Pennsylvania enhances protection for older and disabled adults

The Commonwealth of Pennsylvania will soon require electronic fingerprinting for people who work in home care and long-term care settings. The requirement will cover those applying to work in a long term care facility or home health agency, the state Department of Aging announced this week, and as of June 4, background checks submitted manually will no longer be accepted.

“In addition to enhancing the protections provided to our older adults, electronic fingerprinting will help us to more quickly process background checks,” said Secretary of Aging Brian Duke. “This is important because it will help people obtain jobs in Pennsylvania’s valuable health care industry.”

Prior to the new requirement, the department processed fingerprints manually. It is teaming up with Cogent Systems to provide the processing, which can be done through online registration.

The Older Adults Protective Services Act requires applicants working in long term care and home care capacities to undergo criminal background checks and the fingerprinting is another step toward this protective measure, the department said.

Will home equity augment retirement income?

Social Security at one time provided a reliable source of income for Americans post-retirement. For the first time in history though, future outlooks show that while more Americans hope to rely on social security as a major income source, less money will be available, and alternative sources of income will need to be established.

For some, that will mean more reliance on the home equity they have built.

In a May Gallup Poll, the percentage of non-retirees who say they plan to rely on social security funds post-retirement has increased from 27% before the recession to 33% today.

This means more baby boomers will be relying on Social Security funds to supply their monetary needs once they have retired and are no longer contributing to the workforce.

With a large population of baby boomers and the increasing percentage of people expecting to rely on Social Security, the funds being distributed to retirees will be greater than the funds coming in from current payroll taxes.

All of these factors contribute to a problematic situation as people continue to assume they can rely on Social Security to fund their retirement when they could be seeking alternative ways to support their expenses after retirement.

Despite a drop in home values since the recession, 21% of Americans expect to rely on the equity built up in their homes as a source of income.

Funding retirement without social security requires attentive planning to the future and saving and investing in a 401(k) or other retirement savings account, increasing the size of stock portfolios, and an establishing a pension plan with a place of employment.

In addition to these supplemental ways to fund a retirement, an increased number of Americans plan to simply continue working until a later age than in the past. According to Gallup’s annual Economy and Personal Finance survey conducted in April, the average age at which Americans expect to retire is up from 60 in 1996 to 67.

Additionally, there has been no change in the percentage of people who plan to rely on annuities or insurance plans to supply post-retirement funds.

Social Security at one time provided a reliable source of income for Americans post-retirement. For the first time in history though, future outlooks show that while more Americans hope to rely on social security as a major income source, less money will be available, and alternative sources of income will need to be established.

For some, that will mean more reliance on the home equity they have built.

In a May Gallup Poll, the percentage of non-retirees who say they plan to rely on social security funds post-retirement has increased from 27% before the recession to 33% today.

This means more baby boomers will be relying on Social Security funds to supply their monetary needs once they have retired and are no longer contributing to the workforce.

With a large population of baby boomers and the increasing percentage of people expecting to rely on Social Security, the funds being distributed to retirees will be greater than the funds coming in from current payroll taxes.

All of these factors contribute to a problematic situation as people continue to assume they can rely on Social Security to fund their retirement when they could be seeking alternative ways to support their expenses after retirement.

Despite a drop in home values since the recession, 21% of Americans expect to rely on the equity built up in their homes as a source of income.

Funding retirement without social security requires attentive planning to the future and saving and investing in a 401(k) or other retirement savings account, increasing the size of stock portfolios, and an establishing a pension plan with a place of employment.

In addition to these supplemental ways to fund a retirement, an increased number of Americans plan to simply continue working until a later age than in the past. According to Gallup’s annual Economy and Personal Finance survey conducted in April, the average age at which Americans expect to retire is up from 60 in 1996 to 67.

Additionally, there has been no change in the percentage of people who plan to rely on annuities or insurance plans to supply post-retirement funds.

The history of Memorial Day

Originally called Decoration Day, Memorial Day is a day of remembrance for those who have died in service to our country. It was first widely observed on May 30, 1868, to commemorate the sacrifices of Civil War soldiers, by proclamation of General John A. Logan of the Grand Army of the Republic, an organization of former sailors and soldiers.

During the first national celebration, General James Garfield made a speech at Arlington National Cemetery, after which 5,000 participants helped decorate the graves of the more than 20,000 Union and Confederate soldiers who were buried there. This event was inspired by local observances that had taken place in towns throughout America in the three years after the Civil War. By the late 1800s, many more cities and communities had begun to observe Memorial Day, and after World War I, it became an occasion for honoring those who had died in all America's wars.

Memorial Day is celebrated at Arlington National Cemetery each year with a ceremony in which a small American flag is placed on each grave. Traditionally, the President or Vice President lays a wreath at the Tomb of the Unknown Soldier. About 5,000 people attend the ceremony annually.

Congress declared Memorial Day a national holiday to be celebrated on the last Monday of May.

This could happen to you...

The adult son of a former nursing home resident has been determined responsible for paying his mother’s $93,000 bill by a Pennsylvania appeals court, writes Howard Gleckman of Forbes, and this might be the beginning of a new trend. 

Many states have filial responsibility laws, but few have traditionally enforced them. That may be changing, says Forbes, as nursing home costs increase and residents have less ability to pay them.

“While these laws don’t directly apply to Medicaid recipients, they may force children to pick up their parents’ long-term care costs long before mom is ever eligible for Medicaid,” says the article. “Such a step could still shift significant costs from states to families.”

Read full article...

Is It Ever Too Late to Restore Your Health Through Proper Alignment and Improved Posture?

by Dr. Danielle Gray, Restore Chiropractic

The answer is no, it is never too late.  Did you know that your posture and being misaligned has a direct affect on your overall health and not just neck pain or back pain?  You can take steps today to improve your overall health by improving your posture and making sure that you are in proper alignment.

It’s all connected. 

Poor posture and being misaligned affects your health from your head to your toes because your body is interdependent.  It’s all connected.  Misalignments create a domino effect with your health.  When your head is shifted off center (either forward or sideways), your body becomes imbalanced because it’s center of gravity has been shifted. For every inch of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds.  Imagine trying to carry a bowling ball and your head on your neck! 

If your head is not on straight, the rest of your body will compensate to keep itself balanced over the feet with the eyes level to the horizon. This is accomplished by the head, shoulders and hips tilting or twisting which distorts the spine.  As this progression occurs, the body must compensate elsewhere to alleviate the stress/tension created from the imbalance.  This improper body alignment develops unstable environments structurally and decreases the function of the nervous system. 

The nervous system controls everything in your body. When there is interference to the nervous system’s function, it can cause or contribute to all kinds of symptoms and illnesses.  This means that a misalignment in the spine can disrupt the body’s function leading to symptoms of pain, organ dysfunction, decreased range of motion, balance issues, arthritis and just an overall loss of health. 

90 percent of the brain’s energy output is used in relating the physical body to gravity.  Only 10 percent has to do with thinking, metabolism, and healing.  Consequently, poor posture and being out of balance will cause the brain to rob energy from thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing.  Published research studies indicate that when body balance is restored, the body enters a healing cycle that alleviates pain and symptoms, elevates the immune system, increases blood and oxygen circulation, improves balance, normalizes nervous system communication and creates more optimum body performance.

As described in a paper published in conjunction with the White House Counsel on Aging, “Chiropractic is a health care discipline that emphasizes the inherent recuperative powers of the body to heal itself without the use of drugs or surgery. The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health.

What can you do at home to improve your posture and body balance?

1.       Be mindful of your posture

·         Evaluate areas where you spend the most time to make sure that your environment is ergonomically sound.

·         Post a note or set a reminder to check your posture regularly.  Chin up, shoulders back, back straight, feet on the floor.  Imagine a string attached your chest and it is being pulled up from the ceiling.

2.       Take frequent breaks.

·         If you are reading or watching TV or other activities that are more stationary, move around and change positions frequently.

·         Limit game playing, personal computer work and tablet time to 30-60 minutes.  If you are going to spend more time, take a break every 30-60 minutes and do something else for a few minutes.

·         Spend 10-15 minutes one to two times per day resting on your back with a pillow under your knees.  Resting for even a few minutes, especially in the middle of the day can have profound effects on your nervous system function and on your posture.

3.       Stretch and Strengthen.

·         Stretches such as shoulder rolls or neck stretches can be incorporated into your daily routine.  Stretch and strengthen both your front and back muscles for even balance.

It is important to understand that poor posture and being misaligned may not cause pain right away.  Do not wait until the symptoms arise.  Take control of the situation before it controls you.  If you are experiencing health problems, it is never too late to restore your health through improved posture and alignment.  Visit a Chiropractor today for a complete balance, posture and alignment examination.

Fewer physicians accepting Medicare and Medicaid

A national survey has found that thirty-six percent of doctors are no longer accepting new Medicaid patients due in large part to declining reimbursements.

The survey of 2,232 physicians across all specialties conducted in late April by Jackson Healthcare in Atlanta — the fourth-largest health care staffing company in the U.S. — further found that broken down for specialty, 66 percent of dermatologists, 64 percent of endocrinologists, 58 percent of internists, 57 percent of physical medicine and rehabilitation doctors and 53 of adult psychiatrists said they are no longer able to take on more Medicaid patients.

Other specialties in the survey with a high percentage of doctors who reported stopping accepting Medicaid patients include orthopedic surgeons (50 percent), family practitioners (45 percent), gastroenterologist's (47 percent), neurologists (43 percent), cardiologists (39 percent) and urologists (35 percent).

Currently 26 percent of physicians see no Medicaid patients at all, the survey reported.

According to the Kaiser Commission on Medicaid and the Uninsured, under the Patient Protection and Affordable Care Act (the constitutionality of which is currently under consideration at the Supreme Court), Medicaid enrollment could increase by 22.8 million by 2019.

According to Richard L. Jackson, chairman and CEO of Jackson Healthcare, the low reimbursement rate paired with the large influx of new Medicaid patients will be a problem.

“This is creating the perfect storm that will make it very difficult for the poor and elderly to access a doctor,” Jackson said. “Physicians say they just can’t afford to be part of a system that generates so many patients for so little compensation.”

The survey further noted that 17 percent of physicians said they could no longer afford to see new Medicare patients and 10 percent reported not seeing Medicare patients at all.

How to be your own patient advocate

Studies have shown that patients who help their doctors by providing important health information and preparing themselves for appointments tend to get better care than patients who don't. Here are some simple things we can all do to help maximize our next visit to the doctor.

Before the appointment:
Gathering your health information and getting organized before your appointment are the key steps to ensuring a productive meeting with your doctor. This is especially important if you're seeing multiple doctors or are meeting with a new physician for the first time. Specifically, you need to:
Get your test results: Make sure the doctor you're seeing has copies of your latest X-ray, MRI or any other test or lab results, including reports from other doctors that you've seen. In most cases, you'll need to do the leg work yourself that may only require a phone call to your previous doctor asking them to send it, or you may need to go pick it up and take it yourself.
List your medications: Make a list of all the medications you're taking (prescription drugs, over-the-counter medications, vitamins, minerals and herbal supplements) along with the dosages, and take it with you to your appointment. Or, just gather up all your pill bottles and put them in a bag and bring them with you.
Gather your health history: Your doctor also needs to know about any previous hospitalizations, as well as any current or past medical problems, even if they are not the reason you are going to the doctor this time. Genetics matter too, so having your family's health history can be helpful. The U.S. Surgeon General offers a free web-based tool called “My Family Health Portrait” that can help you put one together.

Prepare a list of questions: Make a written list of the top three or four issues you want to discuss with your doctor. Since most appointments last between 10 and 15 minutes, this can help you stay on track and ensure you address your most pressing concerns first. If you're in for a diagnostic visit, you should prepare a detailed description of your symptoms.

During the appointment:
The best advice when you meet with your doctor is to speak up. Don't wait to be asked. Be direct, honest and as specific as possible when recounting your symptoms or expressing your concerns. Many patients are reluctant or embarrassed to talk about their symptoms, which makes the doctor's job a lot harder to do. It's also a good idea to bringing along a family member or friend to your appointment. They can help you ask questions, listen to what the doctor is telling you and give you support.

Also consider taking some notes or ask the doctor if you can record the session for later review. If you don't understand what the doctor is telling you, ask him or her to explain it in simple terms so you can understand. And if you run out of time and don't get your questions answered, follow up by phone or email, make another appointment, or seek help from the doctor's nurse.

The revolving door of dementia care

Most elderly dementia patients are cared for and die in their homes rather than in an institutional setting, according to a new study published in the Journal of the American Geriatrics Society.

The study’s findings go against a widely-held belief that most dementia patients end up moving into a nursing home and dying there, according to Dr. Christopher Callahan, of the Indiana University School of Medicine and the Regenstrief Institute in Indianapolis, and his research colleagues. In fact, according to the study, about 19% died in nursing homes while nearly half (46%) died at home.

After following about 1,500 dementia patients, researchers found that 74% of those who were sent to a nursing home after a hospitalization didn’t stay there; rather, many ended up either being re-hospitalized in under 30 days (about 25%) or returning home.

Dementia patients did not move straight from home to hospital to nursing home, as the researchers expected. Instead, dementia patients moved back and forth between settings, which can make managing patient care even more complex and add stress for family caregivers.

The study appears in the Journal of the American Geriatrics Society and confirms that families provide the majority of care for dementia patients.

"Our study is the first to track movement of individuals with dementia until death regardless of whether the cause of death was ... dementia or another condition," Callahan said in a journal news release. "A better understanding of the relationships between sites of care for older adults with dementia is fundamental to building better models of care for these vulnerable elders."

The findings challenge beliefs "regarding the permanence of nursing-home care for persons with dementia," Dr. Robert Kane, of the School of Public Health at the University of Minnesota, and Dr. Joseph Ouslander, of the Charles E. Schmidt College of Medicine at Florida Atlantic University, wrote in an accompanying editorial.

"More research is needed to understand how this impacts the quality of care for dementia patients and how we can improve care transitions and management for dementia patients and their families," they noted.

Learn more about dementia...

Coffee...good, bad, good again

Your morning cup of coffee...not only good, but good for you.

We tend to forget that coffee is fruit, looking very much like a red cherry when ripe. Typically, when coffee is harvested, the coffee “cherry” is stripped and its pulp discarded leaving only the bean to be roasted and consumed.

Like many other superfoods such as blueberries and green tea, coffee “fruit” is an excellent source of antioxidants. In fact, a recent study from the University of Scranton found that coffee is the number one source of antioxidants in the U.S. diet.2 Antioxidants are molecules that are believed to protect cells from free radicals - harmful oxygen molecules thought to damage cells and perhaps be the underlying reason why we age.

When an oxygen molecule becomes electrically charged, or “radicalized,” it tries to steal electrons from other molecules, causing damage to the cell’s DNA. Over time, such damage may become irreversible and lead to disease. The job of antioxidants is to “mop up” free radicals, meaning that they neutralize their electrical charge and prevent the free radicals from taking electrons from other molecules.

The importance of antioxidants to the diet cannot be overestimated. Dr. Richard Cutler, the former director of the National Institute on Aging, has said repeatedly that the amount of antioxidants in your body is directly proportional to how long you will live. Just as importantly, antioxidant levels have a major impact on the quality of life – freedom from illness, mental acuity, improved physical appearance, enhanced flexibility and increased energy – enjoyed by seniors.

Antioxidants can come from healthy eating or in the form of supplements, and they include a family of naturally formed components like vitamin A, beta-carotene, lycopene, vitamin E and more.

According to the Linus Pauling Institute, as we age, our cellular production of energy becomes less efficient, leading to age-related diseases that affect the function of the eyes and all types of muscles, including the heart.3 This loss of energy production associated with aging also increases the generation of free radicals and other oxidants, which are capable of damaging essential cellular components, including lipids, proteins and DNA itself.

With this in mind, increasing a senior’s dietary antioxidant intake can play a critical role in maintaining his or her good health. Dietitians understand that half the battle of delivering nutritional value is in finding a food or drink that people enjoy.

According to a recent survey by the National Coffee Association, 69 percent of Americans age 60 and older reported drinking coffee daily, which peaks at 3.8 cups per day on average for those ages 40-59.4 Foodservice research group Technomic also reports that coffee is the drink most widely consumed by seniors, coming in ahead of fruit juice and tap water.5 For this group, coffee-drinking may be one of the best ways to combine nutritional value and health benefits with a simple daily pleasure.

So, how good is coffee for you, anyway?

A wide body of scientific research indicates the major benefits of coffee-drinking, particularly in improving health-issues frequently encountered by seniors.

Memory and motor skills:

2009 study from Finland and Sweden showed that, out of 1,400 people followed for 20 years, those who reported drinking 3 or more cups of coffee per day were 65 percent less likely to develop dementia and Alzheimer’s disease than non-drinkers or occasional coffee drinkers.6
The Harvard School of Public Health acknowledges that in study after study, the data have always shown a consistent link between higher coffee consumption and a reduced risk of Parkinson’s disease.7
The antioxidants and vitamins found in coffee are known to be excellent anti-depressants and memory and performance enhancers.

Heart disease and stroke:

In a study of 130,000 Kaiser Permanente health plan members, those who drank 1-3 cups of coffee per day were 20 percent less likely to be hospitalized for abnormal heart rhythms (arrhythmia) than non-drinkers.8
In a 2009 study of nearly 84,000 women, those who drank two or more cups of coffee per day showed a 20 percent lower risk of stroke than those who drank less.9

Cancer:

A 2008 study published in Planta Medica looked at the effects of long-term coffee consumption on the immune system in cancer tumors and found coffee inhibited the growth of cancer cells by reducing the cancer cell-induced suppression of the normal immune response.10
Recent studies from Harvard University and other public health groups have shown that the risk of developing certain types of cancer, including liver, breast, prostate, esophageal and colon actually decreases with the consumption of coffee.11

Type 2 diabetes:

Coffee contains minerals such as magnesium and chromium, which help the body use the hormone insulin, which controls blood sugar (glucose).
Australian researchers recently looked at 18 studies of nearly 458,000 people. They found a 7 percent decrease in the odds of having type 2 diabetes for every additional cup of coffee drunk daily.12
Coffee has the ability to reduce the release of histamines from mast cells, thereby having anti-allergic properties.13
Coffee contains theophylline which may protect against respiratory problems, such as asthma and COPD.

Arthritis:

Several studies have shown that foods high in antioxidants have anti-inflammatory properties, which can help alleviate arthritis pain and increase freedom of movement.14

While much of this research focuses on the benefits of long-term coffee-drinking, there is also a body of evidence that suggests the benefits of short-consumption on memory, immunity, energy, cholesterol levels, range of motion, activity levels and positive moods.

So, even those who have never had coffee before might consider including it in their daily routine - in moderation, of course.

With all this in mind, it is important that dietitians and senior living professionals understand the important role coffee can play in preventing disease and improving the quality of life of seniors and to look for the healthiest and most beneficial coffee products available to meet the desires of their palates and the demands of their bodies.

Asthma often misdiagnosed in older Americans

People over 65 also have asthma and often face an uphill health battle as a result, a new study suggests. Once hospitalized, these individuals are 14 times more likely to die from asthma than younger adults. What's more, asthma increases their risk for impaired lung function and a worse quality of life.

Part of the reason for the poor outcomes is that asthma is often misdiagnosed and undertreated among older adults. When an older person becomes short of breath or has tightness in their chest, they -- as well as their doctors -- may attribute it to age, being out of shape, or even to their heart, instead of asthma.
According to the study, just 53% of older adults with asthma reported using a steroid inhaler in the past month. Inhaled steroids are the standard treatment used to control asthma.

The study included 77 people aged 60 and older with and without asthma. Of these, 89% of people with asthma also had allergies to allergens including mold, animals, and dust mites. Individuals with asthma were also more likely to report poor health and body pain compared to those without asthma. Hay fever, arthritis, and diabetes were also more common among people with asthma, the study shows.

The findings appear in the May issue of the Annals of Allergy, Asthma, and Immunology.

Social networking making inroads with seniors

The mHealth community, despite its obvious love of at-home monitoring for those with chronic conditions, is missing a major opportunity to create apps for seniors, according to Eric Dishman, who complained about the problem at length to Forbes magazine in a recent interview.

"No one is building apps for seniors," Dishman said. "Look at the number of seniors and disposable income. We don't like to think about getting old." He added that such trends could very soon translate into a generation of older Americans hungry for mobile apps, software, devices to keep them from feeling old.

Additional trends, according to Dishman and some other experts, included:

Social networking making inroads with seniors: Once considered too complicated for seniors, social networks are evolving quickly into micro-networks, or bounded communities that seniors are learning to navigate, according to Dishman. Combining it with easy-to-use tablet technology, he said, is appealing more and more to senior consumers.
"Your mom can wake up with a simple-to-use touch tablet, look at the screen to check the weather; the device asks how she's doing, reminds her to take medication," Dishman said. "A caregiver or nurse is alerted to needs, since they're on the social network."

Michelle Amodio, in a blog post for TechZone360, agreed, pointing to a Pew Research Center study showing that social network use is growing fast among seniors. "Young adults continue to be the heaviest users of social media, but their growth pales in comparison with recent gains made by older users," Mary Madden, senior research specialist and author of the report, told Amodio. "E-mail is still the primary way that older users maintain contact with friends, families and colleagues, but many older users now rely on social network platforms to help manage their daily communications."

Cost playing a major role: Price, more than ease-of-use or utility, may be the final factor in whether seniors buy and use smartphone or tablet apps, according to a Clinton News blog post.

"Many seniors have avoided smartphones because of the cost of their monthly plans," Maria Smith, who works in Mississippi State University's Computer Applications and Services department, said. "Smartphones, which include iPhones and Androids, require a data plan that can cost $50 to $75 per month depending on the options and the carrier. Many budget-conscience seniors have opted to stay with the lower-priced cell phones for calling and text messaging."

However, she noted, the screen-size of smartphones and tablets is a definite plus for the elderly, and so may yet convince seniors to get on board.

The true cost of at home caregiving

The following is an excerpt written by Marilyn Geewax, Senior Business Editor, National Desk, NPR. 

 Few people want to turn over a loved one to institutional care. No matter how good the nursing home, it may seem cold and impersonal — and very expensive. But making the choice to provide care yourself is fraught with financial risks and personal sacrifices.

Those who become full-time caregivers often look back and wish they had taken the time to better understand the financial position they would be getting themselves into.

"I used to hear about people saying, 'Oh you know, we've got to put our parents in a home; we can't deal with it anymore,' " said Yolanda Hunter, 43, a Maryland resident who is struggling with her decision to drop out of the human resources field to become a full-time caregiver for her grandmother. "And I used to think: 'Oh, how cruel are you?'

"You know, but now? I understand," she said.

Hunter belongs to one of three families being profiled in NPR's eight-week series, Family Matters: The Money Squeeze, which airs each Tuesday on Morning Edition. Each family is struggling with how to afford care for an older generation. The do-it-yourself approach is both common and costly.

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