JustCare

Tag: Older adults

  • Coronavirus: You should take it seriously, even in year four

    Coronavirus: You should take it seriously, even in year four

    I don’t know about you, but I have now had my two initial Covid-19 shots and three booster shots. As much as I’d like to treat Covid like a cold, the risk of hospitalization and long-Covid are real and frightening if you have not been boosted, reports The Guardian. Whatever the people near you are or are not doing, you should take Covid seriously.

    What should you do to protect yourself? Get boosted. And, get boosted again when your immunity drops. The bi-valent boosters are very effective. Always wear a mask in public and around strangers when you’re indoors. You will then likely protect yourself from a bad case of Covid. If you could be wearing a mask, you should be.

    Don’t assume you’ll be ok if you don’t get the bivalent booster shot. 84 percent of people appear to be making that assumption at grave risk to themselves and others.

    Don’t assume that you’ll be ok if you’ve already had Covid. Data is mounting that if you’ve had Covid once you’re more likely to face greater physical and mental health risk if you get it again.

    New variants of Covid are virulent. It might be the fourth year of Covid-19, but it is not waning. And, once again, many people are being hospitalized, particularly the unvaccinated and unboosted. Hospitalizations for Covid are at the fourth highest level since the beginning of the pandemic.

    It shouldn’t matter whether the government is requiring people to be masked and tested, you should wear a mask to protect yourself and others.

    Older adults are most at risk. People with Medicare comprise the better part of all patients hospitalized. And, many people are dying needlessly. During the week of January 4, nearly 4,000 people died of Covid, thousands more have become disabled, largely bedbound, with little energy to perform even basic activities of daily living.

    Is Covid going away? Experts do not believe Covid cases have peaked. People in the northeast appear to be hit hardest. The XBB.1.5 subvariant is largely responsible.

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  • Protein helps older adults maintain muscle mass

    Protein helps older adults maintain muscle mass

    Older adults should work to ensure they maintain muscle mass. While people can lose muscle mass beginning in their 30’s, people in their 60’s and older lose muscle mass more rapidly. Anahad O’Connor writes for the New York Times about the value of protein and resistance exercises to help older adults maintain muscle mass.

    Loss of muscle mass as you age–sarcopenia–can jeopardize your health. It increases your risk of falling, breaking bones and becoming physically disabled. That, in turn, can mean loss of independence and a poor quality of life.

    Protein can be a solution to retaining muscle mass as you age. There are plenty of foods you can eat to ensure you have enough protein in your diet, including avocados, nuts, milk, yogurt, eggs, lentils, hummus and fish.

    Combining protein with resistance exercises, such as squats, lunges, pushups and weight-lifting, is the best way to go for your muscles. That will lessen the likelihood of your getting sarcopenia. Walking and other aerobic exercise are also helpful.

    How much protein do you need? Some experts recommend eating 1 to 1.2 grams of protein daily for every 2.2 pounds you weigh. That’s about 60-70 grams of protein a day if you weigh 133 pounds. But, other factors contribute to the calculation, including exercise and physical health.

    How should you include protein in your diet? It’s best to consume foods with protein throughout the day rather than in bulk. That way your body better absorbs the protein

    Are protein supplements advisable? You should not need to take protein supplements if you eat a healthy diet with protein-rich foods. If that’s not possible, whey protein is recommended by some as a good protein supplement. It has lots of amino acids and can be easily absorbed. But, as with most supplements, the data is not clear that whey protein has any effect on muscle mass.

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  • Older adults rise up for a better America

    Older adults rise up for a better America

    The New York Times reports that a burgeoning movement of older adults, including Neil Young and Joni Mitchell, are rising up to fight for a better America. Led by Bill McKibben, Third Act’s mission is to organize adults over 60 in ways that can help deliver progressive change. We’re talking about 75 million people.
    Organizing a large cohort of older adults could be difficult because many people tend to lose their progressive views as they grow older. But, we are at a time when complacency is untenable for many, reinforcing inequities and injustices that must be addressed.

    And, many of the baby boomers grew up in the 60’s, witnessing horrors and fighting for change. They have time now, as well as skills, resources and a hunger, to pick up the battle. To many, it feels as if the US is going to hell in a hand-basket.

    Third Act plans to take on big oil by going after the big banks that support the fossil fuel industry. Watch out Chase, Citi, Bank of America and Wells Fargo. The older generation holds 70 percent of the financial wealth in this country.

    Third Act is also fighting to protect democracy. Older adults represented 44 percent of all voters in the last election. And, older adults often have time to volunteer and help ensure that people get out and vote.

    We could use Third Act to focus on healthcare in America. Right now many of the big “advocacy” groups are industry shills.

    It feels harder than ever to effect change. But, the only way it will happen is if we try and try hard. We’re all in this mess together. And, together is the only way out.

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  • Caregiving: A mediator could help minimize stress among siblings caring for an aging parent

    Caregiving: A mediator could help minimize stress among siblings caring for an aging parent

    Growing old can be difficult, not only for yourself but for your loved ones. It is not uncommon for siblings to drift apart or, worse still, do battle, around how best to care for an aging parent. Next Avenue reports on an interesting strategy for reducing caregiving tension and worry: Hire a mediator.

    A mediator helped one family reach consensus around whether their mom should move into an assisted living facility. The mediator helped them to each share their views, without a lot of emotions at play. The mediator helped them select the assisted living facility and to assume different responsibilities for the move.

    There are always myriad considerations and many items to nail down. One sibling took responsibility for talking to their mom about stopping driving. Another agreed to help their mom with finances. One took responsibility for medical issues.

    Mediators can be a help with a range of elder care issues. There need not be any legal disputes. The goal is for the family to reach agreement as peacefully as possible.

    Mediators will usually speak with each family member individually, including the older adult if possible, to give everyone a voice, get a sense of where people stand on key issues and each person’s ability to be helpful. After that, the mediator can lead a zoom or in-person meeting of the family.

    At the end of the day, every family member will understand all that needs to happen and each person’s role in making those things happen.

    Does your family need a mediator? It depends on how much you are getting done without one and how much stress it entails. Try not to wait for a medical emergency.

    Caregiving is filled with important responsibilities: medical, financial, legal, domestic, you name it. Here’s a link to a range of things you might want to think about if you’re caring for a loved one. Getting the job done is time-consuming and often terribly painful even without the added stress of reaching consensus with others. The goal is to make it as joyful and stress-free as possible.

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  • Older adults in US face high cost-related barriers to care

    Older adults in US face high cost-related barriers to care

    A new report from the Commonwealth Fund finds that cost is a large barrier to care for older adults in the US, larger than it is for older adults in 10 other wealthy countries. Consequently, many older adults in the US postpone needed care or forgo it altogether.

    Congress is aware that cost is a barrier to care for people with Medicare. In response, it is looking at add vision, hearing and dental benefits to Medicare. That could be a huge help for the 63 million people with Medicare, so long as their out-of-pocket costs are minimal. Otherwise, these costs could render the additional benefits meaningless for a large cohort of people with Medicare; they would be functionally uninsured.

    Today, older adults in the US spend more on healthcare than older adults in other nations. About 8.5 percent of older adults in the US skip or postpone needed care because of the cost. In sharp contrast, in Germany, the Netherlands, Norway, and Sweden, fewer than two percent of older adults report facing financial barriers to care. Even in Switzerland and Australia, which impose high out-of-pocket costs on older adults, older adults are less likely to skip or delay care than older adults in the US.

    Not surprisingly, older adults in the US are also twice as likely not to fill their prescriptions and skip doses because of the cost than older adults in other countries. A recent NBER study found that an increase in prescription drug copays of as little as $10.40 keeps more than one in five older adults from filling life-saving prescriptions. As a result, thousands of people with Medicare die prematurely every year.

    Some Democrats in Congress are saying that the government doesn’t have the money to cover a larger share of health care costs for people with Medicare. In fact, right now, Medicare Advantage plans are getting government rebates of $140 per enrollee per month, along with billions a year in overpayments relative to  traditional Medicare. Congress could take some or all of that money and put it towards lower out-of-pocket costs and a reasonable out-of- pocket cap in both traditional Medicare and Medicare Advantage.

    More people with Medicare would not feel the need to forgo critical care if Congress reallocated those tens of billions of additional dollars towards lower out-of-pocket costs for everyone with Medicare and an out-of-pocket cap in traditional Medicare.

    Warning: Medicare Advantage plans might look inexpensive because premiums are usually low.  But, if you get sick and need costly care, your out-of-pocket costs, copays amd deductibles, could be as high as $7,550, depending on the plan you choose. Your out-of-network costs are additional.

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  • Increase in antibiotic resistance affecting older adults

    Increase in antibiotic resistance affecting older adults

    A new study in Clinical Infectious Diseases finds that an increase in antibiotic resistance is affecting older adults, reports Modern Healthcare. The federal government needs to step in and protect older adults from bacterial infections that are drug-resistant.

    In one year alone, 2017, 11,800 people died from antibiotic resistant infections. A large cohort of people spent more than 400,000 days hospitalized in 2017. The cost was $1.9 billion.

    Most of these infections were not hospital-acquired but rather arose in the community. Older adults are especially vulnerable because they are more likely to have compromised immune systems. More than 4,000 older adults died from these infections in 2017, a disproportionately high number.

    According to the Centers for Disease Control and Prevention, each year, nearly three million Americans are diagnosed with antibiotic-resistant infections. More than 35,000 of them end up dying.

    A lot of physicians prescribe antibiotics for conditions that an antibiotic cannot treat.  Overprescribing of antibiotics not only means an unnecessary cost to patients, with some risks, but it also leads to more antibiotic resistant bacteria. One recent study found that 46 percent of urgent care prescriptions were for antibiotics that were not needed to treat people’s condition. Pharmaceutical companies have not been developing new antibiotics to address the pressing need.

    What you should know: According to the CDC, antibiotics only treat infections caused by some bacteria, such as strep throat, whooping cough and urinary tract infections. They are not needed to treat most sinus and ear infections. You should not take antibiotics to treat colds, the flu, most sore throats and bronchitis. Always consult with your doctor if you think medicine is needed to treat your condition.

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  • Low-cost transport improves health for isolated older adults

    Low-cost transport improves health for isolated older adults

    Choe Sang-Hun reports for the New York Times on the value of low-cost transportation services for older adults in rural counties in South Korea. In these counties, taxis ferry people to town and to doctors’ appointments as far as 20 minutes away. Because of government subsidies, the taxis cost just 100-won or .09 cents. The US offers free transportation to older adults in some communities, but we would be well-served to use South Korea as a model.

    When did South Korea begin subsidizing taxi services for rural residents? Beginning in 2013, South Koreans living in one county no longer had bus services. The routes were not busy enough to be worth the government’s investment. So, the buses were canceled.

    The county decided that it would pay for all but .09 cents of the cost of a taxi ride for villagers in small hamlets who live too far from a bus stop to make use of a bus. The taxi takes them to local markets and doctors appointments.

    In 2020, villagers from 40 villages in Seocheon made use of the taxi service 40,000 times. The total cost to the South Korean government was $147,000. Throughout South Korea, the government subsidized 2.7 million rides.

    The taxi service makes a lot of sense: The taxis provide door-to-door service. And, they end up being less costly than a regular bus service. A lot of the rural villages only have a dozen or so houses.

    The taxi service also keeps older villagers socially engaged, freeing them of being isolated in their villages. It allows them to get out and about.

    The trips are subsidized heavily. The same short taxi ride would otherwise cost 100 times what it now costs the villagers. And, if they want to travel further, they pay just a little more. They can make use of the taxi service whenever they please.

    It should be easy for local communities in the US to copy the South Korean model and arrange free or low-cost transportation services for older adults. Some cities offer access-a-ride, which is a start. Contact your local area agency on aging to find out about transportation services for older adults in your community.

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  • Coronavirus: Symptoms can differ for older adults

    Coronavirus: Symptoms can differ for older adults

    During this new wave of coronavirus infections, older adults are increasingly being hospitalized. A new large study in the Journal of Gerontology reveals that symptoms can differ for older adults. If older people you know are not feeling well, physically or mentally–even if they do not have typical symptoms–make sure they are tested for Covid-19 and have what they need to get by.

    The New York Times reports that one in three older adults present in hospital with symptoms very different from the classic ones of fever, coughing and shortness of breath. Determining whether they have Covid as soon as possible can help ensure they receive the best possible treatment for their condition.

    Researchers studied the electronic health records of around 5,000 older adults with COVID. They found functional declines in 25 percent of older adults. They were having difficulty walking, transferring from their be, and were otherwise weak and at risk of falling. More than one in ten older adults felt forgetful, confused or agitated. Another study found older adults were more likely to be tired, to have diarrhea and to lose their appetite.

    These mental and physical atypical symptoms often presented in combination with classic symptoms of fever, coughing and shortness of breath. If you are over 65, do not assume that if you are feeling weak but are fever-free that you do not have Covid-19.

    Covid-19 symptoms such as weakness and forgetfulness are more prevalent among people over 65 and even more common among people over 85. Women and Black Americans are more likely to have these symptoms as are people with chronic conditions such as diabetes and dementia. Researchers attribute these different symptoms to differences in metabolisms of older people.

    People with atypical symptoms had fewer breathing problems and had less of a tendency to need to be put on a ventilator. But, they are still at considerable risk, the same risk as people with typical symptoms. Like older adults with typical symptoms, they tended to have 10-day hospital stays and one in three died.

    If you have COVID, the sooner the treatment, the better. Treatment includes anticoagulant drugs and monoclonal antibodies.

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  • Congressional candidates beware: Oppose lowering drug prices at your peril

    Congressional candidates beware: Oppose lowering drug prices at your peril

    The Alliance for Retired Americans (“ARA”) just released a poll showing that older adults so want affordable prescription drugs that they say they would switch political parties to support a candidate who favors Medicare drug price negotiation. Congressional candidates should beware!

    The ARA found that more than seven in ten voters over 65 say they would be more inclined to support candidates, regardless of their political party affiliation, who want to bring down drug prices for people with Medicare. Indeed, lower prescription drug prices is a policy issue that motivates people less likely to vote to go out and vote.

    Older adults like Medicare a lot, with 86 percent, overall, having “a favorable impression.” (91 percent of Dems and 85 percent of Reps.) But, they are unhappy with the amount they need to pay for their prescriptions. The Medicare Part D benefit has high out-of-pocket costs for anyone taking costly medicines, and it has no out-of-pocket cap.

    Prescription drugs are increasingly unaffordable for older adults. Yet, they often need these drugs to stay alive. An NBER study earlier this year found that a $10.40 increase in copays for Part D drugs led 20 percent of people to stop taking all their medicines. It further found that thousands of people die each year of stroke or heart attack because they stop taking their prescriptions.

    Nearly nine in ten people with Medicare support Medicare drug price negotiation. Democrats and Republicans are strongly aligned on this issue, with 89 percent of Democrats supporting it and 87 percent of Republicans. About half of voters strongly support this policy.

    Politicians should take heed. Older adults vote. In fact, three out of four older adults voted in the 2020 election, proportionally more than any other age cohort. They represent more than 25 percent of all votes cast.

    In addition, most older voters want Congress to take the Medicare dollars saved from drug price negotiation and put them towards additional Medicare benefits.

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  • Coronavirus: Older adults more likely to be vaccinated, regardless of party affiliation

    Coronavirus: Older adults more likely to be vaccinated, regardless of party affiliation

    The Delta variant of the novel coronavirus is wreaking havoc in the US because so many Americans remain unvaccinated. Thankfully, 90 percent of older adults have received at least one COVID-19 vaccine. Political affiliation is not driving vaccination decisions for older adults in the same way that it appears to be keeping younger Republicans from getting vaccinated.

    Kaiser Health News reports that nearly 50 million older Americans have been vaccinated. So, even if they are infected with the Delta variant, they are not likely to be hospitalized, much less to die of COVID. That said, those older adults who are not yet vaccinated are taking a huge gamble with their lives.

    Overall, many Republicans have chosen against being vaccinated, putting their lives at risk. But, the majority of older adults, regardless of political party, have been vaccinated. Political party has not affected vaccination rates among older adults significantly.

    Older adults have benefited from being first up for vaccinations and the focus of many COVID vaccination campaigns. They appear to recognize the dangers of not being vaccinated. The data is clear. Four out of five people who have died of COVID-19 are people over 65.

    Still, one in ten older adults still need to be vaccinated. It is doable. Some states have shown the way, doing an especially good job of ensuring older adults are vaccinated. In Vermont, Pennsylvania and Hawaii, the vaccination rate for older adults is 99 percent. West Virginia has the worst rate though far better than the country as a whole, with 78 percent of older adults vaccinated.

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