Tag Archives: elderly

RAND study: More LTSS for Alzheimer’s patients, caregivers needed

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Caregiver

Image by Enrique Bosquet via flickr.

A new study from the RAND Corporation calls on policymakers to improve long-term services and supports (LTSS) for the growing number of people diagnosed with Alzheimer’s and other dementias and their caregivers. The report focuses on policy options at the intersection of dementia and LTSS.

An estimated 15 percent of Americans over age 70 suffer from dementia, but the number of seniors with Alzheimer’s disease is projected to triple by 2050, affecting as many as 14 million in the United States. This will place an unsustainable demand on dementia-related long-term services and supports, according to the report.

The estimated annual costs of dementia care are between $159 billion and $215 billion, which could more than double by 2040 if the age-specific prevalence rate of the disease remains constant as the nation’s population grows older. U.S. policymakers have made funding for clinical responses to dementia a priority. Continue reading

Oral health is a significant factor in overall well-being in seniors

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Image by Alex E. Proimos via flickr.

Good oral health is a strong indicator of good overall health in older adults. It makes sense that nutritional intake is better when a person has all or most of their teeth. Poor oral health, on the other hand, is negatively linked to obesity, sleep apnea, poorer chronic disease management, higher LDL or “bad” cholesterol levels, malnutritionlow self esteem, and other physiological problems.

A 2011 study assessed geriatric oral health of 386 seniors, and compared physical factors including body mass index, handgrip strength, and one-leg standing time with eyes open – all considered strong indicators of general health status among older adults. They found that oral health scores “are significantly associated with” muscle strength in the elderly, which in turn, affects their activities of daily living.

The good news is that more Americans are keeping their teeth into old age. The bad news is that many still face challenges obtaining oral health care.

Medicare, the nation’s health care program for seniors does not cover routine care. In many states, Medicaid dental benefits for poor adults are also extremely limited. Only a minority have private dental benefits. Overall, roughly 70 percent of Americans age 65 and older have no dental coverage of any kind.

While overall oral health has improved for seniors in recent decades, the lack of access to care has serious implications for millions of elders, particularly those who are poor or living in isolated places or institutional settings.

 

AHCJ topic leaders Mary Otto (oral health) and Liz Seegert (aging) teamed up to compile a tip sheet about oral health in seniors that explains possible links between periodontal disease, diabetes and other conditions. They also suggest some story ideas for reporters to pursue about access to care, programs in your community, caregivers and medical providers and more.

Advocacy group issues nursing home report card

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Alaska is the place to be if you need nursing home care, but steer clear of Texas. Families for Better Care, a Florida-based nursing home resident advocacy group, published a new state-by-state nursing home report card which aggregates data from several key measures.

The group scored, ranked and graded states on eight different federal quality measures ranging from the percentage of facilities with severe deficiencies to the number of hours frontline caregivers averaged per resident per day. The organization analyzed results of staffing data compiled by the Kaiser Health Foundation, performance measures from the Center for Medicare and Medicaid Services’ Nursing Home Compare database, and the Office of State Long-Term Care Ombudsman complaint data to come up with the final grades.

The best nursing home states are Alaska, Rhode Island and New Hampshire; Texas, Louisiana and Indiana were at the bottom.

Other results included:

  • More professional nursing staff are needed  Only seven states provided more than one hour of professional nursing care per resident per day.
  • An overwhelming lack of staffing  96 percent of states offered residents fewer than three hours of direct resident care per day.
  • Widespread abuse and neglect – One in five nursing homes abused, neglected or mistreated residents in almost half of all states.

This is another good opportunity to review the list of nursing homes in your state and compare results. There are numerous story angles that can work here – for example, which nursing home ranks best/worst in your state and why? Are administrators doing anything to correct deficiencies? Are state officials aware of these problems? What, if any, action is being taken? What do family members think?

The 2013 Nursing Home Report Card is available for download.

Advances, policy shifts offer more encouragement for aging-in-place movement

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Image by David Illig via flickr.

Given a choice, most older adults prefer aging-in-place rather than moving to a nursing home or assisted-living facility. Unfortunately, older homes and apartments frequently pose safety hazards for seniors – from lack of grab bars in the bathroom to shelves too high to reach without a ladder.

Associated Press Medical Writer Lauran Neergaard describes this scenario – and what can be done about it – in her recent piece, “Home repair for health? Simple fix-ups may keep low-income seniors independent.” Although I first read the article on The Christian Science Monitor website, (with an AP credit), this is an issue that strikes a chord in communities throughout the United States, and in Canada, too.

Aging-in-place presents numerous challenges for seniors. Something as routine as traveling to a doctor appointment for chronic disease management becomes burdensome if there are difficulties with activities of daily living and transportation, poor understanding of care plans, confusion about prescriptions, or mild cognitive impairment which affects ability to follow a plan or care or remember instructions. Visits by nurse practitioners and home health care nurses are important elements for successful aging in place. Medication reconciliation, monitoring of vital signs, nutritional and mental health checks, and a friendly face can sometimes mean the difference between living at home or an institution, especially if caregivers are not nearby. Continue reading

Hot times: Heat and elderly stories may be routine, but necessary

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

It’s not too soon to focus on the connection between scorching temperatures and the health of older adults. With the southwest already coping with record-breaking heat and the first reports of heat-related death and hospitalizations of elderly residents confirmed, media attention is turning to weather’s impact on elder’s health in their own communities. 

This may be an annual story for many media outlets, but it’s still an important one. A CDC study revealed that over 7,200 deaths occurred from extreme heat between 1999 and 2009, and that heat-related deaths were on the rise, according to their analysis of 2012 mortality data. The elderly are particularly vulnerable to high temperatures for several reasons. The American Geriatrics Society points out that older adults may be less likely to feel hot and take longer to cool down. Many juggle multiple chronic conditions which are affected by extreme heat and take multiple medications, which can lead to dehydration or more trouble regulating body temperature.

As this CDC fact sheet details, the health effects of extreme heat bear repeating. Public health officials need to spread these messages through local media and will likely be available for interviews. Cooling centers are a great place to interview seniors about conditions in their homes, and hospital emergency department directors can speak to any spikes in visits, as well as warning signs and health ramifications.

What else is your city/town/community doing to help the elderly beat the heat? Here’s a KNXV-Phoenix report on a program in Scottsdale, Ariz., and another from The Post and Courier in Charleston, S.C., that might inspire some ideas. In central Texas, the Brownwood News reports on several local organizations that have teamed up to conduct a fan drive and deliver them to elderly residents.

What resources can you point seniors to? What should caregivers know?

Resources:

Project addresses readmission concerns by focusing on the frail

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

A new project is addressing the special concerns of frail elderly hospital patients in an attempt to help prevent lengthy hospital stays and readmissions for elderly folks, Anna Gorman of the Los Angeles Times reports.

Through the “frailty project” at Cedars-Sinai Medical Center, at-risk seniors are identified and, within 24 hours, assessed for “their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.” Continue reading

New findings on frailty challenge assumptions

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

We often accept frailty, with its depleted energy and general wearing down of the body, as an inevitable part of aging. About 4 percent of men and 7 percent of women older than 65 were frail in a 2001 study. After the age of 85, that rises to about 25 percent.

Frailty leads to more serious problems, such as an increased risk of falling. People who are frail also have a more difficult time recovering if they are hospitalized.

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Aging
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But, as Judith Graham points out in AHCJ’s core topic pages on aging, exercise can help stave off the decline in body mass, strength, balance and other characteristics of frailty.

Findings like that challenge our view of frail adults as beyond remedy. They’re not. With careful assessment and help from physicians, social workers, nurses, and physical therapists, their functioning can be improved and their lives made easier.

Learn more about frailty, how it affects aging and get links to some relevant studies in the key concepts section of AHCJ’s core topic on aging.

Seniors have special concerns in natural disasters like Sandy

Judith Graham

About Judith Graham

Judith Graham (@judith_graham), a Colorado-based freelancer, is AHCJ’s topic leader on aging, and as such curates related material at healthjournalism.org. She welcomes questions and suggestions on aging issue resources and tip sheets at judith@healthjournalism.org.

It’s well known that older adults are more vulnerable in times of natural disaster. But there’s nothing like a storm the size of Sandy to drive this point home.

Judith GrahamJudith Graham (@judith_graham), 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 judith@healthjournalism.org.

In the past week, we’ve read about New York City hospitals and nursing homes that decided to wait out the storm rather than evacuating. Sheri Fink, who won a Pulitzer Prize for her report on decisions made at Memorial Medical Center in the wake of Hurricane Katrina, got out ahead of Sandy and talked to city and state health officials as well as facility executives. Her ProPublica story is must-reading for anyone who wants to understand the thinking of officials responsible for preparing for the storm.

A take-home point: Evacuations can be extremely difficult for frail seniors living in nursing homes. Balancing the potential impact of displacing residents against the potential impact of sheltering in place during a storm isn’t easy.

I hope that reporters writing these kinds of Sandy-related stories take this into account. For another look at decisions made by city and state decisions vis a vis nursing homes, see this piece by Ben Hallman in the Huffington Post. Kudos to this reporter for going out during the storm and going to a site where nursing home residents were being sheltered. Continue reading

Experts with ties to drugmakers promoted prescribing opiates to older patients

Judith Graham

About Judith Graham

Judith Graham (@judith_graham), a Colorado-based freelancer, is AHCJ’s topic leader on aging, and as such curates related material at healthjournalism.org. She welcomes questions and suggestions on aging issue resources and tip sheets at judith@healthjournalism.org.

Should older adults use powerful narcotics for ongoing pain relief?

This is a much-debated topic in geriatric circles. Last week, it burst into the public sphere with an article in the Milwaukee Journal Sentinel and MedPage Today by John Fauber and Ellen Gabler.

Their story focuses on a 2009 recommendation by the American Geriatrics Society that physicians consider prescribing opiates more often to seniors with moderate to severe pain.

Potential conflicts of interest may have compromised the Geriatric Society’s guidelines, Fauber and Gabler discovered. Five of 10 panel members who prepared the report had financial ties with opiate drugmakers and a sixth member began serving as a speaker for a drug company in the following year.

In another disturbing finding, Fauber and Gabler reveal that a pain guide endorsed by the Geriatrics Society and funded by an opioid drugmaker highlighted benefits of narcotics while downplaying risks – the potential for addiction, cognitive problems, overdosing, falls and fractures, and the enhancement rather than diminishment of pain.

“None of these side effects was included” in the document; instead, it claimed that “opiods allow people with chronic pain to get back to work, run and play sports,” they write.

The Geriatrics Society told the reporters that it stands behind the guide and is “deeply concerned that public policy may create barriers that will limit older adults’ access to pain medicine.”

In a sidebar, Fauber and Gabler examine a related issue in this controversy: the contention that alternatives to opioids – common over-the-counter drugs such as Aleve, Advil and Motrin – can have more deleterious health effects than narcotics. Continue reading

Reporters must listen to learn, accurately report about the experience of aging

Judith Graham

About Judith Graham

Judith Graham (@judith_graham), a Colorado-based freelancer, is AHCJ’s topic leader on aging, and as such curates related material at healthjournalism.org. She welcomes questions and suggestions on aging issue resources and tip sheets at judith@healthjournalism.org.

How do people feel about growing older?

You might think this is a much-examined subject in the media. It’s not.

While the angst and energy of youth appears endlessly fascinating – what are they wearing and drinking? Which apps do they use? What movies or music are most appealing? – the interior life, tastes and thoughts of older adults are largely ignored.

Public opinion research on the topic is surprisingly scarce. The most authoritative study I know of was published almost three years ago by the Pew Research Center. Results were based on a survey of 2,969 adults.

One of the most provocative findings relates to peoples’ perception of when old age begins. Answers varied across the generations: while young people (age 18 to 29) said they thought 60 was the threshold, middle-aged people moved the bar closer to age 70 and people 65 and older pushed it even further, to age 74.

In an equally interesting, parallel finding, older adults said they felt younger than their actual age – by 10 years or more.

In academic circles, the study of people’s age perceptions is known as “age identification.” Research suggests that older adults think they’re younger than they actually are when they’re healthy, active, and have a purpose in life.

“To me, old age is always fifteen years older than I am,” said Bernard Baruch, a famous financier who died in 1965 at the ripe old age of 95, voicing a widespread sentiment.

This disconnect between society’s notion of what constitutes old age and how individuals perceive themselves is revealing. Who wants to identify as “old” when our cultural narrative about aging – one that revolves around physical decline, loss of efficacy and purpose, isolation and irrelevance – is fundamentally negative?

It turns out, there are health consequences attached to our perceptions about getting older.

In an intriguing line of research, Becca Levy of Yale University’s School of Public Health has shown that people who internalize negative stereotypes of aging are more likely to respond poorly to stress, less likely to take good care of themselves, and more likely to experience cardiovascular events and other serious health problems.

Conversely, people with positive images of getting older live 7.6 years longer than those with negatives outlooks, Levy’s research has demonstrated.

In other words, images of dimwitted, sluggish, incompetent, and unattractive old people that circulate widely in our society aren’t just in bad taste. They’re potentially dangerous to people’s health.

There’s a countervailing push from organizations that recognize the insidiousness of negative stereotypes and want to alter our social construct of aging. One example is the International Council on Active Aging “rebranding aging” campaign, launched last year.

The danger here is that efforts to create a new narrative focused on the positive aspects of aging – one that centers on activity, wellness, encore careers, volunteering, and having more time to spend with friends, family – risks marginalizing older people who aren’t especially healthy or well off financially.

This split is reflected in the terminology we use to describe this stage of life. Recently, I’ve come across the terms “wellderly” and “illderly.” Their meaning is clear, and more commonly used terms such as the “young-old” (translate: healthy and active) and the “old-old” (translate: frail, with a larger share of disabilities) essentially serve the same purpose.

Which brings me back to that Pew Research poll.

While there are many interesting insights in the Pew study about older people, reporters who want to know how people actually experience aging – one of life’s profound transitions – will find no substitute for face-to-face interactions.

One of the best pieces of advice I ever got from an editor was “go out there and see what’s going on, even if you don’t necessarily know what you’re looking for.” I’ll repeat it here, in a different context. When you’re writing about older people, go out and sit down with them and ask them about their lives.

You may encounter a degree of resistance: Many seniors are reluctant to talk about themselves. You may have to probe gently and be agile in redirecting your questions if the conversation isn’t moving along as you had hoped. You may have to spend some time making a personal connection before you start getting answers.

But I suspect you’ll be surprised by what older people will tell you, if you take the time, suspend judgment and truly listen.

Judith GrahamJudith Graham (@judith_graham), 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 judith@healthjournalism.org.