Family inHome Caregiving Blog
It was not surprising to read the story in the Monterey Herald entitled "Oversight of nursing home chains lacking." This is a sad situation, and one of the reasons that we try to enable seniors to remain in their own homes and independent. The report, which was an analysis done by the Sacramento Bee, said that the California Department of Public Health does not try and determine how nursing homes compare on key quality measure even though this information could be potentially life-saving for some seniors. The Bee looked at 1,260 nursing homes and found that one Pennsylvania company operator has 15 nursing homes and rehabilitation centers in California which had abuse rates 7x the national average. Others use restraints when not necessary and the study found that it's very difficult for consumers to find out the quality of care. Many nursing homes appear to be independently owned but are actually part of a major chain with a bad record.
It was great to see the story in Saturday's Monterey Herald about Eleanor Cunningham who celebrated her 100th birthday by skydiving. She took up the sport at age 90 and her doctor gave her the OK, saying that her health makes her more than capable to continue the sport. At Family inHome Caregiving, most of our clients are in their 90's and many of them remain in great health. It's so gratifying to see that seniors can live out their golden years in great health and do the things they love to do…not to mention picking up new habits like sky diving. It's critical when you are at this age to keep active.
Many seniors don't think twice about taking over-the-counter (OTC) drugs. However, there can be drug interactions with prescription drugs, so you should always speak to your physician about what types of nutritional supplements and over-the-counter drugs that you are taking. The Acetaminophen Awareness Coalition (AAC) recently issued a warning that some people may not realize that they are taking way too much of the drug contained in such common medicines as Tylenol. That's because many drugs used to treat coughs, stuffy noses and the sniffles also contain the drug. About 7 in 10 people will buy an OTC medication for these symptoms this year, so make sure you check the label before you do.
The Federal Trade Commission (FTC) announced on Thursday that it shut down a robocalling operation that conned seniors out of roughly $23
million by offering them "free" medical alert systems. The defendants will surrender their cash, cars and a boat in a settlement with the FTC and be barred from telemarketing. The scam involved computer-automated callers telling seniors falsely that a free medical alert system had been paid for by a friend or a family member. Many of them lived alone, and were happy to give a credit card number to get the service after being told falsely that the device was recommended by the American Heart Association, the American Diabetes Association and
the National Institute on Aging. They were then charged $34.95/month for the service. The FTC offers tips and videos to help consumers avoid getting ripped off from these types of calls, which unfortunately are all too common. Never, ever give someone your credit card on the phone who is an unsolicited caller, you have no idea what they are going to do with it once they get the number.
Seniors are often depressed when they enter the hospital, and with good reason. Repeat visits are not uncommon, and having to go in and out of the hospital and rehab centers take an emotional toll. A new study which was published in the American Journal of Surgery found that if the hospital would assess the emotional resilience of patients who were being admitted to hospital
with severe injuries, it could then identify those at risk for depression and a
prolonged convalescence. In the study, resilience refers to a person’s
ability to maintain stable psychological function following a highly
disruptive life event (such as breaking a hip). Physiological factors, including stress and mood
hormones, and character traits such as optimism also do play a role in
resilience, the researchers said in their study. If you take a loved one to the hospital, make sure you talk to the physician to try and get a clear understanding of how the healing process will go and how long the person will be in the hospital and/or a rehab facility. Taking away some of the uncertainty can give you both some peace of mind.
Many people going to the Emergency Rooms are getting the surprise of their lives : a diagnosis completely unrelated to what they went to the ER for in the first place. A report in The New York Times found that so-called "incidental findings" (many of which show up on imaging tests) are common, and many aren't even caught or followed up on by ER staff. Health-care providers are
now trying to develop tracking systems to make sure that these are followed up on. In
a study published in the Annals of Emergency Medicine led by
4.5% of emergency department radiology reports included
recommendations to follow up on incidental findings, but only half of
those were noted in discharge instructions for patients. That's a sad statistic and one I hope is improved upon quickly.
It's not surprising that a new study which was published in the November issue of the American Journal of Geriatric Psychiatry found that feeling younger than your real age could help to preserve memory and
cognitive function as people get older. Exercise also helps. A younger self-image was more common in
physically active people with a lower body-mass index, the latest study
found. The study followed over 1,000 people for 10 years and assessed
cognitive function with tests of memory and executive
function, the capacity to plan and carry out complex tasks. The study
found that, on average, the participants felt 19% younger than their
chronological age. Of the subjects, 89% felt younger and 11% felt older
than their actual age. Those who felt older than their age scored 25%
lower on memory and cognitive tests than those who felt younger. At Family inHome Caregiving, we stress that eating right, getting the proper amount of exercise and social stimulation are keys to leading a healthy long life. I was glad to see this study focus on exercise and feeling younger.
For the first time ever, Medicare has submitted a proposal which would cover annual screenings for lung cancer for older Americans (up to age 74) with long
histories of heavy smoking, covering about four million people at high-risk for lung cancer. It's still a draft decision from the Centers for Medicare and Medicaid Services which would
extend coverage for CT scans to Medicare beneficiaries who smoked at
least a pack a day for 30 years or the equivalent, even if they quit as
long as 15 years ago. Although it's in draft form, I think it will pass.
There is only a month left for Medicare's annual open-enrollment period, any many seniors continue to be confused as to what their best option is. Through December 7, you can change your insurance plan for next year and the most confusing aspect are the so-called Medicare Advantage plans, which about 30% of seniors have. A study published last week by the well respected Kaiser Family Foundation, finds “substantial limitations” in the available evidence. “Despite great interest in comparisons between traditional Medicare and Medicare Advantage,” Kaiser told the Wall Street Journal, “studies comparing overall quality and access to care between Medicare Advantage plans and traditional Medicare tend to be based on relatively old data, and a limited set of measures.”
In all, Kaiser looked at 45 studies published since 2000 that examine the Medicare program. Among the findings:
- Medicare HMOs tend to do a better job than traditional Medicare of providing preventive services. But that comparison runs only through 2009.
- Traditional Medicare tends to get better ratings than Medicare Advantage when beneficiaries are asked about quality of care and access to care. But one study indicated that the gap could be narrowing.
- Among beneficiaries who are sick, traditional Medicare typically gets better reviews. But “very few studies,” Kaiser notes, include evidence based on all types of Medicare Advantage plans, including local and regional PPOs, where enrollment is growing.
We always counsel our clients to make sure that they have a POLST, living trust, will and other important documents in hand for the worst case scenario. Many people avoid this because it's just too painful to think about. It's also important, I believe, to talk personally to your friends and family to make sure that they understand exactly what your wishes are should you become incapacitated. Medicare has finally said that they will consider paying doctors to counsel patients about their options for end-of-life care starting in 2016. It's about time. In 2008, Congress overwhelmingly passed legislation requiring to doctors to discuss issues like having a POLST and living will with their patients. However, after former Alaska Governor Sarah Palin began the debates about "death panels," the issue has been on the back burner.