How many times have people said “You must take care of yourself?” when caring for an elderly loved on who’s hospitalized. There’s stress. …too many things to take care…
The brief’s key findings are:
- When economic times are good, deaths in the United States increase.
- Previous research suggests that a likely culprit is poorer health habits tied to greater job demands.
- However, the increase in mortality is largely driven by deaths among elderly women in nursing homes.
- These nursing home deaths may reflect increased shortages of caregivers during economic expansions.
- Death Rates Higher In Nursing Homes During Good Economy (nursingassistants.net)
Enhancing Use of Clinical Preventive Services Among Older Adults
From the March 24 report:
This new report, Enhancing Use of Clinical Preventive Services Among Older Adults – Closing the Gap, calls attention to the use of potentially lifesaving preventive services by our nation’s growing population of adults aged 65 years and older. By presenting and interpreting available state and national self-reported survey data, the Report aims to raise awareness among public health and aging services professionals, policy makers, the media, and researchers of critical gaps and opportunities for increasing the use of clinical preventive services, particularly among those who are currently underserved.
Older Americans have long been recognized as having unique social, economic, and health needs. Since the passage of the landmark Medicare Act in 1965, numerous policies and programs have evolved to support and improve the health and quality of life for adults aged 65 and older. The most recent addition is the 2010 Patient Protection and Affordable Care Act which addresses coverage for clinical preventive services with a U.S. Preventive Services Task Force (USPSTF) rating of an A or B, immunizations recommended by the Advisory Committee on Immunization Practices, and numerous additional wellness benefits for older adults. Recently issued rules to implement the legislation call for Medicare to eliminate out-of-pocket costs for previously covered preventive services in January 2011.1 The new law also entitles Medicare beneficiaries to a free annual wellness visit that includes a schedule of recommended preventive services. Additionally, a few states have already eliminated co-pays for some cancer screenings and more are poised to do so.
The USPSTF recommends a range of clinical preventive services for older adults. In 2006, these services were ranked by the National Commission on Prevention Priorities (NCPP), a nonpartisan organization of business, nonprofit and government leaders convened by the Partnership for Prevention. Using innovative evidence-based methods, the NCPP identified 25 clinical preventive services that have the biggest impact on health and are most cost effective. The majority of these services are relevant to older adults aged 65 and older. Of the six top services, three are specific to this age group including colorectal cancer screening and influenza and pneumococcal vaccinations.
- Seniors Not Getting Important Preventive Health Services (nlm.nih.gov)
- Health care reform can help align preventive care recommendations with Medicare coverage (physorg.com)
- Reliable? Heart Studies Often Exclude the Elderly (nlm.nih.gov)
- Rising Reports of bad reactions to drugs (jmflahiff’s WordPress blog)
Flahiff, editor of this blog, strongly believes preventative health measures can reduce need for prescription drugs (and the side effects which may come from their use)
Excerpt from this previous posting
“Drugs are chemicals. And you’re putting something in your body. You need to know what it is.” [Editor Flahiff’s emphasis]
If you keep adding drugs to your daily routine, talk to your doctor about whether you can cut back on others, so that you are only taking the minimum necessary amount, she said. Read all the material that comes with medicines, and tell someone immediately if you start to feel unwell. “If something doesn’t feel right, talk to your doctor, talk to your pharmacist.” [Flahiff’s emphasis]
Today’s older Americans enjoy longer lives and better health than did previous generations. These and other trends are reported in Older Americans 2010: Key Indicators of Well-Being, a unique, comprehensive look at aging in the United States from the Federal Interagency Forum on Aging-Related Statistics.It is divided into five subject areas: population, economics, health status, health risks and behaviors, and health care. A link to a powerpoint slide of charts may be found here.
[Editor Flahiff’s note: I remember visiting my great aunt in a nursing home in the early 70’s (I was in my late teens) I found the stupor among the residents very sad…this story was very refreshing to read…
My husband can attest to the importance of personal attention…he is retired and goes to senior centers daily for lunch and the “pool halls”. He makes it a point to visit with those sitting alone at lunch…and has brought a number of folks out their shells during the past few years]
Instead of treating behavioral problems with antipsychotic drugs, the Ecumen chain of 15 homes is using strategies including aromatherapy, massage, music, games, exercise and good talk. The state is helping out.
The aged woman had stopped biting aides and hitting other residents. That was the good news.
But in the North Shore nursing home‘s efforts to achieve peace, she and many other residents were drugged into a stupor — sleepy, lethargic, with little interest in food, activities and other people.
“You see that in just about any nursing home,” said Eva Lanigan, a nurse and resident care coordinator at Sunrise Home in Two Harbors, Minn. “But what kind of quality of life is that?”
Working with a psychiatrist and a pharmacist, Lanigan started a project last year to find other ways to ease the yelling, moaning, crying, spitting, biting and other disruptive behavior that sometimes accompany dementia.
They wanted to replace drugs with aromatherapy, massage, games, exercise, personal attention, better pain control and other techniques. The entire staff was trained and encouraged to interact with residents with dementia.
Within six months, they eliminated antipsychotic drugs and cut the use of antidepressants by half. The result, Lanigan said: “The chaos level is down, but the noise is up — the noise of people laughing, talking, much more engaged with life. It’s amazing.”…
….Medicare spends more than $5 billion a year on those [antipsychotic] drugs for its beneficiaries, including about 30 percent of nursing home residents. Several studies have concluded that more than half are prescribed inappropriately. The drugs are especially hazardous to older people, raising the risk of strokes, pneumonia, confusion, falls, diabetes and hospitalization….
Instead of looking for causes of disruptive behavior among dementia patients, doctors typically prescribe drugs to mask the symptoms, he said, because “It’s the easy thing to do. … That’s true in hospitals, in clinics and in nursing homes.”
Federal regulators are cracking down on homes that don’t routinely reassess residents on psychotropic drugs. But use remains widespread….
Looking older than your age may not be a sign of poor health: Study
Common practice of linking health to how old a person looks not an accurate indicator
Toronto, Ontario, November 5, 2010 – Even though most adults want to avoid looking older than their actual age, research led by St. Michael’s Hospital shows that looking older does not necessarily point to poor health. The study found that a person needed to look at least 10 years older than their actual age before assumptions about their health could be made.
“Few people are aware that when physicians describe their patients to other physicians, they often include an assessment of whether the patient looks older than his or her actual age,” says Dr. Stephen Hwang, a research scientist at St. Michael’s Hospital and an associate professor at the University of Toronto. “This long standing medical practice assumes that people who look older than their actual age are likely to be in poor health, but our study shows this isn’t always true.”
For patients, it means looking a few years older than their age does not always indicate poor health status. The study found that when a physician rated an individual as looking up to five years older than their actual age, it had little value in predicting whether or not the person was in poor health. However, when a physician thought that a person looked 10 or more years older than their actual age, 99 per cent of these individuals had very poor physical or mental health.
“Physicians have simply assumed that their quick assessment of how old a person looks has diagnostic value,” explains Dr. Hwang. “We were really surprised to find that people have to look a decade older than their actual age before it’s a reliable sign that they’re in poor health. It was also very interesting to discover that many people who look their age are in poor health. Doctors need to remember that even if patients look their age, we shouldn’t assume that their health is fine.”
The researchers studied 126 people between the ages of 30 to 70 who were visiting a doctor’s office. Participants completed a survey that accurately determined whether they had poor physical or mental health. Each person was photographed, and the photographs were shown to 58 physicians who were told each person’s actual age and asked to rate how old the person looked.
The study, published in the Journal of General Internal Medicine, provides new insights and questions into the value and limitations of a long standing medical practice of judging a person’s health by how old they appear.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who walk through its doors. The Hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing Knowledge Institute, research at St. Michael’s Hospital is recognized and put into practice around the world. Founded in 1892, the Hospital is fully affiliated with the University of Toronto.