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
Addressing the global epidemic of dementia and improving end-of-life planning and care in the United States are the subjects of two new reports released today by Alzheimer’s Disease International and the Institute of Medicine. Both reports offer insights into the realities of dealing with an aging population and a lack of appropriate services and supports to meet present and future needs.
According to ADI, substantial evidence exists that risk for dementia can be reduced by using the same approaches as those which promote cardiovascular health — eliminating tobacco use, early detection and treatment of hypertension and diabetes. They call for a worldwide campaign to integrate brain health messages into existing public health efforts. Additionally, the report calls for the World Health Organization to include dementia risk in future noncommunicable disease efforts. Continue reading
Postmenopausal women who eat foods higher in potassium are less likely to have strokes and die than women who eat less potassium-rich foods according to new research in Stroke, the journal of the American Heart Association.
Stroke is the fourth leading cause of mortality in the United States, and as this infographic shows, women account for 60 percent of all stroke cases in the U.S. Women also have higher lifetime risk of stroke than men.
In this observational study, researchers tracked 90,137 postmenopausal women, ages 50 to 79, for an average 11 years. They looked at potassium consumption, incidence and type of stroke and mortality during that period. The average dietary potassium intake from food —not supplements — was 2,611 mg/day. All participants were free of stroke history at baseline. Continue reading
I knew next to nothing about the fast-growing assisted-living industry when I started reporting in early 2013 on problem homes in San Diego.
For example, I did not know that many seniors in today’s assisted-living homes are so frail and medically needy that they would have been in nursing homes 20 or 30 years ago. Many live in facilities with no medically trained staff.
Most astonishing to me was the lack of public access to state regulatory reports revealing the quality of care in homes, not only in California but nationally. We’re so accustomed to NursingHomeCompare and HospitalCompare – whatever their flaws – that the hoops families and journalists must leap through to judge an assisted-living home’s quality seem downright primitive. Continue reading
A new study out of the United Kingdom reinforces the influence that culture and societal attitudes can have on the health status of older adults. Psychologists from the University of Kent used data from the European Social Survey to ask respondents, all age 70 or older, to self-rate their health.
In countries where old age is thought of as signifying low status, participants who identified themselves as ‘old’ felt worse about their own health. The opposite was true in places where older people have a perception of higher social status. The researchers concluded that elevating perceived social status of older people would reduce negative connotations associated with old age and the negative impact on how healthy people felt.
The value different societies place on the elderly has a lot to with how they are cared for later in life, evolutionary biologist Jared Diamond explained in a recent TED talk. These effects in turn, influence public policy for global long-term services and supports. The International Federation of Social Workers recently noted, “Although older adults serve as essential resources to their communities, they face a great risk of marginalization.” Continue reading
Photo by John via Flickr.
Georgia has a new task force targeting Alzheimer’s disease and related dementias. The recently published Georgia Alzheimer’s Disease and Related Dementias State Plan lays out a strategy for addressing the needs of patients in terms of care and prevention, the impact on caregivers, and the costs associated with the disease.
The task force is led by James Bulot, Ph.D., director of Georgia’s Division of Aging Services. According to Bulot, 40 states have dementia plans at various stages. The Georgia plan assesses the risk for citizens in the state and takes inventory of services available to Georgians. It also outlines the importance of finding gaps in resources available on a state level.
Bulot believes the Georgia plan will be different because he’ll hold the task force accountable for progress. Unlike other plans which may be updated every five or 10 years, the Georgia plan will be continually modified to reflect changing scientific knowledge and statistics. Continue reading
AHCJ’s latest update to nursing home inspection data gives members three years of the most severe deficiencies found during inspections and the current star ratings assigned by the U.S. Centers for Medicare and Medicaid Services.
The data could be a good starting point for reporters who want to pursue authoritative stories about their local nursing homes.
The data now contains 16,806 such deficiencies as recorded by CMS. Deficiencies are characterized by their severity, “A” being the least severe and “L” being the most severe. AHCJ pruned down the data to include just the most severe of the deficiencies, letters “G” through “L.” These range from an “isolated incident of actual harm” to “widespread immediate jeopardy to resident health or safety.”
Under its star rating system, CMS gives nursing homes between one and five stars. According to the CMS ratings web site “nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.” Each nursing home is given an overall rating, as well as three specific ratings: health inspections, staffing and quality measures.
The AHCJ version of nursing home data is derived from a large file that is split up for easier use by members.
A Huffington Post exposé in June, “Hospice, Inc.,” rekindled some thoughts I’ve long had about the split personality of the journalism on complex topics like aging.
One week, readers see richly reported news features, usually by health care or feature reporters, about the struggle of elders and their families caught in this country’s messy long-term care system. The next, readers get stories by political, economics reporters on bipartisan budget debates (how much to cut this year) or exposés that aim for accountability, but don’t help most families.
The Huffington Post project got me thinking – what’s the responsibility of an investigative team posting an approximately 7,000-word, six-month investigation? How can they get beyond house-of-horrors revelations? Continue reading