Category Archives: Senior Health

Fewer Medicare-subsidized drug plans means less choice for low-income seniors

Denise Scott, 66, is concerned about how much Medicare will pay for her prescriptions in the future.

Denise Scott, 66, is concerned about how much Medicare will pay for her prescriptions in the future.

By Susan Jaffe

Even though health problems forced Denise Scott to retire several years ago, she feels “very blessed” because her medicine is still relatively inexpensive and a subsidy for low-income Medicare beneficiaries covers the full cost of her monthly drug plan premiums. But the subsidy is not going to stretch as far next year.

That’s because the premium for Scott’s current plan will cost more than her federal subsidy.

The 64-year-old from Cleveland is among the 2 million older or disabled Americans who will have to find new coverage that accepts the subsidy as full premium payment or else pay for the shortfall.

As beneficiaries explore options during the current Medicare enrollment period, there are only 227 such plans from which they can choose next year, 20 percent fewer than this year, and the lowest number since the drug benefit was added to Medicare in 2006, according to the Centers for Medicare & Medicaid Services. Continue reading


Doctors, lawyers and even the bank can help detect elder abuse


A younger man holds an elderly man's handBy Shefali Luthra

Elder abuse, which can take the form of sexual or emotional abuse, physical violence and even financial manipulation, affects at least 10 percent of older Americans, according to a review article in the Nov. 12 New England Journal of Medicine.

Elder abuse can happen to residents in nursing homes or those living with family members.

That figure, researchers note, is likely an underestimate, since it’s based on self-reported cases, and potential victims often suffer from dementia or are otherwise isolated from people who might notice something is wrong.

But the estimate drives home how pervasive the problem is, and how familiar its victims might be. Continue reading


It’s never too soon to plan your ‘driving retirement’

At 72, Robert McSherry says he's not yet ready to quit driving or ready to plan how he'll get around when that time arrives. But he's happy to get the insurance discount that comes with taking a driver safety class. (Photo by John Daley/Colorado Public Radio)

At 72, Robert McSherry says he’s not yet ready to quit driving or ready to plan how he’ll get around when that time arrives. But he’s happy to get the insurance discount that comes with taking a driver safety class. (Photo by John Daley/Colorado Public Radio)

By John Daley, Colorado Public Radio

Harriet Kelly has one word to describe the day she stopped driving four years ago: miserable.

“It’s no fun when you give up driving, I just have to say that,” she says.

Kelly, who lives in Denver, says she started to notice her eyesight decline in her 80s. She got anxious driving on the highway so she decided to stop before her kids made the move for her.


Harriet Kelly, of Denver, says she hasn’t had even a fender bender since the 1960s. Still, she noticed in her 80s that her eyesight was starting to decline. So she made a plan to stop driving at 90 — and did just that. (Photo by John Daley/Colorado Public Radio)

“I just told them I’d stop driving on my birthday, my 90th birthday, and I did. And I was mad at myself because I did it,” she says, laughing. “I thought I was still pretty good!”

Kelly is now 94. She says her last accident was in the 1960s.  But, she says, “I think it’s just better to make up your own mind than have your kids go through trying to tell you and end up with arguments and threats and everybody gets mad.”

Her daughter Leslie Kelly says she’s grateful she and her siblings didn’t have to have that tough conversation. Still, she knows it’s been tough for her mom.

“It really cut down on her ability to feel independent,” says Leslie.  Harriet chimes in, “It certainly did!”

But Kelly is a great example of planning for a “driving retirement,” says Dr. Emmy Betz, with the University of Colorado School of Medicine.

“Retirement is something that happens to all of us. Maybe we even look forward to it. You prepare for it, you make financial plans, you think about what you’re going to do,” she says. Continue reading


Nursing home residents face health risks from antibiotic misuse


Three red and white capsulesBy Lisa Gillespie

Antibiotics are prescribed incorrectly to ailing nursing home residents up to 75 percent of the time, the nation’s public health watchdog says.

The reasons vary — wrong drug, wrong dose, wrong duration or just unnecessarily – but the consequences are scary, warns the Centers for Disease Control and Prevention.

Overused antibiotics over time lose their effectiveness against the infections they were designed to treat. Some already have. And some antibiotics actually cause life-threatening illnesses on their own.

Studies have estimated antibiotics are prescribed inappropriately 40 percent to 75 percent of the time in nursing homes.The CDC last month advised all nursing homes to do more – immediately – to protect more than 4 million residents from hard-to-treat superbugs that are growing in number and resist antibiotics.

Antibiotic-resistant infections threaten everyone, but elderly people in nursing homes are especially at risk because their bodies don’t fight infections as well. Continue reading


Dementia taks toll of unpaid caregivers, study


And younger man's hand holds an elderly man's handBy Michelle Andrews

Unpaid caregivers and family members spend more than 100 hours a month, on average, assisting elderly people with dementia who live in the community and not in residential care or nursing homes, according to a new study.

As people live longer, the number with dementia will increase, further straining caregiving resources.

The time commitment was significantly higher than for similar caregivers who helped elderly people without dementia, who themselves put in an average 73 hours each month.

Overall, people with dementia make up 10 percent of noninstitutionalized adults age 65 or older, but they account for more than 40 percent of unpaid caregivers’ time. Continue reading


Number of older prisoners grows rapidly, threatening to drive up prison health costs


StatelineAgingPrisonersLineGraph (1)

By Matt McKillop and Frances Mcguffey

In a year when the nation’s overall prison population dropped, the number of older inmates grew rapidly in 2014, continuing a trend that translates into higher federal and state prison health care spending.

New federal data show that from 1999 to 2014, the number of state and federal prisoners age 55 or older increased 250 percent.

This compares to a growth rate of only 8 percent among inmates younger than 55, according to the Bureau of Justice Statistics, which also reported that the U.S. prison population fell in 2014 to its lowest level since 2005.

In 1999, inmates age 55 and above—a common definition of older prisoners—represented just 3 percent of the total population. By 2014, that share had grown to 10 percent. Continue reading


Seniors tell medical students what they need from doctors


Belle Likover, a 95-year-old retired social worker, told Case Western Reserve medical students that growing old gracefully is all about being able to adapt to one’s changing life situation, including health challenges. (Photo by Lynn Ischay for Kaiser Health News)

By Susan Jaffe

CLEVELAND – When doctors told Robert Madison his wife had dementia, they didn’t explain very much. His successful career as an architect hardly prepared him for what came next.

“A week before she passed away her behavior was different, and I was angry because I thought she was deliberately not doing things,” Madison, now 92, told a group of nearly 200 students at Case Western Reserve School of Medicine here. “You are knowledgeable in treating patients, but I’m the patient, too, and if someone had said she can’t control anything, I would have been better able to understand what was taking place.”

Belle Likover recounted for the students how she insisted when her husband was dying of lymphoma that doctors in the hospital not make decisions without involving his oncologist.

“When someone is in the hospital, they need an advocate with them at all times,” said Likover, who turns 96 next month. “But to expect that from families when they are in crisis is expecting too much. The medical profession has to address that.”

Madison and Likover were among six people all over the age of 90 invited to talk to the second-year medical students this month. The annual panel discussion, called “Life Over 90,” is aimed at nudging students toward choosing geriatric medicine, the primary care field that focuses on the elderly. It is among the lowest-paid specialties, and geriatricians must contend with complex cases that are time consuming and are often not reimbursed adequately by Medicare or private insurance. And their patients can have diseases that can only be managed but never cured. Continue reading


Surge in statin use among very elderly without heart trouble raises doubts


HeartBy Lisa Gillespie

Many doctors are choosing a better-safe-than-sorry approach to heading off heart trouble in very elderly patients.

Inexpensive statin drugs are given to millions of people to reduce cholesterol, even many who do not show signs of heart disease.

But a recent study has found that seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get those drugs than they were in 1999.

Here’s the catch: For patients of that age, there is little research showing statins’ preventive heart benefits outweigh possible risks, which can include muscle pain and the onset of diabetes.  There have only been a handful of studies that included the over-79 population, according to a review in the American Journal of Cardiology in 2012. Continue reading


How one home health agency earned five stars


Annie Wilson swings a soccer ball back and forth as physical therapist Kurt Harcar supports her. (Photo by Michael Tomsic/WFAE)

By Michael Tomsic, WFAE

CHARLOTTE — Home health agencies are a segment of the medical industry that you may not know about if you or a loved one has never needed one. The companies send therapists and nurses into the homes of Medicare patients to help them recover from an illness or surgery.

This summer the federal government started rating home health agencies – doling out one to five stars – to give consumers a better picture of the job  they do. The top grades were elusive: only 239 agencies out of 9,000 nationwide earned five stars, according to a Kaiser Health News analysis.

In North Carolina, Brookdale Home Health Charlotte was one of just two agencies out of more than 170 in the state to earn five stars. How did they manage it? Continue reading


As Alzheimer’s symptoms worsen, hard conversations about how to die


As Alzheimer’s Symptoms Worsen, Hard Conversations About How To Die
September 19, 2015 • Six years after he was diagnosed with both cancer and Alzheimer’s, Greg O’Brien is beginning to talk to his doctor, and to his family, about his “exit strategy” for the final years of his life.


Racial gap in attitudes toward hospice care


By Sarah Varney

BUFFALO — Twice already Narseary and Vernal Harris have watched a son die. The first time — Paul, at age 26 — was agonizing and frenzied, his body tethered to a machine meant to keep him alive as his incurable sickle cell disease progressed.

When the same illness ravaged Solomon, at age 33, the Harrises reluctantly turned to hospice in the hope that his last days might somehow be less harrowing than his brother’s.

Their expectations were low. “They take your money,” Mrs. Harris said, describing what she had heard of hospice. “Your loved ones don’t see you anymore. You just go there and die.” Continue reading


Telephone therapy helps older people in underserved rural areas, study finds


red-telephoneBy Lisa Gillespie

Therapy provided over the phone lowered symptoms of anxiety and depression among older adults in rural areas with a lack of mental health services, a new study shows.

The option is important, one expert said, because seniors often have increased need for treatment as they cope with the effects of disease and the emotional tolls of aging and loss.

“Almost all older adults have one chronic medical condition, and most of these have been found to be significantly associated with anxiety disorder,” Eric Lenze, a psychiatrist and professor at the Washington University School of Medicine in St. Louis, said in an interview.

The study, by researchers at Wake Forest University and published Wednesday in JAMA Psychiatry, examined 141 people over the age of 60 living in rural counties in North Carolina who were experiencing excessive and uncontrollable worry that is brought on by a condition called generalized anxiety disorder.

The participants had up to 11 phone sessions between January 2011 and October, 2013. Half of them received cognitive behavioral therapy, which focused on the recognition of anxiety symptoms, relaxation techniques, problem solving and other coping techniques.

The other study participants got a less intensive phone therapy in which mental health professionals provided support for participants to discuss their feelings but offered no suggestions for coping.

The researchers found that severity of the patients’ worries declined in both groups, but the patients getting cognitive therapy had a significantly higher reduction of symptoms from generalized anxiety disorder and depressive symptoms. Continue reading


Lessons for the Puget Sound from Chicago’s deadly Heat Wave


heat-wave1-e1438208691939By Ashley Kelmore
Public Health – Seattle & King County

Our hotter-than-usual summer in the Pacific Northwest likely won’t reach the extremes of the 1995 Chicago summer heat wave, which killed 733 people.

But some of the issues from that catastrophe are relevant to us here and now, and Dr. Eric Klinenberg describes them in his fascinating book Heat Wave.

Klinenberg proposes that the temperature and humidity are not solely to blame for illness and death from heat.

Instead, it is the heat combined with the systems society has set up (or not set up) that failed people in a complicated way.

Similar neighborhoods, deadly differences

Klinenberg focuses on comparing two neighborhoods that are similar in basic demographics, and even have the same microclimate, but had VERY different death rates.

To explain this disparity, he looks at how the different neighborhoods function. Are people too scared to leave their buildings to seek cooler locations (such as libraries or movie theaters)?

Are they too worried about their finances to turn on the life-saving window AC unit to cool themselves down?

Are they isolated from support systems that could have intervened to make sure they were doing okay? In many cases, the answers are “yes,” “yes,” and “yes.”

Chicago’s government and how they responded (or failed to respond) was also a factor, according to Klinenberg.

Front-line police officers were tasked with community policing but didn’t check in on the community.

Fire chiefs ignored warnings from their staff that they should have more ambulances available.

And sadly, the health commissioner didn’t really ‘get’ that something was amiss. Klinenberg also explores the role the media played in not treating the story with the gravity it deserved until late into the heat wave. Continue reading


Medicare rates home health agencies


Star full faceHome Health Agencies Get Medicare’s Star Treatment

By Jordan Rau

The federal government released on Thursday a new five-star rating system for home health agencies, hoping to bring clarity to a fast-growing but fragmented corner of the medical industry where it’s often difficult to distinguish good from bad.

Medicare applied the new quality measure to more than 9,000 agencies based on how quickly visits began and how often patients improved while under their care. Nearly half received average scores, with the government sparingly doling out top and bottom ratings.

The elderly tend to be less familiar with the reputation of home health agencies than they are with hospitals and other institutions.

The star ratings come as home health agencies play an increasingly important role in caring for the elderly.

Last year 3.4 million Medicare beneficiaries received home health services, with nurses, aides, and physical and occupational therapists treating them in the home.

Medicare spends about $18 billion on the home health benefit, which provides skilled services that must be authorized by a doctor, not housekeeping care that some elderly pay for privately. Continue reading


A new focus on family caregivers


A younger man holds an elderly man's handBy Susan Milligan

Iraq war veteran Doug Mercer had been home in McAlester, Oklahoma, for just four days when he was in a motorcycle accident that left him broken and brain-damaged.

His wife Michelle became his caregiver after he left the hospital, but nobody there explained how to transport him safely.  A few weeks later, Michelle struggled as she tried to get Doug from the car to his wheelchair, breaking his leg.

“They’re sending you home, and you’re thinking, ‘What?’ Nobody instructs you, and says, ‘This is what’s coming home with you and how to use it,’” she said.

The Mercers’ story was a driving force behind an Oklahoma law that took effect in November that requires hospitals to train a designated family caregiver to tend to the medical needs of a released patient.

As many as 42 million Americans take care of a family member at any given time.

Since then, 12 more states (Arkansas, Colorado, Connecticut, Indiana, Mississippi, New Hampshire, New Jersey, New Mexico, Nevada, Oregon, Virginia and West Virginia) have approved similar laws. In Illinois and New York, legislation is awaiting the governor’s signature.

As many as 42 million Americans take care of a family member at any given time. Traditionally, family caregivers provide assistance with bathing, dressing and eating. They shop for groceries and manage finances.

But as the number of elderly Americans with chronic conditions has grown, family caregivers have taken on medical tasks once provided only in hospitals, nursing homes or by home care professionals.

In an AARP survey released in 2012, nearly half of family caregivers said they administered multiple medications, cared for wounds, prepared food for special diets, used monitors or operated specialized medical equipment. Continue reading