Annie Rochette, of the University of Montreal, in a news release from the Heart and Stroke Foundation of Canada. "These patients face huge challenges in their daily lives."

After interviewing 200 stroke victims within six weeks of having their first stroke, the researchers found a high rate of sleeplessness and depression among the participants. Nearly 25 percent were clinically depressed. The stroke patients also reported a significant drop in their perceived quality of life, the study revealed.

The researchers said treatment for symptoms of depression, such as fatigue, loss of appetite, lack of concentration, disturbed sleep and thoughts of suicide, should be an important part of recovery for mild stroke patients.

The participants' average age was 62 years -- younger than the typical age for a severe stroke, which is over 65. About 40 percent still worked before they had their stroke and they were worried about returning to their jobs.

Other mild stroke patients interviewed were concerned about caring for their families and being able to drive. Many feared another stroke and felt uncertainty about the future, the researchers found.
"People who have had a mild stroke are five times more likely to have a stroke over the next two years than the general population," Dr. Michael Hill, Heart and Stroke Foundation spokesperson, said in the news release. "Proper treatment and management of risk factors can help prevent another stroke."

Despite these worries, few of the mild stroke victims were screened for problems with their vision or mental abilities, which are often less obvious than problems with movement. The authors noted that nearly 25 percent of mild stroke patients are only treated in an emergency room and not seen by occupational therapists, neuropsychologists or speech therapists.
"Patients are told to see their family doctor, but given no other tools or rehabilitation," added Rochette. "When they go to drive again, some people are too afraid to get behind the wheel."

New treatment guidelines, including more accessible rehabilitation services, would help more people get needed care, the researchers concluded.

More information
The U.S. National Institute of Neurological Disorders and Stroke provides more information on stroke rehabilitation.

Decisions, decisions, it's that time of year again....

Navigating the Medicare maze is confusing enough, but the added pressure of the looming open enrollment deadline can be overwhelming. The following are 10 things you should know for enrolling in Medicare this year.

1. Open enrollment runs from October 15 to Dec 7, 2011

This window is the time that seniors can sign up for Medicare Advantage (Part C) or Medicare Prescription Drug Coverage (Part D) or they can make changes to an existing plan, move to a new one, change drug coverage benefits or dis-enroll.

2. There are two ways to get Original Medicare (Part A and Part B)

Choose Original Medicare on its own, with the option to add Medicare Part D prescription drug coverage. If you collect benefits from Social Security or the Railroad Retirement Board (RRB), you will automatically get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). There is a premium for Part B. If you don't want to keep Part B, you must follow the directions when you get your Medicare card, indicating you don't want it. Otherwise, you will be charged.

Or choose a Medicare Advantage (Medicare Part C) plan that bundles Original Medicare with extra benefits and may include prescription drug coverage in one plan. Medicare Advantage Plan is like an HMO or PPO. You may have to go to doctors within their service network or pay higher co-pays for going out of network.

3. Your share of the Medicare costs may be larger than you expect

Medicare, the traditional benefit provided by the government, doesn't cover all medical expenses. For example, approximately of 20% of physician fees are paid by the Medicare beneficiary. Seniors often find themselves paying out-of-pocket for many of their healthcare expenses.

4. Medicare Advantage Plans pick up where Medicare leaves off

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare. This insurance provides your Part A, Part B and oftentimes, Part D coverage. You use a Medicare Advantage card for health care.

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.

5. Timing matters

Timing matters when you're joining Medicare. When you turn 65 or otherwise become eligible for Original Medicare (Parts A and B), enrollment windows open. But some of these windows will close quickly. If you wait until later to sign up, you may have fewer choices, and you may pay more. During Open Enrollment Period, you can:
•Change from Original Medicare to a Medicare Advantage Plan.
•Change from a Medicare Advantage Plan back to Original Medicare.
•Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
•Switch from a Medicare Advantage Plan that doesn't offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
•Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage.
•Join a Medicare Prescription Drug Plan.
•Switch from one Medicare Prescription Drug Plan to another.
•Drop your Medicare prescription drug coverage completely.

6. Know what you're paying

When you're deciding whether or not to add, change or drop plans, pay attention to what you're paying. Look at your total out-of-pocket healthcare expenses from last year. It's not just the premium, but check to see what may have changed with the deductible, co-pays, prescription drug costs.

7. Doing nothing is an option

If you don't make any changes during Medicare Open Enrollment, your existing plans will rollover at the end of the enrollment period with no changes and your existing coverage will remain in effect throughout 2012.

8. If you miss the deadline, there may still be hope

If you missed the deadline, you may have to wait until next year before you make changes, or you will pay penalties and higher premiums.

However, there is a second enrollment period from January 1 to February 14. During this time, you can:
•If you're in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare.
•If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

9. Sometimes it's not so easy to "just switch back"

An insurance agent might say that "if you don't like the Medicare Advantage plan, you can just switch back." But it's not that easy. You can get stuck in a plan. You can only drop Medicare Advantage during certain time periods. In recent years, a new "disenrollment period" for Medicare Advantage plans is offered. From January 1 through February 14, a senior can disenroll if they are unhappy with the Medicare Advantage Plan they purchased. They can go back to regular Medicare coverage and, if they wish, pick up a prescription drug plan. (But beware: Medigap is different. Once you give up a Medigap plan, you might not be able to get it back.)

10. Get help if you need it

Don't go it alone. If you don't understand something, ask for help. For information on Medicare and/or personal assistance with signing up for Medicare Advantage Plans (Part C) or Medicare prescription drug coverage (Part D), including instructions on how to join, contact Medicare Marketplace or SGIA Retiree Support Center.

Cuts in Medicare and Medicaid major concern for nursing homes

The following is an article written by Alyssa Gerace for Senior Housing News.

In the past 10-plus years, there has been a trend away from nursing homes and to other, more home-like forms of long-term care for American seniors. Most say the shift is due to nursing homes’ high costs, but also some of the traditional qualities that nursing homes have represented over the years and the rise of alternative options.

Between 1998 and 2008, the number of Americans living in nursing homes shrank 6.1% to slightly more than 1.2 million, says a Brown University study published in the July 2011 edition of Health Affairs. During this same time frame, there was 18.1% increase in the number of Americans aged 65-69, and 8.7% rise in those aged 70 and older, according to U.S. Census Bureau estimations. MetLife estimates that today’s nursing home care costs upwards of $83,000 per year for a private room, on average.

Jodie Spiegel, a lawyer for consumer advocacy organization Bet Tzedek, says in her experience from speaking with clients, the nursing home population is decreasing because there are so many other options available, like assisted living, which has experienced rapid growth. There are more than one million people living in assisted living facilities, according to the Assisted Living Federation of America, even though it’s a relatively new concept that was developed about 25 years ago.

“Previously, when someone required care outside of their home, their only choices were hospitals or nursing homes,” says Spiegel. “Now, there’s assisted living, continuing care, adult day healthcare, senior centers, receiving care at home—there are more choices, and choices are more home-like, which in general is more appealing to people.”

Something else that may be keeping seniors out of nursing homes is the multitude of stigmatized issues attached to those establishments. As a consumer advocate, Spiegel encounters many recurring complaints regarding nursing homes, many of which she says are due to staffing shortages.

“Nursing homes are businesses and they’re trying to make a profit,” says Spiegel. “In a perfect world, nursing homes would be hiring more staff to provide better care, but unless they’re required to do so, they’re unlikely to do so.”

Missouri-based Cheryl Parsons, who’s a registered nurse and a licensed nursing home administrator and consultant, admits staffing can be a major issue for some facilities.

“The problem is, the acuity level has gotten a lot higher in the long term care setting,” says Parson, referring to the level of severity of a resident’s illness. “Hospitals just are not keeping patients, so we’re seeing higher acuity levels,” which translates to higher levels of care and attention being needed. “Couple that with reimbursement issues, owners are having a hard time keeping the bills met, and the staff paid, in order to keep that staffing where it needs to be,” she says. “It is a concern, it’s a big issue.”

Now that nursing homes are facing an 11.1% cut to Medicare payments, the challenges abound. Although both Medicaid and Medicare programs apply to nursing home residents, reimbursement rates from the government-funded programs aren’t as high as what a nursing home could receive from a private pay resident, says Spiegel.

Since many nursing homes have a high population of Medicare- and Medicaid-eligible residents, these facilities could be especially affected by funding cuts, since it will affect their ability to subsidize lower Medicaid reimbursements with Medicare funds.

“You need to pay the bills to keep the doors open and let patients in,” Parsons says. “It weighs heavily on those of us who are committed to the industry and to our residents. Most facilities work very hard and diligently to do so, but it’s always a challenge because of the reimbursement issue.”

Greg Crist, the Head of Affairs for (AHCA) says the important thing to remember is that nursing homes want residents to be in the least-restrictive setting. They’re not trying to pull in large numbers of residents to give them lesser-quality care for a profit, if those residents are better off living at home or at an assisted living facility.

“There will always be a need for long term care,” he says.”We just want to make sure there’s a cost-effective, and least-restrictive method as well. We only want them in our facilities if that makes the most sense.”

The Challenge of Mental Illness in the Elderly

Mental illness presents stresses and challenges at any age or stage of life, but seniors who must deal with issues of aging in addition to a long standing or newly diagnosed mental illness often face overwhelming issues. In addition, most elderly people who have long term mental illness never sought medical attention and treatment for their conditions due to societal attitudes towards mental illness years ago. And those with acquired mental illness remain reluctant to seek psychiatric care, again due to old stigmas about mental illness.

Seniors with age-acquired mental illness

It is not unusual for people to acquire certain mental illnesses after age 65. Depression, for example, is quite common in older persons due in part to the inevitable losses which occur with aging. Also, changes in brain chemistry can cause profound depression in older adults. Several physical problems, including transient ischemic attacks (TIAs), strokes, Alzheimer’s disease and related dementias often cause paranoid thoughts, delusions, hallucinations and aggressive actions. These acquired mental illnesses are often very frightening to the individual and to his or her family members. While symptoms of depression may be – unfortunately – very subtle, the delusional and paranoid behaviors are very distressing to families who previously enjoyed positive relationships with the senior. The senior may accuse his children of trying to take his money, his wife of having an affair, the government of beaming messages to him via the TV, and other such misperceptions. The result of the senior’s delusions is usually increased isolation from those trying to provide care and assistance.

Mental health treatment options for seniors

Effective treatment is available for mental illness of seniors. The first step to obtaining quality mental health care is to have a thorough history and physical exam by a qualified internal medicine physician or geriatrician. The purpose of this exam is to identify any physical problems which need treatment or which may be causing symptoms of mental illness. Help in arranging for treatment of any physical problems may be needed if the senior is unable or unwilling to make necessary arrangements.

Study confirms hospital stays decrease cognition in the elderly

Modern hospitals can fix a multitude of ailments. But for older patients, hospitalization may result in a downward slide in one important respect: cognitive function.

That's the finding of a new 12-year study in the journal Neurology, in which researchers interviewed 1,870 seniors periodically to gauge their thinking skills and memory.

Everyone slows down a bit with age, mentally speaking. But patients who were hospitalized during the study slowed down much faster, on average. Their average "global cognition score" decreased at a rate that was 2.4 times greater than the rate of decline for those who were not hospitalized.

Certain other factors also were linked to a faster mental decline, among them older age and severity of illness. But the apparent impact of hospitalization remained statistically significant even after those factors were taken into account. In other words, there seems to be some consequence of hospitalization itself, regardless of how sick the patient is to begin with, said Robert S. Wilson, the study's lead author and a neuropsychologist at Rush University Medical Center in Chicago.

"After hospitalization, on average, people's rates of cognitive decline were the equivalent of being more than 10 years older," Wilson said.

The study did not reveal what might be causing the accelerated decline. But Wilson said the answer is likely to have multiple elements, such as complications from surgery, the impact of medications, and simple inactivity.

"If you're in the hospital for a week or two or more, you're usually pretty physically inactive," Wilson said. "You may be pretty mentally inactive as well. That might not be a good thing."

The switch to an unfamiliar environment may also play a role. There are patients who function fairly well at home, where they know where everything is, but the switch to a hospital setting may "unmask cognitive symptoms in vulnerable older persons," the authors wrote. Even after returning home, such patients may not regain their prior level of function, Wilson said.

Further research could suggest strategies for better hospital care to keep patients sharp, the authors wrote. Or better yet, improvements in primary care so hospitalization is unnecessary.