As the Department of Health and Human Services continues its shift towards an outcomes-based payment model, one small health system is working with its pharmacists to create an innovative disease management initiative to minimize hospital readmissions and improve health status for its most complex – and costly – patients.
The Comprehensive Health Management program developed by Martin Health System in Stuart, Fla., establishes a progressive role for pharmacists to work directly with older, chronically ill patients. Integrating these neighborhood-based professionals into the system’s primary care practices improves management of patients with chronic diseases such as diabetes, obesity, heart and lung disease, according to David Harlow, Pharm.D., assistant vice president for professional services, clinical imaging, clinical laboratory, clinical pharmacy and disease management at Martin. Continue reading
Hypothermia is a dangerous drop in body temperature that may result in long term, serious health problems such as a heart attack, kidney or liver damage, or death.
Older adults are especially vulnerable to hypothermia because their body’s response to cold is often diminished by underlying medical conditions such as diabetes. Certain medications, including over-the-counter cold remedies, can also affect the body’s response to temperature.
According to the National Institute on Aging, hypothermia is generally defined as having a core body temperature of 95 degrees Fahrenheit or lower. It can occur when the outside environment gets too cold or the body’s heat production decreases. Hypothermia can develop in older adults even after relatively short exposure to cold weather or a small drop in temperature. Recent CDC data shows that nearly two-thirds (63 percent) of the 2,000 weather related deaths for all ages between 2006-10 were due to exposure to excessive cold, hypothermia, or both. Between 1999 and 2002, 49 percent of those who died from hypothermia were aged 65 or older, 67 percent were male. Continue reading
Sometimes all we need is a quick suggestion from our peers to zero in on a good story. In the “Shared Wisdom” section of our core topic areas, we turn to front-line journalists for advice, some simple insight to add to our repository.
Today’s addition is from Sue Scheible of the Patriot Ledger in Massachusetts. Scheible (@sues_ledger) has been a staff reporter at the paper for 46 years and has a weekly column on aging. She offers some tips on filming video of older adults and why video can be so powerful. In one recent video that Scheible shot, an 85-year-old woman explained what she’s learned about talking to doctors.
See what wisdom Scheible offers fellow journalists.
Julianne Moore just won a Golden Globe for her vivid portrayal of the title character in “Still Alice.” The movie, which opens Friday, is based on a novel about a college professor diagnosed with early-onset Alzheimer’s disease. What makes this story so compelling is that it details the devastating toll on both Alice and her family from Alice’s perspective.
While stories about cognitive decline in middle-aged former athletes have made news for some time, the making of this movie points to how the problem is moving into the mainstream and a new willingness to address it. WBUR recently profiled 64-year old journalist Greg O’Brien – who’s been writing about his ongoing battle with the disease since his diagnosis five years ago. Reporter Kim Lemon did a three-part series for WGAL-Susquehanna Valley, Pa., prompted by her husband’s diagnosis. Gary Rotstein describes his journey to craft a multi-year series for the Pittsburgh Post-Gazette about a 57-year old man’s long-term efforts to cope with his diagnosis. Continue reading
It’s the first week of January and winter seems to have finally arrived with a vengeance. In addition to the cold and snow, many older adults are also fighting this year’s flu.
The CDC reports the virus is widespread in 43 states — from New England to the Pacific Northwest. The flu can cause severe illness and life-threatening complications with older adults and those with respiratory problems at especially high risk.
Some 5 percent to 20 percent of the U.S. population gets the flu each year. More than 200,000 are hospitalized from its complications.
By the first day of 2015, CDC’s influenza surveillance systems were showing “elevated” activity, including increasing hospitalizations rates in people 65 years and older. CBS Atlanta reported that “flu-related hospitalizations for the elderly have doubled from this time last year” across the country. Media outlets report increased flu-related deaths among local elderly in recent days. Continue reading
There are plenty of aging-related stories on the horizon for 2015. Here are just some issues and ideas to get you started:
The once-a-decade White House Conference on Aging is scheduled for sometime in mid-2015 – a date is yet to be finalized. It’s the 50th anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th anniversary of Social Security. The conference will focus on four key areas:
- Retirement security
- Healthy aging
- Long-term services and supports
- Elder justice
Look for plenty of updates on the conference by spring.
Issues include financial security, affordable housing, aging-in-place and community-based support services. According to Leading Age Magazine, boomers are poorly prepared when it comes to savings. How are the 50- and 60-somethings in your community preparing for retirement? Or are they? Continue reading
One of the high-profile programs within the Affordable Care Act is the drive to reduce preventable hospital readmissions among the Medicare population. The program focuses on fee-for-service patients who came back to the hospital within 30 days. Hospitals in the third year of the program face a fine of up to 3 percent of their Medicare payments. Kaiser Health News analyzed the most recent CMS hospital data, and found more than 2,600 hospitals faced penalties in the last round and could lose $400 million.
Reducing unnecessary hospitalizations is a good idea, pretty much a slam-dunk quality move.
But is the readmissions program using the right metrics? Are hospitals that are doing all the right things cutting both readmissions and admissions – and therefore facing penalties because the proportion isn’t dropping, the readmission rate is the same share of the total admissions? Some new research suggests that may be the case. As Joanne Lynn, M.D., a geriatrician and prominent health policy researcher put it (and I’m paraphrasing), it’s the denominator, stupid. Continue reading
It’s not that Ezekiel Emanuel, M.D., Ph.D., necessarily wants to die right after he blows out 75 candles on his birthday cake. He just doesn’t want to live to a ripe old age if it means disability, disease or dementia.
Emanuel briefed reporters on the issues of quality versus quantity of life during a Dec. 12 webinar sponsored by Reporting on Health. It was also the theme of his controversial Atlantic article, “Why I Hope to Die at Age 75.”
“You don’t actually pick your own title; I certainly didn’t pick that Atlantic title.” he told more than 200 online participants. “It probably was good for sales for the Atlantic …”
Institutionalized without justification. Stripped of all rights and dignity. No, it’s not some tale out of Guantanamo. It’s happening in cities and towns all over the U.S. Many frail, impaired, or just “unwanted” older adults are shut away, separated from their life savings, forced to endure countless indignities, and in some cases, lose their right to self-determination. It’s legal, but elder advocates say it’s another form of elder abuse.
The treatment of Sarasota’s most vulnerable is the focus of a terrific series on elder guardianship from Barbara Peters Smith at the Sarasota (Fla.) Herald Tribune. Her profiles of these elders whose lives were forever changed will make you want to reach out and speak with seniors and families in your own community. Any one of these stories could be that of your grandmother or mother or brother.
Finding the impetus for this series came about quite by chance, as Smith describes in her “How I did it” piece. It involved many, many phone calls, emails and old fashioned footwork led to hard scrutiny of a system that appeared out of control. Despite many challenges, including how to verify many of the stories she heard, Smith found a pattern that was hard to ignore, and did the due diligence necessary to verify and vet the information used. A phone call, an editor who listened, and a woman desperate to leave a facility she didn’t want to be in provided the appropriate news hook.
When Smith met two women at a seminar on elder fraud, she had no idea what that conversation would lead to. By listening and by using her journalistic instincts, she uncovered a problem larger than she ever imagined. By keeping your antenna up and thinking “big picture,” you also may find a great news story hidden in a seemingly random conversation.