Nancy Berlinger, Ph.D., is a research scholar at The Hastings Center and co-author of a retrospective article on palliative and end-of-life care that was published in the Feb. 12 New England Journal of Medicine.
In part one of our conversation, Berlinger focused on the need to broaden the discussion among and improve training of clinicians on talking to patients about end of life issues. In part two, she discusses foreseeable scenarios, societal perspectives and how to improve media coverage of this complex topic. Continue reading
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
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
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 …”
A recent special “Your Money” section in The New York Times looked at American spending habits from a variety of angles. One piece examined geographic patterns in the consumption of luxury goods. Another explored the emotional aspects of bargain hunting. Then there was an article by Ann Carrns that delved into the difficult spending choices retirees may face in obtaining dental care.
The piece opened with an anecdote about 73-year-old Terry O’Brien, a retired administrative assistant weighing the cost of a $2,000 crown for one of her teeth.
“I always took care of my teeth,” O’Brien told the Times. But since she lacks dental coverage, she opted for a less expensive filling. The call was a tough one that left O’Brien pondering how she will go on paying for her dental care. “I’ll make 100, I bet,” she said. “But I wonder how long my teeth will last.” Continue reading
Compared with other industrialized nations, patients age 65 or older in the U.S. are generally in poorer overall health and have more challenges paying out-of-pocket expenses than their counterparts in other industrialized nations, according to a new study in the November 2014 issue of Health Affairs. (Remember, AHCJ members get free access to Health Affairs.)
Older adults in 11 nations – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States – were asked by telephone about their health and health care delivery. Among the 15,617 adults, age 65 or older, who participated in the 2014 Commonwealth Fund International Health Policy Survey of Older Adults, 20 percent of respondents in every country except France reported problems with care coordination. Access to primary care was most challenging in Canada, the U.S., and Sweden. Continue reading
Image by Alex E. Proimos via flickr.
The term “frailty” seems to be practically synonymous with aging. And while it’s true that adults naturally have a gradual physical decline as they age, not every older adult is frail and not every frail person is old.
Aging, also called senescence, refers to the biological process of growing older. As people age, it becomes more difficult for the body to repair itself and maintain optimal health, according to Neal S. Fedarko, Ph.D., professor of medicine, division of geriatric medicine and gerontology, Johns Hopkins University. People age differently based on both genetics and lifestyle factors.
Frailty is considered a chronic and progressive condition, categorized by at least three of five criteria: muscle weakness, unintentional weight loss, low physical activity levels, fatigue and slow walking speed. The body loses its ability to cope with everyday or acute stress, becoming more vulnerable to disease and death, as Samuel Durso, M.D., director of geriatric medicine and gerontology at Johns Hopkins School of Medicine explained in a recent AHCJ webcast.
Learn more about frailty, and how it affects people’s quality of life as they age, in this new tip sheet.
Two new reports again underscore the need for a comprehensive national long-term services and support initiative.
First, the good news: A new National Center for Health Statistics data brief shows that Americans are living longer. Overall life expectancy rose by 0.1 percent from 2011 to 2012, to 78.8 years, and was highest for non-Hispanic whites and non-Hispanic blacks. Women can expect to live an average of 81.2 years, and men an average of 76.4 years, based on the new analysis.
The report also shows significant decreases in age-adjusted death rates for eight of the 10 leading causes of death: heart disease, cancer, chronic lower respiratory diseases, diabetes, stroke, influenza, pneumonia and kidney disease.
Now the bad news – a new report released by the Office of the Inspector General in the Department of Health and Human Services found increased costs associated with critical access hospitals. Medicare beneficiaries paid nearly half of the costs for outpatient services at critical access hospitals – a higher percentage of the costs of coinsurance for services received at these facilities than they would have paid at hospitals using Outpatient Prospective Payment System rates. Continue reading