Caring for older adults: What physicians, patients should question and what reporters should look at

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Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society. If you have questions or suggestions for future resources on the topic, please send them to liz@healthjournalism.org.

Hospital patient

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The American Geriatrics Society (AGS) today published the results of its examination of care to determine the top five things patients and physicians should question when caring for older adults. 

  • Recommending percutaneous feeding tubes in patients with advanced dementia; instead of offering oral-assisted feeding.
  • Using antipsychotics as first choice to treat behavioral and psychological symptoms of dementia.
  • Using medications to achieve hemoglobin 7.5 percent in most adults age 65 and older; moderate control is generally better.
  • Use of  benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation, or delirium.
  • Use of antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present.

AGS partnered with the American Board of Internal Medicine Foundation’s “Choosing Wisely” campaign to evaluate information from ABIM societies and AGS members. They looked at whether physician-ordered tests and procedures were sufficiently evidence-based, whether the potential health benefits were worth any risks they might pose, if they were redundant or medically necessary. The goal of the campaign is to pinpoint and eliminate unnecessary health spending. Continue reading →

Dentists warn of risk in cleaning pacifiers with saliva

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Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Dental folks collectively caught their breath when they heard about the study, just published in the journal Pediatrics.

The findings: Children whose parents “cleaned” dropped pacifers by sucking on them were less likely to have asthma or eczema at 18 months than children whose parents did not use this particular method.

In a May 6 story for National Public Radio, reporter Rob Stein explained the findings. He started out by talking with a typical mom who described washing her child’s pacifier when he dropped it, even cleaning it in boiling water if it fell “somewhere particularly gross.”

But, then Stein went on to say “there’s a theory that says: That may not be the best way to go. That sterilizing that pacifier may actually have a big downside. To try to find out, Bill Hesselmar, of the University of Gothenburg in Sweden, and his colleagues, studied 184 babies who used pacifiers and their parents. Continue reading →

Welcome to AHCJ’s newest members

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Len Bruzzese

About Len Bruzzese

Len Bruzzese is the executive director of AHCJ and its Center for Excellence in Health Care Journalism. He also is an associate professor at the Missouri School of Journalism and serves on the executive committee of the Council of National Journalism Organizations.

Please welcome these new professional and student members to AHCJ. All new members are welcome to stop by this post’s comment section to introduce themselves.

  • Norman Bauman, independent journalist, New York City
  • Barbara Benson, Pulse editor, Crain’s New York Business, Pleasantville, N.Y.  (@barbara_benson)
  • Kristen Buchanan, independent journalist, Lititz, Pa.
  • Patricia Carroll, independent journalist, Meriden, Conn.
  • Marcia Clemmitt, staff writer, CQ Researcher, Washington, D.C.
  • Katharine Gammon, independent journalist, Santa Monica, Calif.  (@kategammon)
  • Haley Goldbach, student, Stanford University, Belmont, Mass.
  • Harumendhah Helmy, reporter, KBIA-Columbia, Mo.  (@harumendhah)
  • Kristofor Husted, reporter/producer, KBIA-Columbia, Mo. (@krishusted)
  • Joseph Sirven, contributor, NBC Latino, Scottsdale, Ariz.
  • Gabrielle Strobel, executive editor, Alzforum, Dover, Mass.
  • Katie Thomas, reporter, The New York Times, New York City (@katie_thomas)

If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.

Aging eyes deserve evidence-based reporting, research

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Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society. If you have questions or suggestions for future resources on the topic, please send them to liz@healthjournalism.org.

Aging eyes

Photo by 8 Eyes Photography via Flickr

Sitting in the waiting room of my ophthalmologist’s office was an elderly man, who I later learned was 100 years old, perhaps 102, no one was sure.

He could walk with the help of his aide and a sturdy cane and his cognition seemed good. My doctor later told me that this gentleman’s eyesight was as good or better than someone 20 or 25 years younger.

It got me thinking about what happens to our eyes as we age.

Why do some people maintain good vision well into their 90s while others struggle with serious visual decline at a younger age? Loss of vision significantly impacts a senior’s independence, which in turn, may lead to depression. Continue reading →

New tip sheet breaks down how ACA applies to immigrants

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

We’ve posted a tip sheet from the National Immigration Law Center on how the Affordable Care Act affects immigrants. They let us put their guide on the  site with one request – that we include their website and suggest that you check their site if you write on this topic in case there are updates.

There’s no sense in repeating what you can find on the tip sheet (undocumented immigrants don’t get covered, documented ones do under  the circumstances described – generally, they can go in the exchanges with subsidies if they qualify but still face a wait to get into Medicaid). But it is worth addressing the nexis between the health law and the current debate over helping immigrants become documented.

The bill will go through changes before it passes – IF it passes (a big question mark, particularly in the House). But the key message from our perspective as health reporters: Given what’s been said so far by Democrats and Republicans alike, it is highly unlikely that undocumented immigrants will get health benefits WHILE they are going through what looks to be a multi-year process of becoming documented. However, once they are documented they will be treated like the rest of the documented immigrant population.

Steak and eggs: Putting science, health news into context

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Brenda Goodman

About Brenda Goodman

Brenda Goodman (@GoodmanBrenda), an Atlanta-based freelancer, is AHCJ’s topic leader on medical studies, curating related material at healthjournalism.org. She welcomes questions and suggestions on medical study resources and tip sheets at brenda@healthjournalism.org.

Steak and eggs

Photo by avlxyz via Flickr

Is it just me, or do medical journals seem to have a knack for publishing conflicting findings on the same topic within the very same week?

That’s what happened earlier this month when the journal Nature Medicine published a fascinating paper that linked a chemical plentiful in red meat, l-carnitine, to the acceleration of atherosclerosis in mice. Researchers also found convincing evidence that when l-carnitine is converted into another chemical, called TMAO, by gut bacteria it may also be linked to heart disease in people. (For an engrossing account of these experiments and the science behind them, check out Gina Kolata’s story for The New York Times.)

A few days later, I ran across this headline: “L-Carnitine Significantly Improves Patient Outcomes Following Heart Attack.” C’mon now. Really? First l-carnitine is bad for the heart, now it’s beneficial? Continue reading →

Keep caveats in mind when writing about climbing premiums, health reform

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Climbing premiums

Photo by sbluerock via Flickr

Insurers are beginning to file their rate requests and, naturally, they are beginning to generate headlines as well as more political fodder. 

My impression is that the rate hikes (particularly for younger people) are getting way bigger attention than the rate decreases (particularly for older people). That’s partly because runaway costs are a better headline – and fit into a political narrative we’re all hearing.

It’s also because the price increases for younger, healthier people is a serious policy concern. If younger people don’t sign up for the exchanges, and only older sicker people do, the costs will keep rising and fewer people will get covered. That is precisely the opposite of what the Affordable Care Act is supposed to achieve.

But there are several caveats – and I explained several of them in an earlier post. The biggest ones to remember: these are “sticker” prices. Many, if not most, people in the exchange – millions of Americans – will be eligible for subsidies in the form of tax credits. These will be available on a sliding scale to individuals and families up to 400 percent of the federal poverty level. Continue reading →

Pa. bill would require disclosure of food stamp purchases

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Felice Freyer

About Felice Freyer

Felice J. Freyer is a member of AHCJ's board of directors, serving as co-chair of the organization's Right to Know Committee.

Food stamps

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A Pennsylvania congressman last week filed a bill that would require retailers to report which items are bought with food stamps.

The proposed “SNAP Transparency Act,” sponsored by Republican Rep. Tom Marino, would require the secretary of agriculture to establish a uniform reporting system under which retailers would track “the complete range, identities, sizes, quantities, and costs of particular food items” purchased with benefits from the Supplemental Nutrition Assistance Program, or food stamps.

If passed, the legislation could give journalists and advocates access to long-sought information about the food purchases of SNAP recipients, at a time of growing concern about their access to healthy foods and about obesity and related health problems among the poor. Currently the U.S. Department of Agriculture does not have the authority to collect such information.

The act would address one of two issues raised in a recent letter to Agriculture Sec. Tom Vilsack from AHCJ and six other organizations representing journalists and open-government advocates. Continue reading →

Coverage of Tulsa dental clinics’ violations has been cautious

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Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Health officials in Oklahoma are working to test patients of two dental clinics for hepatitis and HIV, after an inspection turned up lax sanitation practices and other violations of the state’s Dental Act.

Shannon Muchmore

Shannon Muchmore

Shannon Muchmore of The Tulsa World has been covering the story, which has gone on to get worldwide coverage, with a steady stream of stories for the past month.

While getting out the latest news, offering descriptions of the lines of people waiting to get tested and exploring the fears of some of the 7,000 patients who state officials say may have been exposed – including one man who believes he contracted HIV while getting a tooth extracted at one of the clinics – Muchmore also has been careful to sound a cautionary note about the intricacies of tracing the bloodborne diseases back to their source. Continue reading →

Does this state make my butt look big?

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Brenda Goodman

About Brenda Goodman

Brenda Goodman (@GoodmanBrenda), an Atlanta-based freelancer, is AHCJ’s topic leader on medical studies, curating related material at healthjournalism.org. She welcomes questions and suggestions on medical study resources and tip sheets at brenda@healthjournalism.org.

A study published this month in the journal Obesity reports that the largest percentage of obese people in the United States live in the Great Plains, not in the South, as surveys have long indicated.

Researchers found 41 percent obesity in a census region that includes Kansas, Minnesota, Missouri, Iowa, Nebraska, and the Dakotas, while the East Central South region—Alabama, Mississippi, Tennessee, and Kentucky – weighed in with 31 percent obesity. Mississippi and Alabama have long ranked first and second as the most obese states in the nation, according to data compiled by the CDC.

The study suggests the dubious honor of being the fattest region in the U.S. should go to the nation’s breadbasket, not to the buckle of its BBQ belt.

“That’s a pretty big difference,” said senior author George Howard, Dr.P.H., chair of biostatistics at the University of Alabama at Birmingham. “Don’t get me wrong, 31 percent obesity is not good, but it’s not the worst.”

The difference is important, too, because these kinds of rankings often help determine which states get federal public health dollars for research and anti-obesity campaigns.

How could this happen? Blame a problem that bedevils all kinds of research: self-reported data. Continue reading →