#PROAGING: Republican Budget Realigns Medicare But Ignores Long-Term Care

The dollars needed for Health Care rise faster than inflationThe macro-economics of aging over the next 40 years do not look great: the first Baby Boomers reached the age of Social-Security eligibility 15 months ago, but the crest of this so-called ‘Silver Tsunami’ will not come until about 2030. It will not recede for another couple of decades. The issue is not the number of people so much as the economy’s ability/preparation to deal with the number. According to the Employee Benefit Research Institute, “The baseline 2010 Retirement Readiness Rating™ finds that nearly one-half (47.2 percent) of the oldest cohort (Early Baby Boomers) are simulated to be “at risk” of not having sufficient retirement resources to pay for “basic” retirement expenditures and uninsured health care costs. The percentage “at risk” drops for the Late Boomers (to 43.7 percent) but then increases slightly for Generation Xers to 44.5 percent.”

The combination of retiring Boomers with lengthening life expectancies with a general political trend to cut taxes for all while reducing services only to the poor has meant that the costs of long-term care are growing, while the will to adjust expectations or fund federal programs is shrinking. The FY2013 budget proposed by Senators Rand Paul (R-Kentucky), Jim DeMint (R-South Carolina), and Mike Lee (R-Utah) earlier this month has not much quelled fears of how Medicare will deal with the spread between long-living retired  Boomers and the costs they will impose on an already stressed healthcare ‘system’.

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#PROAGING: Technology Improves Exercise of Body And Brain

Exergaming improves physical and mental fitness - Photo from TheAtlantic.comLast week we introduced an AARP report encouraging the development of ‘Technology for All,’ namely, technology that includes the interests, expectations, and needs of Baby Boomers. Here is an example of how technology makes a common exercise machine that much more interesting and beneficial: a computer screen offering a virtual tour for a stationary biker.

Hans Villarica of TheAtlantic.com presented a report found in The American Journal of Preventative Medicine that brings computer screens and visual stimuli to recumbent bikers in elder-care homes. The experiment was to encourage exercise among residents on incumbent bikes – some used bikes with screens that monitored their effort and presented a ‘tour’ while others simply rode the bikes for the same amount of time.

Not surprisingly, those who got a tour on what the study calls ‘exergaming’ found the experience of exercising more pleasurable. But the long-term study also showed added cognitive benefits of having the tour inspire/follow the exercisers who had the computer addition. As Hans summarizes the study’s medical/statistical conclusion: “Even though there was no difference in exercise frequency, intensity, or duration between the two groups, the cybercycle riders had significantly better executive function than those who used a plain stationary bike. They also experienced a 23 percent reduction in progression to dementia compared to the control group.”

The addition is simple, the technology is not expensive, and the user gets physical, mental, and emotional benefits. What’s not to like?

 

#PROAGING: AARP Explores Benefits & Challenges of ‘Technology For All’

Technology and social media enrich the experience of retirementWith much fanfare, the first babyboomers moved into the official era of retirement last year as they celebrated 65 years of life. They were the first ripples of a ‘Silver Tsunami’ of Boomer retirees who will bring changes to entertainment, to Social Security, medical services, to retirement life. The American Association of Retired Persons (AARP) released a report calling on entrepreneurs, developers, and service providers to take on the challenges of bringing the myriad technologies (some of which were built by the Boomers) to everyone – including those over 50 who want to use those technologies but might need them modified. Is your organization developing its strategy for the near future?

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#ProAging: SM Savvy Encourages Cross-Generational Connection

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With Thanksgiving a mere 36+ hours away (30 of which might be spent in a ticket line or sitting on a runway or hoping the traffic finally gets moving), we are all thinking about re-connecting to family and old friends. That we do so via social networking platforms has become the assumption among the Millennials and the Gen-Xers, whether in the holiday season or not. The social networking demands of these generations encourage them to keep up with the latest technologies as well – not a bad thing for the economy.

What happens to the previous-generation phones and laptops as younger Americans buy the latest-and-greatest? One thing that happens to them is they become ‘hand-me-ups’.

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#Health: Study Shows Advantages Of Conversation No One Wants

Remember Obama’s Death Panels? No, they didn’t exist. But like ‘cooties,’ the scared and the immature just kept repeating that they were waiting to snatch us up. What the Healthcare Reform Bill wanted to institute was the opportunity – nay, the expectation – for families to have regular consultations with their doctors about end-of-life/palliative care that would per force be covered by insurance.

Healthcare Reform became law in the early days of 2010, and we have been litigating it ever since – and no one has found any mention of a death panel. But even requiring insurance companies to pay doctors for these end-of-life consultations has proven to be a political hot potato – even though evidence of their efficacy is mounting.

A report from a group of oncologists from Sweden is the latest study to show the benefits of having a frank discussion about what treatments are working, what are not working, and what options/opportunities the patient has. The abstract of the report, published in the Journal of Clinical Oncology, can be found here (a subscription to the Journal is required to read the full report).

Fortunately, Paula Span of The New York Times discusses the full report and talks with Dr. Gunilla Lundquist, a palliative care specialist at Umea University and lead author of the study. One of the hard truths of the report is that about 70% of people who have that tough conversation about their terminal conditions die at home and among loved ones, in contrast to under 40% who do not have that conversation yet do not die in a hospital.

Paula Span also steps into the cultural and political difficulties of getting such a study done in the US, or even discussing the Swedish report. Instead, we’ll invoke the Bogie Panel to ensure our freedom from everything, except fear.

 

#ProAging: Bringing Ballots To Nursing Homes Via The iPad

iPad as Ballot in Oregon (Not Voting Machine)

When the people of Oregon needed to replace Congressional Representative David Wu this week, the state Board of Elections used the opportunity to develop means to get ballots to older citizens in nursing homes. The traditional means to do so were to send absentee ballots out, but such ballots waste a great deal of payer, any way – and many do not get returned anyway. As we have noted on this blog, the iPad is a convenient and stimulative way  for retired Americans to access information. And now it is being used as a way for retired Boomers and those of the GI Generation to cast their votes.

The iPad was used to present the ballot to the seniors, who could use the touch screen to enlarge sections if necessary and to mark their votes with a touch. When done, the iPad printed the ballot for the senior citizen to mail in or to stuff into a ballot box.

The idea came from local activists, and we see a rare moment of Apple contributing to a nonprofit’s efforts: Apple donated five iPads to the Congressional district, and $75,000 to help develop the software that presented and recorded the ballots.

As of now, the feedback on this small-scale election is largely positive. According to a report on CBS News, election officials stressed the fact that the iPad is not recording the vote, simply offering access to the ballot and assisting the elder Americans’ abilities to mark it appropriately. The question remains, nevertheless, as to how scalable the pilot program is. Oregon officials seem convinced it will work statewide, and they are investing in more iPads and printers: “At $500 each, the state could buy the iPads for about $36,000. Portable printers cost about $50 each, Trout said, or counties can use existing printers from their offices. The cost of software is still unknown. In the last two-year budget cycle, Oregon spent more than $325,000 to maintain accessible voting tools.”

The portability and touch-screen simplicity of the iPad makes it an idea technology to assist citizens cast votes. Perhaps as the technology rolls out to other districts and states, it will inspire greater electoral turnout among the rest of us.

 

#ProAging: Mandated Cuts In Medicare Stifle Expansion Plans

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This past October 1st, the Centers for Medicare and Medicaid Services (CMS) put into effect new regulations concerning the payment or reimbursement of services to skilled nursing facilities and certain types of housing for older Americans. The reductions in payments were targeted at 3-4%. As the regulations were being finalized late this summer, we posted reactions from many facilities saying they would have to cut staff and/or services to comply with the ruling.

How are the cuts now playing out in the planning of elder care in America?

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#Aging: iPad’s Technology Can Draw Out Memories And Skills For Elderly

One stereotype of the elderly and long retired is that they fear new technology. Yet many of the GI Generation and Silent Generation were, in fact, the ones who started the phenomenal research and development in the middle of the twentieth century that give us our hybrid cars and smart phones today. A recent report from the McClatchy-Tribune Information Services demonstrates how the caregivers of these generations are discovering how quickly and happily their clients and patients are responding to the latest mobile technology, the iPad.

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#Aging: Social Networks Bring The World To Seniors

Elderly Woman With A LaptopThe phenomenal growth of social network sites over the last decade or so is beyond repute. But for most of those years the growth came from those of Generation X (late 20s through 40s) and Millennials (born after about 1975) – both of whose members helped build as well as use the technologies of the internet, mobile devices and social networks.

But in recent years, the biggest movers in terms of usage are from the so-called ‘GI-Generation’ – those over 73. According to a recent report from the Pew Internet and American Life Project,

The fastest rate of growth was seen among the oldest generation of internet users, as the  percentage of adults age 74 and older who use social network sites quadrupled from 4% in December  2008 to 16% in May 2010. Use of these services for all online adults in this time period increased from  35% to 61% over that same time period. (p.16; the entire report can be read here.)

What are they doing with their online time?

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Resources For Issues Concerning Older Americans

Online planning for elder careNumerous resources are available online and in print for information about elder care, aging, homes for older Americans, etc. We would like simply to touch on a few that we think are quite valuable, and which we hope you will as well. We would love to hear from you if you have some favorites that are not yet on our radar as well.

We begin with a few online networks, blogs, and resources. The first is the LifeSpan Network based in Columbia, Maryland. The network consists of over 300 affiliated organizations, nursing homes, and health-care providers in the Maryland/DC/Northern Virginia region. The website offers information on products and services (including reviews), a jobs-posting page focusing on work in the health/elder-care economy, and on numerous conferences and events as well. The network has its own annual conference coming up this October 30 – November 2 in Ocean City, MD, for those who want to hear directly from the good people who are a part of it.

But wait, there’s more.

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#Aging: Likely Further Medicare Cuts Hurt Stocks Of Numerous Care Companies

Care for an elderly womanWhile the ‘compromise’ over the debt ceiling was being shouted over, many analysts noted that the world’s stock markets were, at most, simply unnerved. They were not panicked because investors were confident that some kind of deal would be found and default was not really going to happen. What kind of deal drawn up to avoid the default was less important to them than that a deal would be done.

Yet, rather more quietly behind the overall market indexes most of us pay attention to, stocks for nursing-home companies and their service providers have taken a real hit over the last week. What has spooked investors in elder-care services, if the default has been avoided and Medicare was not expressly cut by the deal?

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#Aging: Establishing A Consultancy to Support Baby Boomers Calls For A Long-Distance Run

Brenda Becker of Top-Drawer Resources, LLC

Brenda Becker

We welcome a new contributor to our ranks, Brenda Becker, an aging-services consultant. Brenda’s consultancy connects seniors with the resources they need.

My husband loves to run. It all started, as it frequently does, when the numbers on the scale were a bit higher than he wanted to see. He decided to lose a few pounds, so ten years ago he hit the road and has not stopped since. At first there were short jaunts around the neighborhood, followed by organized running events in Baltimore, and then “destination” runs in New York City, Phoenix, Orlando, etc. Along the way, he learned a lot about how to support his passion. He, along with all seasoned runners, know that a foundation of proper training, healthy eating, and appropriate footwear can ward off injuries so they can enjoy their sport to the fullest.

While starting a new business is rarely seen as a sport, there are many parallels. To go the distance, one must understand the basics, build a solid foundation, work through the pain, set goals, and follow a passion. I didn’t think about my husband’s running obsession when I first created Top-Drawer Resources in early 2011, but now I can see that we are on similar journeys.

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Aging: Bill Thomas – Elderhood Rising: The Dawn of a New World Age (Video)

As a followup to an article written by Dr. Ronch, Interim Dean at the Erickson School for Management of Aging Services (and an MKCREATIVE client) — where he discusses the paucity of Gerontologists in the USA — I thought it useful to post a link to a compelling video presentation made by another Erickson School faculty member, William Thomas, MD, at TEDx San Francisco recently.

In the early 1990′s, Dr. Thomas and his wife Judith Meyers-Thomas developed the Eden Alternative. Dr. Thomas’ groundbreaking work in person-directed care also led him to imagine a new approach to long-term care that became known as the Green House.

In the video, Dr. Thomas argues that a new lifestage might well evolve out of the growing number of baby boomers in our ranks so that the human lifecycle may soon come to be defined as “Childhood”, “Adulthood” and “Elderhood.”

Thomas suggests that the obsession with “Adulthood” is misplaced and that our elders are “disappeared” into retirement communities simply because they don’t fit the model of existence that has been defined for the “rest of us”. One could also argue that relocation is foisted upon many seniors because they are perceived as having nothing “new” to contribute to society, they are “unproductive”, and consume goods to a lesser degree than other members of the community. This argument is false, argues Thomas (as does this blogger).

Thomas suggests that the Baby Boomers will redefine aging in the same way, and to the same extent, that they redefined adolescence and youthful rebellion.

Watch this amusingly presented, but ultimately, sobering talk by the self-appointed ambassador of “Elderhood.”