Category Archives: Senior Health

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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Dementia taks toll of unpaid caregivers, study

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

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

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

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By Matt McKillop and Frances Mcguffey
Stateline

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

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Seniors tell medical students what they need from doctors

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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
KHN

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

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

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HeartBy Lisa Gillespie
KHN

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

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How one home health agency earned five stars

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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
KHN

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

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