Answers for Seniors

Take The Time To Evaluate Your Medicare Drug Benefits

2008-11-25T17:56:00.004-05:00

Medicare Prescription plans are changing for 2009. Each company offering Part D plans have made changes to their plans for next year. Medicare has approved each change. The question to ask is, "With my existing 2008 plan, am I going to pay more in 2009 than I have to for Medicare Drug coverage?"

I have listed two ways to answer that question. Even if you have been satisfied with your benefits during 2008, take the time to evaluate your plan for 2009. Seniors are not required to change, but may find it financially beneficial to do so.

NOW IS THE TIME TO EVALUATE YOUR PLAN. Open Enrollment will end December 31, 2008.

Many plans have increased monthly premiums, increased certain medicine co-pays, and even changed the drug formulary (list) itself. Use this free tool to evaluate your current plan and see any changes it may have for 2009. If another will be less expensive in premiums or lower your co-pays, you can enroll by phone or online after the analysis.

HERE ARE TWO WAYS TO INDEPENDENTLY ANALYZE THE 2009 PLANS.

1) Call 1-866-955-2022. A knowledgeable and helpful attendent will assist you.

2) Click the web link below to enter your specific medicines and what different plans will cost.

http://plancompare.destinationrx.com/intermediate.aspx?aid=answers

New Marketing Rules for Medicare Plans

2008-11-08T22:20:00.002-05:00

Medicare has enacted several new rules regarding marketing techniques during Medicare Open Enrollment. These rules further define the steps insurance agents are allowed to take to market and enroll beneficiaries. Important changes are as follows:

Absolutely No Cold Calling. All contacts with prospects must be pre-approved by the beneficiary. Don't allow anyone initiate contact without a senior asking for it.

Plans and agents can't provide full meals at seminars. Refreshments are permitted, but full meals were being used to "buy" contracts.

Prospect meetings are to be limited to one topic. Discussions of other topics, like annuities, during an Medicare Advantage appointment should not happen until another time at least 48 hours later.

While these rules are very limiting to the sales of Part D and MA plans, agents who are honest and customer-focused will continue to do well. Dishonest agents hopefully will leave the industry. Seniors will be better served.

Increased Growth In After-Hours Clinics

2008-11-08T05:07:00.001-05:00

Competition, patient demand are fueling growth in after-hours clinics. Doctors are expanding hours to accommodate the demands of busy, informed patients—and combat competition from retail health clinics popping up in drugstores such as Walgreens and CVS. "Given the choice, most patients who have a regular physician would prefer to see them on extended hours than go elsewhere for treatment," said Doug Henley, CEO of the American Academy of Family Physicians. "It’s moving to a more patient-centric (business) model rather than a physician-centered model," Henley said. Read the full article from the Kansas City Star.

State Specific Report Shows Increasing Health Insurance Costs

2008-11-08T05:06:00.004-05:00

Families USA has released a series of state-specific reports showing the rising cost of health insurance premiums compared with median family income. In Alabama, for example, annual premiums for employer-sponsored family coverage rose 79% between 2000 and 20007, while median worker earnings rose 17%. The reports’ findings are based on data from the U.S. Census Bureau and departments of Labor and Health and Human Services.

New Treatments Drive Up Spending On Diabetes

2008-11-08T05:06:00.003-05:00

Annual U.S. spending on prescription drugs to treat diabetes rose 87% between 2001 and 2007. A study in the Oct. 27 Archives of Internal Medicine revealed total annual expenditures for diabetes medications rose from $6.7 billion in 2001 to $12.5 billion in 2007, while the average drug price per prescription rose from $56 to $76. Estimated patient visits to office-based physicians for type 2 diabetes grew from 37 million in 2000 to 45 million in 2007.

New Approach to Medical Costs

2008-11-08T05:04:00.001-05:00

Americans spend more than $265 billion a year out of pocket on healthcare and pile up medical debt, struggle to pay it off and sometimes end up in financial ruin. Now Haddam, CT-based Criterion Ventures is creating a new approach to dealing with those costs. Criterion's idea is to weave together private and public sources of payment, negotiate discounts on hospital and doctor care, and load it all onto a hybrid debit-credit card. Criterion believes the project will help people avoid drowning in medical debt and could also reduce bill collection hassles for care providers. Read the full article from the Hartford Courant.

Are Alternative Medicare Plans Reducing Costs?

2008-09-16T12:15:00.002-04:00

Private Medicare Advantage plans will be paid an average 12.4% more per enrollee in 2008 than the same enrollee would have cost in the traditional Medicare fee-for-service program, according to a new report from the Commonwealth Fund. I wanted to post this report to inform the public of the continued debate over the course of Medicare. In any study, one should question the calculations that are used to determine the results. I, personally, like the fact that seniors have a choice in receiving their healthcare insurance. The Medicare Modernization Act of 2003 has attempted to bring Medicare into today's behaviors and mindset. As the financial impact is calculated and debated, continue to be aware of these issues. Seniors can have a louder voice when informed about the issues. Take time to educate yourself or risk allowing others to make your decisions for you.

Study of Trends in Health Insurance

2008-09-16T12:14:00.002-04:00

A new report from the Employee Benefit Research Institute examines trends in health insurance coverage and the factors that affect coverage, including the strength of the economy. "While the percentage of the non-elderly population with employment-based health benefits was unchanged between 2006 and 2007, and the percentage with public coverage increased, resulting in a decrease in the uninsured, this should not be viewed as an indicator of things to come in 2008," the authors note. "As compared with 2007, unemployment was higher in 2008, meaning fewer individuals will have access to health insurance through a job, and gas and food prices were higher, meaning more individuals will have to choose between health insurance coverage and basic necessities."

Reducing Insurance Options For Seniors

2008-07-04T00:20:00.003-04:00

After the Independence Day recess, Congress will resume debate over cuts and changes to Medicare. Physicians and senior citizens stand to lose if cuts are passed. Many in Congress seem to want to limit the options that seniors now have to receive health insurance through Medicare Advantage plans. Allowing private insurance companies to administer benefits appears to threaten the "government should do it all" viewpoint.

I am probably the only insurance agent working with seniors who has sought out the opinions of hospital intake staff and physician billers regarding Medicare Advantage. Feedback from those who bill for medical services has been very positive. Access to doctors is, in my opinion, a non-issue. Sadly, my " insurance colleagues" have brought criticism on this program because of selfish sales practices. Medicare is right to monitor the industry for "abuses" Don't penalize seniors, however. I don't recommend this program for every senior, but I like being able to give people options as they make health insurance decisions. Please stay informed on HR 6331. Let your opinion be heard. www.house.gov www.senate.gov

Diabetes On The Rise

2008-07-04T00:12:00.002-04:00

An estimated 24 million Americans had diabetes in 2007, an increase of more than 3 million in about two years, according to data released recently by the Centers for Disease Control and Prevention. Another 57 million people are estimated to have pre-diabetes, a condition that puts people at increased risk for diabetes. Among adults, diabetes increased in both men and women and in all age groups, but still affects the elderly most. Almost one-quarter of Americans 60 and older had diabetes in 2007. Creating a culture of wellness and prevention is key.

Anxiety and Elders

2008-06-29T22:20:00.002-04:00

Most of the recent posts to this site have been reports of pertinent studies. All the recent postings detail trends in healthcare, not only for seniors, but also the population as a whole. However, this post is more personal. Working in the eldercare industry, I have seen plenty of anxiety among the senior population. However, in the last several weeks, I have witnessed a heightened level of anxiety in my parents and parents-in-law. When it is close to home, it is difficult to handle. However, the same strategies hold true no matter the person.

I hope this posting will begin a dialogue between those of us facing this anxiety issue among our loved ones. My advice when facing a situation of heightened anxiety among your parents is compassion. Inquire of the person what they are feeling and why they feel this way. Of course, ask these questions in a non-threatening or judgemental way.

One thing I know is that it can be frustrating to deal with a person you feel is worrying about nothing. Take each situation with patience and understand that much of this behavior is a result of some other variable. Be truthful. Be patient. Try to expand your vantage point to gain some perspective.

Please share your thoughts by clicking on the comment line on this entry. Lets get a dialogue started to help others.

Fewer Small Businesses Offering Group Health Insurance

2008-06-29T22:05:00.003-04:00

More than 65% of businesses with 10 or fewer employees say high cost is the most significant barrier to their offering health insurance, according to a survey released by the National Association for the Self-Employed. Only 19% of businesses with 10 or fewer employees currently offer coverage for full-time employees, down from 46% in 2005. One in 10 respondents spent 25% or more of their gross revenue on health insurance, up from 10.1% in 2005. NASE called access to health care the single biggest barrier to people joining and remaining in the ranks of the self-employed. Read the press release.

New Rating System For Nursing Homes

2008-06-29T21:57:00.001-04:00

Acting Administrator of the Center for Medicare/Medicaid Services Kerry Weems announced that CMS will add a nursing home ranking system to its Nursing Home Compare Web site in December. “The new ‘five-star’ rating system will provide a composite view of the quality and safety information currently on Nursing Home Compare to help beneficiaries, their families and caregivers compare nursing homes more easily,” said Weems. The agency said it plans to work with other health care providers and consumers to make similar rating systems available for hospitals. Read more with the CMS announcement.

Health Savings Accounts Increasingly Popular

2008-05-18T23:16:00.002-04:00

More than 6.1 million Americans were covered by Health Savings Account-eligible insurance plans in January 2008, America’s Health Insurance Plans reported yesterday. That’s 1.6 million more people than in January 2007. The average annual deductible was $2,600 for single coverage and $4,846 for family coverage, while the average annual out-of-pocket limit was $3,661 for single coverage and $7,057 for family coverage. HSA products accounted for 31% of new coverage issued in the small-group market, and 27% of new purchases in the individual market, AHIP said.

Rate Of Growth For Family Coverage Premiums Eclipses Income

2008-05-18T23:15:00.003-04:00

The amount employees pay for family coverage increased an average 30% between 2001 and 2005, according to study released today by the Robert Wood Johnson Foundation. That’s 10 times the average pay increase for family policyholders over the period, the study adds. “As costs continue to go up, fewer people can pay their portion of the premium, and fewer employers are able to offer insurance benefits,” said RWJF President and CEO Risa Lavizzo-Mourey, M.D. “This research shows that an ever-increasing number of people will join America’s uninsured unless our nation’s leaders act to reform our health care system.” The study was released in conjunction with Cover the Uninsured Week (April 27-May 3), an annual campaign led by RWJF to raise awareness about the 47 million Americans without health insurance. The AHA is a national partner in the campaign, which includes events to help those who are eligible enroll in low-cost or free health coverage programs.

Recent Congressional Actions On Medicare

2008-04-07T00:28:00.001-04:00

As required by the 2003 Medicare Modernization Act, House and Senate leaders yesterday introduced legislation proposed by the administration to respond to a Medicare funding warning issued by the program’s trustees last April. According to the administration, the legislation (H.R. 5480/S. 2662) takes an approach to strengthening Medicare that includes limits on means testing for Part D premiums and medical liability costs; improved health information technology and electronic medical records; transparency in price and quality information; and incentives for providers to deliver and Medicare beneficiaries to choose high-quality, low-cost health care. At the same time, the president’s fiscal year 2009 budget proposes more than $182 billion in cuts to the Medicare program over five years, $137 billion of which would come from hospitals.

Good News About Cognitive Health

2008-02-29T08:10:00.001-05:00

Rates of cognitive impairment among Americans over 70 are on the decline, according to a new study supported by the National Institutes of Health. Researchers tested memory and judgment among people age 70 and older and found cognitive impairment dropped from 12.2% in 1993 to 8.7% in 2002. They found higher levels of education were associated with better cognitive health, but said more research is needed to pinpoint the factors influencing the ability of older Americans to think, learn and remember. Read more by clicking on the study link.

More Seniors Living With Heart Failure Condition

2008-02-29T08:07:00.000-05:00

The number of Medicare patients living with heart failure rose from about 140,000 in 1994 to 200,000 in 2003, according to a study in the Archives of Internal Medicine. “Identifying optimal strategies for the treatment and management of heart failure will become increasingly important as the size of the Medicare population grows,” the authors conclude. The proportion of beneficiaries with a heart failure diagnosis grew from 90 per 1,000 in 1994 to 120 per 1,000 in 2003. Although the mortality rate declined slightly over the period, more than 60% of patients die within five years of diagnosis, the report's authors said.

Diabetes Among Senior Population Is Increasing

2008-02-16T00:01:00.001-05:00

The annual number of Americans aged 65 and over diagnosed with diabetes increased 23% between 1993-1994 and 2003-2004, according to a study in the Archives of Internal Medicine (2008;168:192-199). The study used Medicare claims and other data to examine trends in the rates of diabetes and its complications. One-quarter of Medicare beneficiaries 65 and over had diabetes in 2003, up from 15% in 1994. The death rate for patients diagnosed with diabetes declined 8.3% over the period when compared with those who were not diagnosed with the disease. Most patients with diabetes experienced at least one complication within six years of diagnosis; for example, almost half had congestive heart failure. “For Medicare, the message is that the increased burden of diabetes will contribute to increased budgetary pressures in the future,” the authors said.

Diabetes Association Estimates Diabetes Costs Nation $174 Billion Each Year

2008-02-15T23:57:00.003-05:00

A new report from the American Diabetes Association estimates diabetes cost the nation $174 billion in 2007. The estimate includes $116 billion in excess medical expenditures and $58 billion in reduced national productivity, according to the report by the Lewin Group. Medical costs attributed to diabetes include $27 billion for care to directly treat diabetes, $58 billion to treat chronic complications attributed to diabetes, and $31 billion in excess general medical costs. Hospital inpatient care accounted for half of the estimated medical expenditures. On average, medical expenditures are more than twice as much for patients with diabetes, the study estimates. As of 2007, 17.5 million U.S. residents have been diagnosed with diabetes, the study estimates, up from 12.1 million in 2002. “The burden of diabetes is imposed on all sectors of society – higher insurance premiums paid by employees and employers, reduced earnings through productivity loss, and reduced overall quality of life for people with diabetes and their families and friends,” the report concludes

Retail Health Clinics On The Rise

2008-02-13T09:34:00.002-05:00

Expect to see more "You're sick, we're quick" clinics coming your way. There are now nearly 1,000 U.S. retail clinics in the U.S., operating in 36 states, according to a study by Verispan. The fastest growing player in the sector is Minute Clinics, which are operated by CVS Caremark. You can read a news article about the study here. http://www.healthcarefinancenews.com/story.cms?id=7520

Medicare Spending Increases Due To Prescription Drugs

2008-01-13T18:19:00.000-05:00

Medicare spending grew 18.7% to $401.3 billion in 2006, as prescription drug spending shifted to Medicare from Medicaid and private coverage, the Centers for Medicare & Medicaid Services reported today. That’s the largest annual increase in Medicare spending since 1981 and twice the growth seen in 2005. Total U.S. spending for hospital care grew 7.0% in 2006 to $648.2 billion, down from a 7.3% increase in 2005, as growth in the underlying cost of hospital services slowed to 4.1% from 4.3%, CMS said. Spending for physician and clinical services grew 5.9% in 2006 to $447.6 billion. That’s down from 7.4% in 2005, due in part to a freeze in Medicare payments. The report appears in the January/February issue of Health Affairs.

Disability Due To CHF

2008-01-13T18:11:00.000-05:00

Congestive Heart Failure is leading to greater likelihood of disability among older adults. Medical breakthroughs in recent decades have allowed heart attack survivors and other heart-disease patients to live longer. But as their hearts decline into congestive heart failure, an increasing number will experience disability and the need for nursing-home care. A new study from the University of Michigan Health System and the VA Ann Arbor Healthcare System sheds light on the degree of disability among people with CHF, as well as the implications for the health care system, community care facilities, families and the patients themselves. Click link for full article.

http://www.chipsnetwork.com/newsstory.asp?article=6190&sid=877912

Drug Plan (PDP) Shopping

2007-11-14T00:44:00.000-05:00

Even if you are satisfied with your Medicare Drug Plan from 2007, it is wise to evaluate your plan and other options for 2008. Beginning November 15 Medicare recipients have an Annual Enrollment Period. After that date, seniors can make changes to the drug insurance and also their
health plan coverage. That enrollment period ends December 31 and coverage begins January 1, 2008. To date, about 8.3 million people nation-wide have elected to have a Medicare Advantage Plan as a replacement for their Medicare supplement. It does work different that the original Medicare benefit structure. The key is to determine if it is right for you.

Many prescription drug plans are slated to take increases in premium. Others have dropped a plan or removed a covered drug from the plan formulary. "As much of a hassle as it is, (shopping around) could save you thousands of dollar. You could be horribly surprised in January if you don't check now." This is a quote from Bill Vaughan, senior policy analyst for Consumers Union.

The Formulary Finder on www.Medicare.gov will give you an independent review of how each plan covers your individual medications. The PDP plan websites can also provide answers to "How much is it?" and "What does it cover?" Take some time to review your options for 2008.

Reviewing your benefit options can give you peace of mind that your plan will cover your 2008 medications and do so with the lowest premiums and co-pays available.

2008 Medicare Figures

2007-11-14T00:30:00.000-05:00

By now most people on Medicare have received their 2008 Medicare and You Handbook. If not, a call to Medicare (1-800-Medicare) will be able to secure a copy of this important guidebook. Like every prior year, there are changes to the out-of-pocket amounts seniors will pay towards their medical care. The following is a list of these changes:

Part B (Doctor Visit) premium increased from $93.50 to $96.40.
Part B deductible increased from $131 to $135.
Part A (Hospital) deductible increased from $992 to $1024

Also, Part B premiums are now subject to means testing. This means higher income seniors (those earning $80,000) will receive higher Part B premium.

These are a few changes to Medicare for 2008. A complete listing of changes can be gained from the Medicare and You Handbook.

Out-Of-Pocket Spending Increases For Medicare Beneficiaries

2007-11-01T23:18:00.001-04:00

A growing share of Medicare beneficiaries' income was spent on health care, with median out-of-pocket health spending up from 11.9% of income in 1997 to 15.5% in 2003, according to a new study published in the November/December 2007 issue of the journal Health Affairs.

The study found that about four in 10 beneficiaries spent at least one-fifth of their income on health care in 2003. The top 10% of beneficiaries spent more than half of their income on health care. The study found that growth in out-of-pocket health spending outpaced growth in income over time. Between 1997 and 2003, median out-of-pocket health spending increased by $1,116 — a 50% increase, while median individual income rose by just 15%. Premiums for Medicare and supplemental insurance were the largest component of the increase, followed by payments for medical care providers and services.

Spending on prescription drugs accounted for a relatively small share of total out-of-pocket health spending in 2003 (13.7%), but accounted for 18.1% of the out-of-pocket spending increase between 1997 and 2003. The authors note that it is too early to determine the effect of the Medicare Part D drug benefit on the overall financial burden of health care spending by Medicare beneficiaries. The article can be found at www.kff.org/medicare/med110107oth.cfm.

1 in 7 Older Americans Has Dementia

2007-11-01T23:12:00.000-04:00

According to the National Institutes of Health, an estimated one in seven Americans over 70 have dementia, including 2.4 million who have Alzheimer’s disease, according to a new study funded by the National Institutes of Health. “As the population ages during the next few decades, the prevalence of Alzheimer’s disease will increase several-fold unless effective interventions are discovered and implemented,” said Richard Hodes, M.D., director of the National Institute on Aging. “These data underscore the urgency of research in this area.”

Impact Of Chronic Disease on America

2007-10-13T11:50:00.000-04:00

A new study released from the Milken Institute called, "An Unhealthy America: The Economic Burden of Chronic Disease," says that chronic diseases such as diabetes and hypertension costs the U.S. economy more than $1 trillion, and could reach nearly $6 trillion by the middle of the century. Most of that total was a result of lost work days and reduced job productivity. The study recommends that "employers, insurers, governments, and communities work together to develop incentives for patients and health care providers to focus on disease prevention." Seniors and the senior healthcare system are particularly impacted by chronic disease. Over 162 million cases of seven common chronic diseases - cancers, diabetes, heart disease, hypertension, stroke, mental disorders, and pulmonary conditions - were reported in the United States in 2003.

Health Care Cost and Access Challenges Persist Across the Country

2007-10-05T23:49:00.000-04:00

Little has changed in local health care markets since 2005 to break the cycle of rising costs, declining insurance coverage and widening access inequities, according to initial findings from HSC's 2007 site visits to 12 nationally representative metropolitan communities. Two years ago, HSC researchers identified several troubling trends warning of growing cost and access problems, including a hospital building boom; intense competition among hospitals and physicians to expand profitable specialty services; growing stress on community safety nets; and few cost-control strategies on the part of employers and health plans. For the most part, those trends continued into 2007, although employers and health plans have stepped up efforts to engage consumers and the hospital building boom appears to have abated somewhat.

Issue Brief No. 114

Long Term Uninsured Continues to Grow

2007-10-05T23:41:00.000-04:00

An estimated 17.4 million Americans under age 65 were uninsured for the entire four-year period from 2002 to 2005, according to a new report from the Agency for Healthcare Research and Quality. About one-fourth of them were poor, living at or below the federal poverty level, and almost one-third were middle income, in families earning between 200% and 400% of the FPL. Hispanics and those reporting fair or poor health were among those most likely to be uninsured

Added Value to Long Term Care Policies In Virginia

2007-09-19T22:46:00.000-04:00

As of September 1, 2007, Virginians are able to purchase a new type of long-term care (LTC)
insurance policy- a LTC Partnership policy.
The LTC Partnership is an alliance between the private insurance industry and Virginia state government to help Virginians afford future long-term care services without depleting all of their assets to pay for care. LTC Partnership policyholders who use their LTC Partnership insurance policy benefits and who eventually apply for Medicaid coverage are able to maintain some level of assets (equal to the LTC insurance benefit paid) above the $2,000 Medicaid asset limit currently in placefor eligibility purposes. Click the link below to find out more.

www.valtcpartnership.org

Memory Loss May Predict Alzheimer's Disease

2007-09-19T22:18:00.000-04:00

A study being reported in the September 12, 2006, issue of Neurology, finds that adults over the age of 60 who complain of severe memory problems may actually be losing brain tissue. Despite scoring well on standard memory tests, the adults in the study who complained of significant memory loss were found to have loss of grey matter of about 3% on MRI brain scans. Patients diagnosed with mild cognitive impairment (early Alzheimer's ) show about 4% loss of brain tissue in the same areas of the brain - the areas where memory is stored.

www.neurology.org

Fruit Juice May Prevent Alzheimer's Disease

2007-09-19T22:15:00.000-04:00

A study published in the American Journal of Medicine finds that seniors who drink fruit or vegetable juices at lease three times a week lower the risk of developing Alzheimer's Disease by 76 percent. The researchers credit the high levels of polyphenols in juices as being responsible for these findings. The antioxidant action of polyphenols (found mainly in the skins of fruits and vegetables) is well noted in other studies.

Cuts to Medicare Advantage Off The Table

2007-09-19T21:20:00.000-04:00

Congressional negotiators have agreed not to include revisions to Medicare in compromise SCHIP (State Children's Health Insurance Program) legislation that would reauthorize and expand the program, and lawmakers could vote on compromise legislation next week.
The draft compromise bill, announced on Sunday, closely resembles the Senate version of SCHIP legislation, which would provide an additional $35 billion in funding over the next five years and bring total spending on the program to $60 billion. The additional funding would be paid for by an increase in the tobacco tax, which would be similar to the 61-cent-per-pack tax proposed in the Senate version.
The compromise bill does not include provisions of the House bill that would reduce payments to Medicare Advantage plans to help fund an expansion of the program, leaving a cigarette tax increase as the primary funding source for the legislation.
To many people this is a complicated and unconcerning issue. This legislation has a far-reaching impact on the healthcare issue in America. The political parties are using it to "draw a line in the sand." Each will try to make use of it in upcoming elections.
For seniors however, it appears that Medicare Advantage plans will remain unaffected. This means that seniors, many of whom could not afford and did not have, a Medicare supplement, will continue to benefit from lower cost MA plans. All Medicare beneficiaries will have this option available to them. Options are a good thing.

Senior Health Benefits Enrollment Coming Soon

2007-09-11T23:22:00.000-04:00

Medicare Advantage or in 2008 renamed "Medicare Part C" will have its open enrollment starting November 15, 2007. The Annual Election Period (AEP) runs from November 15 until December 31, 2007. During that time, Medicare beneficiaries have the opportunity to make changes to their Part D drug benefits. In addition, seniors can enroll into Part C medical insurance replacing traditional Medicare/Medigap coverage.

Insurance carriers that voluntarily suspended sales of Medicare Advantage this summer are resuming sales. Agents will begin to market products for 2008 on October 1, 2007. However, applications cannot be taken until November 15. Details of any changes to the policies will be forthcoming.

Ideas To Keep Us Thinking

2007-09-11T13:30:00.000-04:00

"Use it or Lose it" is a phrase we sometimes hear. Often we think about physical health and muscle usage. What about our minds? Retirement brings thoughts of less worries, less thinking about schedules and tasks. Seek ways to keep mentally stimulated.

Research has shown, to no surprise, that mental stimulation is beneficial to the aging process. Cognitive challenges can even help reduce the risk of dementia. So what can be done to accomplish this task. Here are a few suggestions:

1) Check with the local high school or college for classes for older adults.

2) Many seniors have overcome the fear of computers and now play games, send e-mails, and
organize files with the best of us.

3) Volunteer opportunities with the hospitals and local elementary schools. As the husband of a
first grade teacher, I know there is a need.

4) Church ministry.

5) Crosswords, Brain Teasers and Word Search - often visual impairment limits use of these but
there are many products that solve that problem

6) If a senior in your care resides in a nursing home, ensure that the Activities Director is
making maximum use of mental stimulation exercises to promote the best quality of life.

Below are helpful links to products and services for the above suggestions.

www.henrico.k12.va.us/adulteducation
www.bonsecours.com/bsrichmond/volunteeropps.asp
www.co.hanover.va.us/commres/volsvcs.htm
www.firststreetonline.com/category.jsp?id=57905

Check Your Social Security Statements

2007-09-11T13:05:00.000-04:00

Starting in 2000, the Social Security Administration (SSA) began mailing personalized statement annually to all workers age 25 or older who have worked in employment or self-employment covered by the Social Security system. These statements normally arrive about 3 months before a worker's birthday. Most people focus on the benefit estimate, because they are naturally interested in how much Social Security expects to pay them at retirement or if they become disabled or, if they die, how much their survivors can expect to receive. The statement also includes a record of the worker's lifetime earnings reported to Social Security, and that part of the statement is too often overlooked.

Every worker covered by Social Security pays Social Security taxes. These taxes are matched by the employer dollar-for-dollar. In fact, most American families pay more in Social Security taxes each year than they pay in Federal income taxes, partly because Social Security taxes apply to covered wages and salaries from the first dollar, without any deductions or exemptions. In return for paying these substantial taxes, workers are supposed to get credit for the appropriate amount of Social Security-covered earnings. Those earnings are used by SSA to compute any retirement, disability or survivors benefits to which workers and their families may become entitled. Most earnings reported to SSA are properly credited.

Unfortunately, some are not, for a variety of reasons. Incorrect reporting of the amount of earnings is relatively uncommon. Much more common is the failure to post any earnings for a year. Most such omissions are the fault of workers or employers, who must report all earnings to SSA on Form W-2. If an employer uses the incorrect Social Security number for an employee, then SSA cannot determine who should get credit for the earnings. Many workers have similar names. If a worker changes his or — much more commonly — her name without reporting the change to SSA, then the name and number will not match SSA's records, and the earnings will not be posted. Sometimes the government makes mistakes, too.

Check those statements. Mistakes and ommissions can result in reduced benefits. Mistakes can be caught and corrected. Complete omissions of earnings for a year can always be corrected, if the worker provides evidence of the correct figure. Be alert in your financial planning

Update On Changes to Seniors' Healthcare

2007-08-20T21:17:00.000-04:00

The Children's Health and Medicare Protection Act of 2007 passed both Houses of Congress and is currently being reconciled by a joint committee. This has a far reaching impact on many segments of the U.S. population. the State Childrens Health Insurance Program (SCHIP) is a national program in the U.S. designed for families who earn too much money to qualify for Medicaid, yet cannot afford to buy private insurance. The program was created to address the growing number of children in the United States without health insurance. At its creation in 1997, SCHIP was the largest expansion of health insurance coverage for children in the United States since Medicaid began in the 1960s. In an expansion of this program, Congress has targeted ways to pay for the additional $35 billion price tag. Medicare Advantage, started as a means to reform senior healthcare not only will now be called Medicare Part C, but also will lose millions in support. Payments by CMS to insurers to administer benefits will by cut. This may result in higher premiums for seniors seeking healthcare in this form. To date, about 8.3 million seniors carry insurance through a Medicare-approved private carrier. The argument on one side is that it will adversely affect the poorest of seniors who relied on this program to keep insurance costs down. The supporters of S-CHIP expansion claim that Medicare Advantage payments to contractors is corporate welfare.

Second, increased excise taxes on tobacco are being proposed to offset the increased costs to SCHIP. Particularly, cigar smokers are going to pay much higher prices for their pasttime. You may have seen commercials advocating for the expansion of SCHIP. Commercials are now coming out to oppose Part C cuts. I don't know an easy answer, but careful evaluation must ask if one group's interests should be pited against another. I will try to continue to track this for the blog readers.

Understanding The Risk Of Disability

2007-08-06T16:29:00.000-04:00

Disability is a risk that most Americans still don't consider or understand. In insurance language, short-term disability (STD) is two years and under, while Long-Term Disability (LTD) is beyond two years to permanent. Unlike pre-mature death (unpleasant but important topics), a result of disability is that a person's expenses increase while their income stops.
More than 500,000 individuals received long term disability insurance payments from private companies in 2006 according to the Council for Disability Awareness. Those payments totaled $7.2 billion, an increase of about 7% from 2005. This does not include the $80 billion paid by the Social Security Disability Insurance program (SSDI) to 6.8 million people. SSDI payments have increased 105% since 1996.
The major misconception is that Social Security will be the safety net in case of disability. In fact, 2006 statistics show that only 39% of the 2.1 million workers who filed for SSDI benefits received approval. The following are some other facts regarding disability and a helpful website to learn more.

Disability rate among women is growing faster than men.
Women now account for 47% of all SSDI receiptants.
Musculoskeletal disorders accounted for 25% of all LTD causes followed by Cancer and Stroke.
Only 8% of new LTD claims were accident/injury related.

www.disabilitycanhappen.org

Medicare Advantage Cuts Possible

2007-08-01T17:46:00.000-04:00

Congress is debating the idea of cuts to the Medicare Advantage program established with the Medicare Modernization Act of 2003. Some members of Congress are seeking to use cuts in Medicare Advantage to provide additional funding of (S-CHIP) State Children's Health Insurance Program. To date about 8.3 million seniors receive their coverage through Medicare Advantage. Whether you choose this way or not, it has given seniors more options for healthcare. Options are good in the marketplace. I believe this is a program that should be allowed to grow if it will help the Medicare "crisis" America faces. I am providing a link to a site to voice your opinion. I will try and have more information on these developments to come.

http/www.protectyouradavantage.org

Family's Reaction to Loss of Independence

2007-07-27T18:33:00.000-04:00

Many of my entries previously have been statistics and news stories about health insurance and medical matters. Many have linked to helpful websites that broaden knowledge about these issues. However on my mind recently is my own family's situation. I hope that by regularly reporting from my own family, it can help spur discussion among others. I know many families face the same difficulties. Please share from your own experiences as I know it will help other families cope.

My mother suffers from Muscular Dystrophy and that has tremendous impact on her mobility. In the course of the last year she has had to install a chairlift in her home, give up driving, and could not make it down to the beach on our recent vacation. I and my sisters need to recognize the sense of loss that she feels due to this loss of independence. She commented the other day on her frustration that her freedom has diminished because she is not driving. As a whole, familes need to recognize these feelings, but also focus on "abilities." I know that this is an issue my family faces daily now. Linked to this entry are several helpful handouts discussing aging issues and coping with them. Check it out and add comments from you experiences.

Cornell CARES Patient Handouts

Loss Of A Good Friend

2007-07-24T01:12:00.000-04:00

I saw in the obituaries the other day that Charles "Mac" Boswell passed away at the age of 83. To most reading this entry, this really doesn't mean much. Perhaps someone from Mechanicsville, checking this site, knew Mac or at least recognizes his name. Mac was the first resident I met in the nursing home industry and he left an indelible mark on me.

I was hired in 1999 as the Business Office Manager of Henrico Healthcare Center. I walked into the lobby the first day and came face-to-face with Mac Boswell. This was a new experience for me and I was a bit apprehensive. Mac, siting in his wheelchair, was telling the nurses to assist his mother into the day room common area for lunch. Seeing Mac as elderly himself, I could not believe his mother was also at Henrico Healthcare. I thought he was just another older person with dementia. I was so wrong. Turns out, he and his mother shared a room and had done so for several years. Mac was 75 years old at the time and his mother was 95.

Mac and I became good friends while I was there. His mind was sharp, but his body had been stricken with cerebral palsy since birth. Over the years, he had developed great relationships with many in Mechanicsville. We had talks about his boyhood and the changes he had seen in Mechanicsville, our hometown, over the course of his life. His mother had cared for him throughout his life. When she was unable to care for herself and him, Mac went with his mother to live in the nursing home. I learned a great deal from Mac Boswell, but nothing more important then to treat everyone as valuable. All seniors have needs and desires and have something to add to the discussion of many of these issues. Everyone has worth because of who they are, not what they do. From the first day, I found some real gems amongst the residents living in nursing homes. I continue to visit several homes in the Richmond, VA area on a regular basis with my dog performing pet therapy.

The book of Hebrews 13:2 has become very real for me and I want others to understand its instruction. This passage says, "Be careful to entertain strangers, for by doing so, you entertain angels unaware." Mac Boswell was one of those people that I took the time to get to know. I am so glad I did.

Bill Seeks Parity For Mental Health Services

2007-07-24T01:06:00.000-04:00

The House Education and Labor Committee voted 33-9 today to pass the Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424), bipartisan legislation prohibiting group health plans from imposing greater coverage limits on mental illnesses than on physical ailments. The House Ways & Means and Energy & Commerce Committees, which also have jurisdiction, must mark up their own versions of the bill and reconcile them with the Education and Labor Committee version before the measure can be sent to the House floor.

Mental Health services have always required higher deductibles or have been paid out at lower levels than other medical services by the insurance industry. This bill seeks to provide parity for mental health procedures and the people who unfortunately suffer from these disorders. I will continue, like other aging related topics, to track current legislation affecting this matter.

Heart Disease Ranks As Top Reason For Hospitalization

2007-07-24T00:48:00.000-04:00

Heart disease was the top diagnosis for patients hospitalized in 2005, representing 4.2 million hospital discharges, according to a new report from the Centers for Disease Control and Prevention. The report is based on data from the 2005 National Hospital Discharge Survey. Other leading diagnoses were childbirth (4 million), psychoses (1.7 million), pneumonia (1.4 million), malignant neoplasms (1.2 million), and fractures (1 million). The average length of stay was 4.5 days for heart disease, 2.6 days for childbirth, 7.6 days for psychoses, 5.3 days for pneumonia, 6.8 days for malignant neoplasms and 5.3 days for fractures. Excluding newborns, an estimated 34.7 million inpatients were discharged from non-federal short-stay hospitals in the U.S. The rate of hospitalization for septicemia increased significantly among seniors from 2000-2005, from 61.7 per 10,000 people to 90.8 per 10,000, the report notes.

Ramp Builders Needed To Help Seniors

2007-07-24T00:09:00.000-04:00

This is a direct call to action to help seniors. A group of men in Hanover County, VA serve seniors by building ramps. John Munn (804-746-8483) is the leader of this group. They are a group of retired carpenters and tradesmen who minister to seniors by supplying them with ramps at their houses. I know this because they built one off the back porch of my parents' home. If it weren't for their generosity, my parents would have had to have moved into a more handicapped accessible residence. This ramp has given my mother, who suffers from muscular dystrophy, the ability to "age in place." I am very thankful for their ministry.

I am asking those who read this entry to consider starting a team of ramp builders. Mr. Munn told me there are more requests than his group can handle. He is actively seeking volunteers to start teams. He secures wood and materials from donations and uses volunteer skilled labor. Mr. Munn can help churches develop this type of ministry. He is actively working all over Richmond, VA to help additional groups get started. If you are skilled in carpentry, please consider this as your way to serve our seniors. Call Mr. Munn to get started.

Education On Aging Issues Reduces Family Stress

2007-07-19T08:53:00.000-04:00

Part of my motivation for creating and maintaining this blog is to foster discussion among children of seniors. From my days at Hanover Healthcare as the Admissions Director, I know people are dealing with the issue of aging parents. While there, I admitted over 600 people to the nursing home, most on a temporary basis. One thing was common to most of those admissions. Decisions were made while a family was in "crisis mode." Strokes and hip fractures were completely unexpected touching off a chain reaction of events and decisions. "What care is needed?, Who provides it?, How do we pay for it?" are some of the questions asked at that time. Families get a quick and completely unexpected education about these issues whether they want it or not. They are forced, for the sake of Mom or Dad, to move quickly through the phases of disbelief, denial and acceptance of current circumstances.

No one will ever fully be ready to handle these expected events relating to seniors. I speak from experience. My mother fell on the porch steps of our house at 11pm one evening. This resulted in the family's 5 hour overnight ER visit. However, if through this blog, people can be educated about many of these issues, they can feel more confident in the decisions that are made at the "crisis" time. Education and awareness can reduce the stress families feel when confronted with these issues. As part of these entries, I will begin sharing from my own family's perspective as my mother battles Muscular Dystrophy and my dad deals with his Parkinson's Disease.

Baby Boomers Will Demand More Of Health Care System

2007-07-14T23:57:00.000-04:00

The number of U.S. residents over age 65 will nearly triple between 1980 and 2030 as America's "baby boomers" age, placing new demands on the nation’s health care system, according to a report released recently by the American Hospital Association. The report estimates that six in 10 boomers -- more than 37 million people -- will be managing more than one chronic condition by 2030. It projects that one in four boomers will have diabetes, almost half will have arthritis and more than one in three will be considered obese. By 2020, boomers will account for four in 10 physician office visits and an increasing proportion of hospitalizations.

During a press briefing on the report, AHA President and CEO Rich Umbdenstock said, “Today’s report outlines a tidal wave of health needs. We will need a greater focus on wellness and prevention, new approaches to care delivery and a new look at the American health care system.”

People should read this report. It is a very comprehensive look at healthcare delivery for seniors. These issues are going to have great impact on seniors in the years to come. Click "report" above to read it in its entirety.

Means Testing for Medicare Beneficiaries' Premiums

2007-07-11T22:35:00.000-04:00

The standard Medicare Part B monthly premium will be $93.50 in January 2007, an increase of $5.00 from the 2006 premium of $88.50. All beneficiaries currently pay the same basic premium amount for Medicare Part B, which is set annually at a level that covers 25 percent of the estimated Part B program costs for the year. The Government has subsidized the remaining 75 percent for all beneficiaries.

This 75-percent subsidy will decrease for those making over $80,000 a year beginning in 2007. As a result of a new Medicare law, the Part B monthly premiums for some beneficiaries will be greater beginning in 2007, depending on a beneficiary’s or married couple’s modified adjusted gross income. The income-related Part B premiums for 2007 will be $105.80, $124.40, $142.90, or $161.40, depending on the extent to which an individual beneficiary’s income exceeds $80,000 (or a married couple’s income exceeds $160,000), with the highest premium rates only paid by beneficiaries whose incomes are over $200,000 (or $400,000 for a married couple). The income thresholds will increase annually by indexing to the consumer price index (CPI). The Centers for Medicare & Medicaid Services estimates that about 4 percent of Medicare beneficiaries with Part B will pay higher Part B premiums based on their incomes. The Social Security Administration (SSA) is responsible for all income-related monthly adjustment amount determinations.

To make the determinations, SSA will use the most recent tax return information provided by the IRS. For 2007, in most cases that will be the beneficiary’s 2005 tax return information. If that information is not available, SSA will use information from the 2004 tax return.

Family Struggles with Mom's Dementia

2007-07-08T14:16:00.000-04:00

I met with a lady on Friday in Maryland. She had set an appointment to talk about Medicare insurance changes and if her current plan was sufficiently meeting her needs. Upon introduction, she was pleasant, well spoken, probably about 70 years old. Her daughter pulled me aside prior to her leaving for work to say her mother battles memory problems. I thanked her and told her anything we talked about I would share with the daughter.

Ms. Smith (not her real name) introduced herself by saying she had spent 27 years in the Baltimore City Police Department. She had also had been instrumental in helping establish the FOP (Fraternal Order of Police) chapter at her precinct. She was understandably very proud of this. She went on to tell about taking a clerical position with the FOP after retirement. This ended at the request of her boss three years ago. It was after, according to her, a mini-stroke that left her struggling to accomplish her work. By her description, her tenure didn't end well. She spoke with much animosity.

I moved on to ask about her health insurance only to be brought back to the previous conversation repeated almost verbatim as before. Being forewarned by her daughter and also used to dealing with seniors with memory problems, I could see where this was going. After yet another repeat of her "FOP firing" story, I knew that this person was in no position to make decisions. I politely excused myself and as I was walking out the door, was regailed again with the same story.

I don't share this to criticize or embarass this nice lady. This is reality. Many people are faced with the devastating disease of dementia. I spoke to her daughter by cell phone upon leaving the house. I wanted to let her know nothing needed to be done with her health insurance. She proceeded to share that her Mom developed this condition after her stroke. I could sense frustration in her voice. She wants to take official control of her dealings, but wants to respect her mother's autonomy. Besides it is not worth the verbal sparing that has characterized their relationship in the last year. Betty (also not her real name) told me her 15 year old daughter acts 25 and her 70 year old mother acts 10. I told her she is right in the middle of the "Sandwich Generation."

Betty and Ms. Smith are an example of the affects of dementia on a family. The disbelief, the worry, and the frustration inherent in the onset and coping with this condition. I have seen it many times in others. Many reading this entry have first-hand knowledge of it. My hope by sharing this story and for the blog itself is to say, "You aren't alone." Please provide comments and suggestions that may help others living with this disease. Check out these two websites.

http://www.dementia.com
http://www.alz.org

Not Your Grandma's Nursing Home

2007-07-07T09:32:00.000-04:00

The face in today's nursing home is changing. It is not your "grandma's nursing home". These changes are continuing to focus attention on providing quality care, the funding of that care, and who actually are the customers. The report below does a good job in analyzing the trends of today's nursing home resident. Click the link below for the full report.

Summarizing the report finds that:

The average age of a NH resident is increasing due to healthier lifestyles and more residential options for seniors, such as, assisted living.
Long Term residents decreasing as a percentage of overall population due to increase emphasis on short term rehab and recovery. Increased services are available for seniors to manage health conditions in less intense settings.
Current NH residents have more chronic conditions and are, on average, receiving state assistance through Medicaid. This is putting pressures on nursing home operators to provide the care needed with the limited reimbursement of Medicaid dollars.

People facing decisions of this nature in the upcoming months or years may find this report enlightening. The report is available at http://www.kff.org/medicaid/7663.cfm

Emergency Room Statistics; More Visits and Less Satisfaction

2007-07-07T09:12:00.000-04:00

For those of you who have spent time in the Emergency Department (ED) yourself or while assisting another person, the following figures are not surprising. I have been to the ED of Memorial Regional Medical Center twice within the past year assisting my parents with particular issues. Obviously, seniors have a higher probability for unexpected emergency department visits. Many people I talked with, while working in the nursing home, told me of stories of ambulance rides and ED visits at 3am due to an accident or an exacerbation of their parent's health condition.

The average time spent in emergency departments(ED) rose in 2006, but so did patient satisfaction, according to a new report by Press Ganey Associates. Based on the firm’s patient surveys in 1,500 hospitals, patients spent an average of 4 hours in the ED, 18 minutes more than in 2005. The more patients an ED saw over the year, the longer the average visit, which increased by 30 minutes for every additional 10,000 patients annually. Patient satisfaction dropped as time in the ED increased, with the lowest satisfaction reported from 3-11 p.m. and highest from 7 a.m.-3 p.m.

Visits to hospital emergency departments increased by 5.1 million in 2005 to 115.3 million, according to a report released today by the Centers for Disease Control and Prevention. That averages to about 30,000 visits per ED, nearly one-third more than in 1995. According to the report, the ED visit rate for patients without health insurance was about twice that of those with private insurance. Infants under 1 had the highest visit rate by age. The leading diagnosis for children under 13 was acute upper respiratory infection. Other top diagnoses by age were bruises, adolescents; abdominal pain, adults under 50; chest pain, adults 50-64; and heart disease, seniors. About 12% of ED visits resulted in hospital admission. The leading diagnosis at discharge was heart disease.

Health Insurance Issue Continues To Warrant National Discussion

2007-07-07T08:47:00.000-04:00

Whatever your opinion is on the health insurance debate, the fact remains that a national discussion is needed. Michael Moore, in his new film, Sicko attempts to create items for discussion. I personally don't subscribe to his solutions, but do believe that it is a huge issue in America today. The survey included in this entry provides all the statistics that a "numbers" junkie could ask for in analyzing these issues. I'll pull out from the survey several facts. Please click below to review the entire survey. Of particular note to me is the growth in obesity statistics (page 36 ) and also the continued trend upward of the diagnosis of diabetes (page 82 ).

An estimated 43.6 million Americans, 14.8% of the population, lacked health insurance when surveyed by the Centers for Disease Control and Prevention in 2006. That’s up from 41.1 million, or 14.2%, in 2005, based on the CDC’s latest National Health Interview Survey. Roughly one in five working-age Americans (19.8%) were uninsured, up from 18.9% in 2005; and 9.3% of children, up from 8.9%. Young adults 18-24 had the highest proportion of uninsured by age. Hispanics were more likely to be uninsured (32.1%) than African Americans (15.9%) or whites (10.4%). I know politics for 2008 will impact greatly on the overall discussion. Let's hope candidates from both parties emerge that are bold enough to at least start a reasoned discussion. Please log your thoughts on the issue under the comment section of this entry.

Exercise is Vital For Arthritis Sufferers

2007-07-04T20:45:00.000-04:00

It is a vast understatement to say that arthritis patients hurt when they move. But, it is important for people with arthritis to keep moving and stay active. That message may seem contradictory, but it's not. It is known that exercise can benefit patients over time by:
· decreasing pain.
· improving their gait and mobility by reducing stiffness.
· improving range of motion.
· improving function.
· putting off disability.

Why Are So Many People With Arthritis Not Exercising?
There are myriad reasons why so many people who have arthritis avoid exercise, including:
· fear of pain.
· believing that exercise will make joint pain worse.
· depression and anxiety.
· physical limitations (difficulty walking, grasping, bending, kneeling, lifting, or standing).
· no access to a fitness center (due to expense or lack of transportation).
It is difficult for an arthritis patient to realize that by not exercising and not staying active they are perpetuating the cycle of pain, inactivity, and disability.

Study Reveals Activity Level For People With Arthritis
Data from a national health survey, which included 6,829 people diagnosed with arthritis and 20,676 people without arthritis, was analyzed and reported in the May 2006 American Journal of Preventive Medicine.
According to the data:
· 37% of people with arthritis get no exercise.
· 30% of people with arthritis were getting recommended levels of moderate or vigorous exercise.
· 20% of people with arthritis regularly performed strengthening exercises.

How Can Arthritis Patients Use The Data To Improve Their Activity Level?
Exercise should not be avoided by arthritis patients. Not exercising results in the aforementioned undesirable consequences including more pain, stiffness, inflammation, joint damage, physical limitation, and disability.
Arthritis patients should work with their doctors to develop the best treatment regimen to minimize pain. Arthritis patients must believe in the importance of exercising and believe in what is true about exercise and arthritis:
· Exercise and physical activity are beneficial foreveryone, especially arthritis patients.
· Lack of exercise results in undesirable consequences and worsening symptoms

Part D Drug Plan Selector

2007-07-04T08:27:00.000-04:00

By now most people have heard of Part D prescription coverage available to Medicare recipients. Unlike in 2005 when this benefit was first introduced, there has been a widespread education effort for seniors. However, there may be some that are still unclear how best to evaluate options. Using the website, http://www.medicare.gov/, is a great start to find a plan that works for you. Even if you or a family member is currently in a plan, it is a good idea to re-evaluate your options because you could switch during the election period and reduce your overall costs. Rather than move through the various links on the medicare website, I have provided a link to get you directly to the comparison page. Click the link below, follow the instructions and begin to enter your personalized information. I would also encourage you to speak to a certified Part D representative to ensure that you have explored all your options completely. Click the link below to get started.

http://www.medicare.gov/MPDPF/Public/Include/DataSection/Questions/SearchOptions.asp

Residential Options for Seniors Defined

2007-07-02T08:25:00.000-04:00

Many people when faced with possible residential changes are unaware of the options. The following is a list of residential levels with a short description. Functionality and level of assistance for daily activities (ADL) is the best indicator of the appropriate option.

Independent Living Apartments. Independent living apartments are ideal for seniors who do not need personal or medical care but who would like to live with other seniors who share similar interests. In most independent living facilities seniors can take advantage of planned community events, field trips, shopping excursions and on-premise projects. These apartments are not licensed or regulated.
Adult Homes. Adult homes are licensed and regulated for temporary or long-term residence by adults unable to live independently. Adult homes are licensed as assisted living, but typically have 10 or fewer residents. They usually include supervision, personal care, housekeeping, and three meals a day. Many of these residences accept Medicaid in addition to private funds.
Assisted Living Facility (ALF). An alternative to nursing homes for seniors who need help with their daily routines, but who need 24-hour care, but not on an intensive basis. Room, board, case management, and skilled nursing services come from an outside agency. These can be larger capacity facilities, many times operated by corporations. Most of the larger ALF only accept private funds as means of payment. Some may accept Medicaid funds.
Continuing Care Retirement Communities (CCRC). Continuing care communities offer a continuum of living options, from independent living, enriched living, assisted living, and skilled nursing home, all on one campus. Residents can move from one level of care to the next as needs change. Transitions to different levels of care are easier because people are able to remain in familiar surroundings. In addition, spouses who age at different paces may also remain near each other. Most only accept private funds.
Nursing Home (Skilled Nursing Facility SNF). Skilled Nursing Facilities offer 24-hour a day care for those who can no longer live independently. In SNF, trained medical professionals provide specialized care to seniors with severe illnesses or injuries. Specially trained staff assist residents with daily activities such as bathing, eating, laundry and housekeeping. They may specialize in short-term or acute nursing care, intermediate care or long-term skilled nursing care. Physical, Occupational, and Speech Therapy are a focus for residents while recovering in a SNF. Many facilities are focusing their efforts on treating short-term injuries and illnesses due to the fact that Medicare pays for these services. Advances in medicine are allowing seniors to remain active longer, therefore SNFs are helping seniors return to a higher level of independence after a hospital stay.

ABC News Addresses Realities of Aging

2007-07-01T17:51:00.001-04:00

During the week of June 25-29, ABC News ran stories on the issues relating to aging and the difficulties families face with this topic. With the changing demographics, this topic is proving one of the most challenging we face as a nation and as a family. The purpose of this blog is to provide answers and spur discussion on these topics. ABC did a wonderful job of highlighting the struggles that families face as roles are becoming reversed. Children are becoming caregivers to aging parents. This is nothing new. Today, however, many people, because of the longevity of seniors and the fact that people are waiting to have kids themselves, are faced with care giving for two generations. The term coined for this occurrence is the "Sandwich Generation." People are being "sandwiched" with the care giving tasks of children and parents simultaneously. If you missed it, take time to review the stories.

http://www.abcnews.com/health/eldercare

Where To Turn After a Stroke

2007-07-01T17:18:00.000-04:00

Given that strokes occur every 45 secounds and affect more than 700,000 people each year in America, many families are left with a myriad of concerns on how to adjust to a post stroke environment. Quite often physical functionality is greatly diminished which leads to emotional challenges as well. For those seeking answers to this new reality, I have found one website particularly helpful. It is one of the most comprehensive resources I have found on the topic of strokes and their aftermath. Not only does it define a stroke and suggest measures to avoid them, but also offers advice on adapting your homes and lives to maintain the highest quality of life and level of independence after a stroke.

http://www.strokecenter.org/patients

After visiting this website, please comment on this blog so others may know its value to your family. Please also comment on other websites people may gain needed information to assist a loved one through a stroke.

Medicare Insurance Plans Temporarily Suspend Marketing

2007-06-26T22:07:00.000-04:00

The Centers for Medicare and Medicaid Services (CMS) announced June 15, 2007 that in response to concerns about marketing practices, seven health care sponsors have signed an agreement to suspend voluntarily the marketing of Private-Fee-For-Service (PFFS) plans. This suspension will be lifted only when CMS certifies that the plan has the systems and management controls in place to meet all of the conditions CMS has set forth. The companies include: United Healthcare, Humana, Wellcare, Universal American Financial Corporation (Pyramid), Coventry, Sterling, and Blue Cross/Blue Shield of Tennessee.
“While we note that most health insurance agents are helpful and responsible in describing and explaining choices to beneficiaries, there are a few bad actors that need to be removed from the system for good,” said Leslie V. Norwalk, Esq., Acting Administrator of CMS. “This voluntary agreement demonstrates that CMS and the plans are stepping up to ensure that deceptive marketing practices end immediately, and that beneficiaries understand what they are purchasing.”
“Through a variety of methods, including our ‘secret shopper’ program that uses trained individuals to attend marketing events and report back on the insurance agents’ activities, and the eyes and ears of our thousands of partners throughout the nation, CMS is proactive in protecting beneficiaries from rogue agents. Although the 2700 agent complaints we logged from December 2006 to April 2007 represent less than one half of one percent of the 1.3 million members enrolled in individual PFFS plans, we can always do better,” added Norwalk.

This is a case where the message is being adversely impacted by the actions of unethical messengers. I represent many of these private Medicare plans. I have helped many seniors save money while ensuring comprehensive healthcare coverage. One of my clients is saving $150 per month while benefiting from wellness services she previously did not have. Growth in these plans has been significant(currently 8.3 million members) , not because they are being oversold, but because it meets a need. Strict regulations will hopefully force many unethical agents from the business. These plans are here to stay, giving seniors many more options for health insurance coverage. This can only serve to benefit seniors over the course of time. Speculation is that these plans will be available again during open enrollment later this year, November 15, 2007. I will keep you posted.

Combating Alzheimer's Disease

2007-06-26T20:31:00.000-04:00

Senator Barbara Mikulski (MD) introduced a bill in the U.S. Senate on March 15, 2007. If signed into law, the Alzheimer’s Family Assistance Act would combat the causes and impact of this terrible disease with the following goals:

1. Double the funding for Alzheimer’s research at NIH from $640 million to $1.3 billion.

2. Create a National Summit on Alzheimer’s so the best scientists in the country can come together to look at the current state of research, discuss the most promising breakthroughs, and chart the course for future research.

3. Offer family support because the family is always the first caregiver. The bill would provide a $3,000 tax credit for families caring for a loved one with a chronic condition like Alzheimer’s. It would help them pay for prescription drugs, home health care and specialized day care. It also includes a long-term care tax deduction to help make long-term care insurance more affordable for people and to help people help themselves as they plan for retirement and their future.

At the first hearing on the legislation Sen. Mikulski commented, “Alzheimer’s disease is an all-American disease that needs an all-American effort. Direct and indirect costs of Alzheimer’s and other dementias amount to more that $148 billion annually. In 2005, Medicare spent $91 billion on beneficiaries with Alzheimer’s and other dementias. That number is projected to nearly double to $189 billion by 2015." I will follow the course of this legislation and keep readers of this blog informed of its status.

Women and Strokes; Watch Your Waistline

2007-06-26T19:49:00.001-04:00

Strokes are becoming more of a problem for women than men among the middle aged. More women than men appear to be having a stroke in middle age, according to a study published June 20, 2007, in the online edition of Neurology®, the medical journal of the American Academy of Neurology. Researchers say heart disease and increased waist size may be contributing to this apparent mid-life stroke surge among women. (Full Article). Strokes occuring to those in middle age create unique problems for families. Quite often additional financial burdens occur because minor children are likely still in the home. People underestimate the risk of disability. Income stops but expenses not only keep coming, but often increase. Families struggling to save for college costs have to divert funds to this new medical reality. Temporary or permanent disability can have long term emotional and financial impact. Share stories of overcoming strokes and or advice for women to better their heart health. by clicking on "comment" under this article.

Helping Seniors Beat the Summer Heat

2007-06-24T23:47:00.000-04:00

As we here in Virginia face the sometimes blistering summer season, the ones most often at risk are our seniors. Often residing in older homes and on limited income, seniors have an increased need for cooling assistance. LIHEAP (Low Income Home Energy Assistance Program) has been a federal program since 1979. Administered through local Departments of Social Service(DSS), LIHEAP funds are used to purchase and/or upgrade air conditioners, ventilation systems or pay electric bills for those in need. Applicants must meet certain guidelines including financial and or health/age concerns. Filing schedules for these funds are between June 15 and August 15. Companies such as Dominion Virginia Power also provide corporate support for low income assistance through its Energy Share program. If you or someone you know faces the summer heat without the means for relief, please contact the local DSS office for further assistance. Applications for LIHEAP funds can be found at http://www.dss.virginia.gov/benefit/ea/cooling/forms/cgi

Medicaid Screening Process

2007-06-19T08:44:00.000-04:00

I was speaking the other day to the Hanover County, VA Social Services Department. More specifically to the Long Term Care Social Worker. We agreed that many people are uneducated as to how to apply for Medicaid for an elderly relative. Moreover, many don't get this education until a crisis has occured and someone has entered the hospital and may need services upon discharge. As you know, many decisions under these circumstances can be very stressful. This entry is a very basic checklist of the Medicaid screening process. Some readers may need a quick guide to this process. This whole issue of Medicaid services is huge. I will devote considerable time and effort to inform this blog's readers on these topics. If there are specific questions or comments, please click the "comment" field under this entry.

Steps in Medicaid Screening Process

1. Contact the local Social Services Department for the county of residence of the senior.
Hanover County is 804-365-4100. check your local department.
2. Social Services and the Health Department nurse will coordinate a time for visit.
3. Health Department determines eligibility of applicant and what services would be necessary.
4. Eligibility is based on a person's ability to perform ADLs (activities of daily living)
5. Services will include Personal Care, Day Care, Assisted Living or Nursing Home.
6. Family selects provider of services (DSS can provide list).
7. Provider of services contacts DSS and Health Department for screening forms.

Be Careful What You Ask For

2007-06-14T19:07:00.000-04:00

While many are finding favor with the concept of universal healthcare, imagining it to be a sweet solution to the sour healthcare situation, it might just leave a bad aftertaste in our mouths. Many politicians have proposed such fixes to the health crisis and an increasing number may see it as the answer. My advice: "Be careful." Yes, there is a problem with higher costs for and access to healthcare. However, I don't believe the answer is the federal government. With all its faults, I believe the United States still has the premier health system in the world. Let me ask one question. If you had a very important and irreplaceable package to send, would you entrust it to FedEx or the U.S. Postal Service? Just a thought. Can this carry over to vital issues like healthcare delivery? I would like to start a discussion amongst readers on this topic. I believe honest, open debate is always necessary on such an important issue. Please share your thoughts.

Cost of Healthcare Top Concern of U.S. Adults

2007-06-14T19:05:00.000-04:00

The rising cost of U.S. healthcare is a pressing concern for 85 percent of U.S. adults, according to a recent survey sponsored by the American Society for Quality (ASQ) and conducted by Harris Interactive®. In fact, healthcare costs overtake U.S. adults' concern for other hot button issues including the war in Iraq (79 percent), the rising cost of fuel (80 percent) and the threat of global warming (61 percent).

The issue of universal healthcare coverage wins strong approval in the ASQ survey which found that 79 percent of adults believe universal coverage would improve healthcare quality. According to the ASQ survey, nearly nine in 10 (88 percent) adults think being able to go to any doctor would also improve the quality of their healthcare over the next five years. In other findings, 39 percent of adults said they would be concerned/very concerned about medical errors occurring if they were hospitalized; 29 percent of U.S. adults have not filled a prescription; and 28 percent have delayed a medical procedure due to expense (28 percent).
For more information on the study, go to http://www.asq.org/media-room/press-releases/2007/20070320-healthcare-war.html

More Seniors Are Selecting Private Medicare Advantage Plans

2007-06-14T19:00:00.000-04:00

Enrollment in private Medicare health plans has grown sharply since enactment of the Medicare Modernization Act of 2003, which created a Medicare drug benefit and created incentives for new private plans to enter the Medicare market, according to four new reports from the Kaiser Family Foundation. Private plans called Medicare Advantage plans are now widely available and cover a record 8.3 million beneficiaries, up from 5.3 million in 2003, the reports indicate. Please click on report link above for further details.

Americans Doing More for Heart Health

2007-06-14T18:53:00.000-04:00

More than 93% of U.S. adults engage in at least one of three recommended behaviors to prevent heart disease, according to a new report by the Agency for Healthcare Research and Quality. More than 56% of adults surveyed by the agency in 2004 got moderate to vigorous exercise three times a week, 78% did not smoke and 39% had a healthy body mass index or weight. However, only 18% practiced all three heart-healthy behaviors while 6% did not practice any, and 18% continued to smoke after their doctor found indicators of heart disease.

Wrong Choice of Words

2007-06-14T13:19:00.000-04:00

I noticed something the other day. In reading an article about elderly persons, the word "invalid" was used. The context was to describe a person whose physical condition has been limited due to illness. I noticed that if you say the word differently, it becomes "invalid". This form of the word means lacking value or importance. In describing our elders, this cannot be further from the truth. Even folks with physical and or mental difficulties have tremendous value. I have never met a more rich and vibrant group of people as when I worked as the Admissions Director of Hanover Healthcare Center. I encourage you to visit folks others may label "invalid". You will be richly blessed! Please share your thoughts by posting comments on this blog.

Importance of a Good Doctor

2007-06-14T13:17:00.000-04:00

Good care keeps certain elderly people out of the hospital. Elderly Medicare patients treated by experienced physicians are less likely to be hospitalized for bacterial pneumonia or chronic obstructive pulmonary disease, according to a study released recently by the Center for Studying Health System Change. Patients whose usual physician had less than 10 years experience or difficulty accessing ancillary services were at higher risk of hospitalization for both conditions. The findings are based on a 2000-01 survey of practicing physicians and Medicare claims data.