Smoking Cessation Programs Covered by Medicare

People with Medicare who are diagnosed with a smoking-related disease, including heart disease, cerebrovascular disease (stroke), multiple cancers, lung disease, weak bones, blood clots, and cataracts can get coverage for smoking and tobacco use cessation counseling. These diseases account for the bulk of Medicare spending today. People with Medicare who take any of the many medications whose effectiveness is complicated by tobacco use including - insulin and some medicines for high blood pressure, blood clots, and depression are also eligible for the counseling.

People with Medicare who are diagnosed with a smoking-related illness or are taking medicine that may be affected by tobacco are covered. Medicare will cover up to eight face-to-face visits during a 12-month period. These visits must be ordered by your doctor and provided by a qualified doctor or other Medicare-recognized practitioner.

You pay 20% of the Medicare-approved amount after you meet the yearly Part B deductible.

For more information, go here.

Beyond Dementia - Reasons for Nursing Home Admissions and What You Can Do For Your Elders

The Leipzig Longitudinal Study of the Aged examines predictors of nursing home admissions among seniors without a dementia diagnosis. It is one of the first analyses that don't consider dementia.

1,024 elderly adults over 75 without dementia were interviewed six times on average every 1.4 years, according to the report. During the study, 7.8% of seniors without dementia were admitted to a nursing home.

Factors that led to faster admission to a nursing home include living alone, functional impairment, major depression and stroke. Seniors who had home care aides, as well as seniors who did not regularly see specialist physicians were also more likely to be admitted to a nursing home sooner.

The reasons for admission did not strike me as unusual but may to others. Particularly those living alone being more likely to be admitted. Often that loneliness leads to depression. And it speaks to the fact that many people discount the positive social aspects that any type of senior living arrangement offers. It also makes sense that seniors not under the care of a specialist tend to be more likely to go to a nursing home, most likely because they were not keeping up with their health issues. Those having home care aides surprised me but when I thought about it made sense. Those same care aides are probably more acutely aware of just how much care their clients need and recognize when home care is truly not enough.

Some of these non-dementia issues we can control. Certainly a functional impairment or stroke could be out of our reach to prevent but we can help our elders living alone and often depressed. That is a societal role for anyone. Do you know the seniors in your neighborhood and their circumstances? Perhaps they can use a new friend.

The study appears in BMC Health Services Research 2010.

Source: McKnights

Hospital Delirium - Protecting Your Elders

About a third of patients over age 70 experience hospital delirium, and the consequences can be serious, delaying a patient’s recovery and even leading to placement in a nursing home. Elderly patients who experience delirium are also more likely to develop dementia later on, and more likely to die sooner than patients who do not become delirious.

Read this New York Times article for tips to protect your loved one in a hospital.

Video Blogs on ICYOU Health

I started taking the written contents of my blog and crafting videos around them for icyou Health. They asked me to write a blog about why I do what I do with the elderly. I think it might be worth a read. Thanks.

Fit Brains Aims at Improving Resident Brain Health

Emeritus Senior Living has partnered with Fit Brains, an online brain game site, to improve resident brain health at the company’s communities. The Fit Brains games, which are offered on the Emeritus Web site, were developed by brain health experts and target five major cognitive brain functions: memory, concentration, language, executive functions, and visual-spatial skills.

Emeritus introduced the Brain Health Lifestyle with a goal of stimulating the brain on a daily basis in five key areas: physical fitness, mental stimulation, socialization, nutrition, and spirituality. The company is placing an emphasis on brain health education and will be teaching its communities how to incorporate the Brain Health Lifestyle into the daily lives of its employees, residents, and their families.

I applaud Emeritus for doing this though I wonder what they think of my earlier post regarding the effectiveness of brain games.

Source: Long Term Living Magazine

Best Things to Eat When Your as Sick as a Dog

This was sent to me as a post to consider and while it was written for students I think it applies to all of us.

Check it out here.

More Older People Abusing Drugs

Drug abuse treatment programs across the country are seeing more older users of illegal narcotics than ever before.

According to a report from a division of the Department of Health and Human Services, admissions of adults aged 50 and older in drug treatment programs has nearly doubled over the last two decades, to 12% in 2008 from 6.6% in 1992, Among those older drug users, 16% were admitted for heroin use. That is twice the number from 1992. A total of 11% were admitted for cocaine use. That is more than four times the 1992 level. Over the same period, the percentage of admissions for alcohol abuse among older adults dropped to 60% from 85%.

Good information but please someone start a discussion as to why. Is it the economy, depression? Let's hone in on some core elements and start treating the root cause of the disease.

Source: McKnight's

The Power of Intergenerational Programs

Editor’s Note – This is a guest blog by a young writer Alexis Bonari. We are happy to have her contribute. Enjoy!

As a recent college graduate whose experience with grandparents has been limited by distance, I can say that volunteering at nursing and retirement homes has been enriching. But “volunteering” implies a one-way street, and that was never the case with college kids and baby boomers. There’s a lot for college students to learn from the older and wiser crowd, and intergenerational programs are much more indicative of the symbiotic relationship that can exist between generations. This is an important idea to cultivate, especially with the understanding that modern society includes many distanced relationships between generations, a phenomenon that can negatively impact both young and old individuals.

How Intergenerational Programs Can Help

In a study of school-based intergenerational programs conducted by the UNSECO Institute for Education, the programs are defined as “social vehicles that create purposeful and ongoing exchange of resources and learning among older and younger generations.” The most important factor in these settings is engagement, and with the current lack of involvement between the old and the young, most schools enjoy success with these programs because students are naturally engaged. When kids are deprived of relationships with older individuals, they can develop negative attitudes toward aging that are automatically counteracted when they get to spend time with baby boomers. Most current programs focus on using the strengths of one generation to meet the needs of another, an idea that can be highly effective on both sides of the generational divide. Baby boomers have knowledge, experience, and great stories for kids, and students often contribute energy, creativity, and amusement for seniors in return.

Spotlight Programs

The following are some of the most successful and interesting ongoing intergenerational programs. Let them inspire you and be sure to check with local schools and universities for information on programs near you.

Neighbors Growing Together is a wide-ranging program at Virginia Tech and is just one of several intergenerational programs run at the university. By combining its Adult Day Services program with the Child Development Center for Learning and Research, Virginia Tech has created a truly symbiotic relationship between generations. Activities like taking walks together, making music, engaging in creative crafts, and playing games characterize this program and enable its participants to enjoy the company of a distinctly different generation while learning and growing to appreciate one another.

At Pennsylvania State University, the Intergenerational Outdoor School Program brings fourth graders and older adults together for four days to learn about nature and caring for the environment. Discovery walks help kids learn to appreciate the environment, while senior citizens enjoy sharing their knowledge with a younger generation.

The Florida Intergenerational Orchestra of America invites musicians aged 5 to 88 to participate in performances that bring generations together in a unique and rewarding way. Founded by Lorraine Marks, it offers a variety of levels from Beginner to Advanced and is conducted in a workshop format that attracts both students and snow birds.

Editor’s Note: I would add that The Harvard School of Public Health-Met Life Foundation Initiative on Retirement and Civil Engagement had this to say about such ventures:

"Community based initiatives that bridge the generations should receive special attention. The programs build community by integrating the old with the young, transmitting knowledge and experience to future generations and reinforcing the value of people of all ages. Studies have found that young people in such programs show measurable improvements in school attendance, attitudes toward school and the future, and attitudes toward elders. Adult volunteers report substantial benefits to themselves: the satisfaction of sharing their experience, feeling useful. And giving back to the community."

Bio: Alexis Bonari is a freelance writer and blog junkie. She spends much of her days blogging about Education and CollegeScholarships. In her spare time, she enjoys square-foot gardening, swimming, and avoiding her laptop.

Videoconferencing Enriches Nursing Home Residents' Lives

Using Internet-based communication tools from SKYPE or MSN, researchers in Taiwan helped 34 residents at 10 nursing homes communicate with family members via videoconferencing. All 18 women and 16 men reported that the experience enriched their lives. Each resident used the videoconferencing differently, with 12% of family “visits” taking place daily, 47% weekly, 23% monthly and 18% occasionally. The average chat lasted 12 minutes. After a three-month study period, residents answered questions about their experiences.

Participating residents said the experience helped them to feel they were a part of family life. Some residents spoke with sons or daughters who live in other countries. The report, as well as resident reactions to the videoconferencing program, appears in the Journal of Clinical Nursing.

It makes sense and I have seen some companies popping up that help facilitate this. However some of it is predicated on facilities having the technology and the resident being able to navigate it or at least have some assistance to do so. Perhaps families need to take the lead here. No one else will.

Source: McKnight's

Technology Allows Disabled to Use Nose to Communicate and Maneuver

A technological breakthrough could allow the severely disabled to use their noses to communicate and even maneuver wheelchairs. According to the Weizmann Institute research team, cranial nerves in quadriplegic and other severely disabled individuals are seldom damaged so the brain is still able to send signals to the soft palate at the back of the roof of the mouth. The research team has found a way to convert nasal pressure, essentially, sniffs, into electrical signals that can be relayed to an external device.

During their studies, researchers used the device to help one woman write a message to her family. Severely disabled people were also able to maneuver a wheelchair over a 115-foot course using simple commands: forward was two sniffs in; backward was two sniffs out; left was sniffs out then in; and right was sniffs in then out.

Their research appears online in the Proceedings of the National Academy of Sciences.

Source: McKnights

National Caregiver Survey - Caregivers Need Help!

The results of the 2010 National Caregiver Survey are now available. Some of the statistics were what I expected. Caregivers are typically female boomers caring for an elder in their 80-90's etc. You can see the statistics here.

What struck me is that the majority of caregivers admitted that they don't take care of themselves. 36% work full time jobs. And they expect to be caregivers for another 10+ years.

What they want most is counseling and support to manage their emotions.

I have previously cited statistics about caregiver health including the fact that many die before the one they are taking care of dies. What this survey and caregivers are calling out for is help.

We need more programs to care for the caregiver.

10 Things Your Hospital Won't Tell You

This is a great article from MSN. I have to admit though I worked in and now with hospitals there was information that I was surprised to read.

For example -

"Avoid hospitals in July like the plague."

If you can, stay out of the hospital during the summer — especially July. That's the month when medical students become interns, interns become residents, and residents become fellows and full-fledged doctors. In other words, some of the staff at any given teaching hospital are new on the job.

Summer hospital horror stories aren't just medical lore: The adjusted mortality rate rises 4% in July and August for the average major teaching hospital, according to the National Bureau of Economic Research. That means 8 to 14 more deaths occur at major teaching hospitals than would normally without the turnover.

Another scheduling tip: Try to book surgeries first thing in the morning and preferably early in the week when doctors are at their best and before schedules get backed up.

Good stuff.

Exercise Could Tamper Anger

(Compiled from the New York Times) A study presented at the American College of Sports Medicine suggests that perhaps exercise is a partial remedy for anger control. University of Georgia researchers chose 16 young men with a “short fuse.” The men filled out a survey about their moods at that moment. During the two days of the study, the men were each fitted with high-tech hairnets containing multiple sensors that could read electrical activity in the brain. Next, researchers flashed a series of slides across viewing screens set up in front of each young man. The slides, intended to induce anger, depicted upsetting events interspersed with more pleasant images. Electrical activity in the men’s brains indicated that they were growing angry during the display. On alternate days, after viewing the slides again in a different order, the men either sat quietly or rode a stationary bike for 30 minutes at a moderate pace while their brain patterns and verbal estimations of anger were recorded. The results showed that when the volunteers hadn’t exercised, their second viewing of the slides aroused significantly more anger than the first. After exercise, conversely, the men’s anger reached a plateau.

Nathaniel Thom, a stress physiologist who was the study’s lead researcher, remarked “It’s like taking aspirin to combat heart disease,” he said. “You reduce your risk.” Researchers hope future studies will help to determine the specific underlying mechanisms that link exercise and a reduction of anger.

Thom says the lesson for now is “if you know that you’re going to be entering into a situation that is likely to make you angry, go for a run first.”

You Might Be a Hypochondriac if.....

The following is a guest post from my colleagues at Masters in Healthcare:

Have you ever claimed you were sick at 99 degrees, or believed your tummy ache is the sign of something bigger? Sure, we’ve all exaggerated our aches and pains and claimed we are sicker than it seems, but these are also common signs of hypochondria. According to MayoClinic’s Web site, hypochondria is a chronic mental illness, in which people fear they have an undiagnosed serious or life-threatening disease. Experts have linked hypochondria to obsessive-compulsive disorder, because they both exhibit debilitating and overwhelming effects on the human body and mind. If you find yourself endlessly seeking medical care for a condition that doctors say you don’t have, you may be one of the many people who are suffering from hypochondria. Here are 10 signs you’re a hypochondriac:

• You’re fearful or anxious about having an undiagnosed disease or condition
  Those with hypochondria believe they have an underlying disease or life-threatening condition, based on normal bodily sensations, pains or symptoms. Whether you’ve had a previous health condition or are healthy as can be, the fear of your undiagnosed disease continues to eat at you. If you find yourself excessively fearful or anxious about your health and are convinced that you have a disease, you may be a hypochondriac.
  
  
• You worry that every sensation or symptom means you are sick
  No matter how minor the pain, twitch or sensation is, you think this means you may have a serious disease. For example, a headache means you have a brain tumor, or an upset stomach means you have a digestive condition or cancer. If you find yourself obsessing over certain feelings or sensations and worrying that you’re sick, you may be a hypochondriac.
  
  
• You go to the doctor and seek examinations repeatedly
  In an effort to find the underlying disease or life-threatening condition you think you have, you’ll visit the doctor repeatedly to have tests, examinations and analyses done. If you find yourself visiting the doctor more often than usual and leaving their office with a clean bill of health, but continue to believe you’re sick, you might be a hypochondriac.
  
  
• You switch doctors often
  When you’re convinced that you have a life-threatening disease and your current doctor tells you that you’re healthy and nothing is wrong, but you continue to switch doctors, hoping one will find something, you may be a hypochondriac. You may become frustrated with doctors and health care because you feel you aren’t receiving proper treatment, despite the doctor’s reassurance that you are well.
  
  
• You have social anxiety and strained relationships
  Thinking you’re always sick takes a toll on your social life and relationships. You may find yourself staying at home a lot, avoiding social interaction and ignoring friends, family and others for various health and anxiety reasons. If you’re unable to find happiness spending time with your loved ones and all you can think about is your life-threatening disease, then you may be a hypochondriac.
  
  
• You obsess over health research
  When doctors turn you away or refuse further examinations, you may do thorough health research of your own. You may go to the Internet, read health books or watch television shows that explain symptoms and diseases you think you have. After your research, you are convinced that you have an illness that you read or heard about.
  
  
• You obsessively check your body for signs
  Your heightened body awareness leads you to obsessively check your body for problem signs, such as lumps, bumps, sores, bruises to support your belief that you have a condition or deadly disease. Even when your doctor says the bump is nothing to worry about, you continue to seek examinations and further consultations.
  
  
• You frequently check your vital signs
  Whenever you’re not having a doctor or nurse do it, you have your heart rate, blood pressure, body temperature and other vital signs checked. Checking your vital signs allows you to take your health into your own hands and keep a close eye on these bodily functions. Whenever you spot any irregularities, you’ll have a reason to go to the doctor.
  
  
• You experience emotional distress
  Your excessive fear and anxiety that you may be seriously ill can cause major emotional distress, such as depression, anger and frustration, as well as obsessive/compulsive behaviors and stress. If you are experiencing similar signs of emotional distress, you might be a hypochondriac.
  
  
• You have substance abuse problems
  If you find yourself abusing any substance, including alcohol, illegal substances and over-the-counter medicine like painkillers, Tylenol or Advil, you may be exhibiting signs of a hypochondriac. The emotional distress, anxiety and pain that stems from this mental illness may push you towards abusing substances.

I am sure there is a middle ground between being an educated consumer and, well, a hypochondriac. But though the information was worth passing along.

What If People Refuse to Reform?

Guest blog, Hospital Impact, healthcare reform and consumerism.

Alzheimer's Care to Exceed $20 Trillion in Next 40 Years

A report from the Alzheimer’s Association, “Changing the Trajectory of Alzheimer’s Disease: A National Imperative” shows that the cumulative costs of care for people with Alzheimer’s from 2010 to 2050 will exceed $20 trillion, in today’s dollars. The report also shows that the number of Americans age 65 and older who have this condition will increase from the 5.1 million today to 13.5 million by mid-century.

Total costs of care for individuals with Alzheimer’s disease by all payers will soar from $172 billion in 2010 to more than $1 trillion in 2050, with Medicare costs increasing more than 600 percent, from $88 billion today to $627 billion in 2050. During the same time period, Medicaid costs will soar 400 percent, from $34 billion to $178 billion. One factor driving the exploding costs by 2050 is that nearly half (48 percent) of the projected 13.5 million people with Alzheimer’s will be in the severe stage of the disease – when more expensive, intensive around-the-clock care is often necessary.

A treatment breakthrough that delays the onset of Alzheimer’s by five years – similar, perhaps, to the effect of anti-cholesterol drugs on preventing heart disease – would result in an immediate and long-lasting reduction in the number of Americans with this condition and the cost of their care. A breakthrough that delays onset by five years and begins to show its effect in 2015 would decrease the total number of Americans age 65 and older with Alzheimer’s from 5.6 million to 4 million in 2020.

The Alzheimer's Association is calling for ramped up efforts and intense investment in research for the disease.

Avoid Indiana Long-Term Care if You Can!

Indiana has opted not to participate in the federal program around nurse background checks. According to officials the state cannot afford its $1 million share.

Under the healthcare reform law, states could apply for a federal matching grant of 75% of the cost of implementing nurse background checks, up to $3 million. Monday was the last day states could apply for the matching grants.

Indiana currently relies on the state's 120,000 registered nurses to self-report any criminal history when applying for or renewing their licenses. State nursing home resident advocates decried the decision, saying that state officials passed up an opportunity to protect Indiana residents in nursing homes.

So buyer beware. If mom or dad needs a long-term care facility you have even more homework ahead of you. Or perhaps you might consider a neighboring state with tougher background checks or if you live far away, moving mom or dad closer to you.

Fewer Consumers Seeking Health Care

According to a Deloitte Center for Health Solutions, one in five Americans did not seek medical care for a recent illness or injury, with four out of 10 citing cost as the primary factor. Fewer consumers visited a physician or healthcare professional in the past year; 79% of respondents sought medical attention in 2010 as compared with 85% who did so in 2009.

15% of consumers reported visiting a retail clinic and 34% said they would do so if it cost 50% or less than the cost of a doctor's appointment. More consumers are seeking alternative or natural remedies before seeing a physician. Consumers are also receptive to medical tourism, but only 7% sought healthcare services outside their local community in the last 12 months.

So how about you? Have you been avoiding care? You shouldn't be. The fact is that there are baseline, necessary tests that you need to have routinely to assure you stay healthy. Avoiding these could lead to complications down the road and MORE costs to you. So have those necessary tests, annual physicals, etc. and do shop for care. You can negotiate and you can save money.

Multi-focal Lenses Could Contribute to Falls

From Mcknights - Seniors who wear multifocal prescription glasses could reduce their risk of falling if they switch to a single-focus lens while walking outdoors, new research finds.

Many seniors wear bifocal or multi-focal prescription glasses to help see both close-range and distant objects. Among seniors who spend a lot of time outdoors, these types of lenses could contribute to falls, according to a new British study. Researchers studied 606 seniors aged 65 and older who used such lenses while walking outdoors.

Half the seniors were given single-focus prescription lenses to use while outside. Overall, falls were reduced by 8% among the single-focus lens cohort. There was a 40% reduction among those who were used to walking around outside, but seniors who typically spent their time inside saw an increased risk of falling, suggesting that switching to a single-focus lens might not be a good solution for those seniors.

Perhaps researchers are suggesting that if you wear glasses you wear one pair that is for distance and use them outside and another pair for closeup and use them inside. Makes some sense. I have bifocal contacts and I do give up some distance. So when I am driving I sometimes wear my regular contacts instead and use the bifocal contacts for when I know I will be reading, speaking, performing and need to see words on a page. Might be worth the investment to have a couple of pairs of glasses. Check with your ophthalmologist.

Don't Ignore Mailings from CMS to Seniors about Reform

Medicare beneficiaries have been receiving important information in the mail about the immediate benefits they may see from the enactment of the Affordable Care Act.

The mailings outlines key provisions of the Affordable Care Act that are important for people with Medicare as well as members of their families.

With scammers at the ready, according to CMS, “It’s important that our Medicare beneficiaries get facts about this important new law timely so they can learn what stays the same and what will change and improve in terms of their benefits,” said Marilyn Tavenner, acting CMS administrator. “

“The new law not only strengthens Medicare, but also ensures the guaranteed benefits that beneficiaries have come to rely upon don’t change,” said Tavenner.

The first benefit that several million Medicare beneficiaries have received is a one-time check for $250, if they enter the Part D donut hole and are not eligible for Medicare Extra Help. The donut hole is the period in the prescription drug benefit in which the beneficiary pays 100 percent of the cost of their drugs until they hit the catastrophic coverage. And that is where the scams have started.

Go to www.medicare.gov or call 1-800-MEDICARE to have your questions about Medicare or the Affordable Care Act answered.

Alzheimer's Patients Have Better Recall When Information Sung to Them

Researchers at the Boston University School of Medicine conducted a study to see if Alzheimer's patients would be better able to recall new information if it was sung to them. Alzheimer's patients and healthy control subjects were visually presented with the lyrics to 40 songs. Half of the lyrics were presented along with the original recordings. The other half was presented in a spoken format.

The Alzheimer's patients could more easily recall the lyrics when they were accompanied by the musical recording, according to the researchers. Surprisingly, however, the healthy control group did not experience the same memory benefit of the musical recording. This seems to indicate that the memory encoding and retrieval process of musical information in Alzheimer's patients is fundamentally different than in healthy seniors, according to the study. The report appears online in the journal Neuropsychologia.

This is not at all surprising to me. I have witnessed countless Alzheimer's and dementia patients wake from a comatose slumber and sing my entire program along with me. It would be interesting to conduct a study to see whether people's amount of exposure to music at a younger age has any correlation to better recall. In any case, keep playing your itunes, CDs, cassettes and 8 tracks (yeah I know there are some of you out there!)

Mortality Rates Worsening for U.S.

Mortality rates in the U.S. have been worsening over the last 20 years. A new report shows that its world rankings have slid during that period.

Obesity, smoking and AIDS have been the largest factors in the reversal of a long-progressing trend of increased longevity, according to a report in The Lancet. The U.S., where 60% of adults are classified as overweight or obese, fell from No. 34 in the world in 1990 to No. 49 in 2010 in female mortality and from No. 41 to No. 45 in male mortality in that time span.

Could be worse I guess as Russia dropped from 43rd in female mortality in 1970 to 121st this year. Cyprus topped the list of lowest mortality rate for women. And, Iceland's men have the lowest risk of premature death. Pack your bags!

Beware Medicare Part D Rebate Scams

As another round of $250 Medicare prescription drug rebate checks goes out in the mail, healthcare officials are reminding seniors to be aware of potential scams.

Scammers posing as Health and Human Services officials are calling seniors and saying they need personal information, such as a Social Security or Medicare number or a signature to process the rebate checks.

Medicare officials will never call and ask for Medicare or other personal information.

HHS will automatically mail the checks as soon as seniors become eligible. To be eligible, a senior must already have Medicare prescription drug coverage and must not be on the Medicare Extra Help program. Seniors do not need to take any action to receive the checks.

Seniors who receive calls asking for their Medicare numbers should take the person's name, write down the number he or she is calling from (using caller ID, if possible), and report the call to 1-800-MEDICARE.

Gene Linked to Alzheimer's Discovered

A gene known to affect the aging process has been linked to amyloid plaques, which are a hallmark of Alzheimer's disease. Researchers at the Massachusetts Institute of Technology have discovered that the gene, SIRT1, controls production of the protein fragments that comprise the amyloid plaques. In research they noticed that increased levels of SIRT1 led to learning and memory improvements, while cognitive function appeared to decline when the gene was removed. The discovery of the link could lead to promising treatments.