Consumers Putting Off Medical Care & Risking Health

Consumer Reports National Research Center suggests that despite people saying the recession is over, consumers are acting as if it is not. And in the worst possible way - playing with their health. 

• The percentage of consumers who said they didn't fill prescriptions, took less medicine than a prescribed dose, or failed to undergo a medical test advised by their physician surged 9 percent from 2010 at 39 percent to 2011 at 48 percent.
   
• One in six American households and one in four with incomes less than $50,000 revealed they felt stress over how much they must spend on medical care.

Consumers reported the following:

• Putting off a doctor's visit (21 percent)
• Delaying a medical procedure (17 percent)
• Declining a medical test (14 percent)
• Not filling a prescription (16 percent)
• Taking an expired medication (13 percent)
• Skipping a scheduled dose without asking a doctor or pharmacist (12 percent)
• Splitting pills in half without consent of their doctor or pharmacist (8 percent)
• Sharing a prescription with someone else (4 percent)

If there is one thing you cannot sacrifice is your health. There are resources available to you. Talk to your physician and reach out to your local support network.

Hip Fractures in Women Deadly

Prevent falls. Prevent hip fractures.
@Don Farral, Getty Images

Hip fractures in women ages 65 to 79 are linked to in an increase in short-term mortality according to an ongoing Kaiser Permanente Center for Health Research report.

Investigators followed 1,116 women who had hip fractures and compared them with about 4,500 similar women without hip fractures. 

• They found that the risk of dying within a year of breaking a hip doubled for women in their 70s.
   
• Mortality for women in their 80s remained the same, regardless of whether they had a hip fracture. t
   
• The risk of short-term mortality tripled for otherwise healthy women who suffered a hip fracture in their 80s.

The authors wrote. "Women who are 65 to 70 years of age continue to have an increased risk of mortality for up to five to 10 years; therefore, prevention of hip fractures in these women should be of high priority.

Falls are a leading culprit for hip fractures. Interventions such as balance classes, other exercise and home modifications can cut down on the risk. Do that and you will decrease hip fractures.

The study was published online in the Archives of Internal Medicine.

Caregivers Have Bad Health Habits

Be Thankful to
Our Caregivers
This Season
@Getty Images

While this is a study from just one state, Calif., anecdotally I can report that its implications certainly apply to the country.

The estimated 6 million informal caregivers in California show serious psychological distress and negative health behaviors such as smoking, according to a policy brief by the University of California, Los Angeles, Center for Health Policy Research.

According to UPI.com, the study finds:

• 25.5 percent of middle-age caregivers are more likely than older or younger caregivers to binge drink
   
• 16 percent are more likely to smoke and 30 percent are more likely to be obese.
   
• Caregivers of all ages who reported serious psychological distress were 208 percent more than non-caregivers to smoke.
   
• Nearly one-third of middle-aged caregivers are single, divorced or widowed, and more than two-thirds hold down full- or part-time jobs.

If you are a caregiver, know that there are resources to help you. Just search my blog for a start. And non-caregivers, please reach out to caregivers you know and provide much-needed support.

Holiday Tips When Visiting Elders

The holidays offer a once-a-year time to visit with elderly relatives who live at a distance. These holiday visits are a good time to assess what assistance parents or other elderly loved ones might need.

"Home for the Holidays - what to look for during your annual visit to elderly relatives" is a written blog I published earlier this week. Because videos tend to get more views than written blog do readers, I have summarized some of the post here. The original blog was reprinted with permission by Mary Twomey, MSW, Co-Director, University of California, Irvine, Center of Excellence on Elder Abuse and Neglect.

Medicaid - You May Need It so Know About It

The Perceived
Medicare Safety Net

According to reports from McKnights, very few retirees see Medicaid as having a role in their long-term care needs.

• 10% of pre-retirees and 7% of retirees think Medicaid will pay the majority of their costs for three months in a nursing home.
  
• Only 32% of retirees want major changes in the Medicare program, compared to 47% of pre-retirees.That also reinforces how much retirees perceive as needing Medicare as their safety net.

The truth is that unless you have come to the home from a hospital, in which if eligible Medicare pays, well you have to pay out of pocket until Medicaid kicks in. So it really pays for you to understand how long-term care is funded and what you can do now to protect your assets later, or maybe it's just the first three letters of that word. (Think about it!)

Pollsters concluded that while an aging population may support changes to Medicare, they see the federal-state Medicaid program as irrelevant to their lives. That's at odds with Medicaid, by far, being the predominant payer for nursing homes.


The poll is part of a series developed by NPR, the Robert Wood Johnson Foundation RWJF, and the Harvard School of Public Health.

Joint Commission Awards First Disease-Specific Certifications to Nursing Homes

Claremont Rehabilitation and Living Center in Buffalo Grove, Illinois and Forest Villa Nursing Care in Niles, Illinois, became the first nursing homes in the country to be certified under The Joint Commission’s Disease-Specific Care Certification Program. 

This is significant because it adds another level of quality that you can now use as a benchmark when looking for care for yourself or a loved one.

Claremont Rehabilitation and Living Center was certified for wound care, orthopedic rehabilitation and pulmonary rehabilitation. 

Forest Villa Nursing Care was certified for wound care and orthopedic rehabilitation. A team of Joint Commission expert reviewers evaluated the two nursing homes for compliance with Disease-Specific Care standards focused on delivering clinical care; program management and improvement; and clinical information management.

The Joint Commission’s Disease-Specific Care Certification Program, launched in 2002, is designed to evaluate clinical programs across the continuum of care. Certification requirements address three core areas: compliance with consensus-based national standards; effective use of evidence-based clinical practice guidelines to manage and optimize care; and an organized approach to performance measurement and improvement activities.

Again, this is one more tool for evaluation. You simply ask - are you accredited or certified by the Joint Commission.

Yoga Improves Balance and Reduces Falls

Regular yoga classes helped older male veterans who have had a stroke cope with their increased risk of suffering from a painful or deadly fall, according to a study by Indiana University funded by the U.S. Department of Veterans Affairs.

Having a stroke quadruples a person's chances of falling and increases the chances of breaking a hip. About 80% of stroke victims have difficulties with balance as well.

Veterans with an average age of 66, who had previously suffered from a stroke, attended twice weekly, hour-long yoga  classes taught by therapists. Poses were significantly modified for these participants. They started off doing yoga poses while seated in chairs and then they moved on to standing and seated poses.

Using two established scales for measuring balance, investigators say group members improved their balance scores by 17% and 34%, respectively. 

Stroke or no stroke, the benefits of yoga continue to be uncovered.

Who Runs the Nursing Home? CNA's

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The following is a guest post from Elizabeth O’Malley:

With the advances in healthcare and surgery techniques, more adults are living into their eighties and beyond. Many are able to live independently or with families. However, for those who are physically unable to care for themselves, a nursing home may be considered. Oftentimes a nursing home will take many people cooperating together in order to run successfully, from a certified nursing assistant to various social workers. So who are the people who will be running the care of loved ones in these facilities?

The organizational structure of most nursing homes includes a nursing home administrator at the helm. The administrator may be a clinical professional such as a bachelor's level nurse, or an individual with a degree in health administration. This individual oversees the total operation of a facility. Administrators oversee the hiring and training of employees and develop policies and procedures to assure that the facility complies with federal and state regulations. A nursing home administrator administers the budget, reports to state and federal agencies as often as necessary. He or she convenes and participates in meetings with families, staff, vendors, and insurance providers. The nursing home administrator also has responsibility for direct supervision of department heads in other disciplines such as nursing, social work, various therapies, dietary and environmental services.

The nursing home administrative team usually includes the following professionals: a finance officer or bookkeeper, director of social work who serves as a liaison between families and the facility. The social worker may also double as a community relations director, meaning that he or she promotes the facilities services in the community. Nursing homes may also have a medical director and nursing director. The medical director is a local physician responsible for the clinical or medical aspects of care including examining patients; writing prescriptions for medication, and writing other orders for care.

The nursing director is usually a registered nurse who has total supervision of all nursing staff. Under the nursing director is an assistant director of nursing. This positions supervises other staff including registered nurses, and licensed practical nurses/licensed vocational nurses. These staff nurses provide supervision for nurse’s aides or certified nursing assistants. Other staff working in nursing homes include dietary workers, housekeeping and environmental services employees, occupational, physical and speech therapists; and volunteers.

Each of the aforementioned positions or professions is essential in the successful operation of nursing homes, however, who runs the nursing home? All it takes is a visit to a nursing home to determine who really "runs" the facility. In the day to day operation of any nursing home, one will observe that certified nursing assistants make up the bulk of staff providing direct care to patients. Nursing assistants are the "backbones" of nursing homes. According to the U.S. Department Health and Human Services, there is a shortage of nursing assistants in every community.

Certified nursing assistants work under the direct supervision of a registered nurse or licensed practical nurse. According to the U.S. Bureau of Labor Statistics, certified nursing assistants are responsible for direct care duties, including bathing patients, helping them get dressed, feeding, and caring for the hair. Certified nursing assistants assist patients in toileting and in situations where patients are bedridden, they must change soiled bed linens and clothing. They also assist patients who have mobility issues. This may include lifting, carrying, pushing a patient in a wheel chair, or helping one to remain stable or steady while walking.

To accomplish their work, certified nursing assistants must be in good physical health, with the ability to lift and move patients. Certified nursing assistants must be trained to care for patients through an approved program of study. Nursing assistant training may be sponsored by nursing homes, community colleges or junior colleges, high schools, and online training programs. Training requires a minimum of 50 hours, but some programs may require as many as 90 hours of training. Students in certified nursing assistant training programs must take course work in basic anatomy and physiology, medical terminology, basic nursing, communication, and infection control.

In addition to classroom courses, students must be successful in completing a clinical program that gives them opportunity for hands on application of skills learned in the classroom. Upon successful completion of the classroom and clinical components of the training program, graduates are able to sit for the certification examination administered in the state in which they plan to practice. If a passing score is received, an individual is permitted to wear the title certified nursing assistant and may be employed in a nursing home if desired.

While all of the individuals who work at nursing homes contribute to residents' well-being the organizational structure is at its best, the fact remains that without qualified, caring nursing assistants working in harmony with the nursing directors, most nursing homes and similar health care facilities would be forced to close their doors.

Bio: Elizabeth graduated with a degree in Public Health Administration before relocating with her family to Seattle. She is currently writing, and her favorite topics include health care, work-life balance, and travel.

Diabetes Doubles Risk of Dementia, Alzheimer's

A study on the relationship between diabetes and dementia reveals that diabetes appears to double a person’s risk of developing Alzheimer’s disease or other dementias.

A study published in the September 20 issue of Neurology showed that people with diabetes were more likely to develop Alzheimer's disease and other types of dementia, such as vascular dementia, which occurs when there is damage to blood vessels that deliver oxygen to the brain.

Researchers studied more than 1,000 people who were age 60 and older and given a glucose (sugar) tolerance test after an overnight fast to determine if they had diabetes. Study participants were monitored for an average of 11 years and then tested for cognitive impairments. During the study, 232 people eventually developed dementia.

The study found that people with diabetes were twice as likely to develop dementia as people with normal blood sugar levels. Of the 150 people with diabetes, 41 had developed dementia, compared to 115 of the 559 people without diabetes who developed dementia.

Diabetes is an epidemic. But the worse epidemic is obesity, which many times leads to this disease.

Fall Prone Fail to Adjust Walking Speed

Seniors prone to falling might do so because they fail to adjust their walking speed to their vision impairments.

Irish investigators from Trinity College in Dublin divided 17 participants into three groups and made them complete a walking course, once while wearing goggles that blurred their vision and once without the goggles. 

The first group comprised five older adults who had fallen at least once in the last year; the second group had six seniors who had not fallen; and the third group had six younger adults.

All three groups struggled with the blurred-vision goggles, but the younger group, and the group of seniors without a history of falls both slowed their walking speed to adjust to their vision impairment. The group of seniors with recent falls, however, did not reduce their walking speed compensate for their blurred vision.

Fall prone adults seems to less ability to analyze their surrounding environment.Yet because they are prone to falls this is a skill they need to learn. This is similar to a situation with my father-in-law who continually walks without picking up his feet. He has fallen several times because of this.

November is National Family Caregiver Month

In 1994, the National Family Caregivers Association (NFCA) began promoting the celebration of family caregivers during the week of Thanksgiving. President Clinton signed the first presidential proclamation in 1997 and every president since has issued an annual proclamation appreciating family caregivers. As interest grew in family caregiving issues, National Family Caregivers Week became National Family Caregivers Month.


It is a time to:

• Raise awareness of family caregiver issues
• Celebrate the efforts of family caregivers
• Educate family caregivers about self-identification
• Increase support for family caregivers

Identifying Family Caregivers! is the theme that NFCA has established for National Family Caregivers Month 2011.

Despite the huge role family caregivers’ play in the care of their loved ones, despite the fact that family caregivers are the only people consistently present across all of their loved ones’ care settings, family caregivers are invisible in American healthcare.


Nowhere on medical intake forms is there a question about whether someone is, or has a family caregiver. Nowhere on a person’s medical record is there a place for a notation of any kind about their care status. Without such information, the role of a family caregiver in the life of a person with chronic conditions is essentially negated, and without such information, a family caregiver’s increased risk for depression and chronic disease cannot be monitored. In some situations, it may be obvious that someone is or has a family caregiver, but if it isn’t in the record, it isn’t official, and cannot be taken into account in developing a plan of care – for both parties.


There is an easy fix to this problem. The fix is to have a space on all medical intake forms and electronic medical records to capture information on who is or who has a family caregiver.

Next time you fill out a medical form – just make a notation that you provide care to your parent, spouse, child, etc. who has a chronic condition or deals with the frailties of old age. One form at a time you can make a difference, change the status quo and gain recognition for the important job of being a family caregiver.


More at: www.thefamilycaregiver.org

10 Myths About Falls from NCOA

The National Council on Aging (NCOA) has published myths related to falling. According to the NCOA, many people think falls are a normal part of aging. The truth is, they're not. Most falls can be prevented—and you have the power to reduce your risk. 

Exercising, managing your medications, having your vision checked, and making your living environment safer are all steps you can take to prevent a fall.

Myth 1: Falling happens to other people, not to me.

Reality: 1 in 3 older adults—about 12 million—fall every year in the U.S.

Myth 2: Falling is something normal that happens as you get older.

Reality: Strength and balance exercises, managing your medications, having your vision checked and making your living environment safer are all steps you can take to prevent a fall.

Myth 3: If I limit my activity, I won't fall.

Reality: Performing physical activities will actually help you stay independent, as your strength and range of motion benefit from remaining active. Social activities are also good for your overall health.

Myth 4: As long as I stay at home, I can avoid falling.

Reality: Over half of all falls take place at home. Inspect your home for fall risks. Fix simple but serious hazards such as clutter, throw rugs, and poor lighting. Make simple home modifications, such as adding grab bars in the bathroom, a second handrail on stairs, and non-slip paint on outdoor steps.

Myth 5: Muscle strength and flexibility can't be regained.

Reality: While we do lose muscle as we age, exercise can partially restore strength and flexibility. It’s never too late to start an exercise program.

Myth 6: Taking medication doesn't increase my risk of falling.

Reality: Taking any medication may increase your risk of falling. Medications affect people in many different ways and can sometimes make you dizzy or sleepy.

Myth 7: I don't need to get my vision checked every year.

Reality: Vision is another key risk factor for falls. Aging is associated with some forms of vision loss that increase risk of falling and injury. People with vision problems are more than twice as likely to fall as those without visual impairment. Have your eyes checked at least once a year and update your eyeglasses.

Myth 8: Using a walker or cane will make me more dependent.

Reality: Walking aids are very important in helping many older adults maintain or improve their mobility. However, make sure you use these devices safely. Have a physical therapist fit the walker or cane to you and instruct you in its safe use.

Myth 9: I don’t need to talk to family members or my health care provider if I’m concerned about my risk of falling. I don’t want to alarm them, and I want to keep my independence.

Reality: Fall prevention is a team effort. Bring it up with your doctor, family, and anyone else who is in a position to help. They want to help you maintain your mobility and reduce your risk of falling.

Myth 10: I don't need to talk to my parent, spouse, or other older adult if I’m concerned about their risk of falling. It will hurt their feelings, and it's none of my business.

Reality: Let them know about your concerns and offer support to help them maintain the highest degree of independence possible. There are many things you can do, including removing hazards in the home, finding a fall prevention program in the community, or setting up a vision exam.

Source: National Council on Aging