Most Americans turn toMedicareafter their 65th birthdays to give them the assistance they need to cover their healthcare expenses. With estimates of total lifetime medical costs for retired couplessoaring toward the $300,000 mark, you can't afford not to make the most of the Medicare benefits to which you're entitled.
Every year, Medicare gives its participants the chance to make key changes to their coverage during the annual open enrollment period. With a start date of Oct. 15, it's smart to take the time now to prepare yourself for the choices you'll have once open enrollment begins. That way, you'll be in the best position possible to use open enrollment to get more value out of your Medicare coverage.
Here's some basic information about how Medicare open enrollment works, along with some tips to help you figure out the best way to navigate it.
What Medicare open enrollment's for
The general way that open enrollment works is similar to what those who've had private employer-based health insurance coverage during their careers are used to seeing. Each year, you're given the opportunity to adjust the way that you're covered under Medicare. The available changes include the following:
If you're covered under traditional Medicare this year, then you can move to aMedicare Advantage planfor next year.
If you're covered under a Medicare Advantage plan this year, you can either change to a different Medicare Advantage plan, or you can move back to traditional Medicare coverage.
You can make changes to your prescription drug coverage, either by choosing a Medicare Advantage plan that incorporates prescription drug benefits into its overall package or by selecting a separately offeredPart D prescription drug plan. You can also drop your existing drug coverage or add new coverage.
How long Medicare open enrollment lasts
Medicare open enrollment gives participants about a seven-week window to make changes, with the period beginning Oct. 15 and ending Dec. 7. Changes to your coverage that you make during this year's open enrollment will take effect on Jan. 1, 2019.
The annual open enrollment period is the primary method most Medicare participants have to make changes to their coverage, but it's not the only one. Other special periods apply when certain life events happen, such as if you move to a new area where your current plan doesn't offer coverage or if you become eligible for other benefits such as Medicaid.
Your biggest goal during Medicare open enrollment
Ideally, open enrollment lets you tailor your Medicare coverage to minimize your total out-of-pocket healthcare costs. Many participants make the mistake of focusing only on paying the lowestpremiumsfor their Medicare coverage, but that's only part of the equation. Part B premiums are generally fixed, while various Medicare Advantage and Medicare Part D plans can offer very different monthly premiums.
Yet although a lower-premium plan can look like a good deal, the less comprehensive coverage it offers can end up making you pay more in total costs. If the copayments, deductibles, and coinsurance amounts that you have to pay under a plan offset the lower premiums, then what looks like the "cheaper" plan from the premium standpoint can end up actually being more costly. Conversely, more comprehensive plans might cost more in monthly premiums but end up with lower total costs.
The challenge in achieving this goal is that you have to not only assess your current health but also predict how the coming year is likely to go. The perfect plan for a relatively healthy person can be wholly inadequate for someone with a chronic condition. With prescription drug coverage, you can go from needing no medications at all to having a large set of prescriptions if you suffer an illness during the course of a year. That's why changing from year to year can make sense, and failing to do so can be a huge mistake.
Don't miss your chance
Looking at all the options you have for Medicare coverage is a great way to prepare for open enrollment. If you use your time now wisely, then by the time mid-October comes, you'll be more than ready to make the best available choice to take maximum advantage of Medicare for 2019.
Dr Duchowny added: “Having hand grip strength [as] an integral part of routine care would allow for earlier interventions, which could lead to increased longevity and independence for individuals.”
Your nutritional needs have changed as you have become older. Your calorie needs decrease as you get older, but you may need more of certain food groups.
Calories: The amount of calories you need is dependent on how active you are physically. The government defines inactive lifestyles as those in which you only achieve daily living activities. If you exercise for a half an hour or more per day you are considered active. Your level of activity will determine whether you need more or fewer calories than what's recommended if you have been unable to maintain a healthy weight.
Men- an inactive older man needs around 2000 calories per day; if you are active shoot for 2400 calories per day.
Women- Consume 1600 calories daily if you are inactive, 2000 calories if you are an active female older adult.
Now here are some key nutrients you should pay attention to.
Protein- Healthy older men should try to consume 56 grams of protein per day from meat, fish, legumes and dairy. If you are an older female, try for 46 grams of protein daily.
Fiber- A variety of whole grains fruits and vegetables should help you get to the 28 G of daily fiber for an older adult male per day women, strive for 22 grams of fiber per day.
Vitamins and minerals- You are micronutrient requirements increase as you get older eat a variety of whole foods each day to help you meet your vitamin and mineral needs. Try to stay away from processed meals.
Aim for 800 units of vitamin D from fish, egg yolks, fortified foods and supplements everyday.
Production of stomach acid decreases as you age or take certain medications. If this is the case, you may be vitamin B12 deficient, possibly causing depression and fatigue. Supplements and fortified foods, i.e. orange juice, milk and yogurt are usually absorb B12 well.. You also need more vitamin B6 as an older adult. The recommendation is 1.7 mg daily if you are a man and 1.5 mg if you are a woman. Chicken, fish, potatoes and fruit will help you meet your vitamin B6 needs.
For a chart that will help you keep track of your nutritional intake, Click here. USDA Nutrition Chart
If eating food from a box- read the box and watch your sodium intake!
Most people are aware of the link between exercise and better health. So, why are over half of the population not sufficiently active and suffering from preventable health problems such as overweight and obesity?
The answer can be explained by many variables including individual, environmental, and cultural factors to name a few. However, have you ever considered the importance of a persons self-confidence in first, participating in exercise, and second, sustaining it over a period of time to reap the benefits?
Research shows that this factor is essential to successful physical activity behavior change. Self-confidence is a person's belief in their ability to successfully perform a certain task or establish a positive habit to bring about a desired outcome. Importantly, a person's confidence level in regard to performing exercise has been shown to have a significant impact on a persons success in changing exercise habits. A persons confidence level towards successfully performing exercise behaviors can easily be measured by having the person rate their confidence on a 10 point scale, with 1 being the lowest (not confident) and 10 being the highest (very confident).
Why a persons confidence level may be too low to exercise regularly? Example...one may lack the knowledge about what type of exercise could improve their health condition. This may contribute to the individual not feeling confident about exercise participation as they may have reservations about the safety of exercise not being able to participate properly due to their condition.
Some practical ways that seniors can improve their confidence regarding exercise may include:
Asking their doctor for information, training, guidance or referring to an Accredited Exercise Physiologist
Find an exercise class to see how other people, similar to them, have achieved successful results through exercise for example, patients with chronic conditions. An explanation of the small steps that the older adult can take may also help.
Seek to improve your physical or emotional state before attempting exercise. For example, find help to overcome any anxiety you may have about exercise participation.
Next time you intend to participate in a new health behavior, such as exercise, consider the power of self-confidence in assisting you to achieve successful outcomes.
References:
Bandura, A., (2004). Health Promotion by Social Cognitive means.Health education and behavior,31(2), 143-164
Anne Pringle Burnell created and developed the Stronger Seniors™Chair Exercise DVD Video Programs for older adults and people with disabilities, injuries, or chronic conditions. Anne is a national presenter at conferences including IAFC, ATRI, and the National Council on Aging. She authored several articles and created the Peyow Aqua Pilates and Stronger Seniors programs. She holds certifications including ATRIC, CAFS, AI Chi, and is an education provider for AEA, AF, ATRI, ACE, AFAA/NASM, AquaStretch, and an Instructor Trainer for Stott Pilates, Merrithew Health & Fitness. She teaches in Chicago at Galter Life Center, Swedish Covenant Hospital, Peninsula Hotel Chicago, University of Illinois Chicago and private clients at her Pilates studio.
These preventive checkups help you maintain control of your health care
People who have had Medicare Part B for longer than 12 months are eligible for a free wellness exam.
The phrase “there is no free lunch” certainly applies to Medicare. While the federal program pays the lion’s share of medical costs, beneficiaries can still spend thousands of dollars each year on premiums, deductibles, copays and other out-of-pocket expenses.
But the Affordable Care Act (ACA) expanded access to free preventive care, and that included some important Medicare services. Here’s a list of some examinations and screenings Medicare recipients now get for free.
A “Welcome to Medicare” preventive visit. Thisis available only in the first 12 months you are on Part B. It includes a review of your medical history, certain screenings and shots, measurements of vital signs, a simple vision test, review of potential risk for depression, an offer to discuss advance directives and a written plan outlining which screenings, shots and other preventive services you need. This visit is covered one time.
Annual wellness visit. You’re eligible for this free exam if you’ve had Medicare Part B for longer than 12 months. The physician will review your medical history; update your list of providers and medications; measure your height, weight, blood pressure and other vital signs; and provide you with personalized health advice and treatment options.
Stronger Seniors Chair Exercise DVD Videos
Note:While this visit is free, the doctor may order other tests or procedures for which you might have a deductible or copay.
Mammogram. An annual screening mammogram is free. If you require a diagnostic mammogram, you’ll pay a 20 percent copay and the Part B deductible will apply.
Colonoscopy. A screening colonoscopy once every 24 months is free if you're at high risk for colorectal cancer. If you aren't at high risk, Medicare covers this test once every 10 years.
Diabetes screening. You’re eligible for two free screenings each year if you have a history of high blood pressure, abnormal cholesterol levels, are obese or have a history of high blood sugar levels. The screenings will also be free if two or more of these issues apply to you: You are over 65, are overweight or have a family history of diabetes, or you had diabetes when you were pregnant.
Prostate cancer screening. An annual PSA test is free. A digital rectal exam will cost you 20 percent of the Medicare-approved amount plus the doctor’s services related to the exam. The Part B deductible also applies.
Vaccines. Annual flu shots, vaccines to prevent pneumococcal infections such as pneumonia, and shots for hepatitis B (for those at high or medium risk) are covered free of charge.
Note: The shingles vaccine is not covered by Part A or Part B, but it may be covered by your Medicare Advantage (MA) plan or your Part D prescription drug plan.
Cardiovascular disease (behavioral therapy). As a Medicare recipient, you also get a free yearly visit with your primary care provider to help you lower your risk for cardiovascular disease.
Lung cancer screening. An annual test with low-dose computed tomography (LDCT) is free if you are between 55 and 77, don’t have any signs of lung cancer, are a smoker or have quit in the past 15 years, and you have a tobacco smoking history of at least 30 “pack years” (meaning you smoked an average of one pack a day for 30 years).
Depression screening. A yearly screening is free if conducted in a primary care center where follow-up and referrals are available. Copays may apply for follow-up care.
Scientists have shown how lack of exercise takes a much bigger toll on the elderly - in particular, reducing the power of the muscles in their legs. That power is essential for movements such as climbing the stairs - increasing their risk of lack of independence, and isolation, a major cause of premature death.
Eating healthy is a lifestyle choice shaped by many elements, including our stage of life, situations, preferences, availability of food, culture, traditions, and the personal decisions we make over time. All your food and beverage choices count. MyPlate offers ideas and tips to help you create a healthier eating style that meets your individual needs and improves your health. For a colorful visual of MyPlate and the 5 food groups, downloadWhat's MyPlate All About?. There's also a link for Physical Activity.
Resistance band training builds strong muscles and bones while improving seniors' ability to perform daily activities. According to National Institute of Health, regular weight training fights age-related loss of muscle and bone mass. The a government CDC report that resistance training improves balance and reduces symptoms of chronic disease, including arthritis and Parkinson's. Resistance bands are inexpensive, safe, transportable and provide seniors with external resistance during weight training.
The Stronger Seniors® Core Strength Chair Exercise Program is designed by Stott Pilates Instructor Trainer and Faculty Provider Anne Burnell to help seniors develop the core foundation of the body-The muscles of the Abdominals, the Lower Back, and the Pelvic Floor support the spine and internal organs, essential to the overall fitness of the body.
The Core Strength program is based on the teachings of Joseph Pilates, modified for the chair to make Pilates routines easy for Seniors and the mobility challenged.
Resistance Band included with DVD.
Click on the box below to see a preview of 'Core Strength'
Obesity is a significant health problem in the United States, affecting close to one-third of all adults. Although genetics can play a role in the likelihood that a person will become obese, the condition occurs when the amount of calories consumed exceeds the amount of calories expended over a long period of time. Excess calories are stored as fat in the body, and with long-term caloric excess, an individual eventually becomes obese. Exercising regularly and eating a healthy diet are ways in which to combat obesity.
Benefits of Regular Exercise Regular exercise (and proper nutrition) can help reduce body fat as well as protect against chronic diseases associated with obesity. If you are looking for a reason to start an exercise program, listed below are five of the many benefits of regular physical activity.
Exercise lowers risk for chronic diseases Concerned about heart disease? Regular exercise is a proven way to decrease risk for these and other chronic diseases. It will help to prevent or manage high blood pressure. It also raises high density lipoprotein (HDL) cholesterol, known as the “good” cholesterol, and lowers low density lipoprotein (LDL) or “bad” cholesterol. This combination will decrease the amount of harmful plaques that can buildup on your artery walls and keep blood flowing smoothly. Regular exercise can also help prevent type 2 diabetes, osteoporosis, and certain cancers.
Exercise improves your mood Feeling a little edgy? A quick workout will help calm you down! Exercise stimulates chemicals in your brain that make you feel happy and relaxed. It also makes you feel better about yourself and helps reduce feelings of depression and anxiety.
Exercise helps manage weight It’s a no-brainer. Exercise burns calories. The more you exercise, the easier it is to keep your weight under control. But remember that exercise is not a free pass to eat everything in sight! To burn 100 calories, most people need to walk or run about one mile. And one little chocolate M&M candy contains the amount of calories it would take to run or walk the length of a football field! So be sure not to overestimate the amount of calories you’re burning.
Exercise promotes better sleep Having a hard time falling and staying asleep? A good night’s sleep can improve your concentration and productivity throughout the day, and exercise might be the key to getting better sleep. It can help you fall asleep faster and sleep deeper.
Exercise can be FUN Tired of spending your Saturday afternoons watching TV or doing laundry? Looking for an activity that the whole family can enjoy? Get moving! Exercise doesn’t have to be grueling. Take a dancing class, push your kids on the swing, or try something new. Find an activity you enjoy, and have fun with it!
Starting an Exercise Program For obese persons, the focus of the exercise program should be based on low-intensity aerobic activity with progressively increasing duration. Aerobic exercise provides overall health benefits, including fat loss, an increase in daily energy levels, and reduced risk of health problems. At the beginning of the program, the frequency and duration of the activity is more important than the intensity. Aim for exercising four or five days a week for 30 to 60 minutes. If you were previously sedentary, these sessions can be broken up into three 10-minute sessions, with gradual increases in duration.
In addition to aerobic activity, resistance or weight training can also provide some benefits to overall health. Not only does weight training make you stronger, but it also raises your muscle-to-fat ratio, which increases the amount of calories you burn at rest.
Despite all your inclinations to monitor your weight on the bathroom scale, try to resist focusing on weight loss. The body has a tendency to gain muscle or lean weight initially, so although your body is benefiting from the exercise, the pounds might not drop off right away. Focus on the quality and quantity of the exercise instead.
Engage in activity that puts minimal stress on the joints, such as walking, swimming or water exercises, and cycling.
Ease into your workout. Start slowly for the first five minutes to give your body time to adjust to the activity.
Work at a comfortable pace that allows you to talk without too much difficulty.
Focus on increasing duration first, then increasing intensity.
Slow down for the last five minutes to allow your body to ease back into its resting state
Finish with stretching exercises.
Precautions
It is important to gradually increase the duration and intensity of the exercises, while understanding that you will have to build up to longer and more strenuous workouts.
Jogging can cause stress on the knees and joints and is generally not recommended for the obese because of risk for injury. Instead, stick to lower impact aerobic activities until you are in better shape.
Obese people should be especially careful about heat exhaustion given that they are less able to adapt to temperature changes. Wearing light clothing will allow for better heat exchange while exercising.
Hydration is very important for the obese, since they are susceptible to dehydration. Be sure to drink fluids frequently before, during, and after exercise.
Slow down or stop if you experience chest pains, shortness of breath, palpitations, nausea, pain in the neck or jaw, or major muscle or joint pain.
Integrate physical activity into daily activity:
Take the stairs.
Park farther from the door.
Take a short walk at lunch.
Turn off the TV.
Take walk breaks from work.
Wear a pedometer for monitoring your activity.
People don’t just have time to exercise…they MAKE time to exercise. Be in control of your life. Make exercise a part of your day, everyday!
In photos of the sitting Supreme Court, 84-year-old Justice Ruth Bader Ginsburg looks tiny compared to her colleagues, but don't be fooled: She is "TAN," says her personal trainer, Bryant Johnson, and "by TAN I mean Tough. As. Nails."
Ginsburg's health has been a topic of discussion — and concern among Democrats — since President Trump was elected, but it's particularly buzzworthy right now because of a new book by Johnson that's officially out as of Tuesday: "The RBG Workout: How She Stays Strong...And You Can Too!" Also, because Axios reports that Trump expects to have the chance to replace her, commenting to an unnamed source, "What does she weigh? 60 pounds?"
Ginsburg may be more of a judicial heavy than a physical heavy, but once you see her workout, you'll bet on her over Trump in a push-up contest any day. She does multiple sets of full-on, military-style push-ups. She does one-legged squats. She recently started doing planks. She is, it seems, an iron octogenarian.
The workout itself is a balanced, solid routine that includes some cardio, weights and other strength and resistance training, stretching, core work and balance — all kinds of good, evidence-based moves.
Ginsburg gives extensive public credit to Johnson, who has been training her since 1999; he, in turn, gives props to her will of steel.
I asked him how Ginsburg, who has twice survived cancer, can do this workout at 84, and he pointed to her tough-as-nails character, "her resistance, her tenacity."
"I was talking to the justice about this recently," he said in a phone interview, "and I said, 'Well, justice, if nothing else, I hope the message will get out that you're never too old to start working out and exercising the body. So they can't use age as an excuse."
Hear hear, said Dr. Eddie Phillips of Harvard Medical School, the chief of physical medicine and rehab at the Boston VA (and my co-host on the exercise podcast "The Magic Pill.") He said he's especially impressed by how Ginsburg progressed over the last 18 years of training — for example, from doing push-ups against the wall, to push-ups on her knees, to multiple sets of full push-ups.
"What Justice Ginsburg shows is that indeed, you can get stronger at any age — at 65, at 83 — and I suspect, and the science shows, that she'll be doing a workout at 93, and still adding muscle and still adding functional capacity," he said. "It also keeps her mentally sharp, and extends her life."
The good news for people who want to emulate the Notorious RBG but don't love to work out: She does the workout only twice a week.
Exercise researcher Wayne Westcott, director of the exercise science program at Quincy College, has found that working each muscle group twice a week tends to be enough, and is generally as effective as three times a week. And as people age, he noted, they don't recover as quickly.
"So for people over age 50, let alone over age 80, typically we recommend not training the same muscle groups more than twice a week, because they won't fully recover," he said. So if Ginsburg is doing a total body workout, "which she certainly is, twice a week is perfect for her."
Because of Westcott's research, he was not surprised that Ginsburg managed to get stronger even at an advanced age: "Age does not seem to be a factor in responding to the strength-training stimulus," he said, "as long as you get plenty of protein, because old people don't assimilate protein as well."
Asked about Trump's comments on Ginsburg's size, both Westcott and Phillips responded that being small doesn't necessarily mean a person is weak or frail.
It can be a problem when older people lose muscle mass — it's called sarcopenia — or bone. But strength training offsets that process, allowing them to maintain or even gain muscle mass. Westcott's research has found that even people in their 90s can regain several pounds of muscle mass through training.
I have a feeling "The RBG Workout" is going to sell very well — it's an appealing little yellow tome, easy to throw into a gym bag, and all the exercises are illustrated by pictures of Justice Ginsburg doing the moves, with her big glasses, pulled-back hair and big button earrings.
So I asked Dr. Phillips whether he had any cautions or caveats for readers who are maybe starting from a not-so-super-fit point.
"For anyone inspired by Justice Ginsburg, as we all should be, I would say start slow, but start," he said. "Get moving and then progress slowly, and get some guidance just as she did."
The average monthly 2018 premium for a standalone drug plan will be 9 percent higher.
Drug prices can vary from to plan to plan by as much as hundreds of dollars monthly.
As prescription drug prices continue their upward climb, Medicare beneficiaries should pay close attention to the coverage they choose during open enrollment.
During this window, which lasts through Dec. 7, you can choose drug coverage (Part D) either as a standalone plan that serves as a supplement to original Medicare (Parts A and B) or as part of a Medicare Advantage Plan (Part C).
Either way, experts say that while you should ensure that any medications you take are covered, don't stop your search at the first choice meeting that basic minimum.
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"It's really important to compare plans, because they can be very different in pricing and the pharmacies included," said Matt Chancey, a certified financial planner based in Orlando.
Americans spent $457 billion on prescription drugs in 2015, according to recent data from AARP. With Medicare prohibited by law from negotiating drug prices, retirees — whose budgets often already are often stretched thin — face differences in drug prices from plan to plan that can reach hundreds of dollars.
For instance, the Senior Citizens League compared the prices of the top 10 most-prescribed drugs among 23 prescription plans available in one ZIP code.
"The average difference between high and low prices on that particular list was $593 per month," said Mary Johnson, senior policy analyst for the advocacy group.
Malnutrition is seen in varying degrees in the elderly, along with varying vitamin deficiencies. Malnutrition is due to under nutrition, nutrient deficiencies or imbalances. Most physicians do not see frank malnutrition anymore, such as scurvy; but more milder malnutrition symptoms such as loss of appetite, general malaise or lack of overall interest and wellness.
Common nutrient deficiencies of dietary origin include inadequate intake of vitamin A, B, C, D, E, folic acid and niacin. Malnutrition may also be the result of some socioeconomic risk factors, such as the following:
Fear of personal safety (which affects their ability to go grocery shopping)
Financial concerns
Institutionalization or hospitalizations (that do not ensure adequate nutrition)
Clearly, nutrition plays a vital role in the quality of life in older persons. This is why preventative medicine and focusing on good eating habits is crucial. It is recommended to follow a preventative health maintenance nutritional program, such as theDietary Guidelines for Americans, from the U.S. Department of Agriculture (USDA) and Department of Health and Human Services (HHS), which describestwo eating plans:
The USDA food patterns.
The DASH (Dietary Approaches to Stop Hypertension) Eating Plan.
The USDA food patternssuggests that people 50 or older choose healthy foods every day from the following:
Fruits — 1-1/2 to 2-1/2 cups What is the same as 1/2 cup of cut-up fruit? A 2-inch peach or 1/4 cup of dried fruit
Vegetables — 2 to 3-1/2 cups What is the same as a cup of cut-up vegetables? Two cups of uncooked leafy vegetable
Grains — 5 to 10 ounces What is the same as an ounce of grains? A small muffin, a slice of bread, a cup of flaked, ready-to-eat cereal, or ½ cup of cooked rice or pasta
Protein foods — 5 to 7 ounces What is the same as an ounce of meat, fish, or poultry? One egg, ¼ cup of cooked beans or tofu, ½ ounce of nuts or seeds, or 1 tablespoon of peanut butter
Dairy foods — 3 cups of fat-free or low-fat milk What is the same as 1 cup of milk? One cup of yogurt or 1-1/2 to 2 ounces of cheese. One cup of cottage cheese is the same as ½ cup of milk.
Oils — 5 to 8 teaspoons What is the same as oil added during cooking? Foods like olives, nuts, and avocado have a lot of oil in them.
Solid fats and added sugars (SoFAS) — keep the amount of SoFAS small If you eat too many foods containing SoFAS, you will not have enough calories for the nutritious foods you should be eating.
Ensuring adequate nutrition and proper intake of vitamins and minerals will help keep our aging population feeling more vital and ultimately more healthy, thus using prevention rather than intervention.
A new study reveals high use ofdietary supplementsby Americans 60 and older. In addition to their prescription medications, many older people are taking multiple preparations that have not been approved by the Food and Drug Administration.
The study, published in the October issue of the Journal of Nutrition, is based on data gathered by the government’s National Center for Health Statistics. It found that on a daily basis, 70 percent of older Americans use at least one supplement — preparations that include vitamins, minerals, herbs, amino acids, enzymes and other substances. Twenty-nine percent of older Americans use four or more supplements each day.
Multivitaminsand mineral supplements (39 percent) are the most commonly taken preparations, followed by vitamin D (26 percent), omega-3 (22 percent), B and B-complex vitamins (16 percent), calcium-vitamin D combinations (13 percent), vitamin C (11 percent) and calcium-only supplements (9 percent). Nine percent also use various herbal or plant-based supplements.
The researchers found that supplement use tended to increase with age, and that people who took prescription medications were more likely to use supplements as well. Eight percent of older adults take three medications daily and at least one botanical supplement.
That’s potentially worrisome, because some supplements can alter the effects of medications. For example, use of the herbal supplement ginkgo biloba with blood pressure medications could cause a person’s blood pressure to drop too much, and can raise the risk of bleeding for users of prescriptionblood thinnerssuch as warfarin, according to the University of Maryland Medical Center.
The researchers wrote that health care professionals need to carefully monitor their patients’ supplement use. In a study published in 2010, only a third of patients said their doctors had asked whether they used supplements.
The study was conducted by researchers from the National Institutes of Health and Tufts and Purdue universities.
Eating well is important at any age- adequate nutrition is necessary for health, quality of life and vitality. Unfortunately, for a variety of reasons, many seniors are not eating as well as they should, which can lead to poor nutrition or malnutrition, easily being mistaken as a disease or illness.
Our bodies change as we get older, including perceptual, physiological and and general age-related conditions — such as dental or gastrointestinal conditions. These changes all influence the performance of our body as a whole, which in turn, influences our eating, nutritional intake and overall health.
Perceptual Changes
Perceptual changes later in life can also influence our nutrition, such as changes in hearing, smell and taste:
Hearing: Diminished or loss of hearing also affects our nutrition and food experience. The difficulty and frustration from the inability to hold a conversation with our eating partner out at a restaurant or at a social function can limit one’s food experience.
Smell:The loss of smell can also have a huge impact on the types of food one chooses to eat as there is a loss of satisfaction that can lead to poor food choices.
Taste:One of the most common complaints is in regards to the diminished taste in food. As taste buds decrease, so does our taste for salty and sweet — often times making food taste more bitter or sour.
Physiological Changes
One reason nutritional needs change is due to physiological changes that occur later in life:
Energy:Expenditure generally decreases with advancing age because of a decrease in basal metabolic rate and physical activity, thus decreasing caloric needs.
Function:Our bodies also begin to experience a decrease in kidney function, redistribution of body composition and changes in our nervous system.
Other Aging-Related Changes
Other changes in body function may impact nutritional intake, such as:
Dentition:The makeup of a set of teeth (including how many, their arrangement and their condition). The loss of teeth and/or ill-fitting dentures can lead to avoidance of hard and sticky foods.
Gastrointestinal Changes:Chronic gastritis, constipation, delayed stomach emptying and gas, may lead to avoiding healthy foods, such a fruits and vegetables — the food categories that should be more emphasized rather than eliminated.
These factors alone may contribute to why 3.7 million seniors are malnourished and shed light on the importance of educating caregivers and aging seniors as to specific dietary need options, as well as, catered senior diets and nutritional needs.
Basically, it's a stronger flu shot. Four times stronger to be precise.
This flu vaccine could significantly reduce the risk of hospitalization among especially vulnerable seniors, a large, random clinical trial has found.
Vaccines typically don’t work very well in older people—a problem because the flu can lead to serious respiratory infections in frail patients such as elderly nursing home residents.
“…the rate of hospitalization for any reason, respiratory or otherwise, was significantly lower in the high-dose group…”
While a prior study showed that older individuals could respond better to the high-dose vaccine, it focused on relatively healthy older adults, says lead author Stefan Gravenstein, professor at both the Warren Alpert Medical School and the School of Public Health at Brown University.
It still needed to be established that it would help even the frailest folks, like those who reside in nursing homes.
In this study, a quarter of the sample was over 90. DId the high-dose vaccine also work better than regular-dose vaccine in the population we consider least able to respond. This paper says yes, it can.
The study compared hospitalization rates among more than 38,000 residents of 823 nursing homes in 38 states during the 2013-14 flu season based on Medicare claims data. Just under half the homes, 409 to be exact, administered the high-dose vaccine while the other 414 provided a standard dose.
In the end, the hospitalization rate for respiratory illnesses among high-dose patients was 3.4 percent compared to 3.8 percent among standard-dose patients over the six months after vaccination. Statistical analysis revealed that the relative risk of hospitalization for respiratory illness was 12.7 percent lower for the high-dose group.
Moreover, the rate of hospitalization for any reason, respiratory or otherwise, was significantly lower in the high-dose group as well. For every 69 people given the high-dose vaccine vs. the standard-dose vaccine, one more person stayed out of the hospital during the flu season.
“Respiratory illness as the primary reason for hospitalization accounted for only about a third of the reduction in hospitalization that we measured,” says Gravenstein.
For many patients, the vaccine appeared to help prevent hospitalization for other problems also, including cardiovascular symptoms.
Gravenstein says the finding of a significant reduction in hospitalizations was particularly notable because the predominant flu strain during the 2013-14 season, A/H1N1pdm, was believed to be less virulent in older people who had spent a long lifetime building up immunity to similar strains.
“That there was differential protection in this context both underlines the potential importance of even low-virulence or less transmissible strains to older populations and the fact that vaccines may afford relevant effectiveness among frail older persons even when A/H1N1 predominates,” the authors write.
The study did not find a significant difference in the rate of death. Researchers speculate that while the standard-dose vaccine might not have been strong enough to stave off illness entirely, it may still have been sufficient to prevent deaths in combination with hospital care.
But a significant reduction in hospitalizations can still be a benefit, Gravenstein says, even though the high-dose vaccine is more expensive than the standard-dose vaccine. Especially for older, frail patients, reducing otherwise necessary trips to the hospital can maintain a higher quality of life.
Ultimately, Gravenstein says, the study should provide nursing home leadership with useful information to consider as they plan for future flu seasons.
The state of Washington directs 65 percent of its Medicaid long-term spending to home and community-based services rather than to nursing homes.The national average is 41%.
Washington state has realized $4.4 billion dollars in savings over the last 18 years as a result of focusing on this more personal level of long-term care.
Eye problems and disorders are common in the elderly population. Laser surgeries and other treatments exist to correct and even reverse some of these aging-related conditions. The key is to detect them early. Regular eye exams will help detect vision problems before they become serious. Here is a list of common age-related eye problems that can affect people at various stages in life but often affect the elderly.
Your eye has a lens that helps it to focus. The lens is made of protein. When protein molecules clump, a cloudy spot (called a cataract) forms. This is common in older people. Because cataracts grow slowly, your eye doctor may simply monitor a cataract until it interferes with your vision. Cataract surgery is a very common procedure to remove the cataract from your eye. Talk to your doctor about alternatives if you're not ready to have surgery.
Your eyelids have lacrimal glands that produce tears, and they drain into your tear ducts in your lower eyelids. If your lacrimal glands stop working well, your eyes will become dry and uncomfortable. Eye drops can help, but have your eyes checked. There may be a simple procedure to partially plug your tear ducts (to keep tears from draining too fast).
The eye is filled with fluid. If too much pressure develops in the eye, it is called glaucoma.
Over time, this build-up of pressure can damage the optic nerve and cause blindness. Luckily, this pressure develops slowly and routine eye exams can detect glaucoma before it becomes dangerous.
This is a very long term for loss of central vision. The macula is a part of the retina that processes central vision. Sometimes with aging, the macula deteriorates. This causes problems with driving, reading and many common tasks. Treatment can include laser surgery on the macula.
Because of problems with diabetes, the tiny blood vessels that supply oxygen and nutrients to the retina become less effective, which leads to vision problems. Treatment includes laser surgery and a surgical process known as a vitrectomy. All diabetics should have annual eye exams.
The layers of the retina can detach from the underlying support tissue. If untreated, retinal detachment can cause loss of vision or blindness. Symptoms include an increase in the type and number of "floaters" in your eyes, seeing bright flashes, feeling as if a curtain has been pulled over the field of vision, or seeing straight lines that appear curvy. Surgery and laser treatment can often reattach the layers of the retina.
Sources:
National Institute of Aging. Aging and Your Eyes. Bound for Your Good Health. Pages 69-72.
If you are, well, congratulations. If you are planning on signing up for Medicare, here are the 'basic' basics to know before enrollment begins October 15th.
