Category Archives: Senior Health

World’s older population grows dramatically

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From the National Institutes of Health

The world’s older population continues to grow at an unprecedented rate. Today, 8.5 percent of people worldwide (617 million) are aged 65 and over. According to a new report, “An Aging World: 2015,”  this percentage is projected to jump to nearly 17 percent of the world’s population by 2050 (1.6 billion).

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“Older people are a rapidly growing proportion of the world’s population,” said NIA Director Richard J. Hodes, M.D. “People are living longer, but that does not necessarily mean that they are living healthier. The increase in our aging population presents many opportunities and also several public health challenges that we need to prepare for. NIA has partnered with Census to provide the best possible data so that we can better understand the course and implications of population aging.”

“An Aging World: 2015” contains detailed information about life expectancy, gender balance, health, mortality, disability, health care systems, labor force participation and retirement, pensions and poverty among older people around the world.

America’s 65-and-over population is projected to nearly double over the next three decades, from 48 million to 88 million by 2050.

The report was commissioned by the National Institute on Aging (NIA), part of the National Institutes of Health, and produced by the U.S. Census Bureau. The report examines the demographic, health and socioeconomic trends accompanying the growth of the aging population.

“We are seeing population aging in every country in every part of the world,” said John Haaga, Ph.D., acting director of NIA’s Division of Behavioral and Social Research. “Many countries in Europe and Asia are further along in the process, or moving more rapidly, than we are in the United States. Since population aging affects so many aspects of public life — acute and long-term health care needs; pensions, work and retirement; transportation; housing — there is a lot of potential for learning from each other’s experience.”

Highlights of the report include

  • America’s 65-and-over population is projected to nearly double over the next three decades, from 48 million to 88 million by 2050.
  • By 2050, global life expectancy at birth is projected to increase by almost eight years, climbing from 68.6 years in 2015 to 76.2 years in 2050.
  • The global population of the “oldest old” — people aged 80 and older — is expected to more than triple between 2015 and 2050, growing from 126.5 million to 446.6 million. The oldest old population in some Asian and Latin American countries is predicted to quadruple by 2050.
  • Among the older population worldwide, noncommunicable diseases are the main health concern. In low-income countries, many in Africa, the older population faces a considerable burden from both noncommunicable and communicable diseases.
  • Risk factors — such as tobacco and alcohol use, insufficient consumption of vegetables and fruit, and low levels of physical activity — directly or indirectly contribute to the global burden of disease. Changes in risk factors have been observed, such as a decline in tobacco use in some high-income countries, with the majority of smokers worldwide now living in low- and middle-income countries.

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Long-term care insurance: Less ban, more buck

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Mary Julia Klimenko, 69, in her office in Benicia, Calif., on Friday January 29, 2016. The therapist invested in a long-term care insurance policy, but her monthly premiums have nearly quadrupled over the past two years. Klimenko is furious with the choices she’s been given: pay the higher cost, reduce her costs by cutting her policy’s benefits, or drop the insurance altogether. (Heidi de Marco/KHN)

Mary Julia Klimenko, 69, in her office in Benicia, Calif., on Friday January 29, 2016. The therapist invested in a long-term care insurance policy, but her monthly premiums have nearly quadrupled over the past two years. Klimenko is furious with the choices she’s been given: pay the higher cost, reduce her costs by cutting her policy’s benefits, or drop the insurance altogether. (Heidi de Marco/KHN)

By Barbara Feder Ostrov
Kaiser Health news

Mary Julia Klimenko thought she was prudent 20 years ago when she invested in a long-term care insurance policy, one she believed would help pay for the care she’d need as she aged.

Now she wishes she’d banked the money instead.

Her monthly premiums have nearly quadrupled over the past two years, and Klimenko, now 69, is furious about the choices she’s been given: pay the higher cost, lower her premiums by cutting her policy’s benefits or drop the insurance altogether.

I have no choice. If I drop my insurance, I’ve thrown away all that money. If I pay less, they’re not going to cover what I need.

For now, the Vallejo, California therapist said she will pay the higher premiums, but she’s not sure how many more price hikes she can take.

“I have no choice. If I drop my insurance, I’ve thrown away all that money,” Klimenko said. “If I pay less, they’re not going to cover what I need.”

Long-term care insurance was supposed to help the middle class ease the financial burden of expensive in-home or nursing home care that now can top $90,000 a year.

Consumers were urged to buy policies in their 50s, because premiums rose the longer they waited. About 4.8 million people were covered by long-term care policies in 2014.

But insurers botched just about every aspect of the policies they sold in the early days of the industry, said Joseph Belth, a retired professor of insurance at Indiana University known as one of the insurance industry’s toughest critics.

They underestimated how long people would live and how long they’d need nursing home care — but overestimated how many people would drop their policies and how much interest insurers could earn on the premiums they banked.

Hemorrhaging money, many insurers left the business. Those that remain are in financial trouble on their long-term care policies. They’re charging far more for new policies, and sharply raising the premiums of old ones.

“The industry is a state of severe decline,” Belth said. “Companies … don’t see a way to successfully market the product and make money on it.” Continue reading

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Are routine eye exams needed for seniors?

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Prevention Experts, Eye Doctors Disagree On Vision Tests For Seniors

Michelle Andrews
Kaiser Health News

eye diagramSome doctors and a key group of preventive care experts are not seeing eye to eye on seniors’ need for vision screening during primary care visits.

There’s not enough evidence to know whether giving seniors a vision test when they visit their primary care doctor will lead to earlier detection and treatment of cataracts, age-related macular degeneration or refractive problems that could require corrective glasses and contacts, according to guidelines published by the U.S. Preventive Services Task Force this month in the Journal of the American Medical Association.

The task force, an independent group of medical experts, evaluates the scientific evidence related to preventive services for patients that don’t have symptoms or signs of medical problems.

Under the health law, services that the task force assigns an “A” or “B” grade must generally be covered by health plans, including Medicare, without charging consumers anything out of pocket. In this instance — screening for impaired visual acuity in people age 65 and older — the task force assigned an “I” grade, saying the evidence was insufficient to assess the balance of benefits and harms of screening, the same grade it assigned screening in 2009 when it last reviewed the evidence.

An organization of eye doctors and surgeons criticized the task force recommendation. In an editorial published in JAMA Ophthalmology, Dr. David Parke II, chief executive officer of the American Academy of Ophthalmology, argued that the task force didn’t give enough weight to supporting evidence about the health and quality of life benefits of identifying and addressing visual problems early. Continue reading

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Housing project takes on seniors’s health

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Kan-Lin Chu reads a handout on improving your memory in the lobby of the Hotel Oakland, a low-income senior housing facility in downtown Oakland, California. (David Gorn/California Healthline)

By David Gorn
Kaiser Health News

Hui-Zhen Li doesn’t speak English, but here she can speak freely. She’s standing amid more than 150 Chinese seniors, all perched on metal folding chairs or slouching in wheelchairs, packed wall to wall in the main lobby of the Hotel Oakland.

Li is 89 years old, she knows her own mind, and she’s not afraid to speak it.

“Don’t think you are useless because you’re old,” Li tells the group, admonishing them with a raised finger. “I am 89, and I am not useless. It’s important to always think about your health. You have to always use your brain or you will start to lose memory.”

The gathering at this low-income housing project in downtown Oakland, California, is called Neighbors Helping Neighbors.

It’s part of an ambitious plan to help elderly residents, many of them Asian immigrants, take control of their health — in part by joining at least one of 14 groups intended to enhance their physical and mental well-being. Continue reading

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The agonizing limbo of abandoned nursing home residents

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Bruce Anderson about a year before his accident. (Photo courtesy of Sara Anderson)

By Anna Gorman
KHN

A bad bout of pneumonia sent Bruce Anderson to Sutter Medical Center in Sacramento last May.

As soon as he recovered, hospital staff tried to return him to the nursing home where he had been living for four years.

But the home refused to readmit him, even after being ordered to do so by the state. Nearly nine months later, Anderson, 66, is still in the hospital.

“I’m frustrated,” said his daughter, Sara Anderson. “You cannot just dump someone in the hospital.”

Anderson said her father, who has a brain injury that causes dementia-like symptoms, is confined to the hospital bed and frequently given anti-psychotic medications.

She believes the nursing home, Norwood Pines Alzheimer’s Care Center, refused to readmit him because it wanted to make room for more lucrative and less burdensome residents.

“I didn’t have any question this was about money,” she said.

Bruce Anderson is the victim of a flawed readmission system for patients who want to return to their nursing homes after spending time in the hospital. Continue reading

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Fall prevention essential to preserving health of older adults

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Kim, Alice 09 colorBy Alice Kim, MD
Virginia Mason Issaquah Medical Center
Contributing Writer

If you are an older adult a simple thing can change your life, like tripping on uneven pavement or slipping on a slick surface. If you fall, you could break a bone, like thousands of older men and women do every year. Although a broken bone might not sound bad, it could prompt more serious health issues.

Many things can cause a fall. Your eyesight, hearing and reflexes might not be as sharp as they were when you were younger. Diabetes, heart disease or problems with your thyroid, nerves, feet or blood vessels can affect your balance. In addition, some medications can cause you to feel dizzy or sleepy and make you more likely to fall.

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Virginia Mason physical therapists working with a patient on gait and stability.

However, it’s important to not allow a fear of falling keep you from being active. Doing things like gathering with friends, gardening, walking or going to the local senior center helps you stay healthy. The good news is there are simple ways to prevent most falls.

Do the right things

If you take care of your overall health, you may be able to lower your chances of falling. Most of the time, falls and accidents don’t just happen. Here are a few tips intended to help you avoid falls and broken bones:

  • Stay physically active. Plan an individualized exercise program that works for you. Regular exercise improves muscle health and makes you stronger. It also helps keep your joints, tendons and ligaments flexible. Mild weight-bearing activities – such as walking or climbing stairs – can help slow bone loss from osteoporosis.

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Hospital step up to help seniors avoid falls

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By Susan Jaffe
KHN

Daphne Brown, 65, was putting away the dishes in her Washington kitchen when she fell to the floor. Jane Bulla, 82, fell at home in Laurel, Maryland, but managed to call for help with the cellphone in her pocket.

Susan Le, 63, who has trouble walking due to arthritis, hurt her leg when she tripped on a pile of leaves in Silver Spring. And late one night when no one was around, Jean Esquivel, 72, slipped on the ice in the parking lot outside her Silver Spring apartment.

Falls are the leading cause of injuries for adults 65 and older, and 2.5 million of them end up in hospital emergency departments for treatment every year, according to the Centers for Disease Control and Prevention.

The consequences can range from bruises, fractured hips and head injuries to irreversible calamities that can lead to death. And older adults who fall once are twice as likely as their peers to fall again.

Despite these scary statistics, a dangerous fall does not have to be an inevitable part of aging. Risk-reduction programs are offered around the country. Continue reading

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Report: Home care workers need better job protections

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A younger man's hand holding the hand of an elderly manBy Anna Gorman
KHN

A lack of oversight in the rapidly growing home care workforce could undermine new wage and labor gains for many of the nation’s 2 million workers, according to a report released Monday.

Private agencies employ the vast majority of home care workers, who provide services that are largely paid for by Medicare, Medicaid and other federal and state programs. But the companies are poorly regulated, which could hamper the enforcement of new labor standards, said the National Employment Law Project (NELP), a labor advocacy group.

Home care workers this year gained federal minimum wage and overtime protections after a lengthy battle in the federal courts. The U.S. Department of Labor is expected to begin full enforcement in 2016.

To ensure that workers can take advantage of the new benefits, stronger oversight of the industry is needed, said Sarah Leberstein, one of the report’s authors. Continue reading

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Baby boomers set another trend: More golden years in poorer health

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240px-Peace_sign.svgBy Lisa Gillespie
KHN

After the last of the baby boomers become fully eligible for Medicare, the federal health program can expect significantly higher costs in 2030 both because of the high number of beneficiaries and because many are expected to be significantly less healthy than previous generations.

The typical Medicare beneficiary who is 65 or older in 2030 will more likely be obese, disabled and suffering from chronic conditions.

such as heart disease and high blood pressure than those in 2010The typical Medicare beneficiary who is 65 or older then will more likely be obese, disabled and suffering from chronic conditions such as heart disease and high blood pressure than those in 2010, according to a report by the University for Southern California’s Schaeffer Center of Health Policy and Economics. Continue reading

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Macular Degeneration: a leading cause of blindness

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Learn Basics about the Leading Cause of Blindness in the U.S.

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Dr. Connie Chen

By Guest column Connie Chen, MD
Virginia Mason 

Stephen King, Georgia O’ Keefe, Sam Snead, Bob Hope and Edgar Degas all have something in common — loss of vision due to a condition called macular degeneration.

As many as 11 million Americans have some form of the disease and it is the leading cause of blindness in the United States.

The part of the eye affected is the macula, the area of the retina that is responsible for the sharp, central vision we need for reading and tasks that require seeing things in detail, such as sewing.

Although macular degeneration sometimes occurs in younger people, the condition mainly affects people 65 and older, so it is generally referred to as age-related macular degeneration or AMD.

Symptoms of AMD

The onset of AMD is so gradual that early in the course of the disease most patients don’t notice any loss of vision. As a result, early AMD often goes undiagnosed until the individual has an eye exam.

However, as the disease progresses, vision may become blurred and objects may appear distorted. Individuals with AMD may first notice they are missing letters in words when they read or have difficulty seeing smaller print.

In more severe cases, there may be a significant loss or graying of central vision, while peripheral vision remains unchanged. A person’s ability to adapt to different lighting environments may also be affected.

Causes of AMD

Drusen (yellow spots) in the retina

Drusen (yellow spots) in the retina

The loss of vision is associated with two major changes in the retina. First, there is a build up of cellular debris within the retina, which produces yellow deposits called “drusen.” Second, in some cases the retina releases chemicals that stimulate the growth of new blood vessels, a process called “neovascularizaiton.” The new blood vessels, however, are weak and often leak blood and fluid that damages the surrounding retinal tissue.

Risk factors for AMD

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

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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
KHN

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

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

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

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

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

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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.

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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

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Nursing home residents face health risks from antibiotic misuse

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Three red and white capsulesBy Lisa Gillespie
KHN

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

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