In our small Assisted Living home, we have noticed some decline in our residents after a hospitalization. I saw an article today confirming that has happened elsewhere. Here is a copy of the article from the ALFA web page that I found interesting.
Harvard researchers have found that a hospital stay is related to a faster rate of mental decline and a heightened risk of dying or entering a nursing home for those who already have Alzheimer’s disease.
A study following nearly 800 individuals with mild Alzheimer’s disease found that those who had been hospitalized during the course of the research were nearly twice as likely to experience increased mental decline or death. Of those who were hospitalized, one in 16 passed away, one is seven had to move to an institutionalized setting, and one in five suffered mental decline within one year of getting out of the hospital. If the individual experienced delirium during his hospital stay, he increased his risk for a poor outcome by about 12 percent.
"Delirium prevention may represent an important strategy for reducing adverse outcomes in this population," said Dr. Tamara Fong, an assistant professor of neurology at Harvard Medical School and lead author of the study. Delirium can be prevented through visits by a family member or other familiar person, supplying the individual with necessary eyeglasses and hearing aids, as well as encouraging the individual to get out of bed often for walks. Delirium can also be prevented by keeping older people out of the hospital and treating them in their homes, said Fong. Researchers emphasized that this study’s results highlight the importance of preventing hospitalizations and delirium, which is most likely to occur when individuals with Alzheimer’s disease experience a sudden change in routine.
Read more about this study, Adverse Outcomes After Hospitalization and Delirium in Persons With Alzheimer Disease, published in the June 19 online issue of Annals of Internal Medicine. Learn more about this study.
Thursday, June 28, 2012
Monday, June 25, 2012
Assisted Living Options Grow, Nursing Home Occupancy Declines
I saw a great article today about the growth of Assisted Living and the effect it has on Nursing Facilities. It seems that people have a mental picture of Nursing Facilities of elderly people sitting on the front porch in their wheelchair, smoking cigarettes or just looking out of it. In my opinion, there are people in Nursing Facilities who should not be there but should be in an Assisted Living Home. If they just need help with activities of daily living, they don't belong in a Nursing Facility. I believe pressure by families of the elderly will cause change in the thoughts of governing bodies. It will just take time.
Many of the Assisted Living Homes will not accept Medicaid residents because the level of reimbursement is fairly low. With the pressure of regulations and shareholders, it may be difficult for Medicaid facilities to keep their doors open. Please keep reading below.
By Katherine Kahn, Contributing Writer
Research Source: Health Services Research
Health Behavior News Service
Newswise — A new study finds an association between an increase in assisted living options, which provide older adults with an array of services such as help with everyday tasks in homelike settings, and a decline in nursing home occupancy. This shift in delivery of care has both positive and negative implications for seniors.
The study appears in the upcoming issue of Health Services Research.
Data on assisted living is patchy, primarily because the assisted living industry is not widely regulated and receives little government financing. Additionally, what constitutes assisted living is poorly defined and typically includes a broad range of housing options with varying levels of care.
“Assisted living has, in general, not been very well understood or studied in its role in the broader long-term care marketplace,” said the study’s lead researcher, David Grabowski, Ph.D., professor of health care policy at Harvard Medical School.
To collect data on assisted living, Grabowski and his colleagues contacted each state; however, only 13 states had long-term data available, from 1993 to 2007. Data for nursing homes was gathered from the Centers for Medicare and Medicaid Services, which represents over 95 percent of all nursing home facilities in the U.S., and from Brown University’s Minimum Data Set (MDS) on long term care.
“We found that a 10 percent increase in assisted living capacity led to a 1.4 percent decline in private-pay nursing home occupancy,” Grabowski said. “It’s not a huge effect and it’s not a one-to-one substitution, but I think this is a pretty sizable relationship.”
Since most individuals in assisted living are private-paying residents, researchers accurately predicted that assisted living expansion would have little impact on occupancy of Medicaid nursing home residents or Medicare-eligible patients who were in nursing homes for short-term care after a hospitalization.
Robert L. Kane, M.D., director of the Center on Aging and the Minnesota Area Geriatric Education Center at the University of Minnesota commented that growth in assisted living may not be the only reason for nursing home occupancy decline. “This phenomenon has been known for a long time…the problem is it’s not the only phenomenon in town. For example, there’s been a huge growth in home- and community-based services under Medicaid and it may well be that places that were growing in assisted living were also growing in these programs.”
Grabowski and researchers also found that as assisted living expanded, there was a small but significant increase in the level of care needed among nursing home residents. “This suggests that there is a healthier segment of the potential nursing home population that is being siphoned off and entering assisted living instead,” Grabowski said.
Since nursing homes generally prefer private-pay patients and Medicare patients over Medicaid patients, this trend could have negative financial effects for nursing homes, Grabowski speculated. “Assisted living may be a really attractive option for private paying individuals, but it has implications for Medicaid as well in that nursing homes can no longer depend on cross subsidies from private-paying residents since there’s maybe fewer of these individuals in that marketplace.” The result could be fewer resources for direct patient care of all nursing home residents.
Many of the Assisted Living Homes will not accept Medicaid residents because the level of reimbursement is fairly low. With the pressure of regulations and shareholders, it may be difficult for Medicaid facilities to keep their doors open. Please keep reading below.
By Katherine Kahn, Contributing Writer
Research Source: Health Services Research
Health Behavior News Service
Newswise — A new study finds an association between an increase in assisted living options, which provide older adults with an array of services such as help with everyday tasks in homelike settings, and a decline in nursing home occupancy. This shift in delivery of care has both positive and negative implications for seniors.
The study appears in the upcoming issue of Health Services Research.
Data on assisted living is patchy, primarily because the assisted living industry is not widely regulated and receives little government financing. Additionally, what constitutes assisted living is poorly defined and typically includes a broad range of housing options with varying levels of care.
“Assisted living has, in general, not been very well understood or studied in its role in the broader long-term care marketplace,” said the study’s lead researcher, David Grabowski, Ph.D., professor of health care policy at Harvard Medical School.
To collect data on assisted living, Grabowski and his colleagues contacted each state; however, only 13 states had long-term data available, from 1993 to 2007. Data for nursing homes was gathered from the Centers for Medicare and Medicaid Services, which represents over 95 percent of all nursing home facilities in the U.S., and from Brown University’s Minimum Data Set (MDS) on long term care.
“We found that a 10 percent increase in assisted living capacity led to a 1.4 percent decline in private-pay nursing home occupancy,” Grabowski said. “It’s not a huge effect and it’s not a one-to-one substitution, but I think this is a pretty sizable relationship.”
Since most individuals in assisted living are private-paying residents, researchers accurately predicted that assisted living expansion would have little impact on occupancy of Medicaid nursing home residents or Medicare-eligible patients who were in nursing homes for short-term care after a hospitalization.
Robert L. Kane, M.D., director of the Center on Aging and the Minnesota Area Geriatric Education Center at the University of Minnesota commented that growth in assisted living may not be the only reason for nursing home occupancy decline. “This phenomenon has been known for a long time…the problem is it’s not the only phenomenon in town. For example, there’s been a huge growth in home- and community-based services under Medicaid and it may well be that places that were growing in assisted living were also growing in these programs.”
Grabowski and researchers also found that as assisted living expanded, there was a small but significant increase in the level of care needed among nursing home residents. “This suggests that there is a healthier segment of the potential nursing home population that is being siphoned off and entering assisted living instead,” Grabowski said.
Since nursing homes generally prefer private-pay patients and Medicare patients over Medicaid patients, this trend could have negative financial effects for nursing homes, Grabowski speculated. “Assisted living may be a really attractive option for private paying individuals, but it has implications for Medicaid as well in that nursing homes can no longer depend on cross subsidies from private-paying residents since there’s maybe fewer of these individuals in that marketplace.” The result could be fewer resources for direct patient care of all nursing home residents.
Sunday, June 19, 2011
Toll of Caring for Elderly Increases
A steep rise in people caring for elderly parents is taking a toll on the health and finances of many baby boomers, a new study says. Older caregivers who work and provide care to a parent at the same time are more likely than other workers in their age group to report poor health, with problems including depression and chronic disease. There is evidence they “experience considerable health issues as a result of their focus on caring for others,” the report says.
The percentage of adult children taking care of their parents has tripled since 1994, with nearly 10 million people who are 50 and older doing so in 2008, according to a new analysis of the U.S. Health and Retirement Study, a bank of economic and health data on people over age 50 that was collected by the University of Michigan. The sample contained 1,112 people age 50-plus with at least one living parent.
The financial toll on care providers who are 50 or older averages $303,880 per person in lost wages, pensions and Social Security benefits over their lifetime, due to leaving the work force early to care for a parent, according to the study. For women, the cost is higher: $324,044, with $142,693 in lost wages, $131,351 in lost Social Security benefits, and $50,000 in lost pension benefits or matching contributions to defined-benefit plans.
The study “points out the importance of considering what caregiving does to your financial security,” says Sandra Timmermann, director of MetLife Mature Market Institute, a research unit of MetLife, Inc. that conducted the study with the National Alliance for Caregiving and New York Medical College’s Center for Long-Term-Care Research and Policy. “These were all people over 50, and these are their highest-earning years. They don’t have a lot of time to catch up.”
Another study released last year by MetLife and the alliance found that depression, hypertension, diabetes and pulmonary disease were among caregivers’ more common health problems. They also experienced higher rates of stress, were more likely to smoke or drink alcoholic beverages, and were less likely to get preventive health screenings, including mammograms.
Susie Butler, 54, is an only child helping her 83-year old mother, a widow who suffers from dementia. “You start taking years off your life if you’re taking care of someone with dementia. There’s a lot of stress,” says Ms. Butler, who works full time as the head of Medicare’s caregiver program.
She has had to take time off of work to move her other three times as her condition has worsened, ultimately to an assisted-living facility near Ms. Butler’s home in Annapolis, Md. In January, she had to talk the facility into letting her mother stay after she removed her tracking bracelet and tried to board a bus with a visiting Boy Scout troop. “I never know at work when I’m going to get the call that she’s going to make a break for it,” Ms. Butler says.
And with monthly rent of $5,500 and occasional nursing care at $150 a day, the daughter, says, “We’re eating through her savings very quickly.”
The new study calls for employers to do a better job of accommodating caregivers so they don’t quit, and steering them to stress-management and free caregiving resources. It also points out that caregivers would benefit from paid family leave and says more states are beginning to show interest in doing so by tapping workers’ compensation funds.
“People are living longer, and with chronic disease. Somebody’s got to take care of them, and it’s us,
says Gail Hunt, chief executive of the National Alliance for Caregivers.
says Gail Hunt, chief executive of the National Alliance for Caregivers.
Wall Street Journal June 14, 2011 by Kelly Greene
Thursday, May 12, 2011
10 Warning Signs of Alzheimer’s Disease
1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks at home, at work or at leisure
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality
Monday, May 9, 2011
2011 Alheimer's Disease Facts & Figures
• 5.4 Million Americans are living with Alzheimer’s disease.
• It’s the 6th leading cause of death in the U.S.
1) Heart Disease
2) Cancer
3) Stroke
4) CLRD
5) Accidents
6) Alzheimer’s Disease
7) Diabetes
8) Flu & Pneumonia
9) Nephritis
10) Septicemia
• It is the only disease among the top ten that cannot be prevented, cured or even slowed.
• There are nearly fifteen million caregivers of Alzheimer’s and Dementia patients. If they all lived in the single state, it would be the fifth largest state.
• In 2010, these caregivers 17 billion hours of unpaid care.
• Alzheimer’s costs the nation $183 billion annually.
• Since 2000, death rates of other major diseases (HIV, Stroke, Heart Disease) dropped while deaths from Alzheimer’s have risen by 66%
• Every 69 seconds someone in the U.S develops Alzheimer’s.
• The numbers are rising and time is short. Take the time; spread awareness.
• Send these numbers to someone who needs to know about the Alzheimer’s epidemic.
From the Alzheimer’s Association
Friday, May 6, 2011
When to consider assisted living
Some useful information I thought you might enjoy.
When to consider assisted living
When to consider assisted living
| It has been our experience that too many families wait until there is a crisis to consider assisted living for their loved one. When a crisis happens, the senior is usually frail and unable to take advantage of all the benefits assisted living has to offer. Many families tell us the wished they would have moved their loved ones sooner. What are some signs that it is time to seriously consider assisted living? Difficulty performing daily activities:
Memory loss:
Medication concerns:
Lack of Socialization:
Fear:
Safety concerns:
Information from www.seniorlivingexperts.com |
Tuesday, April 26, 2011
When It's Too Expensive For Dad to Keep Driving
One of the most difficult decisions dealing with my father-in-laws Alzheimer's Disease was taking away his driving priveledges. The family agonized over it for many months before taking action. Once action was taken, the burden was lifted for all involved.
I saw an article written by Kelly Greene in the Wall Street Journal which had some sage advice. I've posted it below.
"Trying to persuade older family members to give up their car keys isn't just an emotionally fraught chore. Increasingly, it is a financial issue, too.
"Cars can be expensive to maintain for an elderly person on a fixed income. The cost of auto-insurance claims in later life -even for fender benders and accidents without injuries-can quickly add up. Conversely, if an aging parent decides to move to a place where transportation is readily available, such as an assisted-living facility or continuing-care retirement community, housing costs could escalate.
"If there is compelling evidence that parents shouldn't be on the road-because of failing eyesight or other physical limitations-then adult children shouldn't want them to drive. People who are 75 and older have higher crash rates per mile than all groups except 16 to 25-year-olds, according to the Insurance Institute for Highway Safety. Many states require older drivers, starting in their 60's or 70's, to nenew their licenses more frequently than younger drivers, to do so in person or to take additional vision tests. Still, health and driving skill can deteriorate between those renewal dates.
"One possible solution: Take the cash that your relative would spend maintaining a car to get safer, reliable rides through taxi services or non-profit groups. There are a growing number of alternative transportation options aimied at older adults who could continue to live independently if they could just find a good alternative to their own car.
"Like many adult children, Julie Markes, a 47-year-old children's book author in Brooklyn, N.Y. is struggling to explain the costs of continuing to drive-along with the safety risks-to her 81-year-old mother, Diana Markes, an actress and artist who lives in Los Angeles. Her mother has had at least a dozen accidents since 2005, including a scary one last month in which she pulled out from a stop sign into oncoming traffic and was hit by a car that "she thought came out of nowhere," the daughter says. Although no one was hurt, the car was totaled and the mother now wants to use the $11,900 insurance check to replace the vehicle.
"Her daughter is urging her to give up the keys, not only because she considers her mother's driving dangerous, but also because her mother is spending nearly $7,000 a year on car insurance. And that bill, along with her rent, is consuming 100% of the money she brings in from Social Security and "an old investment," Julie says. She is hoping that, when her mother's car insurance expires in August, her insurer either won't renew it or will increase the premiums-forcing her to give up driving.
"Meanshile, Julie is trying to stop her mother from buying a car, and instead is encouraging her to consider using the insurance check for taxis and a passenger service run by an affiliate of ITNAmerica, a non-profit based in Westbrook, Maine. The organization, which operates in 12 states, provides driviners around the clock, seven days a week, to take older adults wherever they want to go. The average fee: about $10 a trip. (Drivers also will help with shopping bags and escort passengers to a doctor's office.) By contrast, it costs about $16 a day on average in insurance, taxes and other operatin cists simply to keep a car in the driveway, according to AAA.
"Here are some other options for family members:
"1) Hire a "driving therapist." Driver-rehabilitation specialists can help people who have lost mobility overcome impairments, sometimes with special equipment such as left-foot accelerators or spinner knobs that ease steering. They also perform a toughter job: setting limits on driving times and routes-and letting people know when it is time to give up the keys.
"An initial assessment can take two to three hours and cost at least $200. Additional sessions run at least $100, and patients typically pay out of pocket-thought such therapy can pay off if it keeps a person independent. (In a few states, Medicare may pay for part of the therapy.) To find a driver-rehabilitation Specialists website (www.driver-ed.org) and click on "Find a CDRS."
"2) Find other transportation services through the federal Eldercare Locator (www.eldercare.gov; 800-677-1116). That service will refer you to your local agnecy on aging, which should have information about any publicly and privately provided transportation for people who are 60 or older.
"3) Find a support network. Older adults are forming grassroots networks in various cities and towns with the goal of staying independent-and some include transportation services. To find listins, go to the Village to Village Network website (www.vtvnetwork.org) and click on "VtVN Directory."
Good luck with this very hard decision.
More later.
I saw an article written by Kelly Greene in the Wall Street Journal which had some sage advice. I've posted it below.
"Trying to persuade older family members to give up their car keys isn't just an emotionally fraught chore. Increasingly, it is a financial issue, too.
"Cars can be expensive to maintain for an elderly person on a fixed income. The cost of auto-insurance claims in later life -even for fender benders and accidents without injuries-can quickly add up. Conversely, if an aging parent decides to move to a place where transportation is readily available, such as an assisted-living facility or continuing-care retirement community, housing costs could escalate.
"If there is compelling evidence that parents shouldn't be on the road-because of failing eyesight or other physical limitations-then adult children shouldn't want them to drive. People who are 75 and older have higher crash rates per mile than all groups except 16 to 25-year-olds, according to the Insurance Institute for Highway Safety. Many states require older drivers, starting in their 60's or 70's, to nenew their licenses more frequently than younger drivers, to do so in person or to take additional vision tests. Still, health and driving skill can deteriorate between those renewal dates.
"One possible solution: Take the cash that your relative would spend maintaining a car to get safer, reliable rides through taxi services or non-profit groups. There are a growing number of alternative transportation options aimied at older adults who could continue to live independently if they could just find a good alternative to their own car.
"Like many adult children, Julie Markes, a 47-year-old children's book author in Brooklyn, N.Y. is struggling to explain the costs of continuing to drive-along with the safety risks-to her 81-year-old mother, Diana Markes, an actress and artist who lives in Los Angeles. Her mother has had at least a dozen accidents since 2005, including a scary one last month in which she pulled out from a stop sign into oncoming traffic and was hit by a car that "she thought came out of nowhere," the daughter says. Although no one was hurt, the car was totaled and the mother now wants to use the $11,900 insurance check to replace the vehicle.
"Her daughter is urging her to give up the keys, not only because she considers her mother's driving dangerous, but also because her mother is spending nearly $7,000 a year on car insurance. And that bill, along with her rent, is consuming 100% of the money she brings in from Social Security and "an old investment," Julie says. She is hoping that, when her mother's car insurance expires in August, her insurer either won't renew it or will increase the premiums-forcing her to give up driving.
"Meanshile, Julie is trying to stop her mother from buying a car, and instead is encouraging her to consider using the insurance check for taxis and a passenger service run by an affiliate of ITNAmerica, a non-profit based in Westbrook, Maine. The organization, which operates in 12 states, provides driviners around the clock, seven days a week, to take older adults wherever they want to go. The average fee: about $10 a trip. (Drivers also will help with shopping bags and escort passengers to a doctor's office.) By contrast, it costs about $16 a day on average in insurance, taxes and other operatin cists simply to keep a car in the driveway, according to AAA.
"Here are some other options for family members:
"1) Hire a "driving therapist." Driver-rehabilitation specialists can help people who have lost mobility overcome impairments, sometimes with special equipment such as left-foot accelerators or spinner knobs that ease steering. They also perform a toughter job: setting limits on driving times and routes-and letting people know when it is time to give up the keys.
"An initial assessment can take two to three hours and cost at least $200. Additional sessions run at least $100, and patients typically pay out of pocket-thought such therapy can pay off if it keeps a person independent. (In a few states, Medicare may pay for part of the therapy.) To find a driver-rehabilitation Specialists website (www.driver-ed.org) and click on "Find a CDRS."
"2) Find other transportation services through the federal Eldercare Locator (www.eldercare.gov; 800-677-1116). That service will refer you to your local agnecy on aging, which should have information about any publicly and privately provided transportation for people who are 60 or older.
"3) Find a support network. Older adults are forming grassroots networks in various cities and towns with the goal of staying independent-and some include transportation services. To find listins, go to the Village to Village Network website (www.vtvnetwork.org) and click on "VtVN Directory."
Good luck with this very hard decision.
More later.
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