Improving Older Adults’ Mental and Emotional Well-Being with Home Health Care

Seniors go through a lot of changes that can impact their mental and emotional health. Some of these changes are minor and occur gradually, while others are significant and abrupt.

Below are some of the challenges older adults face that may compromise their psychological well-being.

Challenges That Impact Seniors’ Emotional and Mental Health

Isolation and Loneliness

Different factors can fuel feelings of loneliness and isolation among older adults. These include:

– the death of their spouse, relatives, or close friends
– losing their jobs
– retiring from careers that defined their identity and gave them a sense of purpose and self-worth
– the absence of people they can regularly talk to and confide in
– mobility and transportation challenges that also lead to decreased social activities

Prolonged loneliness can have detrimental effects on seniors’ health. It can weaken their immune system and put them at higher risk of chronic diseases.

Loss of independence

As their health continues to decline, older adults find themselves unable to do things on their own. They may need help cleaning the house, rely on others for transportation, or require assistance when using the toilet or taking a bath. Others may be suffering from chronic illnesses or recovering from injuries that keep them in bed for weeks or months.

All these may leave your elderly loved one feeling helpless and frustrated. They may fear losing their independence and having less control over their lives.

Memory issues

Occasional memory lapses are a normal part of aging. But factors like illnesses, lack of sleep, or depression may worsen older adults’ forgetfulness.

These memory issues can frustrate older adults and even pose threats to their health and safety. They may forget to take medications on time, or accidentally leave stoves and ovens on.

Vulnerability to stress and mental health concerns

Aside from the changes mentioned above, other challenges can increase stress among the elderly.

Their fear of slipping or getting injured can make them more anxious to go to the bathroom alone or leave the house without a companion.

Financial concerns may also weigh them down. They may be worried about not being able to pay for growing medical and living costs or long-term care.

Chronic stress can increase the risk of mental health issues among seniors. According to the World Health Organization, 7 percent of adults over 60 years are suffering from depression and 3.8 percent from anxiety disorders. Data from the Centers for Disease Control and Prevention also revealed that men 85 years or older had the highest suicide rate of any age group.

Chronic illnesses also leave seniors more vulnerable to depression and other mental health concerns. These mental health issues can further impact their physical health and recovery. For instance, seniors suffering from loneliness and depression have higher mortality rates. Depression also affects the success and duration of cardiovascular treatment in older adults. It can even aggravate insomnia and memory loss.

Augmenting Psychosocial Support for the Elderly Through Home Health Care

The benefits home care workers provide go beyond physical assistance. They become additional sources of psychosocial support, helping seniors navigate challenges that come with aging.

Regular emotional support

Having someone to talk to may help older adults manage difficult emotions like loneliness, fear, and frustration. Moreover, having constant emotional support can help reduce their risk of developing mental and physical issues.

Companionship and socialization

The companionship home care workers provide can alleviate chronic loneliness among seniors. They can also help older adults maintain an active social life by:

– driving them to community activities or visits to family and friends
– accompanying them during walks
– helping them use video chat tools to keep in touch with relatives and friends

These activities help seniors stay connected, keeping feelings of isolation and loneliness at bay. Participating in social activities gives them something to look forward to and allows them to create new memories and connections.

Supporting healthy routines

Healthy eating and exercise keep seniors strong and improve their balance. These also keep their memory sharp, boost their mood and help them relax and manage stress.

In-home senior caregivers and home health aides can help older adults stay fit and stick to healthy routines. For example, they can prepare nutritious meals and ensure these meet seniors’ dietary requirements. They assist them during light exercises, accompany them during walks, and inspire them to resume their hobbies.

Physical support to maintain their independence and quality of life

Aging in place allows seniors to retain their sense of independence and control over decisions that affect their lives. Living in a familiar place, surrounded by things that bring them comfort, may also give them a sense of security amidst the changes they are going through.

Home care workers help seniors stay independent while reducing the risks and difficulties that come with aging in place. They help older adults keep their homes clean and safe by handling light housekeeping tasks and removing hazards like electrical cords and rugs. They help them maintain personal hygiene by assisting them with bathing and dressing.

Home health care agencies provide seniors and their loved ones with cost-effective home care options. This flexibility in terms of the type of care and cost can reduce seniors’ financial stress. Clients can decide how often to request these services and what tasks they need help with. Older adults who are recovering from injuries or illnesses can also save on hospitalization costs through in-home skilled nursing care.

Promoting Holistic Health for Seniors

Changes that come with aging can hurt your elderly loved one’s mental and emotional well-being.

This is an area where home care can help. Home care workers become constant sources of social support for seniors, helping them experience healthy aging and a better quality of life.

How New Tech Can Support Caregivers as They Support Seniors

Up to 42% of Americans over the age of 65 take five or more medications, and in 2018, at least one in every five seniors experienced an adverse drug reaction. Such reactions are more common when seniors can’t properly adhere to the instructions that accompany their prescriptions.

In fact, according to U.S. Pharmacist, nonadherence accounts for about half of treatment failures and a quarter of hospitalizations every year. This, combined with the fact that healthcare providers are largely overwhelmed and overburdened, means caregivers have a unique opportunity to improve senior health outcomes. Caregivers can act as an extension of the medical industry to help seniors overcome the hurdles they face when it comes to medicating themselves properly.

Why Medication Adherence Is Challenging for Seniors

Experts agreed that the therapeutic efficacy of any medication requires an adherence rate of 80% or higher. To medicate properly, seniors must closely follow the instructions on each drug’s label and keep a consistent routine around consuming the right doses to avoid complications.

Unfortunately, the current average for medication adherence for chronic health conditions is only about 50%. For most patients, this isn’t enough to improve or stabilize their conditions — much less boost their life expectancy. But nonadherence is often a combination of hurdles that can be difficult for seniors to overcome on their own.

For example, the instructions on drug packaging may be confusing, and age-related memory loss can lessen the chances of proper adherence. The side effects of certain medications may also be uncomfortable, making patients hesitant to stick with them. Overall, keeping track of when and how to take various medications can be overwhelming for anyone.

The Important Role of Caregivers

Daily routines and medical schedules can be much easier for senior patients to adhere to with the assistance of a caregiver. As caregivers, a patient’s family members, friends, loved ones and volunteers can help ensure seniors take their prescriptions as directed and eat regular meals. What’s more, they can better monitor changing behaviors or symptoms that could indicate a poor reaction to medications.

Because the healthcare system is becoming increasingly overburdened, healthcare providers don’t always have the time or means necessary to devote to helping patients adhere to medications. Instead, the healthcare system should focus on providing caregivers with tools they can use to make senior care more manageable, especially when it comes to drug adherence. This will become even more necessary as the senior population grows.

The following tools can help caregivers address the medication adherence problem plaguing American seniors:

  • Automated medication dispensers: Medication dispensers have come a long way — from manually organized pillboxes to modern, automated dispensers that ensure people get the prescriptions they need. One of the most valuable aspects of automated medication dispensers is that they can sync with a mobile application to alert caregivers of missed doses and low prescriptions.
  • Personalized medication reminders: Medical alert systems and healthcare apps — or even simple reminders on a smartphone calendar — are vital to helping seniors prevent missed doses. Some apps are more detailed than others, so consider whether simple reminders will suffice or whether caregivers should receive confirmations as well.
  • Home delivery of presorted medications: In terms of convenience, having presorted medications delivered directly offers a critical advantage for both seniors and caregivers. Automated delivery systems can be synced with medication reminders to create a convenient, holistic routine that makes adherence more accessible than ever.

When Medication Adherence Is Easier

There are very clear, immediate benefits to practicing better medication adherence — the most obvious being the success of the medication. Data suggests that for every 10% improvement in medication adherence, healthcare costs can be reduced by 29%.

Adherence also has a halo effect on other aspects of a patient’s life, improving chances of eating healthy, exercising regularly and taking one’s own personal wellness journey more seriously. Better adherence is key to improving seniors’ quality of life and reducing the burden on the healthcare system, and caregivers are in a great position to help make it happen when armed with the right tools.

Loneliness May Be Due to Increasing Aging Population

Lonely workaholic with alcohol problem

Despite some claims that Americans are in the midst of a “loneliness epidemic,” older people today may not be any lonelier than their counterparts from previous generations – there just might be more of them, according to a pair of studies published by the American Psychological Association.

“We found no evidence that older adults have become any lonelier than those of a similar age were a decade before,” said Louise C. Hawkley, PhD, of NORC at the University of Chicago, lead author of one of the studies. “However, average reported loneliness begins to increase beyond age 75, and therefore, the total number of older adults who are lonely may increase once the baby boomers reach their late 70s and 80s.”

The studies were published in the journal Psychology and Aging.

Hawkley and her colleagues used data from the National Social Life, Health and Aging Project and the Health and Retirement Study, two national surveys of older adults that compared three groups of U.S. adults born in different periods throughout the 20th century. They first analyzed data in 2005 to 2006 from 3,005 adults born between 1920 and 1947 and a second time in 2010 to 2011 from 3,377 people, which included those from the previous survey who were still alive, and their spouses or partners. The third survey, in 2015 to 2016, comprised 4,777 adults, which included an additional sample of adults born between 1948 and 1965 to the surviving respondents from the previous two surveys.

The authors examined participants’ level of loneliness, educational attainment, overall health on a scale from poor to excellent, marital status and number of family members, relatives and friends they felt close to. They found that loneliness decreased between the ages of 50 and 74, but increased after age 75, yet there was no difference in loneliness between baby boomers and similar-aged adults of earlier generations.

“Loneliness levels may have decreased for adults between 50 and 74 because they had better educational opportunities, health care and social relationships than previous generations,” said Hawkley.

Adults over 75 were more susceptible to becoming lonely, possibly due to life factors such as declining health or the loss of a spouse or significant other, according to Hawkley.

“Our research suggests that older adults who remain in good health and maintain social relationships with a spouse, family or friends tend to be less lonely,” said Hawkley.

In a similar study, researchers in the Netherlands found that older adults were less lonely than their counterparts from previous generations.

These researchers used data from the Longitudinal Aging Study Amsterdam, a long-term study of the social, physical, cognitive and emotional functioning of older adults. A total of 4,880 people, born between 1908 and 1957, participated.

The study measured peoples’ loneliness, control over situations and life in general and goal achievement. For example, participants rated loneliness on a scale from 0 (no loneliness) to 11 (severe loneliness) based on feelings such as, “I miss having people around.”

Older adults born in later generations were actually less lonely, because they felt more in control and thus most likely managed their lives better, according to Bianca Suanet, PhD, of Vrije Universiteit Amsterdam and lead author of the study.

“In contrast to assuming a loneliness epidemic exists, we found that older adults who felt more in control and therefore managed certain aspects of their lives well, such as maintaining a positive attitude, and set goals, such as going to the gym, were less lonely,” said Suanet. “Additionally, as is well-known in loneliness research, participants who had a significant other and/or larger and more diverse networks were also less lonely.”

Suanet recommended that older adults take personal initiative to better nurture their social ties, such as making friends to help them overcome increasing loneliness as they age. Also, interventions to reduce loneliness should focus more on bolstering older adults’ feelings of control, instead of only offering social activities.

“People must manage their social lives better today than ever before because traditional communities, which provided social outlets, such as neighborhoods, churches and extended families, have lost strength in recent decades,” said Suanet. “Therefore, older adults today need to develop problem-solving and goal-setting skills to sustain satisfying relationships and to reduce loneliness.”

Seniors may also want to make use of modern technology to maintain meaningful social connections, according to Hawkley.

“Video chatting platforms and the Internet may help preserve their social relationships,” said Hawkley. “These tools can help older adults stay mobile and engaged in their communities.”

Articles: “Are U.S. Older Adults Getting Lonelier? Age, Period and Cohort Differences,” by Louise C. Hawkley, PhD, NORC at the University of Chicago; Kristen Wroblewski, MS, L. Philip Schumm, MA, University of Chicago; Till Kaiser, PhD; and Maike Luhmann, PhD, Ruhr University Bochum. Psychology and Aging. Published Dec. 10, 2019.

How Universities Can Better Support Student Caregivers

More than half of family caregivers are between the ages of 18 and 49 years old – and as the U.S. population ages, increasing numbers of these caregivers will be enrolled in colleges. Often categorized as “nontraditional students,” college-enrolled caregivers are responsible for children, spouses, and dependent parents with disabilities and chronic illnesses. Nontraditional students of all kinds are more likely to drop out of higher education because of obstacles in their non-academic lives, and this certainly holds true for those who have to balance caregiving with their studies.

Historically, Student Affairs professionals have developed programs and services to meet the challenges faced by underrepresented and underserved students. Given the growing prevalence of student caregivers, academic institutions should keep their needs in mind when distributing funds and creating student support services. While each student caregiving experience is unique, the fundamentals are constant. Very often, student caregivers must choose between attending to a human being for whom they are responsible or attending to academic tasks.

Students managing such choices, balancing caregiving and academic demands, face significant barriers. For example, the amount of time they are able to spend with faculty and advisors is often limited by their caregiving responsibilities. Furthermore, efforts to disseminate information about support services on college campuses typically focuses on traditional students and thus may miss or leave out nontraditional students who are not part of established campus communication channels.

Student-Centered Teaching Can Help Caregivers

Student-centered teaching focuses on individual learning needs to promote persistence and success. Effective student-centered instruction is based on the understanding that one size does not fit all. When an instructor makes accommodations for student caregivers as emergencies arise, such flexibility demonstrates empathy and can promote success rather than indicate compromised standards.

Consider the following examples from the lives of student caregivers I interviewed in my research:

  • Waldo told me about his experience during his first year of college. He began caring for his mom, who had Huntington’s Disease, while he was in high school. He grew up in poverty and was the first person in his family to go to college. He chose to stay at home and commute to college so he could continue to care for his mom and save money. During finals week of his freshman year, his mom required brain surgery because of a fall. He asked his statistics professor if he could take the final at an alternative time due to his mom’s surgery. The professor replied that it was his choice whether he came to the final or not, but he would not alter the time.
  • Alex, an assistant professor, cared for his mom who had a stroke while he was completing his PhD. He told me he was lucky the stroke occurred around Thanksgiving, when he had a break from the regular requirements of the semester. As he navigated his mom’s recovery, Alex only had to negotiate with his dissertation chair – who allowed him to alter deadlines to ensure he had the time he needed to care for his mom.

Alex’s dissertation chair practiced student-centered teaching, while Waldo’s professor did not. The advantages to students of such teaching are evident, especially for student caregivers, who need a flexible learning environment to succeed academically and develop healthy coping skills while contending with the overriding needs of those for whom they care.

Student Caregivers, Technology, Insurance, and Health

Student caregivers are at a higher risk for stress-related illnesses than their peers, due to their time constraints and intersecting roles; and such difficulties can be compounded when students lack the time and resources to develop healthy coping strategies. Nevertheless, higher education policies have the potential to improve long-term health outcomes for student caregivers by providing access to appropriate supports and resources. Health is at the core of student learning and success. It is in the interest of university administration to ensure access to institutional support and resources, as the following examples suggest:

  • Natalia, a PhD candidate and caregiver, struggled with anxiety and depression. Her dissertation advisor empathized with her situation and allowed her to work remotely instead of commuting to campus when her mom needed care. She was fortunate to have access to all of the university’s technological resources while at home caring for her mom. Natalia’s advisor also encouraged her to apply for emergency funds. The flexibility and knowledge about university resources that Natalia’s advisor provided, helped her develop and employ healthy coping strategies.
  • Anne, a master’s degree student, told me about the university resources she received as a student caregiver. Assistive technology provided by her university was installed on her personal computer, allowing Anne, her husband, and their children to navigate various tools for coping with learning disabilities. Student health insurance provided by the university allowed her to get allergy shots, orthotics, and counseling to cope with anxiety and depression. Financial aid both increased and decreased stress. She worried about paying back the loans, but before she enrolled in graduate school her family did not have the financial reserves to weather a crisis.

Toward Equity for Student Caregivers

Like other students, caregivers seek higher education to improve their economic and social resources, but they face many obstacles and graduate less often than traditional students. To level the playing field for all students, administrators should ensure all students have access to health insurance, appropriate personally tailored learning technologies, and the flexible schedules and supportive resources they need to study even when caring for others. Colleges, students, and society alike only stand to benefit if student caregivers face easier routes to degrees.

Read more in Lisa Schumacher, “The Lived Experience of Student Caregivers: A Phenomenological Study,” University of Iowa, 2018.

Do I Have to Enroll in Medicare if I’m Still Working at 65?

One of the most common questions asked by seniors these days is “Do I need to enroll in Medicare if I’m still working at 65?” The answer isn’t black and white. It depends on multiple factors and personal preferences. If you don’t plan on retiring at 65, you are going to want to ask yourself these questions to figure out when you should enroll in Medicare.

What is the Size of My Employer?

The first thing you need to consider when deciding to enroll in Medicare at 65 is the size of your employer. If you work for a small employer with less than 20 employees, you need to enroll in Medicare when your Initial Enrollment Period arises.

Medicare will become your primary insurance and your group plan will be secondary. Your group plan monitors your age, so there is a chance that they will stop paying your claims if they realize you are eligible for Medicare and don’t have it. You will also have late enrollment penalties later on because you missed your Initial Enrollment Period for Medicare.

If your employer has 20 or more employees, it’s considered a large employer. When working for a large employer you have three options during your Initial Enrollment Period.

  • Stick with your group plan and delay enrolling in Medicare until you retire.
  • Disenroll from your group plan and enroll in Medicare.
  • Have both your group plan and Medicare for extra coverage.

It’s advisable to research and compare premiums costs for both your group plan and Medicare to see which option is best for you. If you choose option one, you will have a Special Enrollment Period once you retire to enroll in Medicare without penalty.

Do I Have Retiree Benefits?

Retiree benefits are health plans that some employers offer to their retirees. Medicare is the primary insurance for these types of health plans. This means you need to enroll in Medicare if you have retiree benefits.

One type of plan that retirees often ask about is COBRA. COBRA allows the retiree to have health coverage up to 18 months after their retirement. However, Medicare requires you to enroll within the first 8 months of having COBRA if you are over 65. Keep in mind that COBRA can also stop paying claims if they realize you are eligible for Medicare, yet you don’t have it.

What if I Don’t Sign Up at All?

Choosing to not enroll in Medicare when you are expected to can cost you a world of trouble. You can end up getting late penalties and delayed coverage if you don’t sign up on time. Yet we see this all time. A healthy person decides not to enroll and doesn’t realize that later he will have considerable penalties because he simply didn’t know the rules.

In this scenario, he must now wait until the next General Enrollment Period (GEP) which begins January 1st and ends March 31st. When you enroll during the GEP, your coverage doesn’t start until that July. This means that you have gone months without health coverage.

How Can I Enroll in Medicare?

Most people qualify for premium-free Part A, so you might as well enroll in at least that when you are first eligible. If you do decide to enroll in full Original Medicare when you are first eligible, you will be safe from the chaos that occurs when you don’t enroll on time.

If your group plan has decent drug coverage, you don’t have to enroll in Part D for drug coverage. Be sure to check if your group plan includes drug coverage because if it doesn’t, you will need to enroll in Medicare Part D.

You can enroll online at the Social Security website, in person at the Social Security office, or over the phone during your Initial Enrollment Period (IEP). Your IEP is a seven-month period. This one-time window begins three months before the month that you turn 65 and lasts for three months after the month that you turn 65.

Can I Disenroll from Medicare if I Return to Work?

Sometimes people retire and then decide to return to work, perhaps in a new field or part-time. If your new employer has more than 20 employees and offers health insurance coverage, you can enroll in that coverage and drop your Medicare Parts B and/or D if you want to. This will save you from paying those premiums. Be sure to confirm that your employer’s plan is equal to or better than Part D benefits so that you don’t incur a penalty later on when you re-enroll in Part D.

There is usually no need to disenroll from Part A since Part A costs nothing for most people. It can coordinate with your employer coverage and potentially reduce costs if you incur a hospital stay. Just keep in mind that you cannot contribute to a health savings account while enrolled in any part of Medicare, so if your employer plan provides an H.S.A., you’ll want to keep that in mind.

Later when you decide to stop working again, you’ll have a special election period to re-enroll in Parts B and D.

Dealing with Medicare while you are still working at 65 can be difficult. It’s important to learn what type of coverage your employer has along with what changes might be made once you get Medicare. Doing your research ahead of time can help you avoid any enrollment mistakes.

Dilemmas and Solutions for Americans Raising Children While Caring for Elderly Family Members

Approximately half of middle-aged people in American provide financial, health, or emotional support for adult parents and minor or adult children. The term “sandwich generation caregiver” emerged in the 1980’s to describe middle-aged people who support minor children while providing physical, emotional, financial, or legal assistance to adults. Of course, doing so much exacts personal costs. Sandwich generation caregivers often experience stress-related illnesses, lost income, and decreased work productivity. They also find it harder to provide prolonged assistance to adult children.

Historically, caregiving could be shared by extended family members who lived in close proximity. Now more people relocate for career opportunities. Younger people may do senior care at a long-distance, or aging parents may move closer to one of their adult children and increase the burden on that family.

Caregivers who are employed full-time and taking care of multiple family members must adjust their work schedule and often take unpaid leave to fulfill obligations. They may lose Social Security and pension benefits or experience stressful financial strains that can cause them to become ill. Very often, sandwich generation caregivers choose to attend to the health of a child or parent and neglect their own health. Poor caregiver health is becoming a public health issue.

Sandwich generation caregivers also face barriers in the workplace and increase the cost of health care for employers. Health care costs for caregivers are approximately $13.4 billion greater than for employees that do not have caregiving responsibilities. Working caregivers may have a hard time juggling the crushing time demands of work and caregiving; and they may pass up promotions, decrease work hours, and take unpaid leave because they have depleted paid vacation and sick days.

Caregiver absences cost the U.S. economy $25.2 billion annually in productivity; and workers often quit jobs, lose lifetime wages, retirement savings, and pension benefits. Less than half of U.S. employers offer flexible schedules or the opportunity to telecommute to accommodate caregiving tasks.

Guilt and Exhaustion

Sandwich generation caregivers at the same time express guilt that they are not doing enough – and say they feel exhausted from doing too much. Guilt and exhaustion about how caregiving affects their children is a perpetual undercurrent of stress that affects their own health. In one of my research interviews, Sophie said “I was a single mom at the time…[my kids] really needed me here and then it would be my night to go shower mom and put her to bed… I’d cry sometimes all the way there and then I’d get there and Mom would be sitting there, facing the wall …and then on the way home you’d cry because…how could I think that I didn’t need to be there.”  And in another interview, Ellie explained that she felt  “…sometimes it’s almost like a ball and chain and then I think, “What am I teaching my kids… I want them to have the freedom to live their life without feeling obligated to take care of me someday. And sometimes I wonder how strong a message I’m sending in that regard.”

Self-Care Helps Caregivers Cope – and Jobs Can Too

Parenting and caregiving are both consuming roles – yet many caregivers understand that they still need to take care of themselves because otherwise the pressure or anxiety can be overwhelming. Self-care takes many different forms for sandwich generation caregivers: leisure, exercise, and socializing.

Abby, for instance, told me that even during the hardest part of her caregiving experience she still did Friday night dinner and cards with her husband and friends, took her Tuesday golf outing and walked her dog daily. Abby realized that carving out time for herself helped her stay healthy and not resent taking care of her dad. Similarly, at the beginning of our interview, Zach, said he “was not the type of person to feel guilty” about taking time for himself. He incorporated his kids into his coping strategies by going for long walks with them.

Not only do most sandwich generation caregivers need the wages and benefits that work provides, they also need a break from caregiving. Work sometimes offers a “guilt-free” break, allowing them to feel productive and serving as either a social outlet or a place for solitude, as two interviewees explained:

  • Chloe stated that caregiving was mentally and physically exhausting.  She admitted that it was hard to not feel guilty about taking time for herself but she had a “wake up call” during a physical when her cholesterol and blood sugar were elevated. She allowed herself to relax and socialize during her quarterly conference for work.
  • Leah believed the hardest part of being a parent, caregiver, and professor was that she was “always surrounded.” Leah said that she didn’t take any time for herself. She felt she had to work to make up for the “hole” she put her family in to earn her degree but then she revealed that being in her office at work was like a “retreat”.  She could play music and work at the computer and just be by herself while she graded papers and worked on her research.

What Employers Can Do

Employee assistance programs, flexible schedules, and telecommuting options can reduce some of the stress sandwich generation caregivers experience. Such employees often miss work due to caregiving tasks and their own poor health as a result of stress. They may not have the time to practice preventative health habits and coping strategies, and some develop cardiac, psychological, and chronic illnesses. Employee assistance programs can reduce such problems, to the benefit of all concerned. Employers can, for starters, create a supportive environment for caregivers and help them to seek and utilize institutional and community resources.

In some cases, flexible schedules and telecommuting may allow caregiver workers to maintain their job productivity and prevent valued employees from having to reduce work hours or quit altogether. Employers and fellow employees should also realize that for some caregiver workers time at the office can also act as a coping strategy because it offers a physical and emotional break. This should not be seen as a problem. When caregivers practice self-care, they are healthier – and can be more productive even as they balance the complex demands of their work and family responsibilities.

Music: The Secret to Mental Health and Balance While Aging

No matter where you travel, you’ll notice one universal truth — music has a very particular and powerful hold on us all. Cultures everywhere make and love music. This has been the case throughout history. We have used music to relax, communicate and celebrate — the human brain is hard-wired to react to music. According to Kimberly Sena Moore, a neurologic music therapist, “Your brain lights up like a Christmas tree when you listen to music.”

The magic of music goes much further than entertainment — there a surprising number of health benefits for the elderly, and there is a lot of evidence to support the fact that music is a secret weapon when it comes to maintaining optimal mental health and balance in our old age.

Boost Memory by Learning to Play an Instrument

If you want to ensure your memory is strong well into your winter years, consider picking up an instrument. Regardless of what you prefer to play, the act of learning how to play will sharpen your memory recall. This is because the process of learning and playing an instrument requires a great number of complex tasks, such as reading musical notes and knowing where to place your fingers. In time, this expands your working memory capacity and your ability to multiprocess without feeling overloaded. You will also be able to remember information for longer periods.

Music Can Act as a Stress Reliever

Coping with stress can become more difficult as we get older. We have less resilience to it, and it can affect us differently, which is stressful in and of itself. On top of changes in response to stress, we can experience changes in triggers as the years go by, so it is important we all find a way to cope.

There have been many studies to show music has a notable (and positive) effect on our stress and blood pressure levels. In fact, this is the case even if we’re not conscious. One study involving surgery patients found the use of music before an operation reduced stress levels to an even greater degree than anti-anxiety medication. The act of singing sends small vibrations throughout the body, which lowers cortisol (the stress hormone) levels and releases endorphins, thereby helping to keep you calm and collected in trying times.

Music Can Reduce Falls in the Elderly

Remarkably, studies show when the elderly exercise while listening to music, it helps them maintain balance and reduce the risk of falling. Falling is a huge concern for those over the age of 65, and music might well be the answer. According to a 2011 Swiss study, where participants were trained to walk and perform certain movements in time to music, they experienced 54% fewer falls when compared to the control group. The study also found that walking speed and stride length increased as a result.

A Good Drum Beat Can Kickstart Brain Function

The brain instinctively syncs to a rhythm. Because of this, therapists use drumming to get through to patients with severe dementia who don’t normally respond to external stimulus. When dementia patients hear music, you can detect a noticeable shift. They show more of an interest in their surroundings, they clap to the beat or even sing. This is because music can stimulate many parts of the brain simultaneously. Music which was popular when the patient was between the ages of 18 and 25 generally gets the most positive response.

Music Can Soothe Physical and Emotional Pain

Swedish researchers have found your favourite music can be a great pain reliever, as it can distract us and boost positive emotions. Interestingly, by evoking nostalgia, music can help us get through the pain, both physical and emotional.

Music Can Combat Depression and Boost Happiness

A serotonin imbalance in the brain causes depression. When you listen to music, you experience a boost in serotonin, so music can be used as a tool to combat depression in the elderly. Doctors claim the simple act of singing can release oxytocin, providing a significant mood booster. So while music alone may never entirely relieve the symptoms brought about by depression, it can certainly do its bit to enhance wellbeing.

Music Provides Opportunities for Social Interaction

Music can provide an essential source for social contact, which promotes interaction and a sense of belonging. This is increasingly important as we age. By incorporating music therapy and joining a choir, the opportunities to socialise and collaborate let us make new friendships and create new bonds.

Music Can Improve Quality and Quantity of Sleep

Many seniors don’t get as much sleep as they need, which can cause serious medical issues in time. Lack of sleep has been shown to have a profound and negative impact on mental health and wellbeing. A 2009 meta-analysis found music can improve the quality and quantity of sleep. Of course, the benefits may not happen overnight. But if you persist, in as little as three weeks, you should notice a pay off from this relaxation technique. Some of these include falling asleep faster and remaining asleep for longer.

Four Calming Techniques to Improve Your Mental Health

If you are like me and the other nearly 325,000,000 trillion people in the U.S., you have experienced stress. From raising kids, dealing with your boss or handling a health issue, you can feel overwhelmed. But there’s good news! Learn how to create peace and take control of your life.

Determining the Type of Stress

Most people do not realize stress, a response to stimuli comes in two varieties which is good stress and bad stress. Bad stress or distress happens when your perception of an event is threatening. According to Stress Management Society, “Through the release of hormones, such as adrenaline, cortisol…the caveman gained a rush of energy…”. This onset of biological and emotional reactions resulted in the need to fight or flight.

Good stress or positive stress is the opposite response. It is marked by feelings of happiness and a sense of confidence. Your thoughts are focused and the energy is motivating.

Four Paths to Calm

Now that you know more about stress, you can start to manage it. Try these tips to make stress ignite your creativity and passion. Make stress work for you.

1. Keep It in Perspective

So, how do you transform your bad stress into good stress? Change your perception. If your job causes you to relocate, consider it a career opportunity. If the throbbing in one of your molars means you need a root canal, don’t panic. Discuss it with an emergency dentist Calgary. Consider it an investment in your health.

2. Calm the Monkey

Your mind races with thousands of thoughts all day. Anxiety builds as you obsess about future concerns. What if this happens, what if that happens? Stop!

Just breathe. As you mindfully count from 1 – 10, inhale and exhale slowly. Feel your heart rate decrease.

The Buddhists used this breathing method for quiet meditation to conquer the Monkey Mind or frenzied mental condition. In Mindfulness: Taming the Monkey Mind by Mitchell Wagner, the author states, “It is not possible for the mind to be open…when it is consumed by anxiety.”

3. Choose the Right Foods

What do yogurt, pistachios, and spinach have to do with relaxation? They contain key ingredients which affect your mood.

Pistachios

According to Organic Facts, pistachios have “6 grams of protein per ounce…”. Protein contains an amino acid which produces serotonin, a regulator of hunger.

Spinach & Avocado

The folate found in this green leafy vegetable produces dopamine, a chemical producing feelings of pleasure. Folic acid improves memory in adults experiencing stress. Avocados are also high in folate and vitamin E.

Yogurt

This comfort-inducing snack is filled with probiotics. It delivers healthful live bacteria in the gut linked to good mental health.

Strawberries, Raspberries, & Blueberries

These fruits are high in vitamin C which helps fight stress.

4. Become a Yogi

Yoga is a tradition dating back 300 years ago. Yoga is low impact and is a synergy of mind, body, and soul.

The International Journal of Yoga published “Exploring the therapeutic effects of Yoga and its ability to increase the quality of life” and found “Yogic practices enhance muscular strength…reduce stress, anxiety…”. Bikram, Hatha, and Kundalini are some of the best forms of yoga for beginners.

Invest in Stress Management

Consult with your doctor. Read books and attend local exercise classes. Stay up-to-date about trends.

Stress is a part of life. Learn stress management. Anticipate the unexpected and choose a strategy challenging you to do your best. Then, sit back and relax.

Loneliness Found to Be High in Public Senior Housing Communities

Older adults living in public senior housing communities experience a large degree of loneliness, finds a new study from the Brown School at Washington University in St. Louis.

Nevertheless, senior housing communities may be ideal locations for reducing that loneliness, the study finds.

“There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities,” wrote Harry Chatters Taylor, doctoral student at the Brown School and lead author of “Loneliness in Senior Housing Communities,” published in the Journal of Gerontological Social Work.

The study was co-authored by Yi Wang, doctoral student at the Brown School, and Nancy Morrow-Howell, the Bettie Bofinger Brown Distinguished Professor of Social Policy and the director of the Harvey A. Friedman Center for Aging.

The study examines the extent of loneliness in three public senior housing communities in the St. Louis area. Two of the three complexes were in urban neighborhoods, and the last was located in a suburban neighborhood. All were publicly funded under Section 202 Supportive Housing for the Elderly Program. Data for the project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement and social support.

‘We believe that senior housing communities could become ideal locations for reducing loneliness among older adults.’

Results showed approximately 30.8 percent of the sample was not lonely; 42.7 percent was moderately lonely, and 26.6 percent was severely lonely. In analyzing the data, researchers found loneliness was primarily associated with depressive symptoms.

“We speculate that loneliness may be higher in senior housing communities for a few important reasons,” Taylor said. “The first is older adults residing in senior housing communities often have greater risk for loneliness. In order to qualify to live in these senior housing communities, older adults must have a low income, and having a lower income is a risk factor for loneliness.

“Additionally, most of the residents we interviewed identified their marital status as single, which is another risk factor for greater loneliness. Many older adults living in senior housing communities also have greater health and mental health vulnerabilities, which increases the likelihood that an older adult will experience loneliness.”

Despite all that, the study finds, senior housing communities may be better suited to combat loneliness than traditional residential homes.

“We believe that senior housing communities could become ideal locations for reducing loneliness among older adults,” Taylor said. “Senior housing communities are embedded in communities with peers who may have similar age and life experiences. There are occasional activities and support from senior housing management to encourage the building of friendships, bonds and social support among senior housing residents.

“Most senior housing communities also have a common space or multipurpose room available for use, which can also help facilitate building bonds between residents. Senior housing communities are frequently located close to public transportation, which provides access to transportation for residents without automobiles.”

Still, loneliness is frequently a stigmatized condition, he said.

“We often do not like to talk about our feelings of loneliness,” Taylor said. “For practitioners, it is important to be patient when working with older adults, and it could take a while for an older adult, regardless if they reside in a senior housing facility, to admit they are feeling lonely.

“Whether you are a child, relative or family member to an older adult, or provide services to older adults, be patient when discussing issues of loneliness and mental health with older adults.”

Medicare For All – Protection for Your Retirement Plans

An unexpected medical emergency, a life-changing diagnosis, or a car accident are a number of countless situations that can land us in the emergency room, setting off a chain reaction of diagnostic tests, follow-up appointments, prescriptions, treatments, and more. Of course, this all has a significant implication on your pocketbook, and even if you have insurance, the bills can still be staggering.

Health insurance is supposed to be an investment, a sort of safety net to minimize your financial obligations in the event of a significant health illness or injury. But rising premiums, high deductible plans, and coverage exclusions have rendered comprehensive, quality, affordable insurance plans a thing of the past.

This can have significant implications for older adults nearing or at retirement age. A car accident, a cancer diagnosis, or any number of other health issues can quickly drain away savings, including retirement plans.

Health Care Costs Threaten Retirement Plans

Amassing a retirement savings large enough to provide a comfortable living for decades is no small feat. Because seniors tend to see increased health issues and health care costs in their latter years of life, a significant portion of their retirement plan needs to be able to cover those increased costs.

According to a study performed by Fidelity, a 65-year-old couple retiring in 2017 will need to cover approximately $275,000 in health care costs throughout their retirement. That amount reflects a 6% increase over the 2016 figure of $260,000. However, that estimate has increased more than 70% when compared with the initial estimate ever performed by Fidelity back in 2002.

Simply saving up enough money to be able to retire can be a challenge, especially when you encounter unexpected health issues and emergencies earlier on in life. According to a survey by Bankrate, only 41% of adults say that they have enough money in savings to be able to pay off an unexpected cost. However, 45% of survey respondents indicated that they’d had a major unexpected expense in the past 12 months.

And if a family has a high-deductible insurance plan, a single visit to the ER can cost tens of thousands of dollars. Families without adequate savings may feel pressured to reach into retirement savings to fund the emergency, leaving them with even less savings than they’d had initially.

A Compounding Problem

The issue of health care costs depleting retirement savings becomes even more urgent when you consider the seniors who can’t afford to retire at all. The U.S. Jobs Report indicated that the retirement age is increasing, with almost 19% of United States seniors aged 65 or older were working at least part time during the second quarter of 2017. Additionally, 19% of 70- to 74-year-olds were still working.

Working later into life leads to increased retirement savings, but this isn’t a practical option for many seniors. Health issues force many seniors to quit their jobs even if their retirement savings aren’t yet large enough to provide them with long-term security.

Simply finding a job can be a challenge, since employers may be more reluctant to hire seniors (despite age discrimination laws). Seniors may find themselves with fewer job options and may have to settle for lower-paying jobs with poor health insurance policy offerings.

Medicare for All: Protecting Retirement Savings

Medicare for All could be a solution to this growing problem. With single-payer health care, all Americans could enjoy protection against unexpected large medical bills. Americans wouldn’t need to dip into their retirement savings for health-related emergencies. And with reduced health care costs, they could put more earnings into their retirement plans.

If more Americans were able to put aside more retirement savings, they could retire at age 65 without having to worry about extending their employment into their senior years. They could enjoy reduced stress and could focus on healing after a health crisis, rather than worrying about the massive bills that would follow.

With access to the medications and treatments that they need, Americans could enjoy better health, happiness, and an improved quality of life. Isn’t that what we want for our seniors, our retirees, and all American citizens?

Social Workers Can Now Learn Medicare Online and Earn Continuing Education Hours

Social workers can now earn continuing education hours while they learn Medicare at their own pace, anytime and anywhere with Medicare Interactive (MI) Pro, an online Medicare curriculum powered by the Medicare Rights Center.

MI Pro provides the information that social workers and health professionals need to become “Medicare smart,” so they can help their clients navigate the Medicare maze. The online curriculum contains information on the rules and regulations regarding Medicare—from Medicare coverage options and coordination of benefits to the appeals process and assistance programs for clients with low incomes.

“For over 25 years, social workers have been turning to Medicare Rights’ helpline counselors for clear and concise information on how to help their clients access the affordable health care that they need,” said Joe Baker, president of the Medicare Rights Center. “Now social workers can enroll in MI Pro and learn—or enhance—their Medicare knowledge at their convenience while fulfilling their continuing education requirements.”

The Medicare Rights Center, a national nonprofit consumer service organization, is the largest and most reliable independent source of Medicare information and assistance in the United States.

Licensed Master Social Workers and Licensed Clinical Social Workers can earn continuing education hours when they successfully complete any of the four MI Pro programs: Medicare Basics; Medicare Coverage Rules; Medicare Appeals and Penalties; and Medicare, Other Insurance, and Assistance Programs. Each MI Pro program is comprised of four to five course modules.

All MI Pro programs are active for one year following registration.

MI Pro courses are nominally priced. Additionally, social workers who purchase all four programs at once will receive an automatic 20 percent discount.

Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.

Available only through the Medicare Rights Center, Medicare Interactive (MI) is a free and independent online reference tool that provides easy-to-understand answers to questions posed by people with Medicare, their families and caregivers, and the professionals serving them. Find your Medicare answers at www.medicareinteractive.org.

The Critical Role of Caregivers, and What they Need from Us

Caring for loved ones who have aged or become disabled is not a new concept. Many of the services provided in hospitals, clinics and even funeral homes were once provided by families at home. Particularly in communities where traditional cultural beliefs are highly valued, taking care of an aging parent or grandparent is still a responsibility that families (usually women) are expected to take upon themselves. Inner discord can arise when caregivers challenge these traditions which can lead to guilt and in some cases lawsuits.

For example, proceedings from a roundtable hosted by the National Hispanic Council on Aging revealed that caregiver stigma is prevalent among Latinos, which can prevent them from seeking support and resources. Without help, the risk for burnout increases.

Results from a 2015 study by the National Alliance for Family Caregiving and AARP revealed that “an estimated 43.5 million adults in the United States have provided unpaid care to an adult or a child in the prior 12 months”. This number is likely to increase in the coming years due, in part, to an aging population.

Family caregivers perform a variety of services, including helping with ADLs, dispensing medications, managing finances, attending doctor appointments and advocating. Many do so while maintaining full-time employment outside of the home.

Respite is Essential, but lacking

The physical cost of caregiving is staggering, and there are few opportunities for respite. Even when respite is available, caregivers must consider the care recipients’ safety, and their desire to leave home. A person who has a disability or is ill can still make decisions regarding their care. So when they say no to respite care, it can’t be forced upon them. Desperate for a break, some caregivers have gone to extreme measures such as dropping off their loved one at the emergency room for respite. This is a problem that should be addressed in the years to come. But how?

Changes in the workplace

More companies and organizations are beginning to understand that caregiving without support can negatively impact worker productivity. In response, some companies have revisited their policies regarding family leave, allowing flexible work schedules and work from home opportunities. As employers seek new talent, they may find that policies such as these are attractive to job seekers. Two major companies, Deloitte and Microsoft, made headlines after incorporating paid time into their family leave policies. Other companies have adopted similar models.

As the nation grapples with how to provide better support to caregivers, it will need to improve major areas like extending paid leave to family caregivers, creating financial stability for those who need to provide full time care, and providing necessary training and respite to ensure the mental and physical well being for both the caregiver and the recipient. These changes require a shift in how we think about providing care, and changes in policy.

Accessible resources

Caregivers are operating on tight schedules and don’t always have time to attend in person support groups. So having the option of connecting with others through online chats and support groups is more convenient for some caregivers. In addition, they could benefit from ongoing training and resources that will help them to more effectively and safely care for their loved one. This past September, the U.S. Senate passed the RAISE Act, which would require the development of a national strategy to address the growing challenges and economic impact of caregiving. The bill must now go before the House of Representatives.

Money

The financial costs of caregiving cannot be ignored, and the average social security beneficiary does not earn enough to shoulder the burden of the financial costs they incur. Most caregivers likely work not only to maintain a sense of identity but also out of necessity.

Caregivers can face stressful decisions when it comes to choosing between work and providing care, particularly when their loved one is seriously or terminally ill. Too often, relatives are not eligible to be a paid for their time. And when they are, the earnings are not enough to make ends meet. Unfortunately, many caregivers often place their loved ones in skilled nursing facilities, simply because they cannot afford to care for them at home.

The question of who should provide care and how they will provide is one that has yet to be answered. While they wait, however, caregivers are facing stress and financial burden with few desirable options for support. And care recipients aren’t getting the care they so desperately need.

AARP Applauds Unanimous Senate Passage of RAISE Family Caregivers Act

AARP applauds the unanimous passage in the U.S. Senate of the bipartisan Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028).

The legislation, introduced by Senators Susan Collins (R-ME) and Tammy Baldwin (D-WI), calls for the development of a strategy to support the nation’s 40 million family caregivers. It would bring together stakeholders from the private and public sectors to recommend actions that communities, providers, government, and others are taking and may take to help make the big responsibilities of caregiving a little bit easier.

It would bring together stakeholders from the private and public sectors to recommend actions that communities, providers, government, and others are taking and may take to help make the big responsibilities of caregiving a little bit easier.

Every day, millions of Americans are caring for parents, spouses, children and adults with disabilities and other loved ones so they can live independently in their homes and communities for as long as possible. They take on a range of tasks including managing medications, helping with bathing and dressing, preparing and feeding meals, arranging transportation, and handling financial and legal matters. The unpaid care family caregivers provide helps delay or prevent costly nursing home care, which is often paid for by Medicaid.

“Family caregivers are the backbone of our care system in America. We need to make it easier for them to coordinate care for their loved ones, get information and resources and take a break so they can rest and recharge,” said AARP Chief Advocacy & Engagement Officer Nancy A. LeaMond. “Thanks to the efforts of long-time champions of the bill Senators Susan Collins and Tammy Baldwin, we are one step closer to helping address the challenges family caregivers face.” AARP is working to bolster bipartisan support for the RAISE Family Caregivers Act in the U.S. House of Representatives.

The bill (H.R. 3759) was introduced by Representatives Gregg Harper (R-MS) and Kathy Castor (D-FL), along with original cosponsors Representatives Michelle Lujan Grisham (D-NM) and Elise Stefanik (R-NY). The RAISE Family Caregivers Act has the support of about 60 national organizations.

For more information and to track this bill visit Congress.gov.

Child Welfare System Increasingly Relying on Relatives to Raise Children Exposed to Trauma

According to a new report by Generations United, grandparents and other relatives who step in to care for children, play an important role in mitigating trauma, which children in the child welfare system experience at starkly higher rates than the general population.

Thirty percent (127,819) of children in foster care are being raised by grandparents or other relatives, a six percent increase since 2008. In the wake of the opioid epidemic, that number is even more dramatic in the states hardest hit by the opioid epidemic like Ohio, which saw a 62 percent increase in the number of children placed with relatives in foster care since 2010. For each child in foster care with a relative, there are 20 children outside of the system with a relative.

More than half of the children in the child welfare system have endured four or more adverse childhood experiences (ACEs), leaving them 12 times more likely to have negative health outcomes – substance use disorders, mental health problems, and engaging in aggressive or risky behaviors – than the general child population.

“Growing up with a childhood full of trauma and abuse, there were very few moments where I felt safe and very few people with whom I felt protected. Being put into my uncle’s care was the best decision that could have ever been made for me,” explained Kindra, whose last name is withheld to protect her privacy. “It wasn’t an easy road by any means, but I have no doubt in that it completely saved my life.”

Compared to those in care with non-relatives, children in foster care with relatives have more stable and safe childhoods and a greater likelihood of having a permanent home. The have better mental and behavioral health, and are more likely to report always feeling loved.

“These relatives are the loving and protective arms for babies, children and youth who’ve experience trauma,” said Donna Butts, executive director of Generations United. “They are caring for children with multiple high-level needs and they should get the support required for the families to thrive.”

Unlike parents or foster parents who plan for months or years to care for a child, grandparents or other relative caregivers usually step into their roles unexpectedly. At a moment’s notice, they are forced to navigate complex systems to help meet the physical and cognitive health challenges of the children who come into their care.  Grandfamilies are less likely than foster families to have access to specialized training and support from professionals that have expertise in helping children, who have experienced trauma, heal.

“One thing I know to be true: you can’t love away the effects of trauma from neglect and abuse,” said Jan Wagner, grandparent caregiver, Michigan“Our children need the same amount of intensive therapy and services as a traditional foster placement and we, as their caregiver desperately need the same to help them heal.”

Among the report’s recommendations:

  • Reform federal child welfare financing to provide more trauma-informed support to prevent children from entering or re-entering foster care
  • Increase availability of and access to trauma training and supports designed for grandfamilies
  • Address barriers to licensing relatives as foster parents
  • Ensure grandfamilies not licensed as foster parents can access financial assistance to meet children’s needs

Generations United will release The 2017 State of Grandfamilies in America report Sept. 13 at a reception, from 5:00pm to 7:00pm, in room G-11 of the Dirksen Senate Office Building on Capitol Hill in Washington, DC.

Generations United will honor Senator Susan Collins (Maine) and Senator Bob Casey (Pennsylvania)with its 2017 Grandfamilies Champion Awards at the event.

Stressed Out Caregivers Are Using ER Visits for Respite, Study Finds

Emergency room staff call it a “pop drop” – when a disabled older person comes in for medical attention, but it seems like the person who takes care of them at home is also seeking a break from the demands of caregiving.

It’s been hard to actually study the phenomenon. A new University of Michigan study suggests that tired family caregivers are associated with greater ER visits and higher overall health care costs for the person they care for.

In a paper in the new issue of the Journal of the American Geriatrics Society, the team reports their findings from a study of 3,101 couples over the age of 65, each with one spouse acting as caregiver for their disabled partner.

The researchers looked at the Medicare payments and emergency department visits for the disabled spouses in the six months after the caregiver spouses took standard tests to measure their fatigue, mood, sleep habits, health and happiness.

Even after they took into account many factors, the researchers found that in just those six months, emergency department visits were 23 percent higher among patients whose caregivers had scored high for fatigue or low on their own health status.

Patients with fatigued or sad caregivers also had higher Medicare costs in that same time period: $1,900 more if the caregiver scored high for fatigue, and $1,300 more if the caregiver scored high for sadness, even after all other factors were taken into account.

The cost of unpaid help

“Many of us who work in clinical settings feel that patients with high home caregiving needs, such as dementia, often rely on the medical system as a source of respite for their spouses or other caregivers, because other respite isn’t paid for,” says lead author Claire Ankuda, M.D., M.P.H. “But there hasn’t been a lot of data about it, and only recently has our society been talking about caregivers and potential ways to incentivize and support them as a way of keeping patients living at home.”

Ankuda, who led the study during her time at in the Robert Wood Johnson Clinical Scholars program at U-M’s Institute for Healthcare Policy and Innovation, is now training in palliative care at the Icahn School of Medicine at Mount Sinai.

“Informal caregivers, including spouses, enable older adults with functional disability to stay out of the nursing home and live at home where they’d prefer to be,” says senior author Deborah Levine, M.D., M.P.H., an assistant professor of internal medicine and neurology at U-M.

We need to do a better job of identifying and supporting caregivers experiencing distress, in order to help caregivers feel better and hopefully improve outcomes in older adults with disability.” Deborah Levine, M.D., M.P.H.

Long-term data gives key insights

The couples in the study were all taking part in the long-term Health and Retirement Study, conducted by the U-M Institute for Social Research on behalf of the National Institutes of Health. Ankuda, Levine and their colleagues probed HRS data because it allowed them to correct for factors that other, short-term studies can’t – such as the baseline level of Medicare costs, demographic differences including income and education, and even whether the couples have adult children living nearby.

The findings add hard new data about the link between caregivers’ own experiences and the amount the Medicare system pays to take care of those the caregivers take care of at home.

Nearly 15 million older adults get help with everyday activities from spouses and other family or friend caregivers. In the new study, the researchers included couples where one spouse got help from the other with activities such as bathing, dressing, walking, getting into or out of bed, shopping, cooking, and taking medications.

Helping with these tasks on a daily basis, without pay or respite, can take a toll on the caregiver’s own health, wellness and mental state – which can lead to burnout. Medicare does not offer payment or formal respite coverage for family or friends who take regular care of older adults – and only covers home care by certified agencies under certain circumstances.

More research & services needed

Ankuda notes that studies on the impact of supporting family caregivers more formally are just beginning to produce results.

Meanwhile, health policy researchers are beginning to suggest that it may make fiscal sense to incentivize home caregiving, to keep seniors from needing more expensive nursing home care.

“I definitely think there are specific services that could help caregivers, if we can identify those people who are highest risk and provide a basic level of support such as an around-the-clock geriatric care call line that could help caregivers feel less isolated and talk to a nurse about whether, for example, to go to the emergency department,” Ankuda says. “This is a high-cost, vulnerable population.”

Formal respite care, peer support groups and other options could also help stave off fatigue and sadness – and the hospital staff who notice “pop drop” practices could help steer caregivers to such options. So could the primary care clinicians who take care of both the disabled spouse and the caregiver.

Because the new study takes into account the level of Medicare spending for the disabled spouse in the six months before their caregiver was interviewed, it may actually underestimate the impact of caregiver fatigue, she notes.

Indeed, before the authors corrected for the full range of factors, they documented that Medicare costs were lower for patients whose spouse-caregivers who reported being happy or rested. They also saw higher costs among patients whose caregivers had higher depression scores on a standard mood questionnaire.

One factor that wasn’t associated with higher costs in the new study was the caregiver’s score on a standard measure of sleep habits. Sleep disruption is harder to quantify in older people, Ankuda notes. But the measurement of fatigue, which can result from both the strain of caregiving and poor sleep, was clearly associated with both higher rates of emergency department visits and higher overall costs.

How Republican Plans to Cut Obamacare and Medicaid Hurt Older Americans

Trump on Obamacare

Over the last twelve months, my colleagues and I have spoken at length with close to one hundred Native American seniors across the state of New Mexico about their health care and health insurance. Since November 2016, these seniors have expressed profound apprehension about the future of health care and insurance coverage under President Donald Trump’s administration, both for themselves and for their friends and relatives. As one elderly woman put it, “I have care, but is [Trump] going to take that away from us?”

Most Americans assume that regardless of any changes to the Affordable Care Act (Obamacare), the healthcare needs of seniors will be covered by Medicare, which serves individuals who are 65 years of age or older and who have paid into the Medicare system via payroll taxes. In fact, even if the current Medicare system remains in place, Obamacare repeal will have profoundly harmful effects on older people, especially those under 65 who have low-incomes, live in rural areas, or are in need of long term care or help to stay in their homes. In fact, seniors are among the most likely people to be hurt by plans to replace Obamacare.

How Obamacare Has Benefited Seniors

Seniors age 55 and over make up an increasing part of the U.S. population and their healthcare needs are extensive and complex. The National Council on Aging estimates that 92% of older adults suffer from a chronic illness, such as diabetes or heart disease. Seniors also have high rates of cognitive health problems, including Alzheimer’s and dementia. A growing number of older adults experience mental health and substance use problems. Even as they face such health problems, many seniors have limited incomes and struggle with the costs of housing, food, and health care.

Although Obamacare is often seen as an effort to increase insurance coverage among younger and healthier people, it has also provided numerous benefits to seniors. These benefits are not only endangered by current replacement plans, they appear to be specific targets of Republican proposals. For instance, Obamacare’s prohibition of annual and lifetime limits on insurance coverage – as well as its limits on the ways insurance companies can raise prices for people with preexisting conditions – have made it possible for older adults with a variety of health problems to get affordable insurance and care.

Seniors have also benefitted from Obamacare’s expansion of Medicaid, which extended eligibility to adults at or below 138% of the federal poverty level. According to the Kaiser Family Foundation, more than six million seniors have received new coverage from Medicaid, including older adults under 65, Medicare beneficiaries with low incomes, and seniors who do not qualify for Medicare because they did not pay enough into that program during their working years. This last group includes elderly adults who are homeless or disabled, as well as those who were previously farmers, ranchers, and homemakers.

What is more, Medicaid covers long-term and in-home care services not covered by Medicare. These services allow seniors with serious medical concerns to receive high-quality care, either in a nursing facility or their own homes. In fact, the Kaiser Family Foundation estimates that 6 in 10 nursing home residents are covered by Medicaid.

In addition to extending these critical benefits to seniors, the Medicaid expansion has generated new revenues for providers of healthcare services that many elders need – including mental health and substance addiction services, transportation services, and help to purchase medical equipment needed by adults who wish to remain at home throughout their elder years. These improvements are especially important for seniors in rural areas, where service providers are sparse and patients must travel long distances to find care. As our research in the rural state of New Mexico reveals, healthcare providers report that Obamacare has helped them address the complex health issues faced by aging patients.

Obamacare has also significantly improved Medicare – by ensuring access to no-cost preventive care and screenings and expanding prescription drug coverage. Crucially, Obamacare addresses the previous Medicare gap in prescription drug coverage, where insurance did not pay for drug costs after an individual reached a certain level of costs. Obamacare discounts drug prices for seniors who fall into that coverage gap and aims to close the gap by 2020. Repeal of the law would significantly increase the cost of prescription drugs, disproportionately affecting seniors.

How Republican Plans Will Hurt Seniors Overall

Not only will repealing or reducing core benefits of Obamacare disproportionately hurt seniors, Republican proposals include provisions that will specifically penalize seniors, such as those that would let insurance companies charge older people up to five times more for insurance than younger adults. Families USA estimates that this could put marketplace insurance financially out of reach for 3.3 million people over the age of 55. Proposed caps on lifetime benefits and the elimination of regulations regarding the essential benefits that insurance plans must cover will put seniors at risk of “running out” of coverage as they age or being unable to afford insurance that will actually cover their medical needs.

Whether or not Obamacare is ultimately repealed, cuts to Medicaid – a core part of U.S. health insurance since 1965 — remain likely and will have especially harmful effects on the numerous seniors who rely on the program for long-term care, including the estimated one-third of American seniors who fall below 200% of the federal poverty line. In addition, reductions or caps to federal funding for state Medicaid programs will serve to deepen existing inequities in care for poor, older, and disabled people in the poorest and sickest states.

Better Care for Seniors Helps Everyone

Ultimately, while seniors have specific and complex needs, ensuring their health is important for everyone in all parts of the United States. When older people cannot get health insurance or adequate care, the burdens are often shifted to their adult children and grandchildren. Many seniors also care for their children and grandchildren, many of whom get help from Obamacare’s benefits for all low-income adults and children. Although Obamacare has very real limitations, the prospect of repeal is already plunging seniors into a state of fear and uncertainty. All Americans should join senior citizens in worrying about the drastic downsides for families and communities, especially in rural areas, if current Republican plans become law.

Low Medicaid Rates Limit Beneficiaries’ Access to Assisted Living Facilities, Quality Care

More than 700,000 elderly and disabled Americans receive health care in residential care communities, such as assisted living facilities. As the population ages, this number will grow.

A new study by RTI International found that low Medicaid payment rates for services in assisted living and similar settings discourage residential care providers from serving Medicaid beneficiaries, which limits their access to community-based residential care.

The study found that some residential care settings limit the number of Medicaid residents they serve or decrease operating expenses in ways that may also reduce quality of care.

“Medicaid payment rates only cover services in residential care settings; they do not cover room and board,” said Michael Lepore, Ph.D., senior health policy and health services researcher at RTI and lead author of the study. “One of the access barriers is the difficulty that Medicaid beneficiaries have paying for room and board in residential care settings because of their low incomes. This situation dissuades residential care providers from serving Medicaid beneficiaries.”

Residential care settings are community-based homes or facilities that offer room, board and care services, the most popular being assisted living. Compared to nursing homes, these settings often are less institutional and are often the preferred setting.

If Medicaid beneficiaries with long-term service and support needs cannot access residential care settings, then nursing homes may be their only option, ultimately costing taxpayers more money because Medicaid payment rates for nursing homes are higher.

The study, published in the Journal of Housing for the Elderly, found barriers that influence Medicaid beneficiaries’ access to state-licensed residential care include Medicaid reimbursement rates for services, the supply of Medicaid-certified residential care settings and beds, and policies that affect room and board costs for Medicaid beneficiaries.

Researchers examined Medicaid policies in all 50 states and the District of Columbia, interviewed subject-matter experts, and conducted four state case studies informed by reviews of state policies and stakeholder interviews.

“States need to ensure their Medicaid rates for residential care services are sufficient to maintain an adequate supply of these settings and beds available to Medicaid beneficiaries, while also safeguarding quality of care and taxpayer resources,” Lepore said. “Higher Medicaid rates may encourage more residential care settings to serve Medicaid beneficiaries, which may help reduce nursing home use by older adults and people with disabilities and potentially reduce Medicaid spending on long-term services and supports.”

Older Adults with HIV: An Overlooked Population?

When it comes to HIV prevention and treatment, there is a growing population that is being overlooked — older adults — and implicit ageism is partially responsible for this neglect, according to a presentation at the 125th Annual Convention of the American Psychological Association.

“The lack of perceived HIV risk in late adulthood among older people themselves, as well as providers and society in general, inhibits investment in education, testing and programmatic responses to address HIV in an aging population,” said presenter Mark Brennan-Ing, PhD, director for research and evaluation at ACRIA, a non-profit HIV/AIDS research organization in New York City. “Ageism perpetuates the invisibility of older adults, which renders current medical and social service systems unprepared to respond to the needs of people aging with HIV infection.”

There is an enduring misconception that HIV is a disease of the young, and in particular young gay and bisexual men, according to Brennan-Ing, but it is estimated that in developed countries with well-developed health care systems, almost half of all people living with HIV are 50 or older. In some countries, that number is expected to increase to 70 percent by 2020. People 50 and older account for 17 percent of new HIV infections, and are more likely than younger adults to be diagnosed with AIDS at the same time as they discover their HIV status.

Previous research has suggested as many as two-thirds of all older Americans with HIV have experienced stigma due not only to the disease, but to their age. This phenomenon may be even more pronounced among gay and bisexual men, because of an increased obsession with age and internalized ageism within the gay community.

Despite a median age of 58, older Americans with HIV are more likely to exhibit characteristics of people in their 60s, 70s or even 80s, said Brennan-Ing. The combination of stigma due to age, sexual orientation, race/ethnicity, gender identity and expression, and HIV can lead to a number of negative outcomes specific to this population.

“Stigma results in social isolation, either through rejection by social network members or self-protective withdrawal, leading to loneliness and, ultimately, depression,” he said. “Stigma also makes people reluctant to disclose their HIV status, which could affect their health care treatment or prevent them taking precautions to reduce transmission.”

Older individuals who believe in the negative stereotypes associated with aging can also have poor health outcomes. Negative expectations about aging have been associated with poor cognitive test performance in older individuals and can increase stress, resulting in physical health issues, such as heart disease. More important, if an individual believes that aging leads to inevitable health problems and decline, that person may stop engaging in healthy behaviors, creating a self-fulfilling prophecy.

“These mechanisms may be responsible for empirical findings that internalized ageism is related to both chronic disease and longevity,” he said.

While it may not be possible to reduce ageism at the societal level, there are opportunities at the community level for providers of health and human services to buffer or reduce the impact of ageism for those who are infected or at risk for HIV, he said.

Specifically, Brennan-Ing recommended:

• Training health providers in HIV screening, early diagnosis and initiation of antiretroviral therapy in older populations and integration of key services.

• Prevention, education and outreach targeting older adults.

• Treatment guidelines for older individuals with HIV.

• Funding in line with the aging of the epidemic.

• Engagement of communities, community-based organizations and social service providers in outreach, mental health and social support.

• Addressing the needs of special populations.

“With the demographic shift toward older adults in the HIV population globally, and the elusiveness of a cure, addressing the care needs of this aging population are paramount,” said Brennan-Ing. “The aging of the HIV epidemic will be very challenging, but provides the opportunity to mount a global response that will address the needs of this population across regions and settings.”

10 Useful Apps for Your Tech-Savvy Aged Parent

Are your parents aging but still wanting to keep in touch, be in the know, and continue to be avid fans of their smartphones? Now is a great time to be a tech-savvy senior, as they have far more options to choose from when it comes to applications designed to keep their lives simpler and more streamlined. While your mother or father may be huge fans of the new phones available, they may not be aware of all the great options.

They can do more than shop for best deals for catheters online; now they can take control of their lives with some great new products.

Here are ten apps every tech-happy parent should download onto their phone.

1. Pillboxie

This useful app, which is only available for iPhone, gives a visual guide to help with daily, short-term, or weekly medications. Rather than just a note that pops up on your calendar, this is a virtual medicine cabinet that helps users see and organize their meds easily, gives them a gentle reminder to mark what they have taken and see if they missed anything. This app is great for anyone taking medication that just needs a little reminder not to miss a day.

2. Mint Bills and Money

This application is here to make sure you never miss a bill payment. Available for Android as well as iPhone, the app is especially nice because, after its initial set-up, all that’s needed is a quick confirmation to go ahead and digitally pay a bill. This app makes sure that the power never goes off, the cable is always on, and the gas is available. It can also monitor your bank accounts and credit cards to show you any unusual activity or just help you check your balance. No more forgetting a payment or making troublesome trips to the bank.

3. Goodreads

Reading is such a great activity for all of us but, especially, for those of us getting on in years. This app completes the experience with a social element—users can make friends with other fans of their favorite books and leave messages for one another. Book reviews are also encouraged, and readers can list books they plan to read in the future, as well as communicate with their favorite authors. Best of all, the app is free and available for all phones and tablets.

4. Words with Friends

This app goes beyond note writing or just chatting. With this popular word game application, users can challenge friends, family, or random users to a game of scrabble. While traditional rules apply, this app puts a new twist on an old favorite. The game has no time limit, so one match can last if the two opponents need to do other things, they can message one another in the chat section, and those who want to play alone have the solo play option.

Anyone looking for a new friend to play also has the Smart Match option. This option evaluates one’s skill level and matches them to someone at a similar level. Scrabble champions can easily find others who can keep up with them while beginners do not have to get creamed by a pro.

5. Spotify

You may think of Spotify—for Android as well as iPhone—as a place to find new music, but it is also a great place to find old favorites. Does your dad go on and on about the genius of Lawrence Welk? He can find the man’s music here. Users can create personalized radio stations based on their interests and even use the app on their desktop computer to fill the room with their favorite tunes. Don’t be surprised if you catch them dancing once they have their membership.

6. Skype

Keeping in touch is extremely important to everyone in your family, especially those who are getting older. Skype is a wonderful, free app that can be used on a desktop or any phone. The technology combines video and audio for a great option to catch up. Group conversation options are also available, as well as calling a landline or cell phone if necessary. See new babies, check in on distant relatives, and even go exploring together with the help of this very fun application.

7. Lumosity

Designed to keep brains active and memory alive, Lumosity is essentially a gym for your brain that you can access from any phone or tablet. The games on this application were designed by neuroscientists in hopes of helping people challenge themselves mentally and do so in a way that is entertaining and helps them have fun.

You will not feel like you are taking a test, but rather like you are playing a low-key, entertaining video game. The application can help prevent mental issues like Alzheimer’s and dementia. It also just improves general cognition so anyone can jump in on the fun. The app has gone worldwide for a reason—it is just great!

8. Blood Pressure Monitor

Only available for Apple phones, Blood Pressure Monitor helps users take control of their heart health and keep track of their pressure, their heart rates, and their activity. The app comes complete with reminders to take medicine or do an activity, as well as help to export any unusual activity to a doctor’s email. While this is not meant to replace any professional tools, it can help anyone with heart concerns feel better with a visual chart of just how their heart is doing and give a clear warning when something is going wrong.

9. Evernote

Evernote is an especially good one for senior citizens living alone or with limited care. The digital notebook comes in three versions, from free to premium, and offers all kinds of things. Listing different things to remember, a to-do list, audio notes, digitizing business cards, and just writing out documents are all available for both Android and Apple users. Also, it syncs up phones with desktop computers so that it can be used from any interface. Never forget a thing with the help of this great digital personal assistant.

10. WebMD Pain Coach

You have likely already used the WebMD website, which helps identify problems through symptoms, but you may not have tried this great app, though you and your parents absolutely should. It is designed to be a holistic approach to pain management and to take the mystery out of health problems, the app has a pain tracker, offers advice on pain reduction, and helps the user keep a kind of journal to show their doctor to help explain the problem. The app also has a daily goal tracker, dietary suggestions, and a built-in library of articles about preventative health to help users.

How is Technology Transforming the Healthcare Industry

Since the turn of the millennium, the technology industry has sky-rocketed and there are many types of technology which have become a huge part of our lives. We can now get almost anything with the click of a button, be it a meal, taxi or even renting out an apartment. With the healthcare industry, many people believe it is lagging behind in regard to how some of the other industries have developed their technologies. However, there are many companies which have been working on developing the latest pieces of technology which are slowly transforming the industry.

The Issues with the Health Care Industry

The healthcare industry has certainly not had its shortage of issues over the past few years, and this has driven a number of external companies to try and solve them through designing more pieces of technology. Taking the UK as an example, it is a country where the government provides free healthcare through the National Health Service (NHS). Even though this is great because it saves a lot of money, the government are lacking sufficient funds to develop the NHS, and the rate of healthcare is actually beginning to decline.

Firstly, there is a shortage of staff, and this means that the current staff are extremely stretched and not able to provide a quality service to any of their patients. Secondly, the other big issue is that they are unable to develop the technology used in the hospitals, surgeries and care homes.

This means the healthcare industry has worsened, and people are unable to get the adequate care required. However, many people are not just relying on the government anymore and they are instead starting to utilise the companies which are trying to develop alternatives to traditional healthcare.

How is Technology Transforming it?

Because of the aforementioned issues, the healthcare technology market is now flooded with different pieces of technology which are starting to shape the industries future. A lot of these are only available to private healthcare companies, and can be accessed by paying a fee to these companies – but there are also lots which be accessed on the mass market.

For instance, the popular Fit Bit wristbands are a small item which can let you know information about your body which was previously only accessible by a doctor. They can track your blood pressure, temperature, heart rate, recommend a diet and track how well you are sleeping. This is stopping people going for the same number of check-ups they would usually need and is helping to reduce the strain on staff.

There are also items such as GrandCare which can eradicate the need for elderly or disabled people to receive around-the-clock care. This is an item which is installed into the person’s home and tracks when the person takes their medicine, eats their meal or hasn’t moved for a long time. They can also use the device to communicate with their family and friends through video calls and if they haven’t moved for a long time it will send an alert to their family’s or carers phone.

To Sum Up

The healthcare industry was slightly late to the party, but there is no doubt that it is fully starting to get a grasp of how technology can help elevate to the next level. The two examples mentioned are popular now, but within the next few years there will be many more that will help further develop healthcare for people all around the world.

Erick Eiting, MD (GrandCare Systems) Interview @ 2017 Digital Health & Fitness LIVE

Exit mobile version