medicaid cuts impact senior access to pharmacy care

May 16, 2012

Providing quality health care for our beloved family members as they age is one of the most important aspects of being a caregiver. When we think of health care providers, we often immediately think of doctors, nurses, or physical therapists. But one of the most often overlooked providers is one many seniors see more often than any other: their community pharmacist.

Indeed, the pharmacist plays a vital role in the ongoing health of our loved ones in their golden years. They offer advice and instruction on the sometimes multiple and varied medications that seniors become accustomed to taking more of as time passes. Not only that, in many states pharmacists provide life-saving vaccines to senior citizens for diseases like shingles and pneumonia.

At Pharmacy Choice and Access Now (PCAN), we are fighting to ensure that pharmacy access remains available to everyone, including those who are most vulnerable, like our beloved parents, grandparents, and other senior family members. Seniors are among the population most at risk by the lost access to pharmacy care that is resulting from Medicaid reforms being made in several states.

As states across the country are slashing Medicaid reimbursements and taking other measures to cut costs, seniors are the collateral damage. Pharmacies in Texas started closing the next day after the state transitioned its Medicaid patients to managed care. Many rural areas only have one pharmacy to begin with, how will seniors access their medication if their only community pharmacy is forced to shut down?

In California, proposed 10 percent cuts to the state’s Medicaid program (Medi-Cal) threaten more than pharmacies. Senior health centers and care facilities will also feel the effects.

You can help us spread the word by visiting http://rxchoiceandaccess.com — by lending our voices, we may be able to help stop some of these disastrous reforms before they have the chance to hurt America’s seniors!

submitted by Pharmacy Choice & Access Now

baby boomers effect on nursing homes

May 9, 2012

Projections: U.S. & Nursing Home Populations
	Actual	Projections
	2010	2020	2030
Total U.S. Population*	308,746,000	341,387,000	373,504,000
Rate of change		10.57%	9.41%
65 and Older Population**	40,267,000	54,804,000	72,092,000
Rate of change		36.10%	31.55%
Nursing Home Resident Population***	1,401,718
Residents 65 and older****	1,205,477	1,640,673	2,158,226

* U.S. 2010 Census
** U.S. Census 2008 “Projections and Distribution of the Total Population by Age for the United States: 2010 to 2050″
*** CDC “Health, United States, 2010, table 117″
**** npg.org estimates that 86 percent of nursing home residents are senior citizens; Projections for “Residents 65 and Older” were calculated by applying 2010′s Actual “Nursing Home Resident Population” to that estimate. That finding was then applied to both 2020 and 2030′s “Residents 65 and Older Rate of Change” to estimate both years Baby Boomer nursing home occupancy.

The nursing home industry is one plagued with a very big problem: 90 percent of nursing homes are understaffed, making staff to patient ratios too low according to the Centers for Disease Control’s (CDC) National Nursing Home Survey: 2004 Overview. Said report found there was only: 1 Registered Nurse for every 12.6 residents; 1 Practical Nurse for every 8.15 residents; 1 Nursing Assistant for every 2.5 residents; and 1 Nursing Aide/Orderly for every 120 residents. What this translates to is 1 nursing home staff member for every 1.64 residents.

As a result of inadequate staffing levels, the amount of time staff members spend with residents is also inadequate. A Health and Human Services (HHS) study in 2002 found that nursing homes could maximize quality of care if specific staff members met the following daily requirements of time spent with residents: Certified Nursing Assistants spent between 2.4 hours and 2.8 hours daily; Registered Nurses & Licensed Practical Nurses spent between 1.15 hours and 1.4 hours daily; and Registered Nurses spent .55 hours to .75 hours daily with each resident. However, the study found that given the current state of nursing home staffs, if said requirements were applied, only 3 percent of nursing homes would meet the maximum requirements and only 9 percent would meet the minimum requirements.

All of this data was representative of the nursing home population before Baby Boomers began to become senior citizens. Baby boomers began to be classified as such in 2011 and will continue to enter that age category through 2029. Future senior citizen populations applied to nursing homes can be seen in the above chart. Easily seen is this chart is that the senior citizen population increases in 2020, mid-Baby Boomer subversion, and in 2030, one year after full Baby Boomer subversion. And given that understaffing is a primary cause of both abuse and neglect in nursing homes, the increased demand Baby Boomers will put on a disordered industry may cause an increase in nursing home abuse and neglect. Additionally, elder abuse and neglect in general may increase, as people who would normally have placed their elder into a nursing home will be left with no choice but to care for the elder themselves.

Allison Dean is a writer bringing to us how the problems of nursing home abuse and neglect could be exacerbated by the Baby Boomer population’s demand for long-term care.

Allison also writes about

when surgery may not be the right choice

May 2, 2012

My mother, 87yo, lives across the country but close to my younger sister. I was called to D.C. suddenly to have a “family meeting” about a new development regarding our mother’s health.

My sister reported that my mom had exhibited uncharacteristic behavior. Besides shortness of breath, Mom tended to stop as she was walking along to “window shop and look around”. Not typical behavior. I asked why she did that? Heart beating quickly, can’t get her breath? She could not pinpoint why she stopped. My sister & I thought … just the aging process.

Unfortunately this seemed to be more frequent & we decided to see a heart specialist. Through a stethoscope exam, the physician diagnosed a huge heart murmur. He further stated that Mom’s life was threatened by this condition. The cardiologist recommended we scheduled an angiogram to see what it looked like inside.

After confirming on the angiogram and making an appointment with the surgeon to choose open heart or to try to get a procedure through a leg artery (that is still only available to her as a randomized trial) a close family friend, who is a physician, scheduled a second opinion.

The second physician confirmed that everything we heard was completely true. This cardiologist however, pointed out that Mom has a great lifestyle, & in her late 80’s, would not be offered this procedure in a European country because of her age. He said that since she is not symptomatic yet (but will be without any doubt) the third option was to do nothing at this time. The doctor said it is very likely that she would not come out of the surgery the same cheerful optimistic person that she is today.

Conclusion? There is no real conclusion in health care until the actual end. Ours is a wait and see. You never know what you will eventually do. But we chose lifestyle over surgery. Also, it is a huge decision (and the decision, in the end, is the patient’s) Truly, it was good to have both sisters there as well as my Mother’s sister for support in that.

Maybe you have a reason for a second opinion you would like to share. Written by Linda in Scottsdale

when a medical alert becomes alarming!

April 25, 2012

I have noticed that my 86 year old father has memory loss and while it is probably age appropriate, it has also made me wonder at times if overmedication is part of the cause. Then, when reading the New York Times, I saw that Federal health officials had released a safety alert regarding statins, which many seniors, like Dad, take for cholesterol. They said that there may be rare risks of forgetfulness, confusion, muscle pain and even diabetes. Lipitor, Vytorin, Crestor and Zocor were among those named.

This reminded me of when alerts were first released for Fosamax and other bisphosphonates which had been prescribed for my mother and her severe osteoporosis. After years on the drug, she suddenly lost her ability to swallow, also described as a rare side effect of this pill. She had never had any prior esophagus trouble, so Fosamax became suspect! Right?

How seriously should we view these warnings? Big drug companies understandably play down the side effects of these huge sellers. And how does one decide which is worse – using the drug to treat a serious medical problem and ignoring the “rare” consequences or refuse to take it and risk the health issue becoming much worse? Would love to hear from others how they weigh and make their decisions for both themselves and loved ones.

To read the article I refer to, go to: http://www.nytimes.com/2012/02/29/health/fda-warns-of-cholesterol-drugs-side-effects.html

submitted by Norma

everything’s coming up roses

April 18, 2012

Sometime, a long time ago, my mom and I were always at odds, yet I learned young not to exacerbate any controversial situations. The writing, after all, was on the wall and the outcome, wholly predictable. Over the last 36 years, I have been practicing yoga, for the last decade or more as a flowing, breathing moving meditation called The FullBodyElixir(www.CalleyONeillYoga.com) In addition, I am reading the Abraham-Hicks works, listening over and over of late. Also, loving The Power of NOW and my all time favorite THE MASTER KEY SYSTEM by Charles Haanel. All of these systems I have tried actually, amazingly, effectively work to clear the neural pathways of our minds: programming from the pilikia (Hawaiian for troubles, or trauma and drama) to a conscious, sound, positive stable mind. We all are coming to know we are a result of all of our past thinking and we are getting our predominant thinking patterns back to us in the form of life’s relationship and situations.

What is amazing is that between my sister and myself, my mom, at a young 84 is waking up through persistently being pointed to the positive, to the positive, to the positive. To be the love that you want is truly the only answer. So my mom is an awakening being…a not so happy marriage, and still she wakes up everyday, letting it go and letting it go… and we keep sharing our evolution and she sees the results. We have gone from so much pilikia to this: at the end of every phone conversation… every single one, we sing… EVERYTHING’S COMING UP ROSES FOR ME AND FOR YOU…. and the more we focus on this the more it comes into our daily reality.

Watch your thoughts, they become your words, watch your words for they become your actions, watch your actions for they become your habits… watch your habits for they become your destiny…(old Chinese proverb)

I send this to you Toby, and all your readers with so much love and compassion and aloha,

submitted by Calley in Kamuela, HI

canes, wheelchairs & awareness

April 11, 2012

A friend of mine, a polio victim, spends a lot of his time in a wheelchair. He’s comfortable with his situation now but only after having gone through much depression and angst. Another friend has walked with canes for most of her adult life after suffering an auto accident. She struggled through grit and determination, stayed out of a wheelchair for as long as she could. She now spends a lot of her time in a chair in order to get around more easily and without severe pain.

It’s astounding how unconscious people are! I’ve been with these friends in crowds, or even when we are just maneuvering down a street. When they are using their crutches or canes, they are terrified about being around other people. They don’t have much balance to begin with, so the slightest bump can send them reeling. When we’re walking together, I often feel like a blocking back opening a hole in the defense. I’ve practically smashed into people walking briskly right at us who seem to have absolutely no regard for who’s in front of them. And I’m not just talking about people on their cell phones!

I have had people crash into us; I’ve seen people almost knock my friends over; I’ve seen people stop short of crashing and then, almost incredulously, give them an evil stare as if to say, “How dare you impede my forward progress!”

There are many times that there are people in need, those with clear signs of difficulty like people using canes, crutches, and wheelchairs. But there are also those with an infirmity that no one notices who may need a little assistance. Seniors especially are vulnerable. Many have mobility issues, others don’t see or hear well. And their balance, even if they’re not using a cane or walker, is less stable.

Really, folks, we all need to slow down, look around, and be much more aware of those who might need a little assistance or move a bit more gingerly. It’s not asking much – I’m not even asking that you stop doing what you’re doing to help. Often there’s no help needed. Maybe just a bit more patience. I’m just sayin’.

Bart Astor (BartAstor.com) is a recognized expert in eldercare. His best-selling book,”Baby Boomer’s Guide to Caring for Aging Parents” is now in its second printing and is available electronically on Amazon and BarnesandNoble.com. He has appeared on numerous TV and radio shows, including ABC’s “Good Morning America” and PBS’s “MarketPlace.”

Spring – a season of renewal & cleansing

April 4, 2012

Happy Easter and Passover! April is the month, this year that finds these two major religious festivals arriving on the same weekend. They are BOTH powerful holidays that speak to so many issues. For the caregiver in each of us, these festivals can be both bitter and sweet. We hopefully can be with friends and family. Yet, for many of us, we will sit down to a family Easter dinner or Passover seder very mindful that some people are not with us. Perhaps for the first time, we will struggle to find a sense of meaning beyond the pro-forma obligations of hosting or cooking or attending a service.

In that sense, I want to offer a small message that I hope you have a chance to think about. It is a message that comes, really, from the insights of both holidays. Both of these major events (so central to both Judaism and Christianity) speak to us in a profound way. The symbolism of the holidays carries with them a message of renewal and hope in the midst of great transition. The Easter story of Jesus and the Passover exodus from Egypt are powerful symbols of what is possible in our own life.

The stresses, burdens and joys of caregiving often provide us with opportunities to examine our own life. Both holidays propel us to consider that we need to not sacrifice our lives, dreams and hopes. They remind us that each of us can be renewed & in a sense, reborn, if we can shake the fear of change and growth and transition from our own souls. For so many who are feeling weighed down by the issue of caring for a loved one, these holidays can provide a sense of liberation and meaning. There is a higher purpose being served and this often lonely wandering, can provide a foundation for personal growth.

There is a tradition within the Jewish community as Passover nears, to clean out the non Passover acceptable foods (the leaven). There is a ritual that accompanies this cleansing. It is a metaphor for what these festivals can teach. Each of us, every year, is given the opportunity to clean out from our lives and souls, that which enslaves us. Easter and Passover, in their own ways, try and remind us that we are free to cross over our own personal sea and seek that which frees our souls. This transition does not come in a flash. It often is cumulative over time, until we arrive at a place in our life when we take all that has happened to us, embrace it and learn from it and move on into a future of our choosing.

May your holidays be sweet and joyous and healthy.

Rabbi Richard F Address, D.Min

www.jewishsacredaging.com

jewishsacredaging.com on Facebook

is she over medicated?

March 28, 2012

My mom is not herself, but who could be when taking 19 different medications a day for various conditions? Is she over-medicated? Probably, but her doctor has prescribed and is very aware of every pill she takes. Which pill or pills would mom want to give up, as she has been reassured that each is necessary in itself? Her doctor seems to become indignant when she questions him about this.

A friend in the retirement home she lives in was talkative and vivacious. In the last few weeks this woman has become withdrawn and shaky. She had complained of headaches and is now taking medication to alleviate the pain, but at what price? Where is the Nancy we knew?

Drugs do save lives, treat symptoms and alleviate pain but how does one deal with the psychological side effects? According to Health Watchers’ News and Views in a November 2010 article, “Experts estimate that up to one-third of the elderly in our communities may be over-medicated and some 20% of their hospital admissions are due to adverse drug events. The costs related to over-medication in the elderly are thought to exceed $80 billion each year.”

Help me help my mom. What has been your experience with over medication in a loved one and how have you approached/confronted her primary physician? I could use some guidance as I tackle this seemingly delicate, but also crucial and common situation. Written by girlfriend in Iowa, Susan

the theology of relationships – rave

March 23, 2012

Rabbi Richard Address has devoted his career to helping transform synagogues into caring communities. Now, in Seekers of Meaning, his newest and most personal work to date, he explores how the notion of a caring community can be transformative for individuals, particularly baby boomers struggling with issues of aging and mortality.

“Who am I? Why am I here?” These are questions that guide us–or haunt us–our entire lives. As we age, these questions take on new relevance, all the more so as we face the daunting challenges of our aging society. We are seeing the health of our parents decline. We are deferring retirement in a difficult economy. We are becoming caregivers for loved ones. We are struggling with our own issues of health and wellness. Where do we turn for guidance in navigating these uncharted waters? Where do we now seek meaning in our lives?

The answer, argues Rabbi Address, is to be found in our relationships. Using key texts from the Torah, he shows that the foundation of a happy and healthy life is the meaning we seek in it in the community of others–our family, our friends, our congregations–and in our most fundamental relationship, with the very Mystery behind our own existence. This “theology of relationships” can bring much needed change to the Jewish communities that have nurtured us for so much of our lives, and help us make for ourselves an older adulthood that is healthy and sacred.

–

what is a TIA?

March 21, 2012

Recently my Dad suffered a TIA & I had NO clue what the doctor was talking about. Dad had blacked out for a minute & when he came to he was babbling incoherently and temporarily blinded. It seemed to pass after about a half hour but meanwhile my Mom was hysterical. Since then my Mom has also had a TIA (transient ischemic attack). The more I discuss this with my friends the more I find that it is common among the elderly.

People who suffer stroke-like attacks have a mortality rate 20 per cent higher than the general population.

In one of the largest studies of its kind, over 20,000 adults hospitalised between 2000-2007 with a TIA were surveyed for mortality rates.

A TIA occurs when blood flow to the brain ceases for some time, leaving the victim with stroke-like symptoms for a short period. But it could also foreshadow a real stroke if preventative steps are not taken.

The symptoms of strokes & TIA’s are the same, but a stroke is permanent & a TIA does resolve itself. Symptoms include: confusion, difficulty pronouncing words or the inability to follow commands, speech and vision may be affected, mobility & feeling on one side of the body. Has anyone in your family suffered from a TIA?

submitted by Susan in Virginia

medicaid cuts impact senior access to pharmacy care

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