Category Archives: Senior Health

Calming dementia patients without powerful drugs

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By Rachel Dornhelm, KQED

Diane Schoenfeld comes every Friday to the Chaparral House nursing home in Berkeley, Calif. to spend time with her aunt, Lillie Manger.

“Hi Aunt Lill!” she says, squatting down next to her aunt’s wheelchair, meeting her at eye level.

Manger is 97. She has straight white hair pulled back in a neat bun today. It’s tied with a green scarf, a stylish reminder of the dancer she used to be.

Diane Schoenfeld, left, shows a family photo to her 97-year-old aunt, Lillie Manger. (Photo by Rachel Dornhelm/KQED)

Diane Schoenfeld, left, shows a family photo to her 97-year-old aunt, Lillie Manger. (Photo by Rachel Dornhelm/KQED)

They go together to the dining room to look over family pictures. Manger needs to be reminded who is in them. Including one of herself. “That’s me?” she asks. “That’s you,” her niece confirms.

“Am I supposed to remember?” says Manger.

Schoenfeld smiles at her encouragingly: “I don’t know if you’re supposed to. It’s OK either way.”

Manger has dementia. Schoenfeld is her “surrogate decision maker” meaning that legally, she is the person who makes decisions about Manger’s health care. Continue reading

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Hunger stalks millions of US seniors

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In sunlit paradise, seniors go hungry

By Sarah Varney
KHN

NAPLES, Fla.— It wasn’t until the Maffuccis found themselves living on cups of coffee, and coffee alone, that they finally called a food pantry for help.

The couple had sold their suburban New Jersey home where they had raised three children and set out to pursue the glossy dream of an easy-going retirement in sunny southwest Florida.

But Mina and Angelo Maffucci quickly ran out of money—overtaken by illness, bad luck and an economic crisis that claimed their Florida dream home to foreclosure. They soon found themselves staring at an empty cupboard.

“You open up the closet and all we had was coffee,” said Angelo Maffucci, 82, who had been a drywall installer in New Jersey. “I never thought we would be down on our hands and knees like that, but it happened fast.”

aging_hunger_newshour_maffucci-family

Angelo and Mina Maffucci pose for a portrait in the kitchen of their son’s apartment, where they’ve been living for about five years — since they lost their house. (Photo: Ariel Min/PBS NewsHour)

While the U.S. economy adds jobs and the financial markets steadily improve, a growing number of seniors are having trouble keeping food on the table.

In 2013, the most recent data available, 9.6 million Americans over the age of 60 —or one of every six older men and women—could not reliably buy or access food at least part of the year, according to an analysis from researchers at the University of Kentucky and the University of Illinois. Continue reading

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Medicaid expansion helps cut rate of older, uninsured adults from 12 to 8 percent

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ACA health reform logoBy Michelle Andrews
KHN

The health law’s expansion of Medicaid coverage to adults with incomes over the poverty line was key to reducing the uninsured rate among 50- to 64-year-olds from nearly 12 to 8 percent in 2014, according to a new analysis.

“Clearly most of the gains in coverage were in Medicaid or non-group coverage,” says study co-author Jane Sung, a senior strategic policy adviser at the AARP Public Policy Institute, which conducted the study with the Urban Institute.

Under the health law, adults with incomes up to 138 percent of the federal poverty level ($16,243 for one person in 2015) are eligible for Medicaid if a state decides to expand coverage. Twenty-seven  states  had done so by the end of 2014.

The study found the uninsured rate for people between age 50 and 64 who live in states that haven’t expanded Medicaid was twice as high—11 percent—as for those who live in states that have done so.

More than 2 million people between 50 and 64 gained coverage between December 2013 and December 2014, according to the study. Continue reading

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Washington state ranked 11th in the nation for senior health

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Washington MapWashington state ranks 11th in the nation for senior health, ahead of Maryland but behind Maine, and up from its 15th-place ranking last year, according to a senior health assessment conducted each year by the UnitedHealth Foundation.

Vermont was rated number 1 in the nation, followed by New Hampshire, Minnesota, Hawaii and Utah. West Virginia. The Oklahoma, Arkansas, Kentucky, Mississippi and Louisiana came in at the bottom of the list.

The rankings, which appear in the foundatio’ns “America’s Health Rankings Senior Report,” are based on 35 measures of health, which include such factors as availability and quality of health care services, health behaviors, community and environmental amenities, and state health care policies.

Among Washington’s Strengths were:

  • Low prevalence of physical inactivity
  • High enrollment in the Supplemental Nutrition Assistance Program
  • Low prevalence of full-mouth tooth extraction

Among the state’s weaknesses were:

  • High prevalence of chronic drinking • Low prescription drug coverage
  • High prevalence of falls

Highlights:

  • In the past year, hip fractures decreased 21% from 6.7 to 5.3 hospitalizations per 1000 Medicare beneficiaries.
  • In the past 2 years, home health care increased 17% from 73.2 to 85.5 home health care workers per 1000 adults aged 75 and older.
  • In the past 2 years, preventable hospitalizations decreased 15% from 46.4 to 39.3 discharges per 1000 Medicare beneficiaries.
  • In the past year, obesity increased 6% from 25.6% to 27.0% of adults aged 65 and older.
  • In the past year, poverty increased 5% from 7.8% to 8.2% of adults aged 65 and older.
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A top-rated nursing home is hard to find in Texas, 10 other states

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Natalie Anne Sealy's headshot.

Natalie Sealy (Photo courtesy of Billie Pender)

LOCKHART, Texas — The call from the nursing home came just before dawn, jolting Martha Sherwood awake.

During the night, fire ants had swarmed over her 85-year-old mother, injecting their stinging venom into Natalie Sealy’s face, arms, hands and chest.

“She was just lying there being eaten alive,” said daughter Billie Pender, who said she and her sister had repeatedly complained about a broken windowsill in their mother’s room at Parkview Nursing and Rehabilitation Center.

In 11 states, 40 percent or more of nursing homes get Medicare’s lowest two lowest rating.

The Sept. 2 attack devastated Sealy, a retired bank teller with dementia. “She went steadily downhill,” dying in late March, said Sherwood, who brought a lawsuit against the home.

Their mother had chosen the for-profit facility two years earlier because it was near her adult children. The family didn’t know that Parkview scored poorly on staffing and other quality measures.

This year, Medicare rates it one star out of a possible five stars — the lowest rating possible — on Nursing Home Compare, which was designed by the federal government to help consumers choose a long-term care facility.

The problem for Sealy’s family and residents of many parts of the country is they have few, if any, higher-rated options if they want their loved ones close by.

In 11 states, 40 percent or more of nursing homes get the two lowest ratings, according to an analysis by the Kaiser Family Foundation.  (Kaiser Health News is an editorially independent program of the foundation.)

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Texas has the highest percentage of one-and two-star homes in the country: 51 percent of its nursing homes are rated “below average,” or “much below average,” on Nursing Home Compare, according to the analysis. Louisiana is close behind at 49 percent, with Oklahoma, Georgia and West Virginia tying for third at 46 percent. Continue reading

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Running out of money is more than just a worry for many seniors, study finds

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clockBy Michelle Andrews
KHN

For many older people and their families, particularly those dealing with conditions such as Alzheimer’s or cancer that often require long-term, pricey medical care, running out of money is a nagging concern.

Families are right to be worried, according to a new study that analyzed data from nearly 1,200 people who died between 2010 and 2012 and who participated in the University of Michigan’s ongoing national Health and Retirement Study.

Among people who were age 85 or older when they died,  one in five had no assets left apart from their homes, and 12 percent had no assets left at all, only income from sources such as Social Security or pensions.

Among people who were age 85 or older when they died,  one in five had no assets left apart from their homes, and 12 percent had no assets left at all, only income from sources such as Social Security or pensions.

The analysis by the Employee Benefit Research Institute found that those who died younger were even worse off.

Among people who died between age 50 and 64, 30 percent were without assets and 37 percent had only their homes. Continue reading

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High morale linked to longer survival among elderly | Reuters

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Smiley_FaceWhether it is cause or effect is unclear, but high morale seems to go along with a longer life, according to a new Scandinavian study.

Among people 85 years and older, those who felt optimistic about life and had something to look forward to lived five years longer on average than their more pessimistic counterparts.

Source: High morale linked to longer survival among elderly | Reuters

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50 years later the US Older Americans Act limps along, relying on local and state agencies to provide services

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A younger man holds an elderly man's handBy Rita Beamish
Stateline

This year marks a half-century since Congress created the Older Americans Act, the major vehicle for delivering social and nutrition services to people over 60.

But there’s little to celebrate on the golden anniversary of the law that helps people age at home.

Federal funding hasn’t kept up with the skyrocketing number of America’s seniors, now the largest elderly population in history.

That’s left states and communities struggling to provide the in-home support, meals, case management and other nonmedical services that help seniors avoid more costly nursing home care and enrolling in taxpayer-funded Medicaid.   Continue reading

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Some dementia can be treated, but my mother waited 10 years for a diagnosis

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Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

By Roni Caryn Rabin
KHN

When my mother, Pauline, was 70, she lost her sense of balance. She started walking with an odd shuffling gait, taking short steps and barely lifting her feet off the ground. She often took my hand, holding it and squeezing my fingers.

Her decline was precipitous. She fell repeatedly. She stopped driving and she could no longer ride her bike in a straight line along the C& O Canal. The woman who taught me the sidestroke couldn’t even stand in the shallow end of the pool. “I feel like I’m drowning,” she’d say.

A retired psychiatrist, my mother had numerous advantages — education, resources and insurance — but still, getting the right diagnosis took nearly 10 years. Each expert saw the problem through the narrow prism of their own specialty. Surgeons recommended surgery. Neurologists screened for common incurable conditions.

The answer was under their noses, in my mother’s hunches and her family history. But it took a long time before someone connected the dots. My mother was using a walker by the time she was told she had a rare condition that causes gait problems and cognitive loss, and is one of the few treatable forms of dementia.

“This should be one of the first things physicians look for in an older person,” my mother said recently. “You can actually do something about it.” Continue reading

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Standing up to senior falls: local program promotes independence and safety at home

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By Alan Abe, Emergency Medical Services Division
Public Health – Seattle & King County

ems-falls

Do you know someone over 65 who has fallen? Have you reached that age and are concerned about your risk?

Senior falls are all too common, with results that are often serious and sometime even grave.

Nearly 24,000 seniors died nationally in 2012 due to falls, nearly doubling in ten years. And over 2.4 million people – almost four times the population of Seattle – were hospitalized.

What’s driving this toppling trend? More of us are living longer, and as a society, we’re getting older. And with the aging of the baby boomer generation, this trend will continue.  By 2030, the US Census Bureau estimates that there could be about 75 million people over 65 in the United States.

As we age, we tend to collect conditions that make us more vulnerable to falls: diabetes, heart disease, stroke, arthritis and Parkinson’s disease.

So, what can we do about it? We know that 60% of senior falls happen in the home, so if we improve safety and reduce risks there, we can make a big difference.

That’s where King County Emergency Medical Services/Medic One comes in. They have developed the One Step Ahead Fall Prevention Program to help at-risk seniors stay healthy, independent and safe in their homes.

How does the program work? Continue reading

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Doctors In Massachusetts Now Required To Offer End-Of-Life Counseling | CommonHealth

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Map of BostonThe state will review whether hospitals are following the rule and compliance could become an issue in a facility’s licensing review. But the state is not focused on enforcement right now.

via Doctors In Massachusetts Now Required To Offer End-Of-Life Counseling | CommonHealth.

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New Medicaid rule could hinder shift away from nursing homes

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A younger man holds an elderly man's handBy Christine Vestal
Stateline

For more than 30 years, states have been finding new ways to care for aged and disabled Medicaid beneficiaries without confining them to nursing homes.

In fact, the number of people living in skilled nursing facilities has declined significantly over the last decade, despite a marked increase in the ranks of the elderly in the U.S.

Starting this year, a new federal rule will require states to ensure that long-term care alternatives to nursing homes—such as assisted living facilities, continuing care retirement communities, group homes and adult day care—work with residents and their families to develop individual care plans specifying the services and setting each resident wants.

The overarching goal is to create a “home-like” atmosphere, rather than an institutional one.

The overarching goal is to create a “home-like” atmosphere, rather than an institutional one and to give residents choices about their care.

While nearly everyone supports the concept, states, providers and even some consumer advocates are complaining that the rule could make it difficult for health care providers to fulfill increasing demand for long-term care outside of nursing homes.

Under the rule, for example, elderly people with dementia who enter assisted living facilities should not be subjected to constraints, such as locked exits, unless they are at risk for wandering.

But if they share living space with other residents with dementia who do need to be prevented from wandering, it will be difficult to allow them to leave the building whenever they want without jeopardizing the safety of others.

“The goal was completely laudable,” said Martha Roherty, director of the National Association of States United for Aging and Disabilities, which works to help elders and people with disabilities live in their communities for as long as possible.

“Unfortunately, what’s happened is that it is limiting individuals’ choice of what and where to receive (long-term care) services rather than broadening it, especially as it relates to seniors,” she said. Continue reading

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Home health workers struggle for better pay and health insurance

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Home health care workers Jasmine Almodovar (far right) and Artheta Peters (center) take part in a Cleveland rally for higher pay on Sept. 4. (Photo by Sarah Jane Tribble, WPCN/Ideastream)

Home health care workers Jasmine Almodovar (far right) and Artheta Peters (center) take part in a Cleveland rally for higher pay on Sept. 4. (Photo: Sarah Jane Tribble.)

By Sarah Jane Tribble, WCPN

Holly Dawson believes her job is a calling.

She is one of about 2 million home care workers in the country. The jobs come with long hours and low pay.

Each workday, Dawson drives through the Cleveland suburbs to help people take their medicines, bathe and do the dishes. She also takes time to lend a sympathetic ear.

George Grellinger, a former client of hers, has dementia. He recently fell down the back steps of his home. Dawson remains friends and regularly stops in to check on him. To remain living at home, Grellinger had to switch to an aide who is covered by his veterans’ benefits.

A lot of us are barely home because if we don’t go to work, we don’t get time off. We don’t get paid vacations. And some of us haven’t had raises in years.”

When Dawson worked for him, Grellinger paid an agency $37 for two hours of her time each day. Dawson received $13 an hour, higher than the national average for home health aides. She had to pay her own taxes and health care benefits. Dawson says she can’t remember the last time she could afford health insurance.

Dawson says she has been a home health aide for 31 years. She has never done it for the money, rather to help people like Grellinger, she says.

But the conditions of home health work are leading many aides to seek better pay and benefits.

On an early September morning, home health workers held a rally in Cleveland. Jasmine Almodovar, 35, chants with the crowd: “We want change and we don’t mean pennies!”

She says she earns $9.50 an hour, which is actually just above average for a home health worker in Ohio.

“We work really long hours, really hard work,” she says. “A lot of us are barely home because if we don’t go to work, we don’t get time off. We don’t get paid vacations. And some of us haven’t had raises in years.”

Almodovar says her last raise was four years ago. She makes about $21,000 a year so she makes too much to qualify for Medicaid, but paying for a plan on Ohio’s federal exchange doesn’t fit in her monthly budget. Continue reading

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Nearly half of Americans over 65 need help with daily tasks

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Clinic elderly doctor nurse office couchBy Millie Dawson
Health Behavior News Service

Nearly half of Americans age 65 and older, totaling about 18 million people, require help with routine daily activities like bathing, handling medications or meals.

A new study in Milbank Quarterly reveals a growing need for improved services and support for older Americans, their spouses, their children and other “informal caregivers.”

While 51 percent of older Americans in the study reported no difficulty with routine tasks, “29 percent reported receiving help with taking care of themselves or getting around in the previous month,” said co-author Vicki A. Freedman, Ph.D., a research professor with the Institute for Social Research at the University of Michigan.

“Another 20 percent reported that they had difficulty carrying out these activities on their own,” she said.

KEY POINTS

  • Nearly half of Americans age 65 and older require help with routine daily activities such as bathing, meals or taking medications.
  • Substantial numbers of older adults living outside of nursing homes experience adverse consequences from unmet care needs.
  • There is a growing need for improved community-based services and support for older Americans and their caregivers.

Continue reading

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Many women receiving unnecessary Pap tests

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Cytological specimen showing cervical cancer specifically squamous cell carcinoma in the cervix. Tissue is stained with Pap stain and magnified x200. PHOTO courtesy of NCIBy Stephanie Stephens,
Health Behavior News Service

As many as half to two-thirds of women who’ve undergone hysterectomies or are older than 65 years in the United States report receiving  Pap tests for cervical cancer.

This prevalence is surprising in light of the 2003 U.S. Preventive Services Taskforce guidelines recommending that women discontinue Pap testing if they have received a total hysterectomy without a history of cervical cancer and if they are over age 65 years with ongoing and recent normal Pap test results.

Performing these unnecessary tests can result in stress for the patient, increased costs, and inefficient use of both provider and patient time, concludes a new study in the American Journal of Preventive Medicine.

“During this time of health care reform, we could probably use our resources more wisely,” said corresponding author Deanna Kepka, Ph.D., M.P.H., assistant professor at the University of Utah’s College of Nursing and Huntsman Cancer Institute. Continue reading

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