SeniorConnection.org

2012-01-24T01:46:00.000-05:00

If you are looking for help for your elderly loved one, remember, You Don’t Have To Go It Alone! Call Central Massachusetts Agency on Aging at (800) 244-3032 (VTDD), or email Cmaaging@SeniorConnection.org. We are here to help!

Top 10 Trends in Senior Housing for 2012

2012-01-23T13:34:00.000-05:00

Published in Senior Housing News

Adaptability is one of the cornerstones of human evolution. Evolution is a slow process but adaptability, or the ability to “get by” in the short term, happens quickly and is reactionary. With the economy in a state of disarray during 2010 and 2011, the senior living industry and businesses in other areas were focused on survival. But as time heals wounds, we enter a new chapter that allows the senior housing industry to adapt to the the influence of politics, economics and society. This concept of adaptation provides the foundation for long-term change versus radical change, and 2012’s senior housing trends are about adapting to the current reality and positioning for the fiscal realities and political/policy uncertainty in the future of senior housing.

Top 10 Scams Targeting Seniors by NCOA

2012-01-02T16:09:00.001-05:00

Health Care/Medicare/Health Insurance Fraud

2012-01-02T16:08:00.000-05:00

Every U.S. citizen or permanent resident over age 65 qualifies for Medicare, so there is rarely any need for a scam artist to research what private health insurance company older people have in order to scam them out of some money.

In these types of scams, perpetrators may pose as a Medicare representative to get older people to give them their personal information, or they will provide bogus services for elderly people at makeshift mobile clinics, then use the personal information they provide to bill Medicare and pocket the money.

Counterfeit Prescription Drugs

2012-01-02T16:06:00.003-05:00

Most commonly, counterfeit drug scams operate on the Internet, where seniors increasingly go to find better prices on specialized medications.

This scam is growing in popularity—since 2000, the FDA has investigated an average of 20 such cases per year, up from five a year in the 1990s.

The danger is that besides paying money for something that will not help a person’s medical condition, victims may purchase unsafe substances that can inflict even more harm. This scam can be as hard on the body as it is on the wallet.

Funeral & Cemetery Scams

2012-01-02T16:06:00.000-05:00

The FBI warns about two types of funeral and cemetery fraud perpetrated on seniors.

In one approach, scammers read obituaries and call or attend the funeral service of a complete stranger to take advantage of the grieving widow or widower. Claiming the deceased had an outstanding debt with them, scammers will try to extort money from relatives to settle the fake debts.

Another tactic of disreputable funeral homes is to capitalize on family members’ unfamiliarity with the considerable cost of funeral services to add unnecessary charges to the bill.

In one common scam of this type, funeral directors will insist that a casket, usually one of the most expensive parts of funeral services, is necessary even when performing a direct cremation, which can be accomplished with a cardboard casket rather than an expensive display or burial casket.

Fraudulent Anti-Aging Products

2012-01-02T16:05:00.000-05:00

In a society bombarded with images of the young and beautiful, it’s not surprising that some older people feel the need to conceal their age in order to participate more fully in social circles and the workplace. After all, 60 is the new 40, right?

It is in this spirit that many older Americans seek out new treatments and medications to maintain a youthful appearance, putting them at risk of scammers.

Whether it’s fake Botox like the one in Arizona that netted its distributors (who were convicted and jailed in 2006) $1.5 million in barely a year, or completely bogus homeopathic remedies that do absolutely nothing, there is money in the anti-aging business.

Botox scams are particularly unsettling, as renegade labs creating versions of the real thing may still be working with the root ingredient, botulism neurotoxin, which is one of the most toxic substances known to science. A bad batch can have health consequences far beyond wrinkles or drooping neck muscles.

Telemarketing

2012-01-02T16:02:00.000-05:00

Perhaps the most common scheme is when scammers use fake telemarketing calls to prey on older people, who as a group make twice as many purchases over the phone than the national average.

While the image of the lonely senior citizen with nobody to talk to may have something to do with this, it is far more likely that older people are more familiar with shopping over the phone, and therefore might not be fully aware of the risk.

With no face-to-face interaction, and no paper trail, these scams are incredibly hard to trace. Also, once a successful deal has been made, the buyer’s name is then shared with similar schemers looking for easy targets, sometimes defrauding the same person repeatedly.

Examples of telemarketing fraud include:

“The Pigeon Drop”
The con artist tells the individual that he/she has found a large sum of money and is willing to split it if the person will make a “good faith” payment by withdrawing funds from his/her bank account. Often, a second con artist is involved, posing as a lawyer, banker, or some other trustworthy stranger.

“The Fake Accident Ploy”
The con artist gets the victim to wire or send money on the pretext that the person’s child or another relative is in the hospital and needs the money.

“Charity Scams”
Money is solicited for fake charities. This often occurs after natural disasters.

Internet Fraud

2012-01-02T16:01:00.000-05:00

While using the Internet is a great skill at any age, the slower speed of adoption among some older people makes them easier targets for automated Internet scams that are ubiquitous on the web and email programs.

Pop-up browser windows simulating virus-scanning software will fool victims into either downloading a fake anti-virus program (at a substantial cost) or an actual virus that will open up whatever information is on the user’s computer to scammers.

Their unfamiliarity with the less visible aspects of browsing the web (firewalls and built-in virus protection, for example) make seniors especially susceptible to such traps.

One example includes:

Email/Phishing Scams
A senior receives email messages that appear to be from a legitimate company or institution, asking them to “update” or “verify” their personal information. A senior receives emails that appear to be from the IRS about a tax refund.

Investment Schemes

2012-01-02T16:00:00.001-05:00

Because many seniors find themselves planning for retirement and managing their savings once they finish working, a number of investment schemes have been targeted at seniors looking to safeguard their cash for their later years.

From pyramid schemes like Bernie Madoff’s (which counted a number of senior citizens among its victims) to fables of a Nigerian prince looking for a partner to claim inheritance money to complex financial products that many economists don’t even understand, investment schemes have long been a successful way to take advantage of older people.

Homeowner/Reverse Mortgage Scams

2012-01-02T15:59:00.000-05:00

Scammers like to take advantage of the fact that many people above a certain age own their homes, a valuable asset that increases the potential dollar value of a certain scam.

A particularly elaborate property tax scam in San Diego saw fraudsters sending personalized letters to different properties apparently on behalf of the County Assessor’s Office. The letter, made to look official but displaying only public information, would identify the property’s assessed value and offer the homeowner, for a fee of course, to arrange for a reassessment of the property’s value and therefore the tax burden associated with it.

Closely related, the reverse mortgage scam has mushroomed in recent years. With legitimate reverse mortgages increasing in frequency more than 1,300% between 1999 and 2008, scammers are taking advantage of this new popularity.

As opposed to official refinancing schemes, however, unsecured reverse mortgages can lead property owners to lose their homes when the perpetrators offer money or a free house somewhere else in exchange for the title to the property.

Sweepstakes & Lottery Scams

2012-01-02T15:58:00.000-05:00

This simple scam is one that many are familiar with, and it capitalizes on the notion that “there’s no such thing as a free lunch.”

Here, scammers inform their mark that they have won a lottery or sweepstakes of some kind and need to make some sort of payment to unlock the supposed prize. Often, seniors will be sent a check that they can deposit in their bank account, knowing that while it shows up in their account immediately, it will take a few days before the (fake) check is rejected.

During that time, the criminals will quickly collect money for supposed fees or taxes on the prize, which they pocket while the victim has the “prize money” removed from his or her account as soon as the check bounces.

The Grandparent Scam

2012-01-02T15:56:00.001-05:00

The Grandparent Scam is so simple and so devious because it uses one of older adults’ most reliable assets, their hearts.

Scammers will place a call to an older person and when the mark picks up, they will say something along the lines of: “Hi Grandma, do you know who this is?” When the unsuspecting grandparent guesses the name of the grandchild the scammer most sounds like, the scammer has established a fake identity without having done a lick of background research.

Once “in,” the fake grandchild will usually ask for money to solve some unexpected financial problem (overdue rent, payment for car repairs, etc.), to be paid via Western Union or MoneyGram, which don’t always require identification to collect.

At the same time, the scam artist will beg the grandparent “please don’t tell my parents, they would kill me.”

While the sums from such a scam are likely to be in the hundreds, the very fact that no research is needed makes this a scam that can be perpetrated over and over at very little cost to the scammer.

Why You Should Care About The 'Medical Loss Ratio'

2011-12-06T11:33:00.000-05:00

Atlantic Wire - Ted Mann - December 3rd
Unless you are a health care worker or a health care industry employee, you likely haven't given a ton of thought to the medical loss ratio. That is, simply stated, the percentage of health insurance company spending that actually goes to pay for the medical care delivered to people.

If you are a health care industry employee, particularly one of the executive variety, you have likely given a lot of thought to the medical loss ratio in the last several years, and especially in the past day. That's because the federal Department of Health and Human Services just issued its final rule on the topic, implementing an aspect of the Obama health care law that played little part in the public debate, but matters tremendously to insurance companies.

Under the new rules, insurers must spend at least 80 percent of the money they take in from insurance premiums (less taxes and fees) toward providing health care to their customers. If they don't spend that percentage, insurers will now be required to send rebates back to the people paying the premiums.

A thorough explanation of the rule and its effects is at Health Affairs. Over at Forbes, Rick Ungar writes that this is the actual "bomb" health insurers were worried about in the otherwise not-all-that-radical Obamacare bill.

Should There Be Sales Taxes On Internet Purchases?

2011-12-01T10:07:00.001-05:00

This Nation.com
American Government and Politics Online

An increasingly large number of Americans are shopping online, browsing catalogues, selecting items and making purchases from the comfort of their own homes. Beyond convenience, one of the most attractive aspects of online shopping, at least to consumers, is that very few online "stores" charge sales tax, meaning that shoppers pay even lower prices for what they buy online than they would in a traditional store. The days of tax free Internet shopping, however, may be short-lived. Should there be sales tax on Internet purchases or should web shopping remain "tax free"?

To answer this question fairly, it is important to put the sales tax in its proper perspective. Most state and local governments rely heavily on sales tax revenues to fund a wide variety of government functions and programs. All but five states collect a sales tax of some kind or another. The states that collect sales taxes do so in a variety of different ways--some states tax virtually all purchases while others tax a narrower range of purchases. The most commonly exempted class of purchases is food. Tax rates also vary quite widely, from as low as 0.5% in Hawaii to 7.25% in California. Additional sales taxes are also collected in many counties and cities on top of established state sales tax rates.

State and local governments have generally established their taxation and spending patterns over long periods of time, adjusting for local and regional economic conditions and spending requirements when necessary. While it is impossible to anticipate every possible contingency, one of the most important functions of state and local governments is to plan ahead and establish taxation systems that will work down the road as well as today. Each state and local government has developed a mixture of sales, income, property and other taxes to bring in the revenues each needs to maintain roads and highways, build schools, pay teachers, etc. When one or more of a state or local government's expected revenue sources is curtailed or eliminated, its budget plans are no longer useful and it must either scramble for new revenue or cut spending. Neither one of these tends to be very popular with the public.

So, should sales tax be collected on Internet purchases? Ultimately, the answer comes down to this: Most state and local government tax systems and budget plans would be seriously disrupted if sales tax revenue disappeared altogether. If an increasingly larger proportion of purchases are made sales tax-free on the Internet, there will be a fiscal crisis in most states and localities. State and local governments will either have to raise revenue in other ways, by increasing income or property taxes, for example, or by cutting spending.

Most of the uproar over taxation of purchases made on the Internet seems to arise from the perception that any tax on online purchases would be a new form of taxation. This is simply not the case. Purchases off-line have been taxed for decades. Shopping online may be different in many ways, but money is still being exchanged for goods and services. Those purchases would be taxable under any other circumstances, i.e. if the purchases were made anywhere but on the Internet.

Taxing Internet purchases is further complicated because most purchases are made across state borders. In such cases, where should the tax be collected? At the point of sale or the point of delivery? If the tax is collected at the point of sale, there would probably be a migration of online stores to sales tax-free states. The most workable idea would probably be to require the tax to be paid to the state or local government where the purchaser lives. The drawback to this, however, is that at least one rationale for collecting sales taxes in the first place is to provide state and local governments the money they need to build roads, sewers and provide other services that allow businesses to do what they do. If sales taxes are collected in the states and localities where buyers live, the states and localities where sellers are located may not be able to collect the revenues they need.

The issue of sales tax collection on Internet sales is a complicated one. If people want to shop online--and more and more are doing so every day--and they don't want to be charged a sales tax when they do so, they should realize that they will either have to pay those taxes in other ways or be prepared to see reductions in state and local government services. And as states and local governments come to grips with the evolving nature of commerce, they will have to develop new ways of thinking about and administering tax systems.

CMAA Sponsors Food Drive

2011-11-28T10:24:00.000-05:00

Veterans Transportation and Community Living Initiative

2011-11-10T10:07:00.004-05:00

WASHINGTON – U.S. Transportation Secretary Ray LaHood today announced $34.6 million for 55 projects in 32 states and Guam to enhance access to local, affordable transportation services for military families and spouses, and wounded warriors.

Many military families live in suburban and rural communities where filling the gas tank for long commutes is expensive and public transportation is limited. Projects funded by the Veterans Transportation and Community Living Initiative will bridge the gap by enabling states and communities to build or expand so-called “one-click, one-call” centers that offer comprehensive information on local transportation options, and other community services, with just a single phone call or click of the mouse. Typically, such information is not available in one convenient place, and better local coordination will result in better services for veterans and nonveterans alike.

$2 million to the Montachusett Regional Transit Authority in central Massachusetts to expand an existing one-call center by adding agencies serving local veterans. The center will offer an array of traveler and community services and act as a one-stop shop to military families and spouses who need them.

In addition to USDOT, the Department of Veterans Affairs is contributing up to $3 million for the VA health care network to coordinate veterans’ transportation needs with community transportation systems. The Department of Labor’s Office of Disability Employment Policy is contributing $250,000 for social media tools and training to include veterans and the military in community transportation decision-making. The Department of Health and Human Services and the Department of Defense are also lending critical support, in part through their extensive networks of community-based advocates. Additional in-kind support is provided by over a dozen national veteran service organizations.

See Secretary LaHood’s blog post here

Medicare Open Enrollment: Better Choices, Sooner

2011-09-21T14:42:00.001-04:00

Centers for Medicare & Medicaid Services
By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

Every year, people with Medicare get to explore new choices and pick the plans that work best for them. This year, this Open Enrollment period is starting early – on October 15 – and ending sooner – December 7.

As health plans start their marketing and advertising activities in just a few weeks, we want people to know that the Medicare program is strong and, in 2012, they have a broad array of choices. And, there are lots of new benefits thanks to the Affordable Care Act.

Every person with Medicare will have to choose a “Part D” plan to help them pay for prescription drugs. And people who have chosen to enroll in a “Part C” Medicare Advantage plan for their basic health care services have the option of staying in that plan, choosing a different plan, or going back to the Original Medicare program. These are important choices that should be made with care.

The good news is we have strengthened consumer protections and improved plan choices. We’re making it simpler for people to choose a new health or drug plan by reducing the number of duplicate plans. We’ve also worked with plans to reduce cost sharing on important benefits like inpatient hospitalization and mental health services.

And, thanks to our enhanced bargaining power we can report that average premiums for a Part D plan will be the same in 2012 as in 2011. The average premium for Part C plans is going down by 4 percent. That’s great news for people on Medicare who have a fixed income.

As with last year, people with Medicare will continue to have a variety of Medicare Advantage plan choices. Consumers in every part of the country will have a wide variety of Part D plan choices in 2012, including many plans with zero deductibles and plans with some form of generic gap coverage.

People with Medicare are also enjoying important new benefits. Every person is entitled to an Annual Wellness Visit with their doctor so that they can discuss their health and their health care needs. Prevention services like mammograms and other cancer screenings are now available with no cost-sharing. And people who reach the donut hole in their drug costs will get a 50% discount on covered brand name drugs and a 14 percent discount on generics. That puts money back in your pockets.

More good news for consumers is the fact that we’ll be closely monitoring marketplace performance to protect people from misleading information or prohibited tactics by a small minority of unscrupulous plans. Medicare plans are on notice: we’ll move quickly to take action against plans found to be violating marketing rules.

In short, there’ll be a wide range of health and drug plan options available across the country, including Original Medicare. People can turn to www.medicare.gov, call the 1-800-MEDICARE hotline, or consult with a local State Health Insurance Assistance Program (SHIP) for help. We want to make sure people can identify and enroll in the coverage option that suits their needs in 2012.

Debt Ceiling Deal: The Good, the Bad and the Ugly

2011-08-02T09:05:00.003-04:00

n4a’s initial analysis

This afternoon, the Senate passed legislation to raise the debt ceiling, reduce the deficit and create a special committee to determine a second round of deficit reduction decisions. The bill represents the deal agreed to by the White House and Congressional Republicans and Democrats late on Sunday and approved by the House on Monday. The measure was just signed by President Obama, thus narrowly averting a federal government borrowing crisis.

The deal has multiple components, virtually all of which affect aging policy and funding in the short and long-term. n4a CEO Sandy Markwood released a statement today about the deal, which can be found under Policy News at www.n4a.org.

What is in the Deal?
In exchange for raising the debt ceiling limit, Republicans won several concessions, including immediate and long-term cuts to discretionary spending without any of the increases in revenues that Democrats wanted. In a nutshell:

Stage 1: The bill caps discretionary spending over 10 years, driving $900 billion in deficit reduction. For the first two years, the caps have to be applied equally between security and non-security spending (i.e., firewalls).
Stage 2: A Congressional Joint Select Committee on Deficit Reduction will be created to agree upon at least $1.2 trillion and up to $1.5 trillion in additional deficit reduction measures. This 12-member bipartisan committee must produce this legislation by November 23; it will then be subject to an up-or-down vote without amendments. Everything is on the table for this committee’s consideration: revenues, entitlements or further cuts to discretionary programs.
Possible Stage 3: If the joint committee or Congress fails to act by the end of the calendar year, $1.2 trillion in automatic, across-the-board cuts would take effect through a sequestration process. If this occurs, several programs are exempted: Social Security, Medicaid and several low-income entitlement programs. (Medicare benefits could not be cut either, but provider payments could be reduced by up to 2 percent.)

The Good

The raising of the debt ceiling averted significant and numerous economic consequences had the government defaulted.
As desired by the White House, the measure puts off the need to repeat this battle over raising the debt ceiling until 2013 (the debt ceiling would be increased again before then, but under agreed-upon parameters).
Medicaid HCBS programs, Medicare and Social Security were spared immediate cuts, as the first $900 billion in deficit reduction comes entirely from the discretionary side of the ledger.
If automatic sequestration occurs, Social Security (which has not contributed to the deficit), Medicaid, costs for Medicare beneficiaries and several low-income programs are spared.
If automatic sequestration occurs, half of the cuts must come from security, thus preventing unfair routing of non-security programs.

The Bad

Discretionary programs like the Older Americans Act could face painful cuts under the spending caps—the best case scenario for FY 2012 and FY 2013 OAA funding would be only minor cuts but all programs are at risk of being significantly reduced, as appropriators struggle to keep total spending under the cap. With the caps in place for 10 years, there is no immediate relief in sight from reduced or frozen funding levels that do not take into account population growth, human need or other factors that increase demand for programs and services. (It is too early to speculate as to when the economy might recover enough to phase out the caps early, as has been done in past years.)
Discretionary programs are not protected from the second round of drastic cuts, as the joint committee can opt to further reduce either side of the ledger.
The joint committee merely continues the partisan battle over whether revenues should be considered in deficit reduction. If committee members cannot agree on a package, the potential for using revenues to help reduce the deficit is effectively dead, as the sequestration process does not contain that option.
If revenues are not included in the second round of deficit reduction, the cuts to entitlements will need to be that much deeper. To reach $1.2 trillion in cuts alone, the joint committee would have to make significant cuts to Medicaid, Medicare and possibly Social Security.

The Ugly

While details such as final FY 2012 spending levels or what that second round of $1.2-1.5 trillion of deficit reduction would look like will not be known for months, it is apparent the size and scope of this deal is a game changer. But we do know this: the deal will reduce the amount of federal funding available for community-level aging programs at a time when our economy is still struggling and our nation’s population is rapidly aging.
For the older adults and caregivers AAAs and Title VI programs serve, this will mean more people will face waiting lists for critical OAA services—such as home care, home-delivered meals and medical transportation—as well as less help with heating/cooling bills from LIHEAP, reduced availability of affordable senior housing, and similar strains to other federally funded community-level programs.
If Medicaid cuts come to fruition, home and community-based services (HCBS) waivers are particularly vulnerable. If HCBS programs are reduced, older adults will have difficulty getting the supports they need to live in the community and may risk premature institutionalization. Not only is this detrimental to consumers, it also could turn back the clock on national efforts to rebalance Medicaid.
If Medicaid cuts go as deep as is feared, nursing home–provided long-term care could no longer be considered an entitlement and older consumers could no longer have access to this vital safety net for long-term services and supports.
The select committee can consider Medicare and Social Security as other sources of deficit reduction dollars. Reduced benefits or raised costs will place a burden on millions of older adults who rely upon these social insurance programs for economic and health security.

Caregiver Sign-Up Form(Click on the form twice to enlarge)

2011-07-07T13:10:00.000-04:00

Latest Medicare Plan Proposes Shift of Eligibility Age to 67

2011-07-06T10:43:00.002-04:00

Doorland Health
By Emily Mullin

In the ongoing debate over how to fix the country’s Medicare entitlement program – which is predicted to be insolvent by 2024 – lawmakers have introduced yet another plan to overhaul the program.

Senators Joe Lieberman, I-Conn., and Tom Coburn, R-Okla., proposed a plan June 28 that would alter Medicare funding and reduce the national debt.

The plan could save more than $600 billion over 10 years, based on estimates by the Congressional Budget Office, and up to an additional $100 billion in savings from implementing other provisions in the plan. But some are still skeptical of the impact the plan could have on seniors.

One of the more controversial proposals in the plan is to adjust the eligibility age for Medicare from 65 to 67 to reflect changes in average life expectancies. According to the Centers for Disease Control, when Medicare was passed in 1965, the average lifespan for Americans was 70.2. In 2006, the average lifespan for Americans was 77.7 – an increase of 10.6 percent. Lieberman and Coburn argue in their plan that increasing the eligibility age is consistent with the increase in the average lifespan in the U.S.

To read the entire article, please Click Here

WHO: Cell Phone Use Can Increase Possible Cancer Risk

2011-06-02T12:02:00.000-04:00

(CNN) -- Radiation from cell phones can possibly cause cancer, according to the World Health Organization. The agency now lists mobile phone use in the same "carcinogenic hazard" category as lead, engine exhaust and chloroform.

Before its announcement Tuesday, WHO had assured consumers that no adverse health effects had been established.

A team of 31 scientists from 14 countries, including the United States, made the decision after reviewing peer-reviewed studies on cell phone safety. The team found enough evidence to categorize personal exposure as "possibly carcinogenic to humans."

What that means is they found some evidence of increase in glioma and acoustic neuroma brain cancer for mobile phone users, but have not been able to draw conclusions for other types of cancers.

"The biggest problem we have is that we know most environmental factors take several decades of exposure before we really see the consequences," said Dr. Keith Black, chairman of neurology at Cedars-Sinai Medical Center in Los Angeles.

"What microwave radiation does in most simplistic terms is similar to what happens to food in microwaves, essentially cooking the brain," Black said. "So in addition to leading to a development of cancer and tumors, there could be a whole host of other effects like cognitive memory function, since the memory temporal lobes are where we hold our cell phones."

To read entire article, Click Here".

Partnership for Patients: Better Care, Lower Costs

2011-04-27T13:31:00.000-04:00

HealthCare.gov

Doctors, nurses and other health care providers in America work incredibly hard to deliver the best care possible to their patients. Unfortunately, an alarming number of patients are harmed by medical mistakes in the health care system and far too many die prematurely as a result.

The Obama Administration has launched the Partnership for Patients: Better Care, Lower Costs, a new public-private partnership that will help improve the quality, safety, and affordability of health care for all Americans. The Partnership for Patients brings together leaders of major hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly.

The two goals of this new partnership are to:

Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010. Achieving this goal would mean approximately 1.8 million fewer injuries to patients with more than 60,000 lives saved over three years.
Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010. Achieving this goal would mean more than 1.6 million patients would recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge.

Achieving these goals will save lives and prevent injuries to millions of Americans, and has the potential to save up to $35 billion dollars across the health care system, including up to $10 billion in Medicare savings, over the next three years. Over the next ten years, it could reduce costs to Medicare by about $50 billion and result in billions more in Medicaid savings. This will help put our nation on the path toward a more sustainable health care system.

Building on Local and National Work to Improve Patient Safety

In 1999, the landmark Institute of Medicine study, “To Err is Human,” estimated that as many as 98,000 Americans die every year from preventable medical errors. Despite many successful efforts, this statistic has not improved much in the following decade. And many more patients get injured or sicker from preventable adverse events after being admitted to a hospital. After more than a decade of work to understand and address these problems, promising examples of better practices exist, but patients too often are still injured in the course of receiving care. There is much more work to be done to prevent unnecessary harm to patients.

At any given time, about one in every 20 patients has an infection related to their hospital care.
On average, one in seven Medicare beneficiaries is harmed in the course of their care, costing the government an estimated $4.4 billion every year.
Nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days – that’s approximately 2.6 million seniors at a cost of over $26 billion every year.

Consensus Recommendations for the 2011 Older Americans Act Reauthorization

2011-04-12T15:33:00.004-04:00

General Recommendations

Raise or increase the authorized funding for all titles of the OAA. Additionally, any newprograms added to the Act should be given specific authorization levels. With the populationof older individuals expected to grow exponentially in the coming years, the Aging Networkfaces incredible challenges associated with the influx of older individuals into OAAprograms. The scope of the OAA is vast and expanding to cover additional populations whilethe investment in its mission has been severely, and consistently, underfunded.
The Aging Network should be considered the focal point for aging related matters at alllevels of government. Amend the OAA to explicitly recognize the principal role that StateAgencies on Aging have in planning for the social and physical needs of older adults at thestate level, and Area Agencies on Aging at the local level.
Where possible in the OAA, lesbian, gay, bisexual and transgender older adults should beincluded as a vulnerable population with greatest social need as a result of a lifetime ofbigotry, stigma and discrimination.
The underserved, vulnerable communities of all racial and ethnic groups, as well as, lesbian,gay, bisexual and transgender older adults should be explicitly addressed in the OAA in waysthat account for their unique family structures and collective experiences. Terms such as“adult care,” “family,” “family caregiver,” “spouse,” “underserved area,” “vulnerable elder,”and “family violence” should be defined to account for the variety of family and carestructures of all racial and ethnic communities, and LGBT communities, which includepartners and families of choices, as well as spouses and biological families.
Where appropriate and practical in the OAA, data collection, project assessments andreporting requirements should ensure that racial groups, as well as lesbian, gay, bisexual and transgender older adults, are studied and appropriately served.

If you would like to read the entire Consensus Recommendations for the 2011 Older Americans Act Reauthorization, Please Click Here!

UMass Boston Study Examines why Elders in Home Care Switch to Nursing Homes

2011-03-21T10:43:00.001-04:00

A new study released in February by the Gerontology Institute at the University of Massachusetts Boston with assistance from Al Norman, Mass Home Care, looked at why elders leave home care programs and transfer to nursing homes.

The study finds that many elders have made the switch because they lacked sufficient informal caregiver support, needed 24/7 care, were considered a safety risk, or had medical and functional problems that overwhelmed their caregivers.

Other key findings of the study, Massachusetts’ Home Care Programs and Reasons for Discharge into Nursing Homes, include:

Doctors and hospitals account for very few referrals for home care services, 2.5 percent and 9.4 percent, respectively.
Approximately 3,627 elders, or 14.5 percent of those leaving the program, were discharged to nursing homes during fiscal year 2010.
Over a third of home care clients were taking nine or more medications.
Twenty-nine percent of home care clients report problems with short-term memory.
Seventy-five percent of home care clients are not physically able to shop, cook, or feed themselves.
Eighty-five percent of home care clients do not have any advance medical directives, and 55 percent have no one designated to make health care decisions for them if they become incapacitated.

One of the goals of the study was to examine why home care clients go into nursing facilities, and what types of services could help them avoid entering institutions.

Nursing home patient days in Massachusetts have fallen by nearly 30 percent compared to year 2001. “Mass Home Care, which represents 30 home care agencies across the state, is seeking additional ways to develop services to fill in the ‘care gaps’ in the current range of community options,” said Mass Home Care Executive Director Al Norman.

The Gerontology Institute study included interviews with care managers conducted by gerontology students in the College of Public & Community Service, an analysis of aggregate data for over 42,000 consumers provided by Executive Office of Elder Affairs representing three different home care programs, and a review of journal notes kept by care managers for terminated clients.

According to Norman, who served as Community Partner for the study, “Our goal is to reduce the number of elders who leave home care heading for institutions. To do that we need to learn more about what they need and how we can provide it. This is the first study that really focuses on elders at the point of discharge from home care, and from these data, we will begin to develop better programs to keep elders aging in place. We can continue to spend tax dollars smarter by mastering this issue.”

View the full report at the Gerontology Institute website.

Letter of Intent

2011-03-03T12:54:00.001-05:00

For Interested Parties Applying For A Grant

The Letter of Intent should be no more than 2-3 pages, and address the following:

1. Purpose of the program

2. Which of the priorities does the program address?

3. Estimate the amount of Title III funding you will be seeking.

4. Estimate the TOTAL amount of funding needed to run the program.

5. What other funding sources will be providing money to run the program?

6. How is the program intended to operate?

7. What service area/towns do you expect to serve?

8. A brief demonstration of the need for the targeted service(s).

Need can be demonstrated by reference to CMAA, local or existing program data** that shows an increase in demand or a high level of continuing demand for the service(s) the program intends to provide.

** appropriate data might include program service statistics, CMAA needs assessment data (e.g. http://www.seniorconnection.org/pdf/areaplan_06.pdf), needs data collected in specific local service areas, and other relevant sources.

Should you have further questions, please contact John Belding at CMAA.

Highlights - Profile of Older Americans: 2010

2011-02-22T12:17:00.000-05:00

The older population (65+) numbered 39.6 million in 2009, an increase of 4.3 million or 12.5% since 1999.

The number of Americans aged 45-64 – who will reach 65 over the next two decades – increased by 26% during this decade.

Over one in every eight, or 12.9%, of the population is an older American.

Persons reaching age 65 have an average life expectancy of an additional 18.6 years (19.9 years for females and 17.2 years for males).

Older women outnumber older men at 22.7 million older women to 16.8 million older men.

In 2009, 19.9% of persons 65+ were minorities--8.3% were African-Americans.** Persons of Hispanic origin (who may be of any race) represented 7.0% of the older population. About 3.4% were Asian or Pacific Islander,** and less than 1% were American Indian or Native Alaskan.** In addition, 0.6% of persons 65+ identified themselves as being of two or more races.

Older men were much more likely to be married than older women--72% of men vs. 42% of women (Figure 2). 42% older women in 2009 were widows.

About 30% (11.3 million) of noninstitutionalized older persons live alone (8.3 million women, 3.0 million men).

Half of older women (49%) age 75+ live alone.

About 475,000 grandparents aged 65 or more had the primary responsibility for their grandchildren who lived with them.

The population 65 and over will increase from 35 million in 2000 to 40 million in 2010 (a 15% increase) and then to 55 million in 2020 (a 36% increase for that decade).

The 85+ population is projected to increase from 4.2 million in 2000 to 5.7 million in 2010 (a 36% increase) and then to 6.6 million in 2020 (a 15% increase for that decade).

Minority populations are projected to increase from 5.7 million in 2000 (16.3% of the elderly population) to 8.0 million in 2010 (20.1% of the elderly) and then to 12.9 million in 2020 (23.6% of the elderly).

The median income of older persons in 2009 was $25,877 for males and $15,282 for females. Median money income (after adjusting for inflation) of all households headed by older people rose 5.8% (statistically significant) from 2008 to 2009. Households containing families headed by persons 65+ reported a median income in 2009 of $43,702.

The major sources of income as reported by older persons in 2008 were Social Security (reported by 87% of older persons), income from assets (reported by 54%), private pensions (reported by 28%), government employee pensions (reported by 14%), and earnings (reported by 25%).

Social Security constituted 90% or more of the income received by 34% of beneficiaries in 2008 (21% of married couples and 43% of non-married beneficiaries).

Almost 3.4 million elderly persons (8.9%) were below the poverty level in 2009. This poverty rate is statistically different from the poverty rate in 2008 (9.7%).

About 11% (3.7 million) of older Medicare enrollees received personal care from a paid or unpaid sour

FY 2011 and FY 2012 Labor-HHS-Education and Other Appropriations As of February 14, 2011 (Dollars in thousands)

2011-02-16T13:06:00.008-05:00

CLICK TWICE TO ENLARGE

5 Secrets Not To Keep From Your Cardiologist

2011-02-03T11:47:00.000-05:00

If you are taking vitamins or supplements
Alternative medicine and herbal remedies may be great for some to help manage chronic conditions, but cardiologists warn certain supplements can pose serious risks to people who are also taking medications for heart disease.
From alfalfa to yohimbine, a study in the Journal of the American College of Cardiology lists more than two dozen herbal products patients with cardiovascular disease should avoid.
If you have undergone tests from other doctors
Patients may sometimes be shy about admitting to their physician that they have received a second opinion or additional testing, says Dr. Richard Stein, a national spokesperson for the American Heart Association.
"Your goal walking out is to get the best health care -- not to make the doctor feel good," he says. If you've had a blood test, EKG, echocardiogram or angiogram, Stein says to keep your own patient file and bring it with you to your appointment.
"It's not fair to expect a doctor to understand the seriousness of your condition if they don't have all of the information."
If you have skipped your medications
"Patients often lie about taking blood pressure or cholesterol medication," says Dr. Nieca Goldberg, director of the Women's Heart Program at New York University. She says sometimes they believe these drugs aren't necessary if they alter their diet. While that may be true in the long term, the effects of diet change are not as immediate, and the patient may be prolonging the problem.
Goldberg also says another potential problem arises when your cardiologist reads blood pressure and checks your cholesterol levels and notices no change. "You don't want to accidentally be given a prescription for a higher dose, when you're not even taking the lower dose," she explains.
If you are going through hard times
A patient says during the time of her first heart attack, she had been grappling with years of domestic violence and abuse, and she was at a breaking point.
However, it wasn't until 2007, one year after having another stent implanted, when she finally brought this up to her doctor.
"When you're under stress you have extra adrenaline that can stimulate the heart to skip beats and have palpitations," says Dr. Alfred Bove, past president of the American College of Cardiology.
He says patients who have experienced some serious life trauma -- like a death, layoffs, divorce, or even just a stressful job -- may have elevated blood pressure and should be monitored more vigilantly.
If you haven't really stuck to your diet
"Everyone wants to put their best foot forward, so it's easy to come in and say you've started an exercise program when it really didn't happen," says Goldberg. "But just saying you exercised doesn't improve your cardiovascular health."
In fact, it could be harmful, says Stein.
"If a patient tells me they don't have chest pains, but they are doing nothing in terms of physical activity, then I'm not getting an accurate picture of the shape their heart is really in," he explains. "I may want to do a stress test to see what really happens when you exercise."

The entire article can be read at www.CNN.com.

Some Highlights From the Governor’s 2012 Budget Submission

2011-01-25T15:10:00.001-05:00

The Governor’s budget level-funds most of the Elder Affairs line items at the level of the FY 2011 budget as it finally ended up after the restorations of federal matching funds (FMAP) and the supplemental budget.
One notable exception, however, is the home care purchased services account (1630), which drops from $101.68 million to $96.781 million, a loss of $4.9 million (the FMAP restoration and supplemental funding was removed), or a drop of -4.8%. This line item is one of the more popular on Beacon Hill, and we hope to lift it back to at least the FY 2011 level.
The Prescription Advantage program (1455) lost the most money: $9.88 million in funding. But EOEA indicates that current benefits levels in the program should be maintained, because more coverage under the donut hole is being picked up by the federal government. In FY12, the Prescription Advantage program will receive considerable cost relief from provisions in the Affordable Care Act (ACA). Despite a 31% (9.9m) decrease from FY11 funding levels, the FY11 Prescription Advantage Benefit design remains fully intact. There are no changes being made to the Prescription Advantage program.
The protective services/elder abuse account is level funded at $15.25 million. Mass Home Care has made this elder abuse line item its top funding priority for the spring budget session. 53 new reports of elder abuse are received every day, and spending on child abuse and domestic violence is 31 times greater than elder abuse.
The Enhance Community home care Program (ECOP) and care management accounts are also level-funded.
The meals on wheels, supportive housing, Councils on Aging, and supportive housing line items are all level funded at 2011 levels.
In the MassHealth accounts, the Adult Day Health programs are going to be restructured so that only “complex” clients are accepted into the program. This is a serious change that may require legislative advocacy to restore.

“In general, we appreciate the Governor’s commitment to home care for the elderly expressed in this budget,” Mass Home Care Executive Director Al Norman said. “We were braced for the worst---so we can live with these numbers.”

Administration Cuts $15.5 Million From Key MassHealth Elderly Services

2011-01-13T11:37:00.000-05:00

Just hours before a major snowstorm hit the State, the Patrick Administration released a blizzard of cuts to MassHealth programs targeted to poor people and the elderly.

At a short meeting on the afternoon of January 11, 2011, the Patrick Administration announced a series of rate cuts in several key MassHealth programs. The rate reductions come with more than half the current fiscal year already over. A total of roughly $3.25 million will be cut from key programs in the remaining months of FY 2011, plus another $12.3 million will be cut from the FY 2012 budget as a result of rate cuts that will take effect on the Ides of March.

Here are the impacts of several of the major cutbacks announced.

Adults Foster Care: AFC is a program that provides daily assistance with personal care and case management oversight by the provider in caregivers home on a 24/7 basis. The proposed amendments decrease the payment rates for all adult foster care (AFC) services by 6.2% effective March 15, 2011.

the proposed rate for AFC Level I services will decrease from $47.13 to $44.21
the rate for AFC Level II services will decrease from $83.09 to $77.94
the rate for Alternate Placement Level I services will decrease from $37.47 to $35.15
the rate for Alternate Placement Level II services will decrease from $74.93 to $70.28
the rate for Intake and Assessment services will decrease from $242.38 to $227.35

The Division of Health Care Policy and said it was proposing these amendments “to ensure that the payment rates are consistent with efficiency, economy, and quality of care, while maintaining access to services.” DHCFP estimates that the AFC rate cuts will result in aggregate annual expenditure reductions in FY 2012 by MassHealth of approximately $4 million or 6.2% as a result of this proposal. Since the cuts begin on March 15th, they will be in effect for three and a half months in FY 2011, and will reduce payments to AFC providers by $1 million this fiscal year.

In May of 2008, when the Patrick Administration proposed cutbacks in AFC rates, Mass Home Care testified against the rate cuts. “The fact remains,” Mass Home Care said, “that at the end of the day, the core of this program---the caregivers---are making $9,281 per year for level I, and $18,137 per year for level II. When caregivers apply for this program, it will not take them long to calculate these annual rates.” Mass Home Care said two things were certain: “These caregivers are enormously undervalued compared with people doing similar work in state agencies, and the new rates will not be enough to attract the caregivers needed to expand this program, and the ultimate losers from this situation will be the state’s taxpayers, who will foot the bill for more costly placements.”

Mass Home Care concluded in 2008: “Adult Foster Care holds the promise of becoming one of the critical growth programs under Governor Patrick’s “Community First” initiative. Yet today, this program is still largely unknown, and marginally utilized. AFC will become more important because it is a 24/7 residential alternative, and as such, is highly targeted towards those who are in need of significant personal assistance. The level II program in fact, is targeted to those who would otherwise need expensive institutional care. However, if this program continues to remain obscure, with rates that do not reflect the level of care and attention required by its clients, then the Commonwealth will lose the opportunity to keep people in the least restrictive setting, and pay the price for that loss.”

Adult Day Health: ADH is a community based day program providing nursing and therapeutic services and oversight for members in an effort to postpone nursing facility placement. Services provided include nursing, therapy, nutrition, dietary counseling, case management, activities, and assistance with activities of daily living. The proposed amendments decrease the payment rates effective March 15, 2011 for adult day health (ADH) services by an average of 7.8%. The proposed rate for Basic ADH services will decrease from $53.93 to $49.98 per day (7.3%); the rate for Complex ADH services will decrease from $68.68 to $62.95 per day (8.3%); and the rate for Health Promotion and Prevention (HPP) services will decrease from $27.86 to $25.69 per day (7.8%). Rates for ADH services are calculated based upon the median of industry unit costs as reported by ADH providers, to which efficiency standards for productivity and administrative costs, and a cost adjustment factor are applied. The proposed rates for Basic and Complex ADH services are based on 2009 reported costs. The proposed rate for HPP services decreases the current rate by 7.8%.

The Division estimates that aggregate annual expenditures by MassHealth in FY 2012 for ADH will decrease by approximately $3.32 million or 7.49 % as a result of this proposal. Because these rate cuts will take effect for 3.5 months in FY 2011, the cuts are projected to save roughly $968,000 in the current fiscal year.In October of 2009, Mass Home Care testified before DHCFP against cuts in Adult Day Health rates. “ADH is helping almost 7,000 individuals to remain living in the community,” Mass Home Care said, “saving state and federal taxpayers millions of dollars annually. If 7,000 people had to be institutionalized due to lack of ADH services, the cost would be roughly $408.8 million annually. The entire spending for the ADH program for FY 2009 is $90.49 million (including transportation). It is clearly more cost effective to keep people in the community, even when you combine ADH with other in-home supports that these individuals may be receiving.”

Group Adult Foster Care: GAFC is a program providing daily assistance with personal care services and case management oversight by the provider in an elderly/disabled housing complex, or Assisted Living Residence. Because this program does not operate with a set of regulations, it does not have to go through the same public hearing, rate setting process. The Administration has proposed cutting GAFC rates by 7.6%, which will reduce program expenditures in the remaining months of FY 2011 by $1.25 million, and cut FY 2012 expenses by $5 million.

In addition to these listed services, the Administration has proposed cuts to MassHealth dental services, day habilitation, and other services targeted to low-income people.

“Cutting community based services for the elderly is fiscally wrong-headed,” said Mass Home Care Executive Director Al Norman. “Day care and foster care programs keep seniors out of more expensive institutions. At a time when revenues are limited, it makes sense to invest in programs that save taxpayer’s money. As budget strategy, these cuts are inexplicable. On a human level, these cuts are indefensible.”

U.S. Alters Rule on Paying for End-of-Life Planning

2011-01-05T20:34:00.001-05:00

By ROBERT PEAR

New York Times,
January 4, 2011

Entire Article Can Be Read Here!

WASHINGTON - The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.

Many doctors and providers of hospice care had praised the regulation, which listed "advance care planning" as one of the services that could be offered in the "annual wellness visit" for Medicare beneficiaries.

While administration officials cited procedural reasons for changing the rule, it was clear that political concerns were also a factor. The renewed debate over advance care planning threatened to become a distraction to administration officials who were gearing up to defend the health law against attack by the new Republican majority in the House.

In a recently published article by Arthur Caplan, Ph.D, msnbc.com contributor, 'Death panels' alive - and that's good news for all of us, he says, ...Washington, D.C., is not the place to talk about end-of-life care - your doctor's office is.

Death Panels' Alive — And That's Good News For All Of Us!

2011-01-04T10:01:00.000-05:00

Washington is not the place to talk about end-of-life care — your doctor’s office is
By Arthur Caplan, Ph.D. msnbc.com contributor

Watch out! The "death panels" are back. They are going to be used by Obama and his horde of federal health reformers to make sure that if you are old, very sick and go into a hospital, you will never return. So goes the line of utter malarkey put forward with a straight face and Twitter finger last year by Sarah Palin, who notoriously and ridiculously coined the term "death panels" to vilify efforts to legislate paying doctors to talk with Medicare patients about their health care options if they become terminally ill. Her critique worked. The provision to pay doctors for the time involved to talk about end-of-life care for older Americans was dropped from the health reform bill.

But it has come back, this time in the form of regulations to be issued on Jan. 1 by the Department of Health and Human Services. If an elderly person is offered a chance to do advance care planning by their doctor and wants to do so, then Medicare will pay the doctor for the time involved.

Some conservatives and right-to-lifers see rationing afoot. They think encouraging these discussions is simply a way to get old folks to save the federal government money by slyly tricking them into saying that they don’t want a lot of medical care if they are terminally ill. Not only are they wrong, they are dead wrong. Talking with your doctor about what you want to happen and who you want to make decisions for you if you become terminally ill is something every American, young and old, should do.

If you want aggressive care to the very end then you need to say so. If you don’t want to be kept alive with technology should you have a deadly cancer that does not respond to treatment then you need to let your doctor and your family know.

Story: Obama enacts end-of-life plan that drew 'death panel' claims

Few people are comfortable with the topic of death. Some, like Sarah Palin, seem to think that if they pull the covers over their head the Grim Reaper will go away. Not so. Each of us will face end-of-life decisions if not for ourselves then for our family or friends.

Anything, including Medicare money, that can encourage doctors, many of whom do not want to have this conversation with their reluctant patients, to do so is a sound, moral and prudent policy.

No one is telling you what you must say. No regulation says that you cannot insist that everything possible be done. No bureaucrat is whispering in your doctor’s ear to spin the conversation toward insuring your premature demise.

You can change your mind at any time about your views and wishes including during your time in a hospital, nursing home or hospice. Nothing is locked in stone by having this initial conversation about what you want and who you want to make decisions for you if you cannot do so.

If Terri Schiavo taught us anything, it was that you need to specify to your doctor and family who should make decisions for you about your medical care if you are unable to communicate.

If the political conversation over death panels and advance care planning has taught us anything, it is that Washington, D.C., is not the place to talk about end-of-life care — your doctor’s office is.

Article courtesy of MSNBC, contributed by By Arthur Caplan, Ph.D.

Visiting Our Aging Parents for the Holidays: Something You Didn’t Expect Courtesy of Forbes

2010-12-27T15:08:00.002-05:00

.....but how do we spot the trouble signs when they first show up in our loved ones?

It’s sort of like noticing wear and tear on a car. When the first thing wears out, you start noticing lots of other things. “I never noticed so many of those rattles before”, you might say to yourself. Your consciousness of the problem is raised. You’re aware. You spot other signs because you’ve spent time thinking about the age of the car. It’s the same with our parents. We need to think about their vulnerabilities, the changes in their habits, the wear and tear of life. We need to raise our own consciousness.

What should we be looking for? We should be checking out our parents for things that are subtly or obviously different from what we’re used to seeing in them. Memory problems are the first and early warning signs. Did Mom forget a part of the meal, or lose track of cooking? Are there unopened bills on the kitchen table? Is the yard or house in disrepair? Did either parent forget that we were coming to visit?

All of these may be signs of early disease process, depression or other conditions that need our attention and our action. We must not fear insulting our parents by asking them about what we observe. It’s a loving act to bring it up in a respectful way. We can’t stand idly by pretending that nothing is changed. Families who do this may end up with parents who have been financially abused, due to dementia, or whose parents are seriously neglected. Parents may be less able to care properly for themselves lately and it’s up to us to protect them as best we can.

From AgingParents.com, here are Ten Warning Signs Your Parent Needs Help Handling Money. Look for them on your next visit:

You find late notices from a utility company, cable TV, or other monthly recurring bill in your parents’ home.
Your aging parent repeats himself or herself in speaking to you, telling you the same thing or asking the same thing over and over in a single conversation.
Your aging parent shows signs of unusual paranoia, suspicion, or mistrust of something or someone he/she has always trusted. (It could be you!)
You aging parent has a new “friend” who is hanging around a lot, and seems to pressure your parent into doing things he/she would not normally do, including writing checks.
Your parent is not well groomed as she has always been. You see dirty clothing, unkempt hair, or other clues that she has forgotten to take care of herself.
Your parent is suddenly very interested in contests, sweepstakes, and other “get rich quick” offerings and has been giving out personal information and his phone number to enter them.
There is a change in your parent’s giving habits for charitable organizations, which have resulted in large, unusual contributions, out of the norm for your parent.
Your parent is recently widowed, and has never handled the family finances before. She is avoiding the subject of money.
Your aging parent is socially isolated, due to losses, by geography or by choice. There is little activity outside the home and he seems lonely.
Your aging parent has always been proud, stubborn and secretive about money. Even though he’s having trouble keeping track of his bills, he strongly resists asking for your help.

Going home for the holidays can still be a fine experience. And, it may create a new responsibility for us boomers. Watching over Mom or Dad becomes another task we need to undertake. Setting aside time for a frank talk with aging parents about their finances, adding a day to our visit, and creating an opportunity to plan ahead can save untold heartache for our future.

From forbes.com

2010-12-15T10:46:00.000-05:00

Aging Network to Embark on New Level of Volunteerism

2010-12-14T14:59:00.003-05:00

Collaboration of Aging Organizations to Create
“Engaging Volunteers in the Aging Network:
A National Resource Center”
www.n4a

Volunteers in the Aging Network* have been delivering for over 40 years. Deliveringmeals to homebound seniors, delivering rides to doctor’s appointments, delivering counseling to seniorson benefits, in addition to countless other vital roles. With the rapidly aging population, the demand forvolunteers to deliver these services and others continues to grow. Based on this impending need, theU.S. Administration on Aging (AoA) recently awarded a grant of nearly $1 million to create a NationalResource Center to further develop and support the work of volunteers providing services to olderAmericans and their family caregivers. The National Resource Center will deliver the assistance andexpertise volunteers need to bring their efforts to a new level in the Aging Network.

“Volunteers have always been the backbone of the Aging Network. But we want to ensure thatvolunteers, especially older Americans, have the opportunities to use their lifetime of learning and skillsto help address America’s challenges and to enrich their own lives,” said Assistant Secretary for Aging,Greenlee. “This Center will help us better understand the changing needs of volunteers.”

The AoA grant was awarded to a collaboration of aging organizations that are dedicated to servingolder adults and the Aging Network. The collaboration, led by the National Association of AreaAgencies on Aging (n4a), includes the National Association of States United for Aging and Disabilities(NASUAD), the AARP Foundation, Senior Service America, Inc. (SSAI), the Council for Certification inVolunteer Administration (CCVA) and the University of Michigan (for evaluation). AoA will work withthese organizations to expand the capacity of the Aging Network to engage volunteers nationwide.

“This strong collaboration is uniquely positioned within the Aging Network and with older adults acrossthe country to create the necessary leadership and infrastructure to develop effective and replicablecivic engagement efforts for older adults, especially boomers,” said n4a CEO Sandy Markwood.

The three-year project will: conduct research on civic engagement; convene thought-leaders to helpdevelop a plan of action on volunteerism for the Aging Network; develop communication and outreachtools to reach aging services leaders and volunteers across the country; create training programs andtechnical assistance resources for volunteers and volunteer coordinators; and identify and promote bestpractices.

“Volunteer engagement is a natural fit for the Aging Network, and the time is now to bring theleadership, skills and connections of the Aging Network fully into the civic engagement arena,” saidMarkwood. “Our collaboration must create a new vision of community service along with a persuasivecall-to-action to attract the attention of Americans, letting them know their help is needed and there aremany opportunities for them to get involved.”

"The Era Of Deficit Denial In Washington Is Over"

2010-11-29T09:28:00.003-05:00

Eliminate congressional pet spending projects known as "earmarks."
Reduce the corporate income tax rate to 28 percent from 35 percent and stop taxing the overseas profits of U.S.-based multinational corporations.
Overhaul individual income taxes and corporate taxes, giving Congress the choice of reducing the top rate to as low as 23 percent and no higher than 29 percent. The lower the rate, the fewer the tax credits and deductions that would be available to taxpayers.

Under one scenario proposed by Bowles and Simpson, taxpayers would face three tax brackets of 12 percent, 21 percent and 28 percent. Taxpayers would still be able to claim an earned income tax credit and child tax credit as well as all standard deductions and exemptions. Capital gains and dividends would be taxed at ordinary income tax rates. Taxpayers could claim a mortgage interest deduction up to $500,000, but only on their primary residence.

If Congress does not undertake a comprehensive overhaul of the tax system by 2013, the plan calls for a "fail-safe" provision that would trigger across-the-board reductions in tax breaks, designed to raise revenue by $80 billion in 2015 and $180 billion in 2020.

Bowles was White House chief of staff when former President Bill Clinton negotiated a balanced budget plan in 1997; Simpson is a former GOP senator from Wyoming.

Only Bowles and Simpson are guaranteed to support the plan when the panel votes. None of the 12 House members and senators named by Obama have committed to the proposals, though Bowles and Simpson could pick up support from non-elected deficit hawks like Democrat Alice Rivlin and Honeywell International's chief executive, David Cote, a Republican, who won't have to defend themselves to voters. Republican senators seem more likely to vote for the plan than their rigidly anti-tax increase House counterparts.

"I don't know if we're going to get two votes or five votes or 10 votes or 14 votes," Bowles told reporters. "There are enough reasons to vote 'no' in this plan for anybody to vote 'no.'"

A super-majority of 14 of the 18 panel members would have to approve recommendations for a possible vote in the lame-duck session of Congress. That seems out of reach, but Bowles says it's just as important to have jump-started a national debate on what it'll really take to bring the deficit under control.

"Our goal in this whole process has been really simple," Bowles said. "It's basically been to start an adult conversation here in Washington about the dangers of this debt and the deficits we are running."

He added, "The era of deficit denial in Washington is over."

Virtual Dementia Tour

2010-10-30T12:05:00.010-04:00

Second Wind Dreams Virtual Dementia Tour

When a loved one is diagnosed with Dementia, it affects everyone in the family, friends and the community. The Alzheimer’s Association states that Alzheimer’s is being diagnosed every 72 seconds in the U.S. alone, and 7 out of 10 Alzheimer’s patients live at home where family and friends provide 75 percent of the care. Yet studies show that these caregivers are not formally trained to provide the support needed for those living with dementia. The purpose of the Virtual Dementia Tour™-I for Individuals (VDT-I) is to help families better identify with their loved one’s day-to-day struggles, thereby improving their ability to provide care.

This six minute film tracks the life of a man, who at age 80 is living with Alzheimer's; and a son who is trying to understand what it is like to live with the disease. Virtual Tour allows you to see and feel what it is like to live with dementia.

Choices about Life-Sustaining Medical Treatments

2010-10-20T10:00:00.003-04:00

Jena Bauman Adams, MPH MOLST Project DirectorHearing that you or a loved one may be nearing the end of life because of a serious illness or injury is very difficult. It often takes time to adjust to the situation and to consider what it may mean. In addition, medical information – especially about one’s health status, what can happen next and the potential benefits and risks of treatment – can be confusing or overwhelming.

All adults have a legal and ethical right to make choices about medical treatments they want or do not want to receive when they are nearing the end of life. However, patients’ wishes are often unspoken, unknown, or unavailable to health providers at the time treatment decisions are made. That is why it is so important for individuals to have conversations with their loved ones and doctors about all of these matters – not only when they are very sick, but also before an unexpected illness or injury may occur.

In Massachusetts, all adults ages 18 and older are encouraged to fill out a health care proxy form to appoint a person they trust as their “health care agent.” In Massachusetts, if an individual is not capable of making medical decisions as determined by their clinician (e.g. because they are unconscious or due to dementia or other mental limitations), it is their “health care agent” officially named in a health care proxy who is authorized to make medical decisions on their behalf. It cannot be assumed that a family member or next of kin will be authorized to make medical decisions in every situation or setting.

Therefore, appointing a health care agent is the first essential step in advance care planning for every adult after they have turned 18 years old, even if they are perfectly healthy. The next step is to have conversations with your health care agent about your values and goals for medical care, so he or she can make the medical decisions you would have wanted should the need occur.

For individuals with serious advancing illnesses, especially those who may be nearing the end of life, physician-patient conversations about life-sustaining treatment preferences are of particular importance. Such conversations are often difficult for everyone involved; however, they serve to help patients, their loved ones and health care providers better understand the patient’s medical condition, treatment options and goals for care. In fact, these discussions have proven to improve quality of life scores for patients near the end of life and bereavement outcomes for their caregivers. (1)

To assist seriously ill or injured individuals communicate their wishes about end-of-life medical treatments, a new process is being tested in several Worcester-area health care institutions. Called Medical Orders for Life-Sustaining Treatment, the process entails conversation between a patient and the patient’s loved ones and doctor to explore and establish the patient’s treatment goals and preferences. One possible outcome of these discussions is completing and signing a “MOLST” form. A MOLST form is filled out and signed by a patient and doctor together to communicate the patient’s treatment wishes. MOLST instructions are honored by all health professionals across health care settings (e.g. at home, by emergency responders, in nursing homes, at hospitals).

The MOLST process involves:

Discussing your medical condition, treatment options, and your values, hopes, expectations and goals for care with your doctors and loved ones
Learning about the types of medical treatments you might be given if your heart or breathing stop – including the benefits or risks of such treatments and how effective they might be
Identifying any preferences you may have about receiving or not receiving certain types of life-sustaining treatments
Deciding whether or not to document your preferences by completing a MOLST form with your doctor
Completing the MOLST form with your doctor and signing it to confirm that the form reflects the treatment preferences you expressed to the doctor (the doctor also signs the form)
Keeping the MOLST form with you in a location where it can be easily seen or found by your loved ones and health professionals
Telling your loved ones, health care agent and caregivers about your MOLST instructions and the location of your MOLST form

Completing a MOLST form is voluntary and individuals may decide to wait until another time to consider MOLST, or not to complete a MOLST form at all. Individuals can also change their minds about treatments any time, even after signing the MOLST form.

For more information about Medical Orders for Life-Sustaining Treatment, you may ask your doctor, visit: www.molst-ma.org, or call the MOLST program at 508-856-5890.
--------------------------
(1) Wright, A.A., et al., Associations between end of life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA, 2008. 300(14): p. 1665-73.

Congressman McGovern Holds Press Conference in Worcester

2010-10-19T13:34:00.002-04:00

FOR IMMEDIATE RELEASE:
Seniors, Advocates criticize Marty Lamb’s ‘radical’ stance on Medicare, Social Security

Local seniors and senior advocates criticized Marty Lamb today for his “radical and dangerous” stances on Medicare and Social Security.

Citing experts, the McGovern Campaign said that Mr. Lamb’s “10th Amendment Pledge” would undermine the very basis of those vital programs.

“Despite his disingenuous claims of sticking up for seniors, Mr. Lamb is actively working to destroy the constitutional underpinnings of the programs most important to them,” said McGovern spokesman Scott Zoback.

In a statement, University of Chicago Constitutional Law Professor and former Supreme Court Clerk Geoff Stone said that Lamb’s pledge would “threaten the very premise of constitutional government.”

“If American constitutional law had embraced the position now asserted in the Tenth Amendment Pledge, the federal government could not charter federal banks, it could not enact laws prohibiting racial and religious discrimination, it could not establish minimum national standards for protecting the public health and safety,” wrote Stone.

Similarly, Ian Millhiser, a legal research analyst with the Center for American Progress Action Fund wrote in American Prospect last year that “tenthers” read the constitution “too narrowly...to permit much of the progress of the last century.”

Bob Dwyer, Executive Director of the Central Massachusetts Agency on Aging, said that seniors’ “quality of life would be irreparably damaged,” by Lamb’s pledge.

At the press conference at the Worcester Senior Center, McGovern pledged to fight for Social Security and Medicare. “I have always stood up for seniors, and I pledge to you today that I will continue to do so.”

Governor Signs FMAP Bill With $7.1 M in Home Care Funding

2010-10-17T10:55:00.004-04:00

Patrick Signs Budget Bill,
Sticks To Revenue Estimate
By Michael Norton/Statehouse News Service
http://www.statehousenews.com
GateHouse News Service

Gov. Deval Patrick on Friday signed a $420 million spending bill that adds to the three-month-old $27.6 billion state budget and his administration opted to stick with its estimate of tax collections for the fiscal year, which are running $200 million ahead of budget benchmarks.

Services for the disabled, the state's massive MassHealth budget and the State Police and prison system received funding infusions under the $420 million budget bill that Patrick signed without fanfare, shortly before attending a governor's race candidate forum at Emerson College.

The bill, paid for through federal stimulus funds that won’t be available next fiscal year, deploys accounting methods aimed at putting nearly $200 million into a state rainy day fund that lawmakers and Patrick have drained more than $1.5 billion from during the recession.

Patrick returned with an amendment a section of the bill requiring insurers to reimburse ambulance companies directly for services, regardless of whether the companies are members of contracted networks.

"I am concerned about the impact of this section on health care costs because it lacks guidelines government reasonable charges for ambulance services," Patrick said in a letter to lawmakers.

The amendment would set limits on the costs non-network ambulance companies may charge insurers.

House and Senate leaders steered the bill through the Legislature during informal sessions, overcoming concerns about the bill voiced by Republicans, who ultimately agreed to allow the bill to pass.

A year ago today and only three months into fiscal 2010, Patrick lowered the state’s tax revenue estimate by $600 million, calling for emergency spending cuts over the final eight months of the fiscal year that he said could result in the elimination of 2,000 state jobs, unilateral budget cuts, consolidation of state agencies, collaboration on energy purchases, and broader reductions across government.

This year, with tax collections running $200 million above fiscal 2011 budget benchmarks, the Patrick administration is sticking to its tax collection estimate, officials confirmed Friday.

Administration officials are trying to manage heavy, caseload-driven exposures in this year’s budget, especially in health care.

"Estimated revenues continue to be sufficient to meet budgeted expenditures," Administration and Finance Secretary Jay Gonzalez said in a statement.

State finance law calls for the administration by Oct. 15 of each year to signal to legislative leaders any revisions in anticipated revenues for the year, unless there’s no significant change in estimates.

Fiscal 2009 was marked by a string of supplemental budgets that both added government spending and made changes aimed at bringing outlays in line with available revenues. Additional supplemental spending bills are likely this year.

Fiscal analysts and candidates for governor have estimated next year’s state budget gap at between $2 billion and $3 billion, although Senate President Therese Murray, during a debate this week, pegged it at $1.5 billion. Extra federal funds that were critical to efforts to plug huge budget holes this fiscal year and during fiscal 2010 are not expected to be available next fiscal year.

CMS: Medicare Advantage Enrollment To Jump Next Year, Premiums To Fall

2010-09-22T10:33:00.005-04:00

CMS: Medicare Advantage Enrollment To Jump Next Year,
Premiums To Fall (The Hills Health Care Blog By Mike Lillis)Enrollment in the controversial Medicare Advantage (MA) program will increase by 5 percent in 2011, while average premiums will drop by 1 percent, the Obama administration announced Tuesday.White House health officials said the numbers indicate that — despite threats from conservatives and the insurance industry that the new healthcare reform law will cripple MA plans at the expense of seniors — both patients and taxpayers will benefit from the reforms."Despite the claims of some, Medicare Advantage remains strong and a robust option for millions of seniors who choose to enroll or stay in a participating plan today and in the future," Donald Berwick, head of the Centers for Medicare and Medicaid Services (CMS), said in a statement. “The Affordable Care Act gave us new authority to negotiate with health plans in a competitive marketplace. As a result, our beneficiaries will save money and maintain their benefits."The MA program — under which the government pays private insurance companies to cover Medicare patients — has been a lightening rod of controversy since its creation in 2003. Seniors have flocked to MA plans because many of them cover services, like dental and eye care, that Medicare doesn't.But the extra care hasn't come cheap. Despite promises that private plans operating under MA could eventually save money, the cost to treat the average MA patient is roughly 14 percent higher than the cost to treat the average senior under traditional Medicare. The Medicare Payment Advisory Commission, an independent panel that suggests reforms to Congress, has noted that part of the additional cost “consists of funds used for plan administration and profits and not direct health care services for beneficiaries.”Such statements have fueled criticisms from patient advocates and consumer groups that MA is just a giveaway to insurance companies. Many Democrats tend to agree, and the new reform law cuts MA subsidies substantially over the next decade.As part of that effort, Medicare will freeze payments to MA plans next year, before actual cuts take effect further down the line.The freeze has done little to discourage plan participation, CMS said Tuesday, largely crediting the insurance companies themselves. "The plans are making very strong commitment to their programs," Jonathan Blum, director of CMS’s Center for Medicare, told reporters in a phone call. "We're seeing better value for beneficiaries and for taxpayers."Among the other revelations Tuesday:

About 5 percent of MA enrollees will have to choose new plans in 2011, largely resulting from MA reforms enacted in 2008. Of those seniors, all but 2,300 will have the option of choosing another MA plan;
99.7 percent of Medicare beneficiaries will have access to an MA plan in 2011;
Of the roughly 2,100 MA plans submitting 2011 bids, CMS identified 300 that had proposed to hike premiums or other cost sharing on seniors, while also increasing their profit margins. After CMS threatened to deny those plans, all but seven plans reworked their bids to the benefit of seniors. To Read Original Article, CLICK HERE!

Study on Risk Factors for Indoor and Outdoor Falls May Help Tailor Fall-Prevention Strategies

2010-09-15T10:06:00.003-04:00

Hannan and her colleagues found that:

Risk factors for indoor falls included being female, older age, inactive lifestyle, disability, having lower cognitive function, taking more medications, and overall poorer health.

Risk factors for outdoor falls included being male, being younger and more physically active, having more education, and having average or better-than-average health.

Among all the falls that were recorded, 9.5% resulted in serious injury, including 10.2% of indoor falls and 9% of outdoor falls.

The majority of outdoor falls occurred on hard concrete surfaces, including sidewalks, streets, curbs, outdoors stairs, and parking lots. Fourteen percent of outdoor falls occurred in yards or gardens.

The study participants included 765 men and women, ranging in age from 64 to 97; 36% were male and 64% were female.

The findings could have implications in how patients are identified for being at risk for falling. Current fall prevention programs overlook risk factors associated with outdoor falling, the researchers note. They should be updated to consider a person's activity level as well as other characteristics.

"Most fall prevention programs emphasize the prevention of indoor falls, particularly through strength, balance, and gait training; use of assistive devices; treatment of medical conditions; reduction in the use of certain medications; improvement in vision; and the elimination of home hazards," Hannan and her colleagues write. "More attention needs to be paid to the elimination of outdoor environmental hazards involving sidewalks, curbs and streets, such as repairing uneven surfaces, removing debris, installing ramps at intersections, and painting curbs."

The entire article, courtesy of WebMD, can be read at WebMD.

2010-09-13T16:04:00.000-04:00

Check our Calendar of Events Page for a list of Medicare Update Meetings with trained SHINE Counselors.

Straight Talk: Frequently Asked Questions

2010-08-03T15:57:00.003-04:00

National Council on Aging (NCOA) Straight Talk

Will the new law cut my Medicare benefits?
- The new law will not cut basic Medicare—and, in fact, it will give you more benefits. For example, everyone who has Medicare will receive a free annual wellness visit starting in 2011. And Medicare's screening and preventive services will be completely free next year. People with Medicare's drug coverage who fall into the coverage gap, known as the "donut hole," will receive a check for $250 this year to help with their drug costs, plus they'll see significant discounts to their drug costs starting next year. [Section 3301]
Will the new law cut Medicare spending?
- Medicare spending is growing rapidly and will continue to grow. But over the next 10 years, the new law will slow the rate of growth—from 6.8% per year to 5.5%. These figures come from the independent, non-partisan Congressional Budget Office (CBO), which is the group responsible to Congress for health reform cost estimates. Average yearly spending increases per person will be reduced from about 4% to 2%, adjusted for inflation.
How will the new law affect Medicare solvency?
- CBO projects that the new law will save Medicare about $400 billion over 10 years and extend the solvency of the Medicare Trust Fund for an additional nine years—from 2017 to 2026.
How will the new law affect the federal budget deficit?
- Under the new law, Medicare spending increases will slow down and new revenues will be raised, primarily from taxes paid by people with incomes over $200,000. Together, the savings and dollars coming in are expected to be greater than the money going out to pay for new benefits. Therefore, the CBO has estimated that the new law will reduce the budget deficit by $124 billion over 10 years.
Will the new law make it easier to receive and pay for long-term care at home?
- Yes, the law provides new incentives for states to make it easier for lower income people who are on Medicaid to get long-term care at home instead of in a nursing home by providing extra federal funds to provide in-home services. Also, the law creates the CLASS Act (Community Living Assistance Services and Supports), which allows full and part-time workers with incomes of at least $1,200 per year to enroll in a program that provides a cash benefit averaging $75 per day to help them stay at home when they become unable to care for themselves. Workers can choose to participate and have premiums deducted from their paychecks. [Section 8002]

Will the new law improve care for older adults in other ways?

Starting in 2010, companies can get tax incentives if they continue to offer early retirees health insurance, thus lowering the cost of premiums for these individuals.
Starting in 2011, Medicare will pay bonuses of 10% to primary care doctors (general practitioners), which will improve access to these doctors. [Section 5501]
There will be improvements in some nursing home quality standards. [Sections 6101-6114]
There will be improved training for workers who care for seniors. [Sections 5302 and 5305]
There will be new protections against elder abuse, neglect, and financial exploitation. [Section 6703]

How does the new law improve the quality of care for Medicare beneficiaries with chronic illnesses, such as diabetes and high blood pressure?

The law includes new pilot projects that will lead to better quality, communication, and coordination among doctors, specialists, and other providers for people with chronic health conditions. If you must be hospitalized, the law will help you return home successfully—and avoid going back into the hospital—by providing incentives for hospitals to make sure that you get the services you need in your community and by teaching you to take good care of yourself. [Sections 3021, 3024, 3502]

How will the new law improve health insurance coverage for younger Americans who don't have Medicare?

According to the CBO, the new law will provide health insurance to 32 million citizens who previously did not have it, starting in 2014. New consumer protections will also be provided to prevent discrimination and ensure that insurance companies cannot drop coverage for people who become ill.

How does the new law improve preventive care for Medicare beneficiaries?

A new, free, yearly wellness checkup will allow you and your doctor to develop a prevention plan to keep you healthy. And a range of prevention services, such as cancer and diabetes screenings, will be provided free – no more cost sharing. Additional funding will be provided for a range of prevention services for Americans of all ages. [Sections 4103 and 4104]

Will Medicare Advantage plans cut benefits and increase premiums?

We don't know. This year, private insurance companies running Medicare Advantage (MA) plans are paid about $1,100 more per person than what is paid for people in original Medicare. As a result of health reform, starting in 2012 payment rates to MA plans will be gradually reduced in many parts of the country, so that they are about the same as rates under original Medicare. It is unclear how MA plans will respond to these changes. They may choose to increase premiums, reduce extra benefits, or even leave the Medicare program. However, they are not allowed to cut any benefits provided under original Medicare. If you are in a MA plan, it makes sense to review your options during the fall annual enrollment period, just like everyone with Medicare should do each year, to see which way of getting Medicare best meets your needs.

How does the new law impact Federal Employee Health Benefits?

According to the Office of Personnel Management, it has been preparing to implement health reform since the day it was signed into law. Federal employees, retirees, and their families will be impacted in the same way that all other individuals are impacted, with one exception. The provision that requires adult children up to age 26 to be eligible for health insurance coverage under their parents' plan will not go into effect until Jan. 1, 2011 for FEHB plans.

How does the new law impact military health benefits, like TRICARE for Life and VA benefits?

The new law does not impact military health benefits.

Diabetes

2010-07-28T15:26:00.011-04:00

Over 9 million women in the U.S. have diabetes.
And 3 million of them don't even know it!
by The Food and Drug Administration
Did you know ...?

Women with diabetes are more likely to have a heart attack and have it at a younger age.
Some women get diabetes when they are pregnant.
Women who have diabetes are more likely to have a miscarriage or a baby with birth defects.
Women with diabetes, according to recent studies are more likely to be poor, which makes it harder to manage the disease.
Most people with diabetes die from heart attack or stroke.

What is diabetes?

It is a disease that changes the way your body uses food. The food you eat turns to sugar. The sugar then travels through the blood to all parts of the body. Normally, insulin helps get sugar from the blood to the body's cells, where it is used for energy.
When you have diabetes, your body has trouble making and/or using insulin. So your body does not get the fuel it needs. And your blood sugar stays too high.

What are the types of diabetes?

Type 1 --The body does not make any insulin. People with type1 must take insulin every day to stay alive.
Type 2 --The body does not make enough insulin, or use insulin well. Most people with diabetes have type 2.

Are you at risk for diabetes?

Do you need to lose weight?
Do you get little or no exercise?
Do you have high blood pressure (130/80 or higher)?
Do you have a brother or sister with diabetes?
Do you have a parent with diabetes?
Are you a woman who had it when you were pregnant. OR have you had a baby who weighed more than 9 pounds at birth?
Are you African American, Native American, Hispanic, or Asian American/Pacific Islander?

If you answered yes to any of these questions, ask your doctor, nurse, or pharmacist if you need a diabetes test.

What are the warning signs?

Going to the bathroom a lot
Feeling hungry or thirsty all the time
Blurred vision
Losing weight without trying
Cuts or bruises that are slow to heal
Feeling tired all the time
Tingling or numbness in the hands or feet

Most people with diabetes do not notice any signs
What can I do if I have diabetes?
Watch What You Eat and Get Exercise

There is no one diet for people with diabetes. Work with your health care team to come up with a plan for you.
You can eat the foods you love by watching serving sizes. The "Nutrition Facts" label on foods can help. Many packaged foods contain more than 1 serving.
Carbohydrates raise your blood sugar the most. Cut back on these. For example bread, cereal, rice, and pasta.
Be active at least 30 minutes a day most days of the week. Exercise helps your body's insulin work better. It also lowers your blood sugar, blood pressure, and cholesterol.

Use Medicines Wisely

Sometimes people with diabetes need to take pills or insulin shots. Be sure to follow the directions.
Ask your doctor, nurse, or pharmacist what your medicines do. Also ask when to take them and if they have any side effects.

Check Your Blood Sugar and Know Your ABCs

Help prevent heart disease and stroke by keeping your blood sugar, blood pressure, and cholesterol under control.
Check your blood sugar using a meter (home testing kit). This tells what your blood sugar is so you can make wise choices.
Ask your doctor for an A-1-C ("A-one-see") blood test. It measures blood sugar levels over 2 to 3 months.
Talk to your health care team about your ABC's:
- A-1-C
- Blood pressure
- Cholesterol

To learn more:Contact the American Diabetes Association1-800-342-2383 (1-800-Diabetes)

Becoming Over Heated

2010-07-14T15:33:00.012-04:00

Tips for Preventing Heat-related Illness

Prevention is critical to protecting your health. Here are tips to safeguard your health during the hot weather:

Drink more fluids. It’s very important to keep hydrated. Don’t wait until you’re thirsty to drink. Warning: If your physician limits the amount of fluid you drink or has you on water pills, check with him on how much you should drink while the weather is hot.
Don’t drink liquids that contain alcohol or large amounts of sugar. These types of liquids make you lose more body fluid.
Stay indoors and, if possible, stay in an air-conditioned room. If your home does not have air conditioning, visit a shopping mall or public library. You can also contact your local health department to find out if there are any heat-relief shelters in your area.
Electric fans may offer some comfort. However, when the temperature reaches the high 90s, fans will not prevent heat-related illness. Taking a cool shower or bath, or spending time in an air-conditioned place is a much better way to cool off.
Wear clothing that is lightweight, light-colored, and loose-fitting.
NEVER leave anyone in a closed, parked vehicle, including pets.
Some people are at greater risk for heat related illness. Check regularly on:
- Infants and young children
- People aged 65 or older
- People who have a mental illness
- Those who are physically ill, especially people with heart disease or high blood pressure
Visit adults at risk twice a day or more. Watch them for signs of heat exhaustion or heat stroke. Infants and young children will need more frequent watching.

What You Can Do to Help Protect Elderly Relatives and Neighbors

If you have elderly relatives or neighbors, you can help them protect themselves from heat-related stress:

Visit older adults at risk at least twice a day and watch them for signs of heat exhaustion or heat stroke
Encourage them to increase their fluid intake by drinking cool, nonalcoholic beverages regardless of their activity level

Warning: If their doctor generally limits the amount of fluid they drink or they are on water pills, they will need to ask their doctor how much they should drink while the weather is hot.

Take them to air-conditioned locations if they have transportation problems.

Courtesy of CDC and AOA

Closing the Prescription Drug Coverage Gap

2010-07-13T11:11:00.000-04:00

You Could Be Eligible For A $250 Rebate This Year to Help with your Medicare Drug Costs
www.aoa.gov

The Affordable Care Act passed by Congress and signed by President Obama this year contains some important benefits for Medicare recipients.

If you have Medicare prescription drug coverage, and aren’t already getting Medicare Extra Help, Medicare will automatically send you a one-time $250 rebate check after you reach the coverage gap (also called the “donut hole”) in 2010. This rebate is the first step toward closing the Medicare prescription drug coverage gap.

What is the coverage gap and how will I know if I’ve reached it?

Most Medicare drug plans have a coverage gap. This means that after you and your plan have spent a certain amount of money for covered drugs, you have to pay all costs out-of-pocket for your drugs (up to a limit).

The Explanation of Benefits notice, which your drug plan mails to you each month when you fill a prescription, will tell you how much you’ve spent on covered drugs and whether you’ve entered the coverage gap.

Will I need to do anything to get this rebate check?

No. There are no forms to fill out. Medicare will automatically send a check that’s made out to you. You don’t need to provide any personal information like your Medicare, Social Security, or bank account numbers to get the rebate check. Don’t give your personal information to anyone who calls you about the $250 rebate check. Call 1-800-MEDICARE (1-800-633-4227) to report anyone who does this. TTY users should call 1-877-486-2048.

When will I get the rebate check?

If you reach the coverage gap this year and enter the Part D “donut hole”, you will receive a one-time $250 rebate check if you are not already receiving Medicare Extra Help. These checks will begin to get mailed to beneficiaries starting in mid-June.

Checks will be mailed monthly throughout the year as beneficiaries enter the coverage gap. However, this is a one-time benefit and beneficiaries who qualify will only receive one check after they reach the coverage gap.

What if I don’t get the rebate check when I should?

Beneficiaries who hit the donut hole after the program has begun should expect to receive their check within 45 days. Your rebate may be delayed if Medicare doesn’t have information from your Medicare drug plan showing that you reached the coverage gap in time to include you in the next mailing. You should call your Medicare drug plan to make sure all of your information has been sent to Medicare.

If you don’t get your rebate check, contact Medicare. Individuals receiving Medicare Extra Help will not receive a rebate check.
You can also check to make sure Social Security has your correct home address. Call 1-800-772-1213 or your local Social Security office. TTY users should call 1-800-325-0778.

What’s Next ….Coming in 2011

If you reach the coverage gap in 2011, you may get a 50% discount on your brand name prescription drugs at the time you buy them. Stay tuned for more information from Medicare.

Help us spread the word about this important benefit

And help stop scams against seniors

Remember- there are no forms to fill out to receive this benefit once you qualify for it. Medicare will automatically send a check that’s made out to you.

You don’t need to provide any personal information like your Medicare, Social Security, or bank account numbers to get the rebate check. Don’t give your personal information to anyone who calls you about the $250 rebate check. Call 1-800-MEDICARE (1-800-633-4227) to report anyone who does this. TTY users should call 1-877-486-2048.

Go to stopmedicarefraud.gov to learn more about how Medicare is working with law enforcement to stop scams against seniors.

Have other questions about the $250 rebate check or the Affordable Care Act and Medicare?

Please refer to the brochure Medicare and the New Health Care Law--What it Means for You that Medicare has sent you. You can also visit www.medicare.gov, or call 1-800-MEDICARE.

HHS Launches New Consumer Focused Health Care Website, www.HealthCare.gov

2010-07-05T12:09:00.001-04:00

A Powerful New Information Tool That Will Give Consumers More Control Over Their Own Health Care and Allow Them to Compare Their Coverage Option

The U.S. Department of Health and Human Services today unveiled an innovative new on-line tool that will help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage. Called for by the Affordable Care Act, www.HealthCare.gov is the first website to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool.

"HealthCare.gov helps consumers take control of their health care and make the choices that are right for them, by putting the power of information at their fingertips,” said HHS Secretary Kathleen Sebelius. “For too long, the insurance market has been confusing and hard to navigate. "HealthCare.gov makes it easy for consumers and small businesses to compare health insurance plans in both the public and the private sector and find other important health care information.”

"HealthCare.gov is the first central database of health coverage options, combining information about public programs, from Medicare to the new Pre-Existing Conditions Insurance Plan, with information from more than 1,000 private insurance plans. Consumers can receive information about options specific to their life situation and local community.

In addition, the website will be a one-stop-shop for information about the implementation of the Affordable Care Act as well as other health care resources. The website will connect consumers to quality rankings for local health care providers as well as preventive services.

“This website is unlike any government website you have ever seen or used before,” said HHS Chief Technology Officer Todd Park. “It was developed with significant consumer input and is remarkably easy to navigate. This is despite the sheer volume of content it offers consumers: billions of health care choices through the insurance finder and more than 500 pages of new content, all of which is designed to grow with ongoing consumer feedback and as our health care system improves.”

As the health care market transforms, so will "HealthCare.gov. In October, 2010, price estimates for health insurance plans will be available online. In the weeks and months ahead, new information on preventing disease and illness and improving the quality of health care for all Americans will also be posted. The website also includes a series of opportunities where users can indicate whether pages were helpful to them and we will continue to seek user feedback to grow and strengthen the site.

“People need to see what choices are offered, what options cost, and how coverage works in practice,” said Karen Pollitz, Deputy Director for Consumer Support, Office of Consumer Information and Insurance Oversight. “Today "HealthCare.gov takes an important first step in that direction. In the coming months and years, we will add pricing and plan performance information so that consumers can see and understand and make meaningful choices about their health coverage.”

Fatality Crash Rate Falls for Older Drivers

2010-06-22T15:26:00.006-04:00

Tanya Mohn, The New York Times

The rate of older drivers involved in fatal road crashes plunged during the last decade, according to a report released on Tuesday by the Insurance Institute for Highway Safety.

The fatal crash rate of licensed drivers 70 and older fell 37 percent from 1997-2008. The most striking decline occurred among drivers 80 and older, whose involvement in fatal crashes fell by almost half during the same time period.

Older drivers were also less likely to have a severe crash, and there was a greater likelihood that they would survive when they did crash, the report said.

"We expected to see the opposite," said Anne McCartt, senior vice president for research at the institute and co-author of the report. She said the road safety community anticipated an increase in deaths and serious injuries because of the growing population of older people, who are driving more and holding on to their licenses longer.

The reasons for the steady decline were unclear, Dr. McCartt said. The poor economy was thought to have a minor role. Significant factors included the fact that older drivers were doing a better job restricting their driving, they might be healthier and in better shape, allowing them to reduce their risk of crashing in the first place and a greater chance that they would survive when they did crash. Safer vehicles and better emergency medical services and trauma care were also thought to have contributed to the decline.

She said the institute had done a separate study, released earlier this year, that reinforced the idea that older drivers tended to do a good job restricting their driving when they had impairments. The study focused on an innovative program in Iowa, which showed how the state used a variety of ways to identify drivers at risk. Many of the drivers identified by the state had already been limiting their driving late at night or on high-speed roads, Dr. McCartt said. Drivers did tend to be more compliant after state involvement, however, she said.

"Part of the message of our study is older drivers are doing better without very strong restrictions," she said. "They are staying safer."

Bella Dinh-Zarr, the North American director of Make Roads Safe, a global initiative, said the study was important because it highlighted a common misconception that older drivers are a danger to others.

"They are probably the safest and wisest drivers on the road," she said, with a lifetime of driving experience, who tend to hurt themselves more than others when they are in a crash.
She said older drivers today are more aware and have greater access to refresher courses and tools to counteract the natural decline in vision, cognitive and physical abilities as people age. In addition, she said, improvements to road infrastructure - better lighting, striping and crash barriers - have also helped.

"Maybe now we are starting to see some of the rewards," Dr. Dinh-Zarr said. "It brings a lot of hope."

Employer Support for Care Giving Employees

2010-06-14T11:49:00.004-04:00

From The National Care Planning Council

“There are only four kinds of people in this world. Those who have been caregivers, those who are caregivers, those who will be caregivers, and those who will need caregivers.” Rosalynn Carter, Former First Lady

The U.S. Department of Labor estimates that in the year 2010, 54% of workforce employees will provide eldercare for a parent or parents and that nearly two-thirds of caregivers will experience conflict between demands at home and demands from employers.

Today’s employed Baby Boomers are the caregiver generation for their parents. They are finding themselves juggling care responsibilities around their employment obligations. Sometimes employees find they have no option but to take leave from work or use sick time to meet their caregiving demands.

Employers also feel the toll it is taking on their employees. A report by the AARP describes the cost to employers:

“Companies are also seeing the emotional and physical toll that caregiving takes on their workers. In one study, 75% of employees caring for adults reported negative health consequences, including depression, stress, panic attacks, headaches, loss of energy and sleep, weight loss, and physical pain. Businesses suffer, too, by having to pay high health insurance costs and in lost productivity. That doesn’t count the promotions or assignments workers turn down that require travel or relocation away from aging relatives."

Businesses that don’t offer benefits or address eldercare wind up paying for them. A recent study by the MetLife Market Mature Institute and the National Alliance for Caregiving states that U.S. companies pay between $17.1 billion and $33.6 billion annually, depending on the level of caregiving involved, on lost productivity. That equals $2,110 for every full-time worker who cares for an adult.

Eldercare cost businesses:

$6.6 billion to replace employees (9% left work either to take early retirement or quit)
Nearly $7 billion in workday interruptions (coming in late, leaving early, taking time off during the day, or spending work time on eldercare matters)
$4.3 billion in absenteeism" AARP

Typically, human resource departments work with employees on many issues that may affect their work productivity. There are programs for drug and alcohol abuse, domestic violence, illness, absenteeism and child care; but, help with eldercare issues is not normally provided.

The AARP report follows several companies who are providing help with eldercare issues and what they are doing for their employees.

“Freddie Mac has a free eldercare consultant and access to subsidized aides for a relative up to 20 days.
Verizon Wireless offers seminars on eldercare issues and allows full-time workers 80 hours a year in back-up care, 40 hours for part-time, and $4/hour for in-home help.
At the Atlanta law firm Alston & Bird LLP, workers can donate vacation time to colleagues who have used up theirs to care for family members. “ AARP

A growing number of companies nationwide are directing their HR departments to provide resources, education and group help for caregiving issues by:

Providing materials from community resources such as phone numbers to their local Senior Centers or Area Agencies on Aging.
Making available brochures and booklets on specific programs and services by eldercare experts
Providing speakers to educate employees on caregiving options
Allowing options to use paid sick leave, employee job sharingand flexible hours
Allowing employee caregivers to use business computers for caregiving research
Contracting with companies who provide eldercare services to help employees

Eldercare service providers are also reaching out to help employee caregivers by providing informational presentations at the work place during lunch time or other times set up by employers. One such presentation provided information on reverse mortgages. Jason, who had been trying to help his parents pay for home care, learned at a work site presentation that a reverse mortgage was one way to cover caregiver expenses.

The HR Department of a local business in Utah, invited the Salt Lake Eldercare Planning Council to present a “Brown bag, Lunch and Learn” during their employees' lunch hour. In 30 minutes time, those who attended learned how the services of a Care Manger, Home Care Provider, Elder Attorney, Medicaid Planner and Financial Consultant can help with caregiving decisions. Problems were discussed, questions answered and employees left armed with information and the names of professional people they knew could help them.

“This was the most productive lunch I have ever attended”, related Mary, one of the attendees.

“I had been very hesitant to contact an attorney to discuss my parents' estate, because of the cost involved. The attorney at our 'lunch and learn' answered my few basic questions which will allow me to prepare what I need before I meet with him to finalize my parents' estate planning.”

Besides workplace help for employers and employees dealing with caregiving, the internet is also a great research tool. The National Care Planning Council website at www.longtermcarelink.net is a comprehensive resource for eldercare, senior care and long term care planning. It contains hundreds of articles on all aspects of eldercare. Professional providers list their services on the NCPC website. Each of their listings provides unique information on specific eldercare services and how to obtain help.

Employers, employees and eldercare service providers working together can make parent or senior caregiving a workable solution for all.

Recognizing Symptoms of Dementia

2010-06-07T13:15:00.001-04:00

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone’s favorite foods are always on the agenda. On the top of the menu is Grandmas Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side, perhaps a half cup full of salty.

Though the family was disappointed over the cake, of more concern was Grandma’s confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma's mental state?

One might say that for an elder person a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia?

An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia.

"Dementia causes many problems for the person who has it and for the person's family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question.
Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later.
Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people."

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer’s disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer’s. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.

"The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it's a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive.

The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support." The Four Steps of Long Term Care Planning

Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients. Don’t forget care facilities as well. It may be the best loving care a family member can give is to place their loved one in a facility where that person is safely monitored and cared for.

The National Care Planning Council supports caregiving services throughout the country.
www.longtermcarelink.net

Can Fosamax and Other Osteoporosis Drugs Contribute to Bone Fractures?

2010-06-06T15:57:00.000-04:00

What you need to know

by: Katharine Greider | from: AARP Bulletin | May 28, 2010

For years women, especially postmenopausal women, have been prescribed osteoporosis medications called bisphosphonates (a group of drugs that includes Fosamax, Boniva, Actonel and Reclast) to strengthen their bones. But recent reports have raised questions about whether long-term use of these drugs might be linked to an unusual fracture of the thighbone.

Two studies presented this spring at the annual meeting of the American Society of Orthopaedic Surgeons added to that concern as they pointed to changes in bone quality among women taking bisphosphonates for several years.

Doctors stress, though, that these medications do prevent fractures—especially hip fractures—in large numbers of women who have osteoporosis, and that the thighbone fractures are relatively rare.

Here’s what we know so far.

What did the new studies show?

These small studies were designed to explore whether prolonged use of these osteo drugs changes bone quality in ways that might promote thighbone fractures.

In one study, researchers at Columbia University Medical Center examined 111 postmenopausal women to measure the strength of their thighbones. About half of the women were not taking the drugs, and the other half had taken them for at least four years. The study found that for those on the medicines, bone strength improved during the first four years of drug therapy. But as they continued to take the drugs beyond four years, those improvements deteriorated, although not all those gains disappeared.

In the other study, researchers at the Hospital for Special Surgery in New York examined samples from the thighbones of 21 postmenopausal women; 12 had taken bisphosphonate drugs for an average eight-and-a-half years. The age of the bone tissue from women taking the drugs showed less range—there was more old bone and less soft, flexible newer bone—compared with women not on the drugs.

What do these findings mean?

Bisphosphonates work by suppressing the natural process in which bone tissue is removed and replaced with new bone. In osteoporosis, bone removal outstrips replacement and results in light, fragile bones. It’s possible, the studies’ authors suggest, that long-term drug therapy sometimes produces bone that’s thick and hard but harbors tiny flaws from accumulated damage or structural irregularities, which reduce the bone’s resistance to cracking.

Why did doctors first begin to be concerned about these drugs?

Certain kinds of bone fractures are considered typical for those who have osteoporosis. These include fractures in various places on the hip and spine.

But over the last several years physicians have published a series of reports of cases where women taking bisphosphonate drugs for a number of years experienced unusual breaks or cracks in the thighbone several inches below the hip.

Joseph M. Lane, M.D., an orthopedic surgeon at the Hospital for Special Surgery and NewYork-Presbyterian Hospital and a coauthor of one of the studies presented in March, says that in past decades this kind of break was so rare that few of his colleagues had ever encountered it. Since about 2000, he says, that’s changed. It’s still unusual, representing about 1 in 100 to 1 in 50 hip fracture cases treated at NewYork-Presbyterian Hospital between 2002 and 2007, says Lane. But, it’s a serious, hard-to-treat problem that seems to affect mainly younger, active postmenopausal women.

I’ve been taking a bisphosphonate for years. Should I stop?

Both the American Society of Orthopaedic Surgeons and the Endocrine Society have issued statements urging patients with osteoporosis not to stop taking their medications without consulting their physicians. To do so could expose them to the potentially disabling and even deadly fractures the drugs are meant to prevent in the first place.

“What we have to keep in mind,” says Elizabeth Shane, M.D., a Columbia University endocrinologist and co-chair of a major professional task force reviewing these thigh fractures, “is that garden variety fractures can be just as devastating as this type of fracture, but much, much, much more common—and these drugs do a pretty good job of preventing those types of fractures.”

If you treat 10,000 women with osteoporosis for longer than five years, research shows, you’ll prevent about 100 of these common fractures, says Shane, while perhaps—if bisphosphonates are indeed promoting the thighbone breaks—leading to two of these more unusual fractures. Two very small studies have followed women taking these drugs for up to 10 years, without uncovering serious problems.

Do I have to take the drugs indefinitely to maintain stronger bones?

Not necessarily. An important study published in late 2006 in the Journal of the American Medical Association compared results among women who discontinued Fosamax after five years versus women who continued taking the drug. Up to five years later, those who had gone off medication had roughly the same risk for most types of fractures as those who kept taking it.

“From the studies it would appear that once you’ve taken Fosamax for five years, if you stop for a year, probably nothing much changes,” says Ethel Siris, M.D., a past president of the National Osteoporosis Foundation who directs the Toni Stabile Osteoporosis Center at Columbia University Medical Center. The benefit appears to continue, she says, “probably because you’ve accumulated enough drug in your system. Once you’ve been off for two years, there’s a slight reduction in the hip density. It’s as if the effect is starting to wear off.”

Given these results, some physicians recommend a drug “holiday”—stopping the medications temporarily—to avoid unnecessary expense and inconvenience, if nothing else.

Who’s most at risk for the femur fractures? What can I do to avoid this problem?

Experts suspect that a small, specific group of women may be more at risk for unusual thighbone fractures. Perhaps these women have other conditions besides osteoporosis, have taken additional medications or have a genetic vulnerability. Unfortunately, no one can say at this point just what those risk factors are.

What doctors do know is that many women who suffered this type of upper-thigh fracture complained of thigh pain beforehand, sometimes for months.

“Since these cases have been published, I routinely ask all my patients if they have pain in their thighs,” says Shane. Such pain in osteoporosis patients taking bisphosphonates should prompt an x-ray of both thighs, and, if the images indicate a problem, referral to an orthopedic surgeon.

Are we certain osteoporosis drugs are causing these unusual fractures?

No. Studies haven’t been done to confirm that these unusual fractures are on the rise, nor is it clear that they are caused by Fosamax and other bisphosphonates.

In response to news reports on the studies, the U.S. Food and Drug Administration released a statement saying the agency would continue to investigate this “potential safety signal,” but so far hadn’t found evidence that women taking the osteoporosis medicines are at an increased risk.

Katharine Greider lives in New York and writes about health and medicine.

Spouses Face Challenges in Caring For Themselves and Their Ailing Partners

2010-05-26T10:23:00.002-04:00

By Paula Span
Kaiser Health News
Tuesday, May 25, 2010
Published in the Washington Post.

They met on a blind date in 1949 and married two years later. They lived in the same Cape Cod-style house in Silver Spring for nearly 50 years. So when Leonard Crierie was diagnosed with Alzheimer's disease in 2005, there was no question that his wife, Betty, would take care of him at home for as long as she could.

Betty led him into the shower, helped him dress each morning and took him everywhere with her because, once he started wandering, as some dementia patients do, she dared not leave him alone. She learned how to change the colostomy bag he wore since he'd survived rectal cancer years earlier. She slept, fitfully, with a monitor by her bed so that she could respond if he needed her at night.

"It was difficult, but I was able to take care of him," says Betty, now 80. "Because it happens slowly, you don't realize how bad it's getting."

She agreed to have Leonard attend an adult day program at nearby Holy Cross Hospital -- he enjoyed socializing there -- so that she could get a few hours' break several times a week; she found a Holy Cross caregivers support group very useful. But she refused the pleas from her three adult children to hire an aide to help at home. "I always felt like I had it under control," she explains, though her children thought the $18-an-hour cost also troubled a frugal woman who shops at dollar stores.

As the months passed, "we could see the stress level affecting her," recalls her daughter Linda Fenlon. "The frustrating part was, we wanted her to have some independence, some quality of life. But she saw it as her duty in life to take care of him."

For four years, Betty Crierie rarely asked for or accepted her family's help, until a Wednesday last June. As she left her support group meeting, she remembers, "I got this funny feeling in my chest." It worsened on the 10-minute drive home. She called her daughter and said, "I'm calling 911. I think I'm having a heart attack."
'In sickness and in health'

Caring for a sick or disabled elderly relative exacts a toll -- physical, emotional, financial -- on any family member, but being a spousal caregiver brings particular challenges.

"Spouses are older and dealing with their own age-related health limitations," says Steven H. Zarit, a Pennsylvania State University gerontologist. The tasks they shoulder have grown more demanding: Family caregivers now administer arsenals of medications and undertake procedures, from wound care to dialysis, that were once the province of medical professionals.

Moreover, today's longer life spans, in which once-fatal conditions such as heart disease have become manageable chronic illnesses, mean that the "sickness" part of "in sickness and in health" can last for many years. Spouses determined to single-handedly honor their vows, says Suzanne Mintz of the National Family Caregivers Association, "are using their old rules to fight a new problem."

The medical and psychological literature have long reported that caregivers face risks to their own well-being, especially when they're caring for people with dementia. Caregivers under stress have higher levels of depression and anxiety; their immune systems suffer. A 2005 Commonwealth Fund overview found that caregivers of all ages reported chronic conditions -- including heart disease, diabetes, cancer and arthritis -- at nearly twice the rate of non-caregivers, 45 percent vs. 24 percent.

In an oft-cited study published in the Journal of the American Medical Association in 1999, University of Pittsburgh researchers followed nearly 400 elderly spousal caregivers for four years and reported that those experiencing mental or emotional strain had 63 percent higher mortality rates than non-caregivers. (Caregivers not experiencing emotional or mental strain did not have elevated mortality rates.)

And a study published this year by a team from the University of South Florida and the University of Alabama at Birmingham found that high caregiving strain among spouses increased the risk of strokes by 23 percent; the association was particularly strong among husbands caring for wives.

"Spouses are likely to take on more than they can reasonably do," Zarit says.

Betty Crierie was the classic example: Caring for her increasingly disabled husband, trying to shelter their adult children from the burden, unwilling to bring in a costly home-care aide when she felt she was doing fine on her own -- until she had her heart attack. "We didn't realize how much she was doing until we took turns taking care of Dad ourselves," Linda Fenlon says. "It was so labor-intensive. We very quickly realized she couldn't continue."

While their mother recovered, the children moved their father into a nursing home, a wrenching act for all concerned. Betty visited Leonard there two or three times a week, continuing to do his laundry at home, until he died five months later at age 83.
Depression-era values

Why is it so difficult for older caregiving spouses to seek help? Zarit's research has shown that compared with adult children taking care of an ailing parent, spouses don't turn to adult day programs until later in the course of illness, and they're more apt to withdraw the participant after a short time.

Sister Kathy Weber, who leads the Holy Cross support group that Betty Crierie attended, sees a Depression-era-bred reluctance to spend money on care, even when couples can afford it. "They're supposed to get along somehow and squirrel it away for their kids -- who want them to use it now, for their care, which would make the children's lives easier, too," Weber says.

Spouses don't want to lose control of their homes or their relationships. Sometimes they hope to protect their partners' dignity, not wanting children to see how diminished they've become. "There's a lot of pride there," Weber says.

What might help, caregiver advocates say, is for health providers to regard older couples as a unit, recognizing that a caregiver's compromised health could prematurely institutionalize an ailing spouse. Some geriatric practices already do so. "On the intake forms in doctors' offices, there should be questions to identify whether someone is a family caregiver," suggests Mintz. "That would alert the physician and the staff to the situation and raise questions about that person's own health. Is she taking care of herself?"

Meanwhile, President Obama's proposed 2011 budget would add $102.5 million for family caregiving programs, "a step in the right direction," Mintz says. The money would boost existing programs that serve family caregivers, including training and counseling, referrals, respite care, transportation, adult day programs and home care. AARP analysts estimate the increased funding could help an additional 200,000 families. Family caregivers can use the help: Medicare pays for doctors and hospitals but provides only very limited post-hospitalization home care, and Medicaid (which covers only the poor) allots most of its dollars to nursing homes. The financial burden of caring for a spouse at home falls mostly to families themselves.

But even with better support, watching a partner decline is difficult. "They are about to lose their lives as they've known them," Weber explains.

That's what happened to Sheila Fridovich, whose husband, Bernard, developed Pick's disease, a form of dementia, in his late 60s. Sheila kept him at home in Annapolis, eventually hiring a daytime aide, for nearly six years.

"I couldn't eat; I couldn't breathe; I didn't have a moment's peace," she acknowledges. Yet she refused to see a therapist or join a support group. "I needed to iron it out in my own head," she says.

"We grew up in a generation where getting help from a therapist is not stigmatized," theorizes her daughter Lauri Fridovich Lee, who joined a support group online. "For the older generation, it is."

Eventually, consulting with a Veterans Affairs physician about drug coverage, Sheila discovered that Bernard, a Navy veteran, was eligible for admission to a specialized dementia unit at the VA Community Living and Rehabilitation Center in Baltimore. She moved Bernard there in 2006. At 79, he's still a resident and gets excellent care, she says. But after a stroke, he cannot speak, and she's not sure, on her Sunday visits, if he knows who she is.

"It's a traumatic experience for a husband and wife, far more than for their kids," Fridovich says now. She's only 71, still working part time as an educational consultant, but "the way I live is not the way I lived before. I'm married but I'm not; I have a husband but I don't. I'm in no man's land."

Span is the author of "When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions." This article was produced in collaboration with Kaiser Health News. KHN is an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan health-care policy organization that is not affiliated with Kaiser Permanente.

Does Older = Happier?

2010-05-03T09:37:00.001-04:00

Below is an interview with Susan Turk Charles, Associate Professor of Psychology & Social Behavior, Ph.D. University of Southern California, conducted by Laura Rico, University Communications

Q: Why does happiness increase with age?
A: One reason why people over 60 tend to be happier is that they're more capable of regulating their emotions. Avoiding negative or stressful experiences plays a major role in their success. For example, when young people disagree with close friends or family members, they're more likely to argue their point of view. Older people are more prone to let it go and walk away, and they feel better about their actions as a result. Our research also shows that seniors spend less time thinking about negative aspects of a situation than do younger adults.

Q: Why are older people more adept at controlling their emotions?
A: We think it has to do with their perspective on life. They realize that time left is getting shorter. In contrast, younger people often must engage in unappealing activities to serve the future. They may think, "I need to interact with this unpleasant person because it might be good for my career," whereas older folks have the freedom to select emotionally meaningful activities and only associate with people they like. Plus, life experiences have taught them what they'll regret and how best to avoid problematic situations.

Q: What role does memory play in older adults' happiness?
A: It's key to emotional regulation. Research has shown that how people remember events from their past may be as important as the events themselves. We find that the recollections of older adults are more positive than those of younger adults. They recall unpleasant emotions as less intense and reappraise memories in a better light. Even when asked to relate a bad experience, seniors are more likely to mention positive angles along with the negative.

Q: Why are depression and isolation often associated with aging?
A: If an older adult in your life has become despondent, you need to recognize that this is not a normal age-related change. A physical exam may find an underlying condition that's causing the dark mood. Psychotherapy could also help. Regular exercise and social relationships are crucial to preventing depression in older people.

Q: How did you become interested in studying aging and emotions?
A: When I was an undergraduate at Stanford University, the prevailing view was that emotional development ended at 18 to 20 years of age. It was frightening to think that at 65 you'd be just the same as at 18! I wanted to explore the changes that occur in the last seven decades of life.

Q: Why is it important to understand aging?
A: By the year 2030, one in five Americans will be older than 65. Currently, Europe and Japan have aging populations that aren't being fully replenished by births or immigrants. Imagine the implications for society and public health! In the U.S., you can see how advertising and marketing have moved in that direction, with frequent TV commercials about pharmaceuticals, medical supplies, life insurance and estate planning.

The face of aging has changed too: Celebrities in their 50s and 60s look amazing. Older people are more physically active than ever, and it's not rare to see them doing things such as yoga previously associated with only the young. At the same time, a rise in obesity jeopardizes longevity and quality of life for many. An older population also means a greater number of people with dementia or who care for loved ones with dementia. We face both great opportunities and great challenges as our society grays, and we need to maximize health and well-being for this growing demographic. Successful aging in the U.S. will benefit not just seniors but everyone.

PATRICK RELEASES $2.5 M IN FUNDING FOR ELDERLY "OPTIONS" COUNSELING PROGRAM

2010-04-12T11:08:00.000-04:00

The Patrick Administration today released $2.5 million in state funding to expand a provision of the 2006 Equal Choice law for the eldelry and disabled which had not been implemented.

According to Mass Home Care, which has been pushing for the release of this funding, this program represents 'smart money' because it helps guide elders away from nursing homes into less costly forms of community care.

The 2006 law requires people who are seeking nursing home admission to have a free counseling session to talk about their options to remain living in the community. Despite legislative efforts to fund this program, is has only been available in three pilot sites.

But because of today's announcement, the Long Term Care Options program will be spread statewide---more than two and a half years after the mandate was created.

"This is a win for the Governor," said Al Norman, who helped write the 2006 law that created the Options counseling program. "It will give seniors a better chance to live at home, and save taxpayers millions of dollars in the process."

"We applaud the Governor for putting this money out into circulation," Norman said. "It gives families hope that they can find an alternative to institutional life."

The funding for this program will be administered by 11 Aging & Disability Resource Consortia (ADRC).

MassHealth Exemption Bills By Nicholas G. Kaltsas, Esq.

2010-04-04T09:26:00.000-04:00

Currently, there are three identical bills pending in the Massachusetts legislature on nursing facility and long term care. These bills are as follows: House Bill No. 1069 (HB 1069) which has been presented by Christopher G. Fallon on the petition of 19 house members; Senate Bill No. 309 which has been presented by Harriette L. Chandler on her own petition; and Senate Bill No. 572 which has been presented by Robert A. O'Leary on the petition of 6 senate members.

The law as it exists currently in the Commonwealth of Massachusetts states you must have two (2) years of long term care insurance coverage on your policy when you enter a Nursing Home. In essence, under the current law, if an individual’s long term care insurance policy provided home care benefits, and those benefits were accessed, it could be that the exemption currently provided in the Code of Massachusetts Regulations from Estate Recovery for receipt of MassHealth could be jeopardized. Let me give you an example: Let us assume Sally had 3 years coverage under a long term care insurance policy. Let us further assume that policy not only provided benefits in the event Sally were to go into a nursing home, but also provided benefits to Sally in the event she needed home care services so she was able to remain in her home. Under the current scheme, if Sally accessed her long term care insurance for home care and she had less than two (2) years of coverage at $125.00 a day at the time she entered a nursing home, she would lose the exemption against Estate Recovery as currently provided by regulation.

The currently proposed revisions to the Massachusetts law state that you need two (2) years of coverage at $125.00 a day when you purchase your long term care insurance, and not at the time you enter a Nursing Home. This bill would allow a policyholder to protect their home from the Medicaid lien as long as they buy $125/day for 2 years, even if they use up all of their policy coverage at home before entering the Nursing Home and qualifying for Medicaid.

House Bill No. 1069 (HB 1069) which has been presented by Christopher G. Fallon and Senate Bill No. 572 which has been presented by Robert A. O'Leary are in the Health Care Financing Committee. Senate Bill No. 309 which has been presented by Harriette L. Chandler is in the Elder Affairs Committee.

Hopefully the Massachusetts legislature will see the wisdom that it is far more cost effective to provide care at home (rather than in a long term care facility) and will stop penalizing Massachusetts citizens who try to stay in their homes for as long as possible by accessing their long term care insurance coverage. SUPPORT THESE BILLS!

Attorney Kaltsas practices law at Elder & Disability Law Advocates in Worcester and Framingham, Massachusetts
and hosts WTAG’s Saturday morning talk show ”The Senior Focus” at 11:00 AM.
”The Senior Focus” can be heard on True Talk Radio -- 580 AM or 94.9 FM

Please feel free to call Attorney Kaltsas in Worcester at 508-755-6525 or Framingham at 508-620-4525.
Or listen to The Senior Focus and call your comments or questions into the show at 508-755-0058.

Be Wary of Tax Relief Scams

2010-03-28T15:01:00.002-04:00

You may have seen them on television and the internet companies promising to reduce your tax debt, stop garnishments, remove tax liens, or settle your debt.

Individuals in debt to the Internal Revenue Service (IRS) are regularly preyed upon by scam tax relief companies who charge thousands of dollars and deliver nothing. In many cases these scams involve a personal tax evaluation costing several thousand dollars only for the taxpayer to be told that there is nothing that can be done. The IRS has issued warnings about these companies.

If you cannot pay your taxes by the April 15 deadline, you should contact the IRS as soon as possible, as they will listen to your case and offer the best solution to your situation.

The IRS has many options for you to pay your taxes, including:

1. The IRS may give you an extension of time to pay from 30 to 120 days.

2. An installment plan that allows you make regular monthly payments until your tax bill is resolved.

3. Request an offer in compromise, an agreement between you and the IRS to settle your tax debt for less than you owe.

4. Plan ahead for next tax season: Adjust your withholding or increase your estimated tax payments so you will have a lesser tax obligation next year.

For more information about your personal income taxes and/or tax relief, contact:

Barbara Anthony, Undersecretary 10 Park Plaza Suite 5170 Boston, MA 02116
Hotline 617-973-8787 888-283-3757 www.mass.gov/consumer

Internal Revenue Service (IRS)
Phone: toll-free (800) 829-1040

Massachusetts Department of Revenue (DOR)
Phone: toll-free in MA (800) 392-6089, (617) 887-MDOR

DOR’s customer service call center hours for tax help are 10 am - 1 pm and 1:30 pm - 4 pm, Monday through Friday.

How the new Health Reform legislation will affect seniors.

2010-03-22T10:51:00.001-04:00

The Medicare prescription-drug benefit would be improved substantially. This year, seniors who enter the Part D coverage gap, known as the "doughnut hole," each would get $250 to help pay for their medications.

Beyond that, drug-company discounts on brand-name drugs and federal subsidies and discounts for all drugs would reduce the gap gradually, eliminating it by 2020. That means that seniors, who now pay 100 percent of their drug costs while they're in the doughnut hole, would pay 25 percent.

Further, as under current law, once seniors spend a certain amount on medications, they'd get "catastrophic" coverage and pay only 5 percent of the cost of their medications.

Government payments to Medicare Advantage, the private-plan part of Medicare, would be cut sharply starting next year. If you're one of the 10 million enrollees, you could lose extra benefits that many of the plans offer, such as free eyeglasses, hearing aids and gym memberships. To cushion the blow to beneficiaries, the cuts to health plans in high-cost areas of the country such as New York City and South Florida — where seniors have enjoyed the richest benefits — would be phased in over as many as seven years.

Beginning this year, the bill would make all Medicare preventive services, such as screenings for colon, prostate and breast cancer, free to beneficiaries.

If Reform Fails

2010-03-16T10:54:00.002-04:00

This editorial from The New York Times, is a part of a comprehensive examination of the debate over health care reform. You can read all of these editorials at: nytimes.com.

As the fierce debate on President Obama’s plan for health care reform comes to a head, Americans should be thinking carefully about what happens if Congress fails to enact legislation.

Are they really satisfied with the status quo? And is the status quo really sustainable?

Here are some basic facts Americans need to know as Congress decides whether to approve comprehensive reform or continue with what we have:

HOW REFORM WOULD WORK: Let’s be clear, the changes Mr. Obama and Democratic leaders in Congress are proposing are significant. But, despite what the critics charge, this is not a government takeover. And the program is not only fully paid for, it should actually reduce the deficit over the next two decades.

Under the new system, all people would be required to have health insurance or pay a penalty. If you are poor or middle class you would also get significant help through Medicaid coverage or tax credits to pay the premiums.

The legislation would create exchanges on which small businesses and people who buy their own coverage directly from insurers could choose from an array of private plans that would compete for their business. It would also require insurance companies to accept all applicants, even those with a pre-existing condition. And it would make a start at reforming the medical care system to improve quality and lower costs.

46 MILLION AND RISING: If nothing is done, the number of uninsured people — 46 million in 2008 — is sure to spike upward as rising medical costs and soaring premiums make policies less affordable and employers continue to drop coverage to save money.

The Congressional Budget Office projects 54 million uninsured people in 2019; the actuary for the federal government’s Centers for Medicare and Medicaid Services projects 57 million.

It should be no surprise that people without insurance often postpone needed care, and many get much sicker as a result. That is morally unsustainable. It is also fiscally unsustainable for safety net hospitals — which foist much of the cost on the American taxpayer when the uninsured end up in the emergency room. As the number of uninsured rises, that bill will rise.

The Senate’s reform bill would reduce the number of uninsured by an estimated 31 million in 2019. The Republicans’ paltry proposals would cut the number by only three million.

To read this story in its entirety, please visit The New York Times

From The Centers for Medicare & Medicaid Services

2010-03-09T15:07:00.001-05:00

While caregivers face a range of challenges every day, few can generate as much concern and uncertainty as trying to successfully manage a transition in care from the hospital to home setting.

That’s why the Centers for Medicare and Medicaid Services’ (CMS) Ask Medicare initiative has developed two new videos to help caregivers and their loved ones successfully navigate the process. The videos present tips that are practical and easy to follow – and they highlight resources that are available for additional support.

The first video Tips for Making a Hospital to Home Transition provides insights and expert guidance on important issues caregivers need to plan for, and manage, when bringing a loved one back home from the hospital. It offers advice on maintaining effective dialogues with health care providers, preparing the home for new equipment needs, planning for additional expenses, and more.

The second video highlights a detailed checklist, the Planning for your Discharge Guide, which CMS has developed to help caregivers – and their loved ones – walk through a range of questions that need to be answered to ensure a successful and stress-free future of in-home care.

Please visit the Ask Medicare web site at www.medicare.gov/caregivers to view these and other helpful resources, including our free e-newsletter, real caregiver stories, targeted tips and tools. And please share them with others who may benefit from the information.

Because the more we all know about the challenges and joys of caregiving, the more we can support those who do so much for others.

Thank you,

Centers for Medicare & Medicaid Services

Discharge Missteps Can Send Seniors Back To Hospital

2010-02-21T10:07:00.001-05:00

Mr. Park, 85, recently was admitted to the hospital with community-acquired pneumonia and, after five days of intravenous antibiotic therapy, he was discharged home.

Mr. Park lives with his daughter. He has hypertension, benign prostate hyperplasia and mild Alzheimer's disease. His medications at home included bisoprolol/HCTZ, 5/6.25 mg; tamsulosin, 0.4 mg; and donepezil, 10 mg once a day. While he was in the hospital, the bisoprolol was switched to 50 mg of metoprolol twice a day because bisoprolol was not on the formulary. At the time of his discharge, an intern reviewed his hospital medication list and wrote out the prescriptions, which were given to Mr. Park by a nurse. Mr. Park's daughter filled the new prescriptions. When he returned home, Mr. Park resumed taking his usual medications, plus the new ones prescribed in the hospital. The combination of bisoprolol and metoprolol made Mr. Park bradycardic and dizzy. He fell on his way to the bathroom. When the emergency medical technicians arrived at his home, his heart rate was just 38 beats per minute. Mr. Park was readmitted to the hospital.

Patients often are discharged from the hospital to their homes unprepared to care adequately for themselves. Because of postdischarge missteps, many involving a medication mistake, patients too often may find themselves back in the hospital. Given the medications Mr. Park was mistakenly taking after he returned home, his dizziness and bradycardia could have been predicted and his readmission avoided.

This article provided by American Medical News. To read the entire article, please click here: AMA

HHS Awards Major Grant to SAGE To Create First-Ever National Resource Center for Lesbian, Gay, Bisexual and Transgender Elders

2010-02-18T14:33:00.000-05:00

Health and Human Services Secretary Kathleen Sebelius and the Administration on Aging have awarded Services & Advocacy for Gay, Lesbian, Bisexual & Transgender Elders (SAGE) a three-year, $900,000 grant to create the nation's only national resource center on LGBT aging. The National Technical Assistance Resource Center for LGBT Elders will assist communities across the country in their efforts to provide services and supports for older LGBT people. The Resource Center will provide training to aging service providers and LGBT agencies nationwide, and will offer critically important educational tools to LGBT older people.

"The creation of a National Technical Assistance Resource Center for LGBT Elders is a monumental step forward for the LGBT community," said Michael Adams, Executive Director of SAGE. "SAGE is extremely gratified to be given this opportunity to create and oversee the Resource Center in close cooperation with the Administration on Aging," continued Adams. "We are confident that working with AoA and our partners - who represent an extraordinary collaboration between the aging services network and the LGBT community - we will make a difference in the lives of every LGBT older person in every community in this country."

"Agencies that provide services to older individuals may be unfamiliar or uncomfortable with the needs of this underserved population," said Health and Human Services Secretary Kathleen Sebelius. "The Resource Center will provide information, assistance and resources for both mainstream aging organizations and LGBT organizations and will provide assistance to LGBT individuals as they plan for future long-term care needs."

Assistant Secretary for Aging Kathy Greenlee explained: "AoA frequently turns to national organizations to support the Aging Network in their efforts to work with specific minority populations that are traditionally underserved. In the past, AoA has funded national organizations to provide technical assistance on providing supports and services to African Americans, Hispanic Americans, Asian and Pacific Islander Americans and Native Americans. With the full support of the current Administration, we now recognize that LGBT older adults also represent a community with unique needs that must be addressed."

Entire article can be read here: www.Sageusa.org

It’s in OUR Hands!

2010-02-10T11:09:00.000-05:00

This year, it’s time to Be Counted as part of the US Census!

The Census Bureau will mail everyone a short Census questionnaire in March. The hope is that everyone immediately takes the time to respond to the questions and mails the form back as soon as possible after receiving it.

People with disabilities have a major stake in a complete census count. An accurate count impacts several important programs and services, such as MassHealth, Medicare, SSI, programs funded by the Rehabilitation Act, housing, Vocational Rehabilitation, accessible transit, and special education for children ages 3 through 5.

Census officials believe that people with disabilities have been under-reported in past Census counts and have taken steps to increase the count. The Disability Policy Consortium is prepared to help by providing information to people with disabilities. The DPC has information on our website (www.dpcma.org) on how to participate in the Census, with specific details for people who are Deaf, Blind, and Deaf-Blind.

It is important that this information is shared with all PCAs. Please make sure PCAs understand the importance of the Census and that they must list all family members!

Questionnaire Assistance Centers (QAC) will be available to assist those unable to read or understand the census form. For those with visual impairments, Language Assistance Guides will be available in large print and Braille. Deaf and hard-of-hearing persons who do not have access to Video Relay Service (VRS) can call 1-866-783-2010 via FedRelay, a free and confidential federal government communications service. In addition to these options, Language Assistance Guides also will be available in 59 languages at all QAC locations.

The Census Bureau cannot share questionnaire responses with any other entity or government agency, including immigration status.

For more information, please contact Robyn Powell at rpowell@dpcma.org or 617-542-3522.

Information is also available at www.2010census.gov.

Please consider joining the DPC – for FREE - at www.dpcma.org (click “Join DPCMA”). Together, we can make a difference!

Prescription Advantage State Pharmacy Assistance Program

2010-02-09T13:55:00.001-05:00

For Members of Prescription Advantage:
Since Prescription Advantage has not been paying any part of your Medicare drug (Part D) premium this year, you should be paying your full monthly premium directly to your prescription drug plan. For most of you, Prescription Advantage will continue to help pay for your prescriptions, if you reach the Part D coverage gap (donut hole). Also, if you are unhappy with your current plan, you get one additional time each year to change your plan.

For those who may wish to become Members of Prescription Advantage:
Prescription Advantage can help lower your prescription costs. If you become a member and you do not have a Part D plan, you can join a plan now. You do not have to wait for the next Open Enrollment Period in November. If you are unhappy with your current drug plan, becoming a member gives you a chance to choose a different plan.

You are eligible to join Prescription Advantage, if you are 65 or older and your annual income is less than $54,150 for a single person or $72,850 for a married couple. If you are under 65 and disabled, you may also qualify, but at a lower income. There is no charge for joining Prescription Advantage if you have an annual income less than $32,490 for a single person and $43,710 for a married couple. There is no asset limit!

Call Prescription Advantage today for an application form. You can reach Prescription Advantage at 1-800-AGE-INFO (1-800-243-4636), then press or say 2.

You can now access our monthly SHINE chat line, sponsored by the Central Massachusetts Agency Aging, on the second Tuesday of each month. To attend the SHINE Session, go to www.SeniorConnection.org and click on Connection for Caregiver button. Then click on the Support Groups and Chats button. Create a username and password, log in and click on SHINE.

If you need help on any aspect of your health insurance, SHINE offers free counseling at your local Senior Center or Council on Aging. Call your Senior Center or COA and ask for a SHINE appointment. You can reach a SHINE volunteer by phone at 1-800-AGE-INFO (1-800-243-4636) If you get the SHINE voice mail, leave your name and phone number and a counselor will call you back as soon as possible. SHINE (Serving the Health Information of Elders) is coordinated by the Massachusetts Executive Office of Elder Affairs in partnership with the Friends of the Milford Senior Center, The Massachusetts Councils on Aging, and other local agencies.

Thank you, Senator Moore!

2010-02-01T12:34:00.002-05:00

Last week our office received the Massachusetts Senate citation sent through Sen Michael Moore (D-Millbury) in commemoration of Central Massachusetts Agency on Aging’s (CMAA) 35 years of service to elders and caregivers in the region. It is a terrific honor to receive this, and we offer our “Thanks!” to him and Senate President Therese Murray for this distinction.

Senator Moore is a new friend to CMAA, and we appreciate the work he does, and the sensitivity he has shown around concerning elders and caregivers of elders.

Certainly, the Board and Staff here at Central Massachusetts Agency on Aging wish Sen Moore well as he continues his journey in the Massachusetts Senate. Our hope is for his ongoing support of our agency and for those whom we serve.

"The Era Of Deficit Denial In Washington Is Over"

2010-01-29T09:20:00.000-05:00

Social Security Cuts Are Part Of Deficit PlanBy ANDREW TAYLOR, Associated Press Andrew Taylor, Associated PressWASHINGTON – Divisions remain within President Barack Obama's deficit commission on politically explosive budget cuts and slashes in Social Security benefits, even as the panel's co-chairmen go public with a revised plan to tame the runaway national debt.The new plan by co-chairmen Erskine Bowles and Alan Simpson, to be unveiled Wednesday, faces an uphill slog. Resistance is certain, not only because of the idea of raising the Social Security retirement age, but also because of proposed cuts to Medicare, curtailment of tax breaks and a doubling of the federal tax on a gallon of gasoline.Though the plan appears unlikely to win enough bipartisan support from the panel to be approved for a vote in Congress this year or next, Bowles has already declared victory, saying he and Simpson have at least succeeded in initiating an "adult conversation" in the country about the pain it will take to cut the deficit.The plan faces opposition from many commission members. House Republicans appear uniformly against tax increases, while liberal Democrats like Jan Schakowsky of Illinois appear unlikely to be able to accept big cuts in federal programs for seniors.Obama named the commission in hopes of bringing a deficit-fighting plan up for a vote in Congress this year, but it appears to be falling well short of the 14-vote bipartisan supermajority needed.A new version of the plan, obtained by The Associated Press on Tuesday, makes mostly minor changes to a draft that whipped up enormous controversy when unveiled earlier this month. Some domestic spending cuts are modestly higher than previously proposed, and health care savings from overhauling the medical malpractice system would reap less than proposed earlier this month.Unlike their original proposal, Bowles and Simpson stop short of calling for caps on medical malpractice awards. Instead they recommend changes in how awards are made.But other proposals remain the same. Among them are a gradual increase in the Social Security retirement age to 68 by 2050 and 69 by 2075, using a less generous cost-of-living adjustment for the programs and increasing the cap on income subject to Social Security taxes.The plan also retains a 15-cent-a-gallon increase on gasoline, a three-year freeze on federal worker pay and the elimination of 200,000 workers from the federal payroll through attrition.The proposal obtained by the AP was a draft that was still undergoing changes Tuesday evening.Other recommendations:• Eliminate congressional pet spending projects known as "earmarks."• Reduce the corporate income tax rate to 28 percent from 35 percent and stop taxing the overseas profits of U.S.-based multinational corporations.• Overhaul individual income taxes and corporate taxes, giving Congress the choice of reducing the top rate to as low as 23 percent and no higher than 29 percent. The lower the rate, the fewer the tax credits and deductions that would be available to taxpayers.Under one scenario proposed by Bowles and Simpson, taxpayers would face three tax brackets of 12 percent, 21 percent and 28 percent. Taxpayers would still be able to claim an earned income tax credit and child tax credit as well as all standard deductions and exemptions. Capital gains and dividends would be taxed at ordinary income tax rates. Taxpayers could claim a mortgage interest deduction up to $500,000, but only on their primary residence.If Congress does not undertake a comprehensive overhaul of the tax system by 2013, the plan calls for a "fail-safe" provision that would trigger across-the-board reductions in tax breaks, designed to raise revenue by $80 billion in 2015 and $180 billion in 2020.Bowles was White House chief of staff when former President Bill Clinton negotiated a balanced budget plan in 1997; Simpson is a former GOP senator from Wyoming.Only Bowles and Simpson are guaranteed to support the plan when the panel votes. None of the 12 House members and senators named by Obama have committed to the proposals, though Bowles and Simpson could pick up support from nonelected deficit hawks like Democrat Alice Rivlin and Honeywell International's chief executive, David Cote, a Republican, who won't have to defend themselves to voters. Republican senators seem more likely to vote for the plan than their rigidly anti-tax increase House counterparts."I don't know if we're going to get two votes or five votes or 10 votes or 14 votes," Bowles told reporters. "There are enough reasons to vote 'no' in this plan for anybody to vote 'no.'"A supermajority of 14 of the 18 panel members would have to approve recommendations for a possible vote in the lame-duck session of Congress. That seems out of reach, but Bowles says it's just as important to have jump-started a national debate on what it'll really take to bring the deficit under control."Our goal in this whole process has been really simple," Bowles said. "It's basically been to start an adult conversation here in Washington about the dangers of this debt and the deficits we are running."He added, "The era of deficit denial in Washington is over."

Older Americans Act Reauthorization Input Opportunities

2010-01-27T11:23:00.000-05:00

Since 1965, the Older Americans Act (OAA) has gained recognition as a unique and highly regarded statute that has stimulated the development of a comprehensive and coordinated service system. This system has contributed greatly to enhancing the lives of older individuals, family caregivers, and persons with disabilities. In 2011 Congress will consider reauthorization and amendments to the Act effective in FY 2012. In anticipation of this process, the Administration on Aging (AoA) is soliciting input concerning the reauthorization through three mechanisms: (1) AoA-Convened Listening Forums; (2) OAA Reauthorization Input Events; and (3) Direct Input via the AoA Website.

For more information or to register, please click here: www.aoa.gov

New Credit Card Regulations Take Effect in February

2010-01-26T15:13:00.002-05:00

The Credit Accountability Responsibility and Disclosure (CARD) Act
is a comprehensive credit card reform bill that was signed into law by President Obama in May 2009. The Act will become effective on February 22, 2010, and provides new protections for consumers, including:

Enhanced disclosures of credit card terms require:

Cardholders to be given 45 days notice of any interest rate increase
Issuers to provide disclosures upon card renewal when the card terms have changed
Issuers to disclose the period of time and total interest it will take to pay off the card balance if only minimum monthly payments are made
Full disclosure of payment due dates and applicable late payment penalties.

Elimination of Universal Default - credit card issuers can no longer increase the interest rate on one card if a customer missed a payment on another card.

Restrictions on Interest Rate Hikes - no interest rate increases during the first year or on existing balances.

Penalty Payments - card issuers must wait until payments are 60 days late before charging penalty interest rates.

No Fees for Payment by Phone or Online

Bills Must Be Mailed 21 days Before Due Date - no weekend or early morning deadlines.

No More Two-Cycle or Double Billing - cardholders can’t average your balances for the last two statements and charge you interest on that number.

Application of payments - credit card companies must apply any payment above the minimum to the highest interest rate balance.

Over-the-Limit Fees - these fees can only be applied if the consumer consents to over-the-limit transactions.

Age Requirements - applicants under the age of 21 must obtain a co-signer OR show they have sufficient income.

Early Good News for OAA III B and Caregiver Funding

2010-01-25T09:51:00.001-05:00

Early Indicators of President’s FY 2011 Budget Begin to Appear

On a fittingly spring-like day in Washington, some excellent news sprouted up from news reports of the President’s State of the Union address, which is set for this Wednesday evening. As part of a larger set of initiatives designed to help middle-class Americans, the White House will champion increases in existing programs that help older adults and their family caregivers.

While this will not be official until the President’s FY 2011 budget is released the first week in February, n4a believes that the budget will contain a total of $102.5 million in increases for three critical federal programs: $50 million for Title III-B, Supportive Services, of the Older Americans Act (OAA) and $52.5 million for OAA Title III-E, the National Family Caregiver Support Program (NFCSP), and the Lifespan Respite program, currently administered by the Administration on Aging. It is not yet clear how the funds for NFCSP and Lifespan Respite will be divided. These increases would represent a major increase for NFCSP and a 13.5 percent increase for III-B over FY 2010 funding levels. It is also a major victory for n4a’s advocates who have been pressing for OAA increases, most particularly Title III-B, for years.

References to this caregiving/aging initiative may be included in the President’s State of the Union address on January 27, so stay tuned.

To read the White House’s press release: http://www.whitehouse.gov/the-press-office/president-obama-and-vice-president-biden-preview-initiatives-middle-class-families
To read the White House fact sheet, which provides more detail on the proposed initiatives:
www.whitehouse.gov

Worcester Senior Center Seeks Canes, Wheelchairs for Haiti Victums

2010-01-21T12:15:00.001-05:00

WORCESTER — A volunteer group at the Worcester Senior Center is seeking donations of gently used wheelchairs, walkers, canes and crutches to send to the victims of the earthquake in Haiti.

The Retired Senior Volunteer Program’s Worcester Area Volunteers are organizing the donation drive. The items will be shipped by the International Medical Equipment Collaborative in North Andover to the Dominican Republic. The items will then be driven to Port-au-Prince, at the epicenter of the disaster.

Items may be dropped off at the Worcester Senior Center, 128 Providence St., starting Tuesday. The center is open from 9 a.m. to 3 p.m. Monday through Friday. RSVP health and safety coordinator Rita Sullivan said donations will be kept at the senior center until Feb. 12, when they will be picked up and sent on their way to Haiti. For more information, call Ms. Sullivan at (508) 791-7787.

Governor Patrick Has Done It Again!

2010-01-21T11:26:00.003-05:00

He's done it again--for the third year in a row.
From: Al Norman, Mass Home Care

Governor Patrick once again has failed to articulate any vision for an elderly agenda for the Commonwealth in his annual State of the State speech.

In 2009, the Governor said we should "check on your elderly neighbor when its cold to make sure the heat is on." That was the only reference to seniors.

In 2008, the Governor said: "Too many young families and seniors are still being pushed out of their homes by escalating property taxes."

And this evening's State of the State kept alive the absence of any elderly themes. The closest he came to a senior issue was one anecdote about a "grandmother" in Lynn who had to take in her children's family into her home---and then lost her job.

Nothing about how the state has driven down the use on institutions by 25% since 2000.

Nothing about the aspirations of seniors to live out the days at home.

Nothing about his frustrations to implement a plan that gives senior citizens a right to care in the least restrictive setting.

What could he say?

   There are 2,300 seniors waiting to get into home care.

   I impounded $2.5 million meant to help guide seniors to their alternatives to nursing homes.

   I cut $1 million from the elder abuse protection program.

   I failed to submit an 1115 waiver that we spent two years negotiating with the federal government.

   I shut down virtually all of my "Community First" agenda.

This is the State of the State, and for this reason, there seemed to be very little for the Governor to talk about.

Thank you, Senator Harriette Chandler!

2010-01-20T14:59:00.000-05:00

On the occasion of CMAA’s 35th Anniversary, Senator Harriette Chandler (D-Worcester) offered a Special Citation on behalf of the Massachusetts Senate. It was delivered to the offices in West Boylston after the recent event was cancelled due to weather.

In his letter of thanks sent to Sen. Chandler, Executive Director Robert P. Dwyer expressed the gratitude of CMAA’s Board and staff. He wrote:

...I would also like to recognize the help that you have offered to CMAA over these last several years. You have been a good friend to this Agency, certainly as an expression of your care and concern for your constituents who are elders and caregivers of elders. Your appreciation for our mission and work has always been felt.

Senator Chandler has been a friend of CMAA for many years. Our best wishes to her in the coming year!

Drug Benefit adds 1 million more Seniors!!!!

2010-01-09T11:23:00.001-05:00

The Extra Help Program from Social Security will now be available to more than 1 Million seniors who were previously not eligible. As of January 1, 2010, The Social Security administration will no longer count life insurance as an asset in calculating you eligibility for this valuable program. Also they will no longer count assistance from family members in calculating your income for the program. It is estimated that these changes will make 1 million more seniors eligible for this program nationwide. Income limits continue to be $16,245 for singles and $21,855 for married couples living together. Assets such as stocks, bonds and bank accounts must be limited to $12,510 for singles and $25,010 for married couples. The value of homes and automobiles are excluded.

Social Security Administrator Michael J. Asture has urged seniors who were rejected for the program in the past to reapply. This could save you as much as $4,000 in costs for you prescriptions on your Medicare Part D Program. If you feel you are qualified you can apply for the program online at www.socialsecurity.gov or by calling 1-800-772-1213. Seniors can also apply at their local Social Security office.

Certified SHINE (Medicare) Counselors Needed

2010-01-08T10:45:00.000-05:00

The SHINE program helps seniors and people with disabilities on Medicare to understand the many and increasingly complex insurance options available to them. The need for trained volunteers to educate and provide unbiased information has never been greater.

Through an intensive training program, SHINE (Serving Health Information Need of Elders) Counselors become certified to explain health insurance options. They work one-on-one with Medicare beneficiaries to educate, answer questions, solve problems, and screen for low-income health programs. SHINE Counselors also attend monthly meetings where they receive on-going training, support, and opportunities to share their experiences and concerns with other counselors. SHINE Counselors are expected to work an average of 5-6 hours per week meeting with clients and doing necessary follow-up work. They generally counsel in Senior Centers or other public settings that have a private meeting space. Some computer experience is required.

SHINE Counselors are intelligent and dedicated individuals, who are truly making a difference in many people’s lives. This is a unique and wonderful volunteer opportunity for the right person. Please consider joining our dedicated team. Training will be held this spring and will be held two days a week over a six week period. For more information about becoming a SHINE Counselor call Ed Roth, Central Region SHINE Director, at 508-422-9931. Bilingual, bicultural and minority individuals are encouraged to apply.

One Man’s Trash as Another Man’s Treasure

2010-01-03T15:35:00.001-05:00

What is Hoarding?

1. Hoarders have an obsessive need to acquire and save many objects, and tremendous anxiety about discarding them, because of a perceived need for the objects for their apparent value. Sometimes an excessive emotional attachment to them develops. A compulsive hoarder will have thoughts like “I will need this later on” or “this should not be wasted” but the frequency and the importance attached to them are clearly excessive in compulsive hoarders. If they have any doubt at all as to the value of an object, compulsive hoarders will keep it.

2. Living spaces sufficiently cluttered so as to prevent activities for which those spaces were originally designed. It becomes impossible to use many areas of the house for their original purpose.

3. Significant distress or impairment in functioning is caused by the hoarding. An excessive amount of time may be spent "churning,” or moving items from one pile to another but never actually discarding any item nor establishing any consistent organizational system. Many compulsive hoarders have limited social interactions since hoarding may make them socially isolated. Sometimes they are too embarrassed by their clutter to have people come to their home, sometimes for many years.

To read the entire article on Hoarding, please visit our site Connection For Caregivers

BUSINESS TAX RATE FALLS

2009-12-26T12:59:00.000-05:00

The state’s business corporation tax rate of 9.5 percent falls to 8.75 percent on Friday, Jan. 1, 2010 and the financial institution tax rate of 10.5 percent drops to 10 percent. The rate reductions were included as part of a corporate tax law reform bill last July that included a pair of major changes – the so-called combined reporting and check-the-box reforms – sought by Gov. Deval Patrick to bolster state tax collections and close what he called loopholes in the tax code. The Patrick administration at the time promoted that rate cut as a way to help businesses in Massachusetts, especially smaller ones, stay competitive. It was paired with tax law reforms that at the time were projected to generate $285 million in fiscal 2009, $390 million in fiscal 2010 and $269 million in fiscal 2011. At the time of the bill’s passage, Sen. Cynthia Creem estimated between 15,000 and 20,000 Massachusetts businesses would benefit from overall tax rate reductions that take effect next week.

Preliminary Survey Results

2009-12-15T09:53:00.000-05:00

During September and October 2009 Central Massachusetts Agency on Aging undertook a survey of elder residents throughout the region to gather information on issues with which elders might need assistance.

Based on the sampling drawn from local street lists, it appears that the elder population of Central Massachusetts was approximately 144,000 as of January 1, 2009. The state estimate for 2010 is 148,000 so this seems to be a reasonably accurate figure

A sharp increase in the percentage of elders with incomes below the poverty line was noted. The preliminary figure for 2009 is 12.4% in comparison to 8.1% in the 2005 survey.

Overall, the top needs ranked by CMAA’s “need index”, which considers both the number of respondents with specific needs and the degree to which these needs are unmet, include the following:

Help with applying for financial assistance
Preparing tax forms
Home repairs
Finding employment opportunities
Finding volunteer opportunities
Paying property taxes
Problems dealing with large debt
Problems dealing with depression/loss
Problems coping with a disability

The majority of these are related to financial circumstances and all of them show an increase in the proportion of respondents identifying the need in comparison to the 2005 survey. Clearly, the current recession has had a significant impact on elders in Central Massachusetts.

From The Auburn VNA Extended Care, Inc

2009-12-04T12:37:00.001-05:00

Earlier this year the Greater Worcester Community Foundation approved a grant to Auburn VNA Extended Care to be used to assist low-income elders and their caregivers with home care services. Through this grant elders in our community have been able to continue receiving home care services, and not have to do without or have family members stretching to provide. We've been able to assist income eligible elders bridging to home care services provided through agencies contracted with Elder Services of the Worcester Area or Tri-Valley Services. We are planning on having a fund raiser in the spring to replenish this fund, so we can continue to provide with the these needed services. Auburn VNA Extended Care is a non-profit private duty home care agency, and the sister agency of the Auburn Visiting Nurse Association (also known as Auburn District Nursing).

2009-11-09T10:39:00.001-05:00

HUMAN SERVICE ADVOCATES EXPECT GUV TO DETAIL MEDICAID CUTS TODAY:

2009-11-06T14:03:00.001-05:00

Human services advocates are bracing for details of cuts to Medicaid programs they say the Patrick administration may announce Friday. Officials from several human services organizations say the details of proposed cuts are still uncertain but fear that subsidized Medicaid plans may see co-pay increases and personal care attendant hours for eligible patients may be reduced. The officials are preparing to pepper the administration with letters, should Gov. Deval Patrick pull the trigger on the cuts, a possibility they said was up in the air Friday afternoon. Officials in the Executive Office of Health and Human Services did not respond to requests for comment. Patrick cut nearly $82 million from health and human services programs during an October round of budget cuts aimed at partially closing a $600 million midyear spending imbalance. Developing 12:06 P.M.

Need Help Understanding 2010 Medicare Plans?

2009-11-05T14:17:00.000-05:00

We are in the middle of the Medicare Annual Open Enrollment period, which lasts until December 31. During this time, all Medicare beneficiaries can change their Medicare health coverage as well as their Medicare Prescription Drug Plans (Part D Plans).

Some Medicare Advantage plans will no longer be offered in 2010. If you are in one of these plans, you must choose a new plan. In most cases if you do nothing, in January you will be put back in Original Medicare with no drug coverage. If you have any questions on your Medicare Advantage Plan feel free to contact us and we will assist you with selecting another plan.

If you have a Medicare Stand Alone Drug Plan, you need to check that your drugs will continue to be covered by your drug plan and how much they will cost you (your co-payments) in 2010. Most plans have increased monthly premiums, but a number of plans have significantly increased co-payments also. If you would like to compare Drug plan or look for a cheaper plan that covers your drugs. You can contact Medicare at 1-800-633-4227. You can also contact MassMedLine at 1-866-633-1617 these folks will input your medications into the system to help determine the best plan for you.

Although you have until December 31 to make changes, we recommend making any changes as early as possible, so you will have paperwork from your new plan showing you are covered on January 1, 2010.

The good news is that help is available:

Call Central Massachusetts Agency on Aging at (800) 244-3032 and ask to schedule a SHINE appointment. SHINE Counselors are available to help you make choices. You may also call the regional SHINE office at (508) 422-9931.

Seniors Get The UnCOLA

2009-10-25T12:11:00.000-04:00

Because of the low growth in consumer prices, senior citizens will see no Cost of Living Adjustment in their checks this January.

Social Security and Supplemental Security Income (SSI) benefits are adjusted annually to reflect the increase, if any, in the cost of living as measured by the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) prepared by the Bureau of Labor Statistics. The purpose of the annual cost-of-living adjustment
(COLA) is to ensure that the purchasing power of Social Security and SSI benefits is not eroded by inflation.

But now the recession has claimed another victim: Social Security recipients.

In response, on October 14th, President Barack Obama asked Congress to legislate a second round of $250 economic recovery payments to Social Security recipients in 2010. This year’s stimulus bill (the American Recovery and Reinvestment Act, or ARRA) included those payments, which went out to all Social Security beneficiaries in the summer. The President
is now urging Congress to authorize a repeat of that program for the coming year, citing continued economic hardship among the Social Security population.

The $250 figure is equivalent to approximately 2% of the average annual Social Security retirement benefit. It is estimated that the cost of this proposal is $13 billion. This is the White House’s first ARRA extension request. The announcement came on the heels of the news that there will be no cost-of-living adjustment (COLA) in 2010, given the country’s negative inflation rate.

“Older adults struggling to make ends meet in this recession will be directly aided by this relief, and we hope the expenditure of these payments will have a stimulative effect on the economy, as well," said Paul J. Lanzikos, President of Mass Home Care. "Given the lack of a cost-of-living adjustment in 2010 for Social Security recipients, this one-time payment will be especially
helpful to those living on a fixed income," Lanzikos said.

According to the Social Security Administration, under present law there is a COLA for Social Security and SSI benefits provided only when there is an increase in the average of the Consumer Price Index-W from the third calendar quarter of the prior year to the third calendar quarter of the current year of at least one-tenth of one percent (0.1 percent). If the CPI-W increases by less than 0.05 percent, or if the CPI-W decreases, there is no COLA. If there is no COLA, Social Security and SSI benefits remain the same. That means for every year after 2010, the Social Security will be lower than it would have been if there had been a COLA in 2010. Since there is no COLA in 2010, the starting point for the measuring period for the 2011 COLA will remain the third calendar quarter of 2008.

There has been an on-going debate in Congress about whether or not the CPI-W accurately measures the impact of inflation on seniors, since their expenditures on consumer goods is much more weighted on medical services and drugs than younger workers. Congress has yet to agree on creating a special CPI for elders, and as a result the CPI-W is not seen as a fair indicator of the rising costs for drugs and health care out of pocket expenses that seniors face.

HOME CARE WAIT LIST TOPS 1,000

2009-10-20T12:48:00.002-04:00

STATEWIDE---As Governor Deval Patrick considers what additonal cuts to make in the state budget, cuts already incurred this year in the elderly home care program have forced more than 1,000 people on a waiting list for services.

According to Mass Home Care, the wait list in the home care and enhanced home care program stood at 1,077 elders as of October 19th. The group said the number is understated, because seniors must be visited at home and assessed for need before their name can go on a wait list.

The waiting list was imposed on September 8th. Forty one days later, more than 1,000 people are waiting. Mass Home Care says that cuts already implemented will push the waiting list up to as many as 6,000 people by the end of June.

"It is ironic that the door to nursing home care is wide open, but the door to home care has been slammed shut for hundreds of seniors," said Al Norman, Executive Director of Mass Home Care. Norman said the Commonwealth's official policy for long term supports is "Community First," but that has translated into 'cut community first' instead.

Norman said that the typical home care client is a woman in her mid 80s who needs significant help with her activities of daily living, such as bathing, dressing, eating, walking and toileting.

Cutbacks this year have been made to the home care program, the Enhanced Community Options Program, and Community Choices---the three programs that help keep people living in the least restrictive setting.

Based on the 2006 "Equal Choice" law that Mass Home Care wrote, seniors and individuals with disabilities are supposed to be given a choice of where they wish to be served---at home or in an institution. Because of these budget cuts, seniors now have the choice of nursing home care or a waiting list. "We are narrowing some people's choices to a nursing home," Norman noted. "This is exactly what state policy says we should avoid."

Norman said seniors across the state have been contacting the Governor's office urging him not to make another round of cuts to community services. "'Hands off Home Care'" was the message, Norman said. "The hits we've already received have a taken a toll on very vulnerable seniors. It's fiscally short-sighted to cut the programs that keep people out of the more expensive levels of care. In a budget crunch, this is precisely the time to keep home care open, and divert people away from institutions."

Take Our New Caregiver Survey

2009-10-19T12:37:00.000-04:00

<p>Loading...</p>

Job Worries

2009-10-11T12:03:00.001-04:00

With 105,000 jobs lost over the past year, the Massachusetts economy and the state’s taxpayers continue to struggle and are unable to afford the spending levels prescribed on Beacon Hill. Despite a steady stream of laws in recent years touted by proponents as job generators, lawmakers received a report Thursday showing Massachusetts ranks 46th among states in job creation between 2000 and 2009, a sobering fact that undercuts some arguments about the state’s diverse economy. As Sen. Steven Panagiotakos, the Senate budget chief, pointed out repeatedly at this week’s revenue review hearing, the income tax provides about 60 percent of the state’s tax revenues and the state’s largest pool of tax revenue is inextricably linked to its success or failure in creating jobs. House Republicans, who portrayed a series of approved tax increases as job killers, on Friday began agitating to bring attention to cost-saving proposals the Democrats have turned aside previously, saying the ideas deserve attention again. With immediate budget problems to go along with the gaping fiscal 2011 gap, the proposals –managed care in MassHealth, rules to expedite the sale of surplus land, state employee furloughs, revisiting the Pacheco privatization law, and encouraging medical facilities to return unused, unexpired medications – are likely to get a second look in the months to come. More immediately, House Speaker Robert DeLeo says the next major economic development bill will be centered around legalization of casinos and slot machines at racetracks, a proposal that has generated emotional debate from both sides and which is expected to draw lots of attention in the weeks leading up to an October 29 public hearing. Despite the tough long-term numbers, the rate of job growth has slowed and Patrick says Massachusetts is positioned well to rebound from the recession more quickly than other states. The latest unemployment and jobs data will be released on Thursday. Legislative leaders continue to keep their fall agenda largely under wraps, with DeLeo seeking out initiatives that don’t cost any money and top Hill officials working behind the scenes on an education bill. The Senate has one formal session next week on its radar, a tentative formal on Thursday. The House plans a formal session for Thursday, which could feature consideration of a bill, now before the House Ways and Means Committee, to close out the books on fiscal 2009. Fiscal conservatives will be on the lookout for spending expansions. “I don’t know how we’ll get beyond the fiscal insanity if there’s any new spending in this,” Rep. John Rogers (D-Norwood), a former Ways and Means chair, said Friday. Rogers said the soon-to-be-downgraded revenue estimate would be “screaming at us to do the exact opposite.”

The Buzz on Beacon Hill

2009-10-10T11:51:00.000-04:00

The buzz on Beacon Hill next week is over the contraction state government will soon undergo as Gov. Deval Patrick deals with an eroding tax base, which state revenue officials say could carve between $400 million and $600 million out of this year’s expected collections. Patrick and the Legislature have already deployed waves of tax increases and spending cuts and poured billions of dollars from the state rainy day fund and federal stimulus dollars into the budget, leaving them with few popular choices to address the new red ink in the $27 billion budget and next year’s gap, estimated preliminarily at between $2 billion and $3 billion. Groups of developmentally disabled individuals have taken over the governor’s lobby in a regular vigil to protest potential cuts, which appear inevitable by month’s end. Administration officials are making no promises about which services and programs might be preserved as Jay Gonzalez, Patrick’s new budget chief, looks to officially lower the fiscal 2010 revenue estimate by Thursday. “We’re going through a process. We need to know what our options are,” Health and Human Services Secretary JudyAnn Bigby told the News Service Friday. “Obviously, the governor is going to hear a lot of recommendations, a lot of cases made for particular things. It’s going to be a couple weeks before we even know what the level of cuts will need to be. We are very hopeful we can make sure that we do the most we can to maintain the supports that people are looking for.”

A Tasty Way To Raise Dough

2009-10-08T11:52:00.001-04:00

ANN L. HARTSTEIN TO HOLD A LISTENING TOUR IN WORCESTER

2009-09-30T11:52:00.006-04:00

Date:	10-14-2009
Time:	12:15 - 1:30 PM
Location:	Worcester Senior Center 128 Providence Street Worcester MA 01604

Governor Deval Patrick’s newly-appointed Secretary of the
Executive Office of Elder Affairs, Ann Hartstein, will be
holding a public forum at the Worcester Senior Center.
Secretary Hartstein will meet with elders and their
families for an interactive dialog about issues important
to the region, their families and themselves.

The Central Massachusetts Agency on Aging

Elder Services of Worcester Area, Inc.

the Executive Office of the Worcester City Manager,

Division of Elder Affairs

and The Massachusetts Senior Action Council

are proud to host this event.

No reservations are required unless you wish to have lunch at noon.
To reserve lunch, call 508-799-8070 by October 12th.

The Executive Office of Elder Affairs promotes the
independence and well-being ofMassachusetts’ elders
and people needing medical and social supportive services.
By providing advocacy, leadership and management expertise,
Elder Affairs is able to maintain a continuum of services responsive
to the needs of their constituents, their families, and caregivers.

Nonprofit Groups Upset at Exclusion From Health Bills

2009-09-14T11:18:00.004-04:00

Nonprofit organizations say they are upset that Congress and the Obama administration have not addressed their rising health care costs in the various health care proposals being floated on Capitol Hill.

The main bill in the House would award a tax credit to small businesses that provide their employees with health insurance - but nonprofits do not pay income taxes and thus would not benefit.

"Why should employees of nonprofits be treated worse than employees of for-profit businesses?" said Jonathan A. Small, government affairs consultant at the Nonprofit Coordinating Committee of New York.

Nonprofit groups were hoping that the president would include them in his speech to Congress on Wednesday, but instead he mentioned only "families, businesses and government."

"There was nothing in that much-repeated trilogy of those needing help that spoke to nonprofits," said Lester M. Salamon, director of the Center for Civil Society Studies at Johns Hopkins University.

Some nonprofit groups have called for a subsidy along the lines of the Earned Income Tax Credit, in which money would be returned to organizations that demonstrate they have paid for an employee's health care.

As a group, nonprofit organizations are the nation's fourth-largest employer. But their advocates say policy makers know little about the workings of nonprofits, which pay payroll taxes and, in rare instances, taxes on unrelated business activities, but are exempt from taxes on their income.

"In this administration, there are so many people who came from the nonprofit community, but they don't really seem to think about the unique laws and rules that govern it," said Diana Aviv, president and chief executive of the Independent Sector, a nonprofit trade association.

When the concerns of nonprofit groups were raised on a conference call after the president's speech on Wednesday, representatives from the White House Office of Public Engagement and Intergovernmental Affairs were taken aback, and nonprofits have reported similar reactions from staff members in House and Senate offices.

"We had our nonprofit lobbying day on Capitol Hill in July, and our members spoke to their elected officials about this issue," said Tim Delaney, chief executive of the National Council of Nonprofit Associations. "We heard a constant refrain: 'Gee, we never thought about nonprofits as employers before.' "

Linda Douglass, a White House spokeswoman, said she had no comment because the policy was still being analyzed.

A recent survey of nonprofit groups by the Listening Post Project at Johns Hopkins found that the impact of rising health care costs was "mammoth."

Only 2 percent of the organizations responding to the survey said they were "not too concerned" about health care costs, and 72 percent of the respondents said those costs had risen - with roughly one-third of those reporting increases of 10 percent or more.

By STEPHANIE STROM

New York Times

Keeping People at Home, Out of Nursing Homes

2009-09-12T08:59:00.002-04:00

Anita Cole knows that her life of 75 years is coming to an end.

Still, she says from the hospital bed near the DVD player she uses to watch “The King and I” in one of six bedrooms in the Blackstone home of her daughter and son-in-law, “I’m lucky” because there are so many people who are worse off.

She did not feel so lucky during the year she spent in a nursing home just over the state line in Woonsocket. By the time she left it and arrived nearly two years ago in the six-bedroom home of Jackie and Alan Morrissette, with the help of Tri-Valley elder services in Dudley, she had bedsores you could put your hand in, said Jackie Morrissette, Mrs. Cole’s daughter.

Mrs. Cole, who used to fix knitting machines in the mills, said that some aides and nurses were kind and attentive, but Mrs. Morrissette said that some of them abused her mother.

Tri-Valley was a godsend, Mrs. Morrissette said. Even though Mrs. Morrissette used to work as a certified nursing assistant in nursing homes and as a certified medical technician, clearing the trail through paperwork by herself and coming up with a proper plan to bring her mother home would have taken far longer without the agency’s help, she said.

The Morrissettes sold their pizza restaurant and Mr. Morrissette became a personal care assistant about two years ago. Now he makes a living from the paid shared living arrangements they have taking care of Mrs. Morrissette’s mother, who has latter-stage Parkinson’s disease; a 74-year-old woman with physical ailments and mental disabilities; and a 37-year-old Vietnamese woman with severe physical and cognitive problems.

Mrs. Cole and her two housemates are benefiting from the home atmosphere and family-style care that the Morrissettes provide, but so are taxpayers.

Albert Norman, executive director of Mass Home Care, an association of 30 nonprofit agencies serving the elderly, said that “somewhere around 15 percent of people in nursing homes today could come out” if there were proper support. That would be about 5,000 of the 30,000 nursing home residents on Medicaid, he said.

Many nursing homes charge $58,000 a year, Mr. Norman noted. The annual cost of serving disabled elderly people in the community averages $26,000, less than half the cost, he said

Already support programs enable 10,000 Massachusetts nursing home-eligible people to live in homes in the community, Mr. Norman said. That saves the state and federal governments $580 million a year.

Massachusetts Senior Care Association, whose members include nursing homes, questions whether 5,000 nursing home residents could live in the community, according to Scott Plumb, senior vice president. The state, with its “cataclysmic budget” is not adding services but cutting back adult day health and other programs, creating waiting lists to get community services, he said.

“If somebody can be cared for safely and effectively at home, that’s where they should be cared for. Nursing homes are not in the business of taking care of people who don’t need to be there,” Mr. Plumb said. “There are some people in nursing homes, particularly with mental illness, who if the state were to make a strong, funded commitment to community care, that they could be cared for in the community.”

Since February or March, five agencies in the Worcester area have formed the Aging and Disabilities Resource Consortium, according to Ellen M. Messier, director of programs for the Center for Living & Working in Worcester. Besides Center for Living & Working, they are Central Massachusetts Agency on Aging, Elder Services of Worcester Area, Montachusett Home Care and Tri-Valley Inc.

“The point is to have no wrong door,” Ms. Messier said. The agencies are collaborating, so they know each others’ services.

If an elderly person or someone with disabilities who needs help living on their own calls the “wrong agency,” that agency will connect the right agency to the caller, she said.

Mr. Norman said the 11 consortiums across the state will fight the “silo” concept of service provision that separates services for elderly people from those for people with disabilities, when some people may need both. “Individuals don’t age in silos,” he said. The same person may need services to transition from middle age into old age.

Ginger Wills Howe, Tri-Valley program director for home and adult family care, said that long-term options counselors under the consortium will be an important addition to the outreach work the agencies already do. With a $2.5 million infusion from the state Legislature, the options program will go to people, usually when they are in a hospital, to counsel them on how they can return to the community rather than enter a nursing home, Mr. Norman said.

There has been a 20 percent drop in nursing home patient days in Massachusetts over the past nine years, he said. He’d like to see that trend continue, believing the state can reverse its ratio of 61 percent of Medicaid money — $1.5 billion — going to nursing homes and 39 percent spent on community care, much as he said Oregon and Washington state already have done.

Sometimes all that people who are not nursing home-eligible need is three hours a week of personal care services, the Mass Home Care executive director said.

Karen S. Monroe, 60, spent three months in UMass Memorial Medical Center — Memorial Campus after a motor vehicle accident that left her in a wheelchair, and then 3-1/2 years in the Odd Fellows Home. She said that her daughter’s home in Dudley, where she lived before the accident, was not accessible, and that she languished in the Odd Fellows home 2-1/2 years longer than she thinks she needed to be there. Finally on June 1, with the help of the Center for Living & Working, she got an apartment on Pleasant Street from the Worcester Housing Authority.

While Ms. Monroe said she was well taken care of at Odd Fellows, “I have more freedom here,” she said. She can cook for herself or sit outside or go to the nearby CVS, she said.

Ms. Messier of Center for Living & Working said the tragedy of living in a nursing facility when you don’t need to is that “You’re isolated, when you can be out in the community and doing things and living independently. There’s nothing better than being able to live independently.”
http://www.telegram.com

Message from Assistant Secretary for Aging Kathy Greenlee on National Day of Remembrance and Service

2009-09-11T13:15:00.002-04:00

On September 11, 2001, our nation experienced the worst terrorist attack in our history. On that day, families, friends and all Americans citizens were torn apart by the loss of the innocent individuals who perished in New York City, at the Pentagon in Arlington, Virginia and in a field in southwestern Pennsylvania. Eight years later, we continue to mourn their loss and celebrate their lives. We also pay tribute to the heroes and first responders who gave so much when their fellow citizens needed them the most.

The Administration on Aging(AoA) is proud to join President Obama and the entire nation as we acknowledge September 11 as National Day of Remembrance and Service. Today we reflect on how blessed we are to live in the United States. We come together to continue to show strength in unity and courage in the face of adversity. We remember the past, but we look to tomorrow. We are Americans. We will endure.

Today, America's spirit of compassion and generosity continues to shine.

All across the country, people are taking time today to lend a hand to those who need a boost. I am very proud that AoA staff and members of our national network of state, tribal and community-based organizations that serve older Americans are fanning out in communities across the country to perform meaningful service activities on behalf of at risk and frail older persons, their caregivers and their families. Whether it's serving a meal to a hungry senior, running errands for those who are homebound or just spending some time with those who are alone and isolated, these gestures make a big difference in their lives. I ask everyone to take some time today and throughout the year to help someone less fortunate. Together we can help tackle the tough challenges our country faces now and in the

future.

When Is It Time To Stop?

2009-08-23T14:47:00.012-04:00

As a senior citizen was driving down the freeway, his car phone rang. Answering, he heard his wife's voice urgently warning him, "Herman, I just heard on the news that there's a car going the wrong way on 280. Please be careful!" "Hell," said Herman, "It's not just one car. It's hundreds of them!"

This joke is becoming decreasingly humorous as the media covers more and more fatal car accidents involving elderly drivers. As a caregiver, you might have three generations of drivers to be concerned about: your children, yourself, and now your elders. You feel the heavy burden of trying to keep everyone safe. Telling your elder that they cannot drive may be even more difficult than telling your children that they can.

Rather than gaining freedom, as in the case with new drivers, losing a license would be taking that same freedom away. Driving may be the means by which elders go shopping, visit friends and family, attend medical appointments, or go to a show. If you take away their license, they have to rely on others in order to continue with their usual schedule. If you don’t take away their license, they may be putting themselves and others in danger, possibly without knowing that they are doing so.

The issue of elderly driving is controversial. While some people claim that driving skills vary from one elder to another, just as with any other age group, there are deficits in aging that very much affect the way someone is capable of driving. Aging Parents and Elder Care cites that there can be a slowing of response time, hearing and/or vision loss, muscle strength and flexibility loss, and drowsiness as a side effect of medication or a lower tolerance to alcohol.

The National Motor Association “does not support frequent re-testing or age-based restrictions” based on their reasoning “neither has been found to be effective in identifying and preventing problem drivers, in any age segment of the population (NMA). Another article presents the opinion that “this isn't about statistics. This is about common sense. The idea that, after an initial road test, the only thing the state of Massachusetts tests drivers for is their eyesight is patently ludicrous. Massachusetts is one of only three states that has no additional requirements or road tests as drivers’ age” (Cullen, 2009).

One option is being put into action in Iowa. They have introduced a requirement that drivers age 70 and older renew their licenses in person. If a DMV official suspects a problem, drivers may be asked to take a road test. They may then choose between taking the standard test or a newly devised “local” test. If they opt for the latter, an examiner will evaluate them on their usual route—to the store, to church, to the doctor and so on. Those who pass the local test are licensed only on that route and may also be restricted to lower speeds and daylight-only driving (Russo, F., 2005).

If either you or your elder are not convinced that the subject of elderly driving needs more attention now and in the future, here are some facts provided by “Night Vision and Driving: How Safe Are Older Motorists”:

· “The National Highway Traffic Safety Administration says 6,512 people — 15 percent of all Americans who were killed on the road in 2005 — were 65 or older.”

· “According to a Vision Council report released in the fall of 2006, the 10 states with the highest rate of fatal crashes included four that required no vision screening for license renewal and four that require only screenings at intervals of eight or more years.”

· “Motor vehicle crashes are the leading cause of injury in adults between 65 and 75 years old, and the second leading cause of injury to those 75 or older, according to the CDC.”

· “When measured by crashes per mile driven, data show a substantial rise in crashes by driver over age 70, according to the American Association of Retired Persons.”

By 2030, one of four drivers will be 65 or older so the more effectively we address elderly driving issues, the safer the roads will be (Russo, F., 2005). Be a responsible citizen and use your best judgment to do what is best.

View Our Slide Show Presentation

2009-08-20T13:48:00.000-04:00

This is Who We Are
CMAA Slide Show

View more presentations from cmaaging.

Advocates Say Elders Still Face “Unequal Choice”

2009-07-29T15:10:00.000-04:00

Three years ago this Monday, August 3rd, elderly and disability rights advocates gathered at a State House ceremony as Governor Mitt Romney signed into law Chapter 211, the Equal Choice Law. Despite passage this law on August 3, 2006 the promise that elders and individuals with disabilities would be cared for in the least restrictive setting, still has not been fully achieved. The major provisions in the law have hardly advanced. Even though the Romney and Patrick Administrations have coined the term “community first” to describe long term care services, advocates charge that in many ways this is still an “institutions first” state. As examples:
* The General Court this week adopted a FY 2010 supplemental budget that added $10 million for nursing home rates, but only $200,000 for care managers in the home care program. Institutions got 50 times the funding that community care received.
* A new report from the state’s Executive Office of Human Services indicates that MassHealth spending on long term care supports is still dominated by institutions. In FY 2008, a total of $2.88 billion was spent by MassHealth for long term care---of which 61% ($1.748 billion) went to institutions, and only 39% went to community programs ($1.131 billion). If the two sectors had been in a 50/50 balance, community based services would have received an additional $308.6 million that year.
Fiscal Year Community Institutional Total % spent in % spent in
Spending Spending Spending community nursing homes

FY 2008 $1,131.627,326 $1,748,839,747 $2,880,467,073 39.3% 60/71%
Source: Massachusetts State Profile Tool, July, 2009. EOHHS

Three years after the Equal Choice Law was signed, here is a report on what has been implemented, and what has not:

1. PRE-ADMISSION COUNSELING. Chapter 211 created a Pre-Admission Counseling service for long term care which includes an assessment of community based service options for people in hospitals who are heading towards nursing homes. The purpose of this counseling is to help divert people into the community, and save Medicaid the expense of nursing home days. These assessments are mandatory for people seeking MassHealth payment, and must be offered to private paying consumers. The state is required to report the number of diversions to the community generated by pre-screening.
STATUS: Only 3 regional areas have a preliminary program---and only in selected hospitals on the North Shore, Metrowest, and Merrimack Valley regions. Less than $500,000 was allocated in FY 2009 for this project. In FY 2010, the legislature funded $2.5 million for expansion of this program. As of the 3rd. anniversary of the Equal Choice law, none of the new funds have been allocated to the field. The state has indicated that the so-called “Long Term Care Options” program will be pushed out statewide this year, but no timetable or contracts have been awarded. Consumers should have been able to access this program three years ago, regardless of where they live in the state.

2. ADOPT MASSHEALTH REGULATIONS. Chapter 211 requires the Division of Medical Assistance to adopt regulations to implement the “least restrictive and most appropriate”setting language.
STATUS: No activity. No changes to the regulations for Medicaid have been made.
3.SUBMIT AN 1115 WAIVER that establishes MassHealth eligibility at 300% of SSI and $10,000 asset level.

STATUS: This waiver was submitted to the federal Center of Medicare and Medicaid Services (CMS) in December, 2006. Two years and half years later, the 1115 waiver has been scrubbed for FY 2010, and there is no funding in the FY 2010 budget for this waiver. House 1 proposed to start the waiver in July, 2009. At one point in the budget process, a total of $41 million was requested by Governor Patrick—of which $20 M was from federal stimulus funds. The Governor’s budget said this waiver would seek “to encourage flexible service options in the community for those who might otherwise need to seek services in a facility setting. The proposed strategies will enable some individuals to continue to live independently in community settings and support others in returning to community settings from institutions.” In June, 2009 the Governor pulled his budget request for the waiver, reduced the line item to $0, and the item was not funded by the General Court.
“The recession alone cannot be blamed for the lack of progress in this civil rights law,” said Mass Home Care Executive Director Al Norman, who helped write the law. “Civil rights do not disappear in lean fiscal times. The fact is, keeping people at home is saving the state more than half a billion dollars annually in avoided nursing home costs. The Equal Choice law is part of the solution, not part of the problem.”

Norman said Mass Home Care will continue to urge the Patrick Administration to shift funds into the community. Although nursing home patient days have fallen nearly 20% since the year 2000, Norman said the state still needs to shift funds for elders into community settings, much as the state has already done for other populations, like the developmentally disabled. Norman said that funds for the developmentally disabled are 85% spent in the community. “Advocates for the developmentally disabled have shown us the way this should be done,” Norman said. In FY 2008, the state spent a total of $1.18 billion on Developmental Services, of which 84.5% went to community care. “That’s where we need to get with elderly long term care,” Norman admitted. “If community long term care got 84.5% of the spending as developmental services did,” Norman said, “we would have received an additional $1.3 billion in FY 2008. That’s a huge imbalance.”

“We should be much further along the path of ‘rebalancing’ how our tax dollars are spent in the community,” Norman noted. “Twenty-seven other states have a greater percentage of their long term care clients living at home.” As of 2006, the percentage of MassHealth long term care expenditures going to community care services in Massachusetts was only 22%---which ranked the state 20th in the nation. The top five states for “rebalancing” their expenditures into the community are:
State Percent of 2006 Medicaid LTC Expenditures going to community care services for adults with disabilities Rank
Oregon 55% 1
New Mexico 54% 2
Washington 54% 3
Alaska 51% 4
California 47% 5
Massachusetts 22% 20

“Whether it takes three years or thirty years---we’re going to keep on pushing for all individuals with disabilities to have the right to live in the most integrated settings appropriate to their needs. That’s what the Equal Choice law is really all about.” Norman concluded. “We are still living in a state with an unequal choice of care, and are still discriminating against individuals with disabilities by spending more of our tax dollars on the most restrictive form of care, instead of the most integrated form of care.”

Health Care Reform Leaves Out Seniors

2009-07-28T09:17:00.000-04:00

The current debate over health care reform in Washington, D.C. has left many seniors scratching their heads---because the major worry of older people is not even being discussed. As of 2010, an estimated 40 million Americans will be over the age of 65—and that number will double to 80 million by the year 2040. By 2020 one in six Americans will be age 65 and older. The fastest growing segment of the aging population is individuals over the age of 85---often the most vulnerable older adults needing long-term care services and supports, and whose numbers will reach 7.3 million by 2020, and 15.4 million by 2040. Health care solutions in 2010 are totally out of touch with the graying of our population by 2040. An engineer might say we are designing for the wrong event. Whether or not there is an employer mandate to provide health care, for example, it is of little consequence to millions of seniors who are living in retirement, and have no employer. Just over a month ago, legislation was introduced in Congress that would reform the way long term care is provided to individuals with disabling conditions. For many seniors, the financial burden of long term care is more frightening---because Medicare covers very little long term care---and many seniors are not poor enough to get onto MassHealth. For seniors, health care reform is not the burning issue---it’s long term care reform. During this debate, Medicare has been called “socialized medicine,” so the obvious move to expand Medicare to younger populations is off the table.

The long term care legislation introduced is called Project 2020 (S. 1257/H.R. 2852), and its purpose is to improve the way consumers in all points of life (age, disability, income) access information on long-term care; to provide cost-effective health promotion and chronic disease management programs in every community to keep older adults healthier and thus save Medicare dollars, and to preventing people from spending their life’s savings to qualify for Medicaid nursing home eligibility by offering those most at-risk of nursing home care a range of home and community-based services to keep them off Medicaid in their own homes for as long as possible. This nursing home diversion program is estimated to create net savings of $27 million in Massachusetts from 2010 to 2014 by keeping people out of institutions.

Project 2020 provides the first coordinated national long-term care strategy that will generate savings in Medicaid and Medicare at the federal and state levels. At the same time, Project 2020 will enable older adults to get the support they need to successfully age where they want to—in their own homes and communities.

Project 2020 is estimated to reach over 41 million Americans and will reduce federal Medicaid and Medicare costs by approximately $2.8 billion over the first five years, resulting in a net savings to the federal government of nearly $250 million. The program would also generate significant savings for state governments.

This legislation builds on the existing network of community-based long-term care agencies. In Massachusetts, community based care has helped to drive down the number of Medicaid nursing home days by roughly 20% since 2000.
Project 2020 provides the nation’s rapidly increasing aging population, as well as persons with disabilities, with enhanced home and community-based support services while at the same time saving Medicaid and Medicare dollars.

The limited context of the health care debate is leaving many seniors cold. It’s time for Congress to remember long term care. One way to do that is to include Project 2020 in whatever health care reform bill has legs.

Until this happens, 40 million Americans are being left out of the debate.

(Courtesy of Mass Home Care)

Drug Companies Pledge $80 BILLION FOR OLDER ADULTS IN Health Care Reform

2009-06-30T12:04:00.002-04:00

The White House announced an agreement with brand-name drug manufacturers to provide discounts of up to 50 percent for older adults and people with disabilities when they reach the coverage gap, or “doughnut hole,” in the Medicare Part D prescription drug benefit. The discount agreement would take effect only if it is part of successful health reform legislation.

Drug companies said they would give most people with Medicare a discount of up to 50 percent on brand-name and biologic medicines, but not generic drugs, that they purchase when they are in the coverage gap. Currently, Medicare Part D plans cover 75 percent of drug costs until the total amount (what the enrollee pays plus what the plan pays) reaches $2,700, and then individuals with Medicare must pay the full price for their drugs until their out-of-pocket spending exceeds $4,350.

The commitment came in a deal with the White House and Senator Max Baucus, Democrat of Montana and chairman of the Senate Finance Committee. However, the White House estimated that out of the $80 billion, $30 billion would be used to assist people with Medicare when they are in the doughnut hole, according to the New York Times. The other $50 billion reflects savings to the government that could be used as part of the health care reform package, but these savings have not yet been identified.

According to reports by the White House, people with Medicare Part D will not need to complete complicated paperwork to obtain the drug discounts directly from their pharmacies. Although individuals with Part D will pay half the cost of their drugs while they are in the coverage gap, the full cost of medicines will count toward their out-of-pocket limit. Courtesy of Medicarerights

"The Reverse Mortgage Man"

2009-06-24T09:13:00.000-04:00

"The Reverse Mortgage Man"
07/07/09 @ 10:00 AM
What is a Reverse Mortgage? Would it be right for you or your loved one? Do you have questions about how reverse mortgages work? If you are an elder, a caregiver or a professional we have all the answers to these and other related questions. The Central Massachusetts Agency on Aging will collaborate with Joe DeMarkey, MetLife Bank to offer . . . [Learn More]

Music Therapy Might Soften Depression Symptoms

2009-06-21T15:43:00.003-04:00

Music therapy might help ease the symptoms of depression, though its effectiveness as a stand-alone intervention is not certain, according to a recent review of five small studies.

Four of the studies found reduced depression symptoms in participants receiving music therapy compared to those who did not. The fifth study did not find any difference.

The benefits of music appeared greatest when providers used theory-based therapeutic techniques rather than “winging it.”

. . . to read the entire article Please Click Here.

SeniorConnection.org

Top 10 Trends in Senior Housing for 2012

Top 10 Scams Targeting Seniors by NCOA

Health Care/Medicare/Health Insurance Fraud

Counterfeit Prescription Drugs

Funeral & Cemetery Scams

Fraudulent Anti-Aging Products

Telemarketing

Internet Fraud

Investment Schemes

Homeowner/Reverse Mortgage Scams

Sweepstakes & Lottery Scams

The Grandparent Scam

Top 10 Stories of 2011

Why You Should Care About The 'Medical Loss Ratio'

Should There Be Sales Taxes On Internet Purchases?

CMAA Sponsors Food Drive

Veterans Transportation and Community Living Initiative

Medicare Open Enrollment: Better Choices, Sooner

Debt Ceiling Deal: The Good, the Bad and the Ugly

Caregiver Sign-Up Form(Click on the form twice to enlarge)

Latest Medicare Plan Proposes Shift of Eligibility Age to 67

WHO: Cell Phone Use Can Increase Possible Cancer Risk

Partnership for Patients: Better Care, Lower Costs

Consensus Recommendations for the 2011 Older Americans Act Reauthorization

UMass Boston Study Examines why Elders in Home Care Switch to Nursing Homes

Letter of Intent

Highlights - Profile of Older Americans: 2010

FY 2011 and FY 2012 Labor-HHS-Education and Other Appropriations As of February 14, 2011 (Dollars in thousands)

5 Secrets Not To Keep From Your Cardiologist

Some Highlights From the Governor’s 2012 Budget Submission

Administration Cuts $15.5 Million From Key MassHealth Elderly Services

U.S. Alters Rule on Paying for End-of-Life Planning

Death Panels' Alive — And That's Good News For All Of Us!

Visiting Our Aging Parents for the Holidays: Something You Didn’t Expect Courtesy of Forbes

Aging Network to Embark on New Level of Volunteerism

"The Era Of Deficit Denial In Washington Is Over"

Virtual Dementia Tour

Choices about Life-Sustaining Medical Treatments

Congressman McGovern Holds Press Conference in Worcester

Governor Signs FMAP Bill With $7.1 M in Home Care Funding

CMS: Medicare Advantage Enrollment To Jump Next Year, Premiums To Fall

Study on Risk Factors for Indoor and Outdoor Falls May Help Tailor Fall-Prevention Strategies

Straight Talk: Frequently Asked Questions

Diabetes

Becoming Over Heated

Closing the Prescription Drug Coverage Gap

HHS Launches New Consumer Focused Health Care Website, www.HealthCare.gov

Fatality Crash Rate Falls for Older Drivers

Employer Support for Care Giving Employees

Recognizing Symptoms of Dementia

Can Fosamax and Other Osteoporosis Drugs Contribute to Bone Fractures?

Spouses Face Challenges in Caring For Themselves and Their Ailing Partners

Does Older = Happier?

PATRICK RELEASES $2.5 M IN FUNDING FOR ELDERLY "OPTIONS" COUNSELING PROGRAM

MassHealth Exemption Bills By Nicholas G. Kaltsas, Esq.

Be Wary of Tax Relief Scams

How the new Health Reform legislation will affect seniors.

If Reform Fails

From The Centers for Medicare & Medicaid Services

Discharge Missteps Can Send Seniors Back To Hospital

HHS Awards Major Grant to SAGE To Create First-Ever National Resource Center for Lesbian, Gay, Bisexual and Transgender Elders

It’s in OUR Hands!

Prescription Advantage State Pharmacy Assistance Program

Thank you, Senator Moore!

"The Era Of Deficit Denial In Washington Is Over"

Older Americans Act Reauthorization Input Opportunities

New Credit Card Regulations Take Effect in February

Early Good News for OAA III B and Caregiver Funding

Worcester Senior Center Seeks Canes, Wheelchairs for Haiti Victums

Governor Patrick Has Done It Again!

Thank you, Senator Harriette Chandler!

Drug Benefit adds 1 million more Seniors!!!!

Certified SHINE (Medicare) Counselors Needed

One Man’s Trash as Another Man’s Treasure

BUSINESS TAX RATE FALLS

Preliminary Survey Results

From The Auburn VNA Extended Care, Inc

HUMAN SERVICE ADVOCATES EXPECT GUV TO DETAIL MEDICAID CUTS TODAY:

Need Help Understanding 2010 Medicare Plans?