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…
Elderly Tend to Drive Slower to Make up for Reaction Time
Thu, 10 Mar 2011 11:00:00 -0600
Narrowed field of vision limits ability to detect potential pedestrian hazards, experts say
ScienceDaily (Mar. 29, 2011) — Members of California’s aging lesbian, gay and bisexual population are more likely to suffer from certain chronic conditions, even as they wrestle with the challenges of living alone in far higher numbers than the heterosexual population, according to new policy brief from the UCLA Center for Health Policy Research.
Half of all gay and bisexual adult men in California between the ages of 50 and 70 are living alone, compared with 13.4 percent of heterosexual men in the same age group. And although older California lesbians and bisexual women are more likely to live with a partner or a family member than their male counterparts, more than one in four live alone, compared with one in five heterosexual women.
A lack of immediate family support may impact aging LGB adults’ ability to confront statistically higher rates of diabetes, hypertension, poor mental health, physical disability and self-assessed fair or poor health, compared with demographically similar aging heterosexual adults.
The study, which draws upon three cycles of data from the biennial California Health Interview Survey (CHIS), underscores the importance of considering these unique needs and chronic health conditions in providing health care and social services to the estimated 170,000 self-identified aging LGB adults in California — a population that will double in size over the next 20 years.
“Many aging LGB Californians do not have biological children or strong family support,” said Steven P. Wallace, the lead researcher on the project. “Organizations that serve these communities need to take this into account and consider outreach and support mechanisms that enable these individuals to maintain their independence and ability to age safely and in good health.”
The policy brief, “The Health of Aging Lesbian, Gay and Bisexual Adults in California,” includes the first data published on aging LGB adults based on a large statewide population. And among a population whose health needs are too often associated only with HIV and AIDS, the study offers the first insights about broader health conditions and trends….
- Groundbreaking report released: ‘Bisexual Invisibility: Impacts and Recommendations’ (pinkbananaworld.com)
- Lesbians, gays, bisexuals at higher risk for severe mental health problems (news.bioscholar.com)
- San Francisco Human Rights Commission Approves Groundbreaking Report: Bisexual Invisibility: Impacts and Recommendations (pinkbananaworld.com)
- Day 27- Sexuality in the US (feministactivism.wordpress.com)
- Bullying, Harassment of Gay/Lesbian Teens: Expert Q&A (webmd.com)
- Strong link found between victimization, substance abuse (eurekalert.org)
- Physiological Impacts Of Homophobia (mccswu.wordpress.com)
- Americans Have Higher Rates of Most Chronic Diseases Than Same-Age Counterparts in England (jflahiff.wordpress.com)
- Doctors lack data on LGBT community: report
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]
ScienceDaily (Mar. 14, 2011) — A new report shows that older people who receive Guided Care, a new form of primary care, use fewer expensive health services compared to older people who receive regular primary care.
Research published in the March 2011 edition of Archives of Internal Medicine ***found that after 20 months of a randomized controlled trial, Guided Care patients experienced, on average, 30 percent fewer home health care episodes, 21 percent fewer hospital readmissions, 16 percent fewer skilled nursing facility days, and 8 percent fewer skilled nursing facility admissions. Only the reduction in home health care episodes was statistically significant.
According to the study, Guided Care produced even larger reductions in a subset of patients who received their primary care from one well managed health system. Guided Care patients in Kaiser Permanente of the Mid Atlantic States experienced, on average, 52 percent fewer skilled nursing facility days, 47 percent fewer skilled nursing facility admissions, 49 percent fewer hospital readmissions, and 17 percent fewer emergency department visits; the differences for skilled nursing facility days and admissions were statistically significant….
More information about Guided Care is available at twww.GuidedCare.org.
From the Web site…”Guided Care® is a new solution to the growing challenge of caring for older adults with chronic conditions and complex health needs. A Guided Care nurse, based in a primary care office, works with 2-5 physicians and other members of the care team to provide coordinated, patient-centered, cost-effective health care to 50-60 of their chronically ill patients. The Guided Care nurse conducts in-home assessments, facilitates care planning, promotes patient self-management, monitors conditions monthly, coordinates the efforts of all health care professionals, smoothes transitions between sites of care, educates and supports family caregivers, and facilitates access to community resources. ”
- Guided Care improves physician satisfaction with patient/family communications (scienceblog.com)
- Chronic disease care poorer in nursing and residential homes under GP target scheme (eurekalert.org)
- Post Trauma Care: Better Chance Staying At Home (medicalnewstoday.com)
The network of public services that supports California’s low-income, disabled elderly is fragile, affecting the ability of these vulnerable residents to live independent lives in their own homes, according to a new study from the UCLA Center for Health Policy Research.
This policy note reports the first findings from a yearlong effort to follow the lives and challenges encountered by several dozen representative older Californians in Los Angeles, San Diego, San Francisco and Santa Clara who are enrolled in Medicare and Medi-Cal and who receive in-home and community care.
The documentary project comes as California lawmakers consider additional cuts to a network of services that help seniors remain “safely in their homes” — the stated goal of these public programs and the way in which an overwhelming number of Americans say they want to age.
The policy note, “Holding On: Older Californians with Disabilities Rely on Public Services to Remain Independent,” shows seniors struggling to live functional lives in the face of already reduced caregiving hours. For example:
Caring for the caregivers
Sara cares for her disabled son and husband, whose heart disease, diabetes, incontinence and limited mobility require 24-hour care. There’s help from In-Home Supportive Services (IHSS) and other family members, but Sara is the primary caregiver. Now, her back is acting up. She’s been delaying seeing a doctor to take care of her own needs — who will care for her family if she’s hospitalized?
Paralyzed by polio, Mary breathes with the help of a ventilator and gets around in a wheelchair. She needs help to dress, bathe, use the toilet and eat. She’s created an elaborate system to meet her needs, using maximum IHSS hours of support and offering room and board to another caregiver in return for care. Mary’s happy with her life and rates her health as “excellent,” but she knows that even a small change in the delicate balance of her care system will send her to a nursing home.
Incapacitated by stroke and diabetes and confined to a wheelchair, Jack spent time in a nursing home a couple of years ago, and he’s not in a hurry to go back. In the nursing home, he felt unsafe and more isolated than he does in his own house with support from IHSS. Jack’s a realist. He knows a nursing home may be in his future again, but he wants to choose when and where he’ll go.
According to the researchers, all participants in the study are aware that the networks of care they’ve cobbled together could easily unravel, and most say they’d rather “make do” by eating less often, letting their homes become less safe or allowing their medical conditions to worsen than give up their independence and go to a nursing home — the likely scenario if they lose the in-home services they now rely upon.
“These seniors are using every sort of innovation and self-deprivation to make do,” said Steven P. Wallace, the study’s senior author and associate director of the UCLA Center for Health Policy Research. “They have nowhere to turn if their fragile care systems are further undermined.
“Policymakers need to see the faces of these vulnerable Californians as they crunch the numbers in budget discussions,” Wallace added. “Further cuts are an assault on their independence. Slashing in-home and community care will also increase total health care costs as these seniors increasingly use emergency room care, are hospitalized or enter institutions — under conditions that could have been prevented.”
Budget cuts looming
California, which is home to the largest number of older adults in the country, has several programs funded by federal, state and local dollars to assist low-income adults with disabilities. Proponents of these programs say that while such care isn’t perfect, it is far less expensive and more humane than the alternative — placing seniors in publicly financed nursing homes.
Yet, IHSS program-hours were trimmed by 3.6 percent in January 2011, and they face further across-the-board cuts of 8.4 percent, plus additional targeted reductions in the governor’s proposed budget. Adult day health care centers are slated for elimination, and supplemental security income cash benefits are to be reduced for single low-income aged and disabled individuals.
All the older adults in the study receive IHSS support, ranging from 20 hours of in-home help each month to the maximum of 283 hours per month. Most need help with household tasks, such as cleaning and cooking, and personal tasks like getting dressed or taking medications. Many require help getting in and out of bed, bathing and using the toilet. Some who might benefit from adult day health care or other supportive programs are unable to participate because of limited mobility or lack of transportation.
“California’s current system to support old and young adults with disabilities at home operates in silos and is not person-centered,” said Bruce Chernof, M.D., president and CEO of the SCAN Foundation, which is funding the study. “The Brown administration has an important opportunity to design a more stable, integrated, efficient and person-centered system that can meet the needs of these vulnerable residents throughout the state.”
- Home Care Services (MedlinePlus.gov) has links in areas as related issues (as nursing home alternatives), financial issues,organizations, and law/policy)
- US Administration on Aging has links to local programs, a benefits check up, related information, and more.
- National Association of Area of Area Agencies on Aging includes information on policy/advocacy, programs and resources/publications. It also includes links to local resources.