Many Americans who have experienced a serious illness or injury within the past year are concerned about the financial costs of medical care, and the quality of and access to that care, according to a new poll out today from NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health. Results of the poll, one of the first of its kind, reveal that three out of four sick Americans say that cost is a very serious problem, and half label quality of care as very serious problem. 

These findings provide the basis for NPR’s “Sick in America,” a series looking at the serious issues facing the ill in this country, beginning today and airing all week on Morning Edition and All Things Considered. In the series, NPR correspondents from around the country take measure of what it’s like to be sick in America, from deteriorating insurance coverage, to an increasingly fragmented health system, to a nursing shortage and the quality of hospital care.

 The poll surveyed both the general public and those with a serious illness, medical condition, injury or disability. It was conducted by researchers at the Harvard School of Public Health. Complete results are at NPR.org, where all reports in the series will be available. Among the key findings:

 · A large majority of the general public (87%) thinks the cost of care is a serious problem for the country. In addition, about two-thirds of the general public (65%) believes the cost of care has gotten worse over the last five years.

 · More than 40 percent of sick American say that the cost of their medical care over the last 12 months has caused a “very serious” (20%) or “somewhat serious” (23%) problem for their or their family’s finances.

 · High costs affected access to care. One in six sick Americans say that there was a time in the past 12 months when they could not get the medical care they needed. Of that group, 52% report that it was because they could not afford the needed care, and 24% say it was because their insurers would not pay for it.

 · Interestingly, 78 percent of both the recently sick and the non-sick said that not being able to afford the tests or drugs they need was a major reason for the problems in quality of care.

 · Half of those who’ve been hospitalized overnight during the past 12 months (51%) said they were very satisfied with the quality of care they received.

 “Sick in America” is being reported by NPR’s Science Desk, with NPR correspondents Richard Knox, Patti Neighmond, Julie Rovner and Rob Stein, and reporter Sarah Varney of member station KQED.

 The poll is part of an ongoing series of surveys on health conducted by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health.

 

The L.A. Times reported that the price of drugs widely used by elderly Americans grew by almost double the rate of inflation from 2005 to 2009, according to a new study by the AARP.

The average retail price over the five-year period for the 469 drugs most often used by AARP members grew by 25.6%, compared to the 13.3% rise in inflation over the same period, according to the report.

The report also says that 406 of the 469 most commonly used drugs are used to treat chronic conditions and that the average cost of taking such medicines for chronic conditions was $1,152 higher in 2009 than it was five years earlier.

 

Critics and health care experts fear that Iowa Governor Terry Branstad’s relationship to the nursing home industry will cause premature deaths of vulnerable and disabled elderly.  Disability Rights Iowa, which is part of a national network of advocacy groups established by Congress in the 1970s, published a scathing, open letter to Branstad, questioning the governor’s lax supervision of Iowa’s nursing homes.

Sylvia Piper, executive director, Disability Rights Iowa, Des Moines recently wrote "Terry Branstad believes nursing home residents, many who have witnessed or experienced abuse or neglect, no longer need anyone to protect them. Rod Roberts, director of the Iowa Department of Inspections and Appeals, gets his marching orders directly from Branstad. They both agree that no inspectors are needed; the nursing homes should be left to police themselves."  Sylvia Piper told Branstad in the letter that because of his “political choices, people are suffering and dying on a regular basis in Iowa’s nursing homes.”  In March, Roberts who has no prior management experience, eliminated the positions of 10 nursing home inspectors and two abuse prosecutors, citing budget constraints. After lawmakers restored funding for the positions, the department opted to spend the money elsewhere, saying the inspectors were not needed.

"Branstad has a lucrative arrangement with the nursing home lobby. They give his campaign tens of thousands of dollars, he helps them run under the radar by removing those who would hold them accountable. Under this egregious arrangement, nursing home residents are left alone and helpless in an environment historically notorious for abuse and neglect."

The (Republican) state auditor, long-term care ombudsman, and Iowa citizen’s aid ombudsman cited him for failing to adequately regulate nursing homes. Clearly, he wants to protect his campaign contributors. There has been an increase in complaints regarding nursing homes and other types of care facilities in Iowa.

Piper said her organization has investigated specific cases in which residents have died or been injured as a result of negligent care that could have been prevented through more aggressive action by the inspections department. 

 

See articles at Des Moines Register, here and here.

 

 

The National Institute on Aging (NIA), part of the National Institutes of Health, has some advice for helping older people avoid heat-related illnesses, known collectively as hyperthermia.

Hyperthermia occurs when the body overheats. Conditions involving hyperthermia have different names, including heat stroke, heat fatigue, heat syncope (lightheadedness or fainting in the heat), heat cramps and heat exhaustion.

Risk of heat-related problems increases with age.  Older people can face risks related to hot weather. As people age, their bodies lose some ability to adapt to heat. They may have medical conditions that are worsened by heat. And their medications could reduce their ability to respond to heat.

Health-related factors that may increase the risk of hyperthermia include:
Pre-existing diseases such as congestive heart failure, diabetes and chronic obstructive pulmonary disease
Decreased ability to move around
Dementia or cognitive impairment
Certain medications that may cause dehydration or that may affect the responses to heat by the heart, blood vessels or sweat glands.
Being substantially overweight
Drinking alcoholic beverages
Being dehydrated
Age-related changes in the skin, such as decreased functioning of small blood vessels and sweat glands

Lifestyle factors that can also increase the risk of hyperthermia include hot living quarters, lack of transportation, overdressing, visiting overcrowded places, and not understanding how to respond to weather conditions. Older people, particularly those at special risk, should pay attention to any air pollution alert in effect. People without fans or air conditioners should go to shopping malls, movie theaters, libraries or other places with air conditioning. In addition, they can visit cooling centers which are often provided by government agencies, religious groups and social service organizations in many communities.

Heat stroke is an advanced form of hyperthermia. It occurs when the body is overwhelmed by heat and unable to control its temperature. In heat stroke, the body temperature is at least 104 degrees Fahrenheit. Someone with heat stroke may have a strong rapid pulse, lack of sweating, dry flushed skin, faintness, staggering and mental status changes such as confusion, combativeness, disorientation or even coma. Seek immediate medical attention for a person with any of these symptoms, especially an older adult.

If you suspect that someone is suffering from a heat-related illness:
Move them into an air conditioned or other cool place
Urge them to lie down and rest
Remove or loosen tight-fitting or heavy clothing
Encourage them to drink water or juices if they are able to drink without choking, but avoid alcohol and caffeine
Apply cold water, ice packs or cold wet cloths to the skin.
Get medical assistance as soon as possible.

The Low Income Home Energy Assistance Program (LIHEAP) within the Administration for Children and Families in the U.S. Department of Health and Human Services helps eligible households pay for home cooling and heating costs. Individuals interested in applying for assistance should contact their local or state LIHEAP agency. For more information, go to www.acf.hhs.gov/programs/ocs/liheap/ or www.acf.hhs.gov/programs/ocs/liheap/brochure/brochure.html.

For a free copy of the NIA’s AgePage on hyperthermia in English or in Spanish, contact the NIA Information Center at 1-800-222-2225 or go to http://www.niapublications.org/agepages/hyperther.asp, or www.niapublications.org/agepages/hyperther-sp.asp for the Spanish-language version.

The NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute’s broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, aging, and health, go to www.nia.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

 

Liz Nutt manages content for Accountingdegree.com. She has been reading “South Carolina Nurshing Home Blog” and sent us an article from her website to share called "10 Scary Financial Scams That Target the Elderly".

"Financial scams can target people at any age, but seniors are often favorite targets of scammers because most are homeowners, have substantial savings, are more trusting and may not know enough about the latest technology and laws to protect themselves. These scams cost older Americans millions, if not billions, every year — and despite crackdowns, they aren’t likely to stop anytime soon."

 

 

AOL Health had an article about the Top 10 most important family concerns in caregiving for a parent.  Consider:

1. Rally the Troops
Deborah Halpern, Communications Director for the non-profit National Family Caregiver’s Association, urges that caregiving your parent is not a one-person job or burden. Instead, you should have a family team that includes friends and neighbors, each with a role and responsibility in the caregiving process. There must be a ringleader, according to Halpern, who contacts each family member with the invitation or challenge to "step up to the plate and help."
When several family members are involved, even for just a few hours each week, the burden on the primary caregiver is reduced significantly. Sharing responsibilities also brings more family members into active contact, sharing, support, monitoring, understanding and visiting with Mom or Dad.

2. Talk with Your Parent
Discuss freely with your elderly parent his or her current needs, limitations and concerns, stating your positive belief and commitment to providing the services and assistance to maintain independence and activity while also fulfilling medical and other needs.

3. Consult with Medical Practitioners
Meet with physicians and other medical providers to learn their concerns and suggestions.

4. Bring the Family Together
Stage a potluck dinner or other gathering to bring all possible family, friends and neighbors together. Define a mission or program to maintain your parent’s independence, activity and medical needs. From the session with your parent and then medical practitioners, have a prepared list of tasks that need to be covered, such as helping on meal preparation, driving to and from medical appointments, assisting on household chores, or visiting on a regular basis for personal chats — then make task assignments accordingly.

5. Identify Community Services
There are many professional and volunteer services available in every region of the United States, with information and coordination provided by the Area Agency on Aging  Every community has an Area Agency on Aging, and this federally-mandated organization is staffed by professionals who know every elder program and service in your area.)

6. Observe Changes in Your Parent’s Condition
The family team concept in caregiving offers effective and unique opportunities for observing and identifying physical, mental or emotional changes in your parent. The primary caregiver may not recognize subtle changes, while a family member who assists for a few hours each week may quickly identify changes and can share them with the caregiving team. The family plan can be adjusted accordingly, professional counsel can be sought and/or support changes can be made to keep your parent independent, active and positive.

7. Cover your Bases, Legally
Everyone in your family caregiving group should be legally able to ask questions and receive information from medical providers, from physicians to pharmacists, physical therapists to visiting nurses. Today, under the federal HIPAA law, a legal authorization must be signed by Mom or Dad for each of the family members who are authorized to discuss their care with healthcare providers. Medical professionals can provide the necessary forms at no cost. There should be a Durable Power of Attorney legal document executed in which your parent names one or more family members who have authority to make medical decisions if the patient cannot.

8. Seek Financial Advice
Your parent’s financial and property assets, including any debts or obligations, should be listed and defined, including the source of each and every document. The documents should not be stored in a safe deposit box at a financial institution unless at least one family member’s name is also added to the box ownership. Failing such a co-ownership, on the death of your parent, the bank will not open the safe deposit box. Period. Your parent should have a legal will in effect and be a "self-proving document." The latter is achieved when the parent, witnesses and notary public are together at the same time to witness each other’s signatures.

9. Know Your Loved Ones’ Wishes for Final Disposition
Another great gift from the parent to the family is a pre-determination and even pre-funding of a final disposition after death. Careful planning and funding now can avoid almost-frantic decisions, which often end up costing more if family members must address such issues at the time the parent dies.

10. Watch the Caregiver’s Emotional and Physical Health
The emotional and physical health of the lead caregiver should be a top concern for the rest of the family. There should be offers to provide relief time for the caregiver. This can include coverage so that the lead caregiver can get out to dinner, movie or a walk in the fresh air. Without such relief, the physical and mental toll can be heavy on the lead caregiver.

 

 

Below is a press release about a new book that is essential for anyone taking care of elderly relatives or will be in the future.  This book is essential reading for almost everyone considering the demographics and aging in America.

Sustenance and Hope for Caregivers of Elderly Parents; Bread of Angels

Former Social Worker and Author Gloria G. Barsamian Serves Up Support and Guidance to Millions of Caregivers

Today, Praeger Publishing announces the nationwide release of Sustenance and Hope for Caregivers of Elderly Parents; The Bread of Angels by Gloria G. Barsamian.

At some point, nearly everyone faces the difficulties of providing care for a family member. More than 50 million Americans do so today, most often for an elderly parent. And with the 65-and-up age group growing faster than any other population segment, that number will continue to rise. But what about the caregivers, and the physical and emotional stress they inevitably endure?
Sustenance and Hope for Caregivers of Elderly Parents tackles the important and timely social issue of parent caregiving. The book provides first-hand accounts and even personal diaries of real families who have faced caregiving issues. It also outlines practical advice for caregivers – offering daily stress reducers and coping mechanisms. Bread of Angels offers a wealth of insights from experienced caregivers, and is a refreshing new vision of the positive potential for caregiving and the rewards that come with evolving relationships between adult children and their parents.

Author Gloria G. Barsamian spent 28 years as a social worker at the Lahey Clinic in Burlington, Massachusetts – helping adult children and their parents deal with catastrophic illness. She says "I saw more and more people caught ill prepared and ill equipped, physically and psychologically, to care for an elderly parent. My goal is to provide guidance and reassurance to the millions faced with one of the greatest challenges of their lives."

Like no other work, Bread of Angels, captures the emotions of today’s millions of caregivers, as well as care-receivers, spouses, and grandchildren. Barsamian shows how old ways of thinking about caregiving can be replaced with new, healthier possibilities that enrich the lives of caregivers and care-receivers.

Sustenance and Hope for Caregivers of Elderly Parents (Praeger) is available June 30, 2009 through Amazon.com, BarnesandNoble.com, Walmart.com and other national book retailers.

For more information, please contact Ann Noder, Pitch Public Relations, LLC (480) 263-1557 or Ann@PitchPublicRelations.com.
 

Every nursing home in the country should buy this book and make it mandatory reading for all their employees.