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Care for the Caregiver The Journey Fall 2016

By |November 10th, 2016|

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The Journey Fall 2016

Eldercare Q&A December, 2016 Drug Abuse & The Elderly

By |October 27th, 2016|

Q: Is drug abuse an issue with older people?

A: Yes.  Little attention has been paid to the issue of substance abuse—both legal and illegal drugs–among the elderly. But recent data demonstrates that drug abuse is increasing among elders, and is a larger proportion of all substance abuse among this population.

One study in 2011 reported that 6.3% of those age 50 to 59 reported they had used illicit drugs in the past month, more than twice the rate recorded in 2002. Baby boomers (born between 1946 and 1964) haved a lifetime rate of illicit drug use higher than those of people older than them. The number of older adults needing treatment for substance abuse is estmated to increase from 1.7 million in 2000 to 4.4 million by 2020.

Nonmedical use of prescription drugs among people 50 years and older is predicted to increase to 2.7 million American by 2020, and one recent study of elderly men in hospital emergency rooms showed that 11.6%  involved opioid use—a rate nearly 5 times higher than marijuana, and 6 times higher than cocaine.

One large study of emergency department admissions in 2008 for illicit substance abuse among adults over age 50 years noted that nearly 60% were aged 50 to 54 years, while only 1.5% were over age 75 years. Substance abusers were 70%  male. The substances most commonly abused include cocaine (50%–60% of cases), heroin( 25%), and marijuana ( 20%).

Researchers define “early onset users” as  individuals with a long history of substance abuse, who continue to abuse as they age. “Late-onset” substance abuse is a less common pattern, accounting for less than 10% of substance abuse among the elderly. Some elders who start abusing drugs do so because of medical factors, like higher rates of painful medical conditions that push the elder toward self-medication, and the development of psychiatric conditions like  depression or dementia. Older adults also suffer from higher rates of many of the same risk factors found in younger adults—like bereavement, social isolation, financial difficulties, or poor support systems

Some studies suggest that in recent years prescription opioids have replaced heroin as the opioid of choice, including among the elderly. But among people who were early users of illicit drugs,  heroin has been a drug of choice for so long that changing trends are not immediately reflected among elderly users.

The most common addiction among the elderly is with legal substances, like nicotine and alcohol. Psychoactive prescription drugs come in third, and illegal drugs, like marijuana, cocaine, or narcotics, come in fourth. One study of alcohol use in assisted living  found that 60% of residents drank alcochol, 34% drank daily, 19% had health impacts from drinking, and 12% had physical or psychosocial harm from alcohol. Alcohol abuse is a risk factor for a psychiatric illness: older adults are 3 times as likely to develop as mental disorder if they have a lifetime diagnosis of alcohol abuse.

Some studies recommend that every 60 year old should be screened for alcohol and prescription drug use/abuse as part of their routine  physical exam. But diagnosis of elder drug abuse is a challenge for primary care doctors. Older patients may feel compelled to hide their abuse. Doctors  may become absorbed with other medical concerns and neglect to explore the possibility of substance abuse. Bringing more attention to elderly drug abuse will hopefully encourage physicians to become more comfortable learning about treating older substance abusers.

HESSCO Highlights and Happenings Fall 2016

By |October 20th, 2016|

HESSCO Fall 2016 Newsletter

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Eldercare Q&A Medicare & Your Maintenance Care

By |September 30th, 2016|

Eldercare Q&A                     November, 2016

 Medicare & Your Maintenance Care

Q: Do I have to “improve” to keep getting home health care?


A: No. One of the biggest mistakes that nursing homes, rehabilitation centers, and home health agencies make is telling people on Medicare that they can’t get skilled nursing, home health care, or physical therapy because they’ve “reached a plateau,” or “failed to improve.” The courts have ruled that “improvement” is not a requirement for Medicare therapy or home health benefits. A federal judge recently ordered Medicare to do a better job of informing health care providers that the so-called “improvement standard” was no longer in effect.

Older patients with chronic and progressive diseases like Alzheimers, Parkinson’s, or congestive heart failure are unlikely to “improve” over time, but they can still get physical therapy or home health care. Rehabilitation therapy helps prevent declines in walking, eating, speaking, dressing and bathing.  Denying someone access to these treatments can worsening their disability, threaten their independence and result in more expensive health care needs.

People on Medicare might get confused reading their Medicare & You booklet, which describes on page 50 that home health is “part-time or intermittent.” That does not mean it has to be short-term. It is true that a doctor must approve your care, and you must be “homebound,” which is defined as having trouble leaving your home without help, and that leaving your home is a major effort. But you cannot be denied care because you are not “improving.”

In a 2013 court decision in Vermont, Medicare was ordered to pay for home health services to prevent a deterioration in a patient’s condition. The “stability presumption” was found to be unlawful. The Judge wrote: “A patient’s chronic or stable condition does not provide a basis for automatically denying coverage for skilled services. The determination of whether a patient needs skilled nursing care should be based solely upon the patient’s unique condition and individual needs, without regard to whether the illness or injury is acute, chronic, terminal, or expected to extend over a long period of time. In addition, skilled care may, depending on the unique condition of the patient, continue to be necessary for patients whose condition is stable.”

The fact that skilled care in a nursing home or at home has stabilized a person’s health does not render that level of care unnecessary. An elderly person need not risk a deterioration of her fragile health to validate the continuing requirement for skilled care. Your “failure to improve” cannot be used as a reason to deny you Medicare therapies or home health care. Your care cannot be cut off because you “exhibit a decline in functional status.”

If you are on traditional Medicare or Medicare Advantage, and receiving services from a nursing facility, rehab facility or home health agency, and you think your covered services are ending too soon, you can ask for a fast appeal, referred to as an “expedited determination.” Your provider will give you a notice before your services end that will tell you how to appeal. For more assistance, call 1-800323-3205 and ask for the Medicare Advocacy Project.

September is Healthy Aging Month

By |September 2nd, 2016|

10 Tips For September Is Healthy Aging® Month

Think it’s too late to “reinvent” yourself? Think again. According to Carolyn Worthington, editor-in-chief of Healthy Aging® Magazine and executive director of Healthy Aging®, “it’s never too late to find a new career, a new sport, passion, or hobby.”

Worthington is the creator of September is Healthy Aging® Month, an annual health observance designed to focus national attention on the positive aspects of growing older. Now in its second decade, Worthington says September is Healthy Aging® Month provides inspiration and practical ideas for adults, ages 50-plus, to improve their physical, mental, social, and financial well being.

“Use September as the motivation to take stock of where you’ve been, what you really would like to do if money was no object,” says Worthington. “And try it! Who says you have to do something related to what you studied in school? Who says, you can’t become an entrepreneur, start your own home business later in life, test your physical prowess, or do something wildly different from anything you’ve done before? Only that person you see in the mirror!”

To get you started on reinventing yourself, here are some ideas from the editors of Healthy Aging®Magazine (www.healthyaging.net). Maybe they will help you think outside the box:

10 Tips for Reinventing Yourself during September Is Healthy Aging® Month:

  1. Do not act your age or at least what you think your current age should act like.  http://healthyaging.net/healthy-aging-month/10-tips-for-september-is-healthy-aging-month/

Elder Home Care Wait Lists to Begin in 25 Days

By |August 8th, 2016|

News from Mass Home Care – The Baker Administration has officially announced that starting September 1st, waiting lists for some elders will begin in the home care program.  Home Care Wait Lists Sept 1 2016 An Avoidable Crisis

Eldercare Q&A Keeping Your Cool on Very Hot Days

By |August 2nd, 2016|

Eldercare Q&A – September, 2016

Keeping Your Cool On Very Hot Days

Q: Are seniors at greater risk for hyperthermia?

A: Yes. Too much heat is not safe for anyone, but most people who die from hyperthermia are over the age of 50.

QA Eldercare September 2016 Keeping Your Cool On Very Hot Days-1

Senate Proposes Elimination of Crucial Medicare Counseling Program – Medicare Rights Blob

By |July 18th, 2016|

The U.S. Senate Appropriations Committee recently approved a 2017 spending bill that completely eliminates funding for the Medicare State Health Insurance Assistance Program (SHIP).

Older adults, people with disabilities, and their families and caregivers need assistance understanding the A, B, C and Ds of Medicare. Operating in every state, SHIPs answer questions about Medicare and help people solve problems. Eliminating SHIPs would leave millions who need support comparing coverage options, appealing denials, applying for financial assistance, and navigating increasingly complex Medicare benefits stranded—with nowhere to turn.

Today’s Medicare beneficiary must choose among more than 20 prescription drug plans, an average of 19 Medicare Advantage plans, as well as various Medigap supplemental insurance policies—all with different premiums, cost sharing, provider networks, and coverage rules. For more than 24 years, SHIPs have advised, educated, and empowered individuals to navigate their state-specific Medicare choices. Specifically, SHIPs help beneficiaries resolve fraud and abuse issues, billing problems, appeals, and enrollment in low-income protection programs. . In 2015, SHIPs provided assistance to more than 7 million people with Medicare.

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Be Prepared for Extreme Heat

By |July 12th, 2016|

Be Prepared for Extreme Heat

July 7, 2016, by Kathleen Votava, Office of Regional Operations, Administration for Community Living

As summer is upon us, this is an important reminder regarding planning for and responding to periods of extreme heat. It is a time to prepare yourself and those in your care. Whether you are an older adult, an individual with a disability, or a family member caring for a loved one with functional needs, each person’s requirements and abilities are unique. During periods of extreme heat, every individual can take important steps to put plans in place and prepare for potential risks, such as power outages. By evaluating your own personal needs and making an emergency plan, you can be better prepared for any situation. Read More

World Elder Abuse Awareness Day – Tools, Tips, Resources

By |June 14th, 2016|

Tools & Tips

Every year an estimated 5 million older Americans are victims of elder abuse, neglect, or exploitation. And that’s only part of the picture: Experts believe that for every case of elder abuse or neglect reported, as many as 23 cases go unreported.

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