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Medicare Card Scams.... Be Aware! October 16, 2017 11:07


29% of older Americans use four or more supplements each day October 16, 2017 10:52

A new study reveals high use of dietary supplements by 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.

Multivitamins and 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 prescription blood thinners such 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.


Seniors Have Different Nutritional Needs October 05, 2017 20:21

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.

More on malnutrition soon.....


What is the 'Senior' Flu Shot? October 05, 2017 14:07

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.

Nope, the flu vaccine won’t give you the flu

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.


Turning 65 Soon? September 06, 2017 12:26

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.  

Also, you should start browsing Medicare.gov


Is Your Doctor Aware of How Expensive are the Drugs He/She Prescribes? September 06, 2017 12:22

FYI...This is NOT medical advice. Talk to your health care provider.

In 2013, pharmacy benefits manager Express Scripts estimated that the United States wasted $418 billion on “bad medication-related decisions”—with $55.8 billion alone on high-priced medications when more affordable drugs could have been used instead.

Expensive is simply not always better.

Here are ten prescriptions that are usually very expensive, even with insurance. All of them have cheaper alternatives that work just as well.

  1. Vimovo. This is a mixture of the anti-inflammatory naproxen and generic Nexium, which is esomeprazole. Here’s an idea: instead of paying hundreds of dollars for this, get generic naproxen 500 mg tablets and 20 mg tablets of esomeprazole and there you have it: your own Vimovo for just pennies.

  2. Dexilant. This is a very expensive brand-name proton pump inhibitor (a class of drugs that includes Prilosecand Protonix). A number of studies have compared the various proton pump inhibitors to one another and while some differences have been reported, they have been small and of little clinical importance. Do yourself a favor and give lansoprazole or pantoprazole a try instead.

  3. Benicar. Used for high blood pressure, this is an expensive brand-name angiotensin receptor blocker (ARB) in a class that has many generic options. Benicar is certainly no better than the cheaper drugs in the class (valsartan and losartan are examples). Plus, Benicar can produce a “sprue-like enteropathy” which gives you severe chronic diarrhea and weight loss, and can occur months to years after starting the drug. Hmmm.

  4. Vytorin. This is a mixture of simvastatin and Zetia (ezetimibe). Unless you’ve recently had a heart attack, you don’t need to waste money on this and here is why: statins, like the cheap generic simvastatin alone, are the first choice in virtually all patients with high cholesterol in whom the goal is reduction of cardiovascular risk. People have been paying for Vytorin for years and yet it remains “uncertain” whether the combo of simvastatin and Zetia that makes up Vytorin provides additional clinical benefit. A recent study showed benefit in people hospitalized after heart attack but for most people, stick with just the simvastatin part and don’t bother with the combo.

  5. Bystolic. There is no evidence this beta blocker is better than two similar generic options, metoprolol and carvedilol. Bystolic is what is known as a “beta 1 selective” beta blocker used for the treatment of high blood pressure and it does provide a survival benefit in patients with heart failure. Sounds great, right—but wait. In heart failure patients, there are three beta blockers that have shown survival benefit. You guessed it: metoprolol, carvedilol, and Bystolic. Metoprolol and carvedilol are generic and much cheaper so there is no reason to pay money here.

  6. Zafirlukast (Accolate). Though available as a generic, it is still much pricier than the other option in the same class, montelukast (Singulair). There is no proof that zafirlukast is any better than montelukast for asthma, and in fact, montelukast is usually preferred because it is used once daily and can be taken at any time in relation to meals.

  7. Celecoxib (Celebrex). Celebrex, used for arthritis, has just recently become available as generic celecoxib so it’s still quite expensive and many folks pay a high price for it. However, meloxicam (Mobic), another Cox-2 inhibitor similar to celecoxib, is much cheaper and also works well for the treatment of osteoarthritis and rheumatoid arthritis.

  8. Pristiq. This is an expensive brand-name SNRI antidepressant used for depression and fibromyalgia. There is no evidence that Pristiq is any better than the cheaper generic duloxetine (Cymbalta) for fibromyalgia. For depression, there are two generic SNRI options in this class, venlafaxine and duloxetine. You should try those first before paying for Pristiq.

  9. Pataday. These antihistamine eye drops are used for red, itchy eyes related to allergies. Patanol and Pataday are expensive brand name eye drops in this class which includes azelastine (Optivar) as a good generic option that is much cheaper. Pataday carries the advantage of once daily dosing compared to twice a day but is it worth the cost?

  10. Avodart. Two 5-alpha-reductase inhibitors are approved in the US for symptoms related to enlarged prostate: Proscar (finasteride) and Avodart (dutasteride). One is cheap, one is not. In a large one-year study, finasteride and the more expensive Avodart worked just as well for reduction in prostate volume, urinary flow rate and urinary symptom scores, and adverse effects were similar. Don’t waste your money on Avodart when you can save on finasteride.


Talking to Your Doctor About YOUR Healthcare July 03, 2017 08:28

Here are ways to put your priorities at the top of your doctor's agenda..

How do you make sure that your preferences and priorities get on the agenda with your health care providers? And how do you make sure they stay on the agenda beyond a single office visit?  Find out here...  http://www.nextavenue.org/make-care-person-centered/


Eating well, staying Active and Mental Exercises Can Reverse Physical Frailty in Seniors June 21, 2017 12:26

The important message from our studies is that frailty is not an inevitable part of aging. There is much that older people can do for themselves to avoid becoming frail and disabled, so it is vital that they pay attention to good quality diet and nutrition, engage in physical exercise, 

Poststroke exercise – the benefits September 20, 2016 13:06

This review focuses on the benefits of both exercise and cognitive training for stroke patients.

Primarily, increased physical activity had several benefits for stroke patients including weight control, reduced risk of diabetes, cardiovascular disease, arthritis, osteoporosis, cancer and depression.

The authors identified two types of exercise used in post-stroke training; aerobic exercise (AE) to improve cardiovascular fitness and resistance exercise (RE) to improve muscle strength.

Stronger Seniors Chair Exercise Program


SHIP Medicare Program in Jeopardy July 05, 2016 11:16

Would you call a U.S. program that helps 7 million seniors save money on Medicare annually “unnecessary”?

Probably not. But a network of more than 3,300 free Medicare counseling services could lose its $52 million in federal funding due to budget cuts. The State Health Insurance Assistance Program (SHIP) is on a list of more than a dozen programs lined up to get the axe from the Senate Appropriations Committee.

“Duplicitous or unnecessary,” said U.S. Senator Roy Blunt, explaining the rationale. The Missouri Republican probably meant “duplicative” there, but never mind. He is wrong either way. This is one SHIP that definitely should be kept afloat.

Navigating the Medicare program is complicated - more complicated than it needs to be. Over the years, Congress has added coverage options built around marketplaces offering commercial plans. The typical senior selecting a Part D prescription drug plan must choose between an average of more than 20 choices, according to the Medicare Rights Center (MRC). Those who opt for a Medicare Advantage plan must choose from an average of 19 possible prescription drug plans.

That approach is driven mainly by conservative ideology, which holds that the private market can deliver superior efficiency and products. But there is precious little evidence that this approach works in healthcare. Independent studies have shown repeatedly that Medicare enrollees waste money by over-insuring themselves in the Part D program.

A new analysis of hospital networks in the Medicare Advantage program by the Kaiser Family Foundation (KFF) finds spotty participation by hospitals in plans, and that shopping for a plan with a specific hospital in network “can be tough for consumers.” The study also finds that some plans lack access to the highest quality academic medical centers.

Adding insult to injury, the powerful Senate Appropriations Committee recently voted to end funding for SHIPs, which help seniors navigate these messy options. SHIPs operate in all 50 states, plus Puerto Rico, Guam, the District of Columbia and the U.S. Virgin Islands. The local SHIPs have more than 14,500 counselors - 57 percent of whom are highly trained volunteers, according to MRC. (Find your local SHIP here: (bit.ly/1OU0sfN) .)

 

TOUGH DECISIONS

Medicare offers an annual enrollment period during which beneficiaries can shop for new prescription drug or Medicare Advantage plans. During last year’s autumn enrollment period (Oct. 15 to Dec. 7), SHIPs helped nearly 1.1 million seniors, according to MRC data.

Very few enrollees bother to re-shop their coverage annually - but they should. Insurance companies often change their offerings year-to-year in ways that can increase drug costs, or make it more difficult to obtain certain drugs. At the same time, a senior’s drug needs may have changed since the last plan selection period in ways that make a plan less beneficial.

A study by the Kaiser Family Foundation found that, on average, just 13 percent of enrollees voluntarily switched their drug or Medicare Advantage plans - but that nearly half of those who did switch plans saved at least 5 percent the following year, mainly on premiums.

SHIPs also helped nearly 1.3 million low-income seniors with Medicare enrollment last year, according to MRC. Much of that work was focused on options to save money on premiums, such as Extra Help, which often covers up to 75 percent of prescription drug costs (reut.rs/1OXKZ9b). About 1.2 million low-income beneficiaries who qualified for Extra Help were enrolled in higher-cost Part D plans last year, according to KFF - a sure sign that greater outreach and assistance is needed.

SHIPs also help with enrollment in Medigap plans, which help cover gaps in traditional Medicare such as copayments, coinsurance and deductibles. They also can help seniors make sure they enroll on time, avoiding costly late enrollment penalties.

The budget cuts approved by the Senate Appropriations Committee were part of a broader move to increase funding in some areas where dollars are needed. All told, $2 billion would be shifted to the National Institutes of Health, and used to restore year-round Pell Grants for college students, and to increase resources to prevent and treat opioid abuse.

“Our understanding is that some tough decisions were made,” said Stacy Sanders, federal policy director at MRC. “It’s the product of a tight budget environment.”

SHIP funding actually has declined against inflation - spending for fiscal 2017 would be just over $66 million if it had kept up with inflation, according to the National Council on Aging.

A vote by the Senate is not expected until this fall, and the House of Representatives has yet to weigh in. Here is hoping that Congress can somehow right the SHP.

 


Just in Case You didn't Already Know June 17, 2016 15:02

mandyLogo

https://www.medicare.gov/medicare-and-you/medicare-and-you.html?linkId=25372763