Posts Tagged "elderly"

Medicare to Cover 3 New Dental Procedures

“Is it medically necessary for a person to be able to chew?” Dr. Lisa Simon, a physician and dentist at the Harvard School of Dental Medicine, asks.

This is a serious question for older Americans in fragile health. I know a 93-year-old man whose teeth problems make it extremely difficult for him to eat meat and many other foods on the dinner table.

Two-thirds of retirees do not have dental insurance, which means they may decide to forgo getting expensive dental care. The importance of dental care to nutrition and health is also an equity issue for older Blacks and low-income retirees, who are more likely to be missing all of their teeth.

Medicare has historically paid for very few dental procedures. But the Centers for Medicare and Medicaid Services has expanded its existing, limited coverage to include treating patients who have oral infections prior to an organ transplant and patients who need a cardiac procedure or treatment of head and neck cancers.

Simon, who advocates for integrating dental care into overall medical care, argues in the journal Health Affairs that Medicare’s expansion of coverage for medically necessary procedures does not go far enough.

“These provisions are an overly narrow interpretation of what makes a health care service          ‘necessary,’ ” Simon writes.

She lists several examples of medically necessary conditions that don’t seem to fit Medicare’s updated definition. They include cancer patients who have oral inflammation during chemotherapy, diabetes patients with periodontal disease, and elderly women being treated for osteoporosis with injections that put them at risk of painful jaw deterioration. …Learn More

Connect with a Senior During the Holidays

Hannah Boulton defies the stereotype of the lonely retiree longing for companionship during the holidays. But after two-plus years of a pandemic, even this dynamic former nurse who’s lived on three continents started feeling a little isolated.

Ally Brooks and Hannah Boulton

Ally Brooks and Hannah Boulton

Then she met Ally Brooks, a high school senior, through the Sages and Seekers program at the senior center in Duxbury, Massachusetts, in September. The program, modeled on a national nonprofit’s workshop, paired up seven retirees with seven high school seniors. It was such a success – the program was Boulton’s’ idea – that a second one is planned in January for a new crop of seniors.

The 76-year-old Boulton and Brooks bonded immediately over their love of travel. Boulton shared her adventures, having lived in Okinawa during the Vietnam War, where her first husband was stationed, and in Karlsruhe, Germany, where her second husband worked.

And she encouraged Brooks to follow through with a plan to apply to four colleges in England and Scotland, including, coincidentally, one that Boulton’s late husband had attended. “I was so excited for her, and of course I’ll visit her” in college, she said. “I just feel like we’re connected.”

Participants in the Sages and Seekers program

Participants in the Sages and Seekers program

Chris Coakley, who manages the volunteers for the Duxbury senior center, said the Sages and Seekers program fulfilled its goal of easing the isolation she saw was affecting the town’s older residents.

A significant minority of older Americans in various surveys have said they are lonely, and the pandemic only heightened that feeling, which already existed for reasons ranging from hearing loss to struggles with the death of a spouse or a chronic illness.

The pandemic, Coakley said, made the center’s staff realize “how important it was to have connections.”

So consider taking the initiative yourself to reach out to an older family member or neighbor. Invite someone for a meal during the holidays or drop in for a visit.

It takes a little work. But the effort will make a difference. …Learn More

Low-Income Retiree Gets Financial Coach

Every state should have what Delaware has: a program that helps low- and moderate-income seniors find a financial survival strategy.

Stand by me logoSince it opened in 2013, the program, Stand by Me 50+, has connected more than 2,300 older residents – mostly retirees – with federal and state aid programs, advised them of Social Security’s rules, and helped them pay medical bills or eliminate debt. The services are free.

Kathleen Rupert, a financial coach and head of the organization, helped one man in his 70s pay off $13,000 in debt. Another retiree doubled his income from Social Security after she determined that he was eligible for his late wife’s $1,700 benefit. About 44 percent of the program’s clients have monthly income of $1,500 or less.

“We go wherever the need is – to senior housing, senior centers, community centers, libraries,” she said. “We set up appointments at Panera Bread or Hardee’s – wherever they’re available.”

Squared Away interviewed three clients who said the financial solutions they got from the program have given them peace of mind. Here is the first client’s account of how Stand by Me 50+ helped her.

Peggy Grasty with great granddaughters, Aaliyah Gale and Quamiylah Sease.Peggy Grasty with great granddaughters, Aaliyah Gale and Quamiylah Sease.

Peggy Grasty retired in 2010 after two decades at Elwyn, a non-profit social services agency where she was a supervisor and worked with people with mental disabilities. She continues to help people – voluntarily. The 71-year-old takes other retirees under her wing who need assistance because they have trouble walking or aren’t as capable as her.

She initially contacted Stand by Me because she couldn’t make ends meet. She has a comfortable, federally subsidized apartment in Wilmington, Delaware. But her income is limited to a $1,500 Social Security check and a $53 pension from a job long ago waxing floors and driving a bus for a Pennsylvania middle school.

Stand by Me got help for Grasty through two programs: federal SNAP food stamps and a Delaware non-profit that pays low-income residents’ medical bills. By doing this type of work, the program addresses a real need. Although myriad financial assistance programs are available for low-income workers and retirees, they are frequently unaware of the programs, assume they don’t qualify, or may need help navigating the application process. …Learn More

Nursing Home Staffs’ Vax Rates by State

One in four of the more than 900,000 Americans who have died from COVID resided in nursing homes. Yet two years into the pandemic, hesitancy about protective vaccines persists in the facilities in many states.

In January, the Supreme Court upheld a regulation by the Biden administration that required all staff to be vaccinated in long-term care facilities that receive Medicare or Medicaid funding, which is pretty much all of them.

But a newly released rundown of state vaccination rates may not provide much comfort to vulnerable elderly residents and their families living in Ohio, Oklahoma, and Missouri, which rank at the bottom – only about 70 percent of nursing home staff were fully vaccinated as of Jan. 30, according to the Kaiser Family Foundation. The national average was 84 percent.

The highest vaccination rates – 99 percent of staff – were in Massachusetts, Maine, New York, and Rhode Island.

Kaiser’s vaccination rates were calculated based on the staff working in 10,600 U.S. nursing homes who’ve received two doses of the Pfizer or Moderna mRNA vaccines or one shot of Johnson & Johnson’s traditional vaccine. The rates exclude booster shots, which are not part of the federal mandate. The nationwide booster rate for staff, which Kaiser provides separately in its report, is a low 28 percent – the Hawaii, New Mexico and California rates are double that.

A partial reason for the wide range of vaccination coverage is that states have different deadlines for complying with the federal mandate – some were in January and some are in February. But numerous states, including Louisiana, Tennessee, and Virginia, have low vaccination rates because they are, despite the Supreme Court ruling, seeking other legal avenues to challenge the mandate.

The size of a state’s population of people over 65 doesn’t seem to have much bearing on vaccination rates in nursing homes. …Learn More

Thinking ahead roadmap logo

How to Pick (or Be) a Retiree’s Financial Ally

If you need help managing your finances in old age, it’s a lot of work to find someone – and not a very pleasant task to think about.

But it’s crucial that retirees plan for this. As to when or whether you might need help, it really depends on your individual circumstance.

Attorney and researcher Naomi Karp cites a variety of studies that provide some clues to the different ways this process can play out. People who develop dementia obviously need what she calls a financial advocate. This might be a trusted friend, family member, lawyer or professional financial adviser.

But roughly a third of aging Americans who are experiencing natural cognitive decline are prone to making poor decisions about their money, she explained during a recent webinar sponsored by the federal Consumer Financial Protection Bureau (CFPB) where she used to work.

Financial acumen actually peaks well before retirement – at 53! – but wisdom makes up for some of that, she said. During one’s 70s and 80s, financial literacy declines, but unfortunately confidence about one’s abilities remains high. “That’s a risky situation,” Karp said.

She and other financial experts have put together an interactive website the Thinking Ahead Roadmapwith six steps to follow to find an advocate. Each step has tips, tools, and information to guide you through the process. An adult child or caregiver could also use this website if they feel the need to assume more responsibility for an elderly parent’s finances. …Learn More

Elderly lady looking out the window

Caregivers Lament Elderly’s COVID Isolation

The magnitude of the tragedy is unfathomable: Americans have lost nearly 187,000 family members living in nursing homes to COVID-19.

Even when residents survive outbreaks in the facilities, their family caregivers experience trauma. Barred from visiting residents during the lockdowns, caregivers observed – on Zoom, over the phone, or from the other side of a nursing home window – loved ones suffering from the devastating impact of isolation.

“To think in her final year[s] when she is most vulnerable and most in need of love and support from her children and was denied this for 6 months is in my opinion devastating,” one caregiver said in a survey of 518 caregivers, the vast majority of them women and mainly daughters.

Granted, nursing homes – and the entire country – were not prepared for a once-in-a-century pandemic that has been difficult to control, given that COVID-19 is often asymptomatic. The lockdowns were a health precaution. Many nursing homes were also put in an untenable position when COVID-19 created staff shortages as nursing assistants and other workers took time off after contracting the disease or simply quit their jobs. And perhaps better communication between nursing home staff and family members would have eased some of the concerns.

Nevertheless, the caregivers’ perceptions of what unfolded inside nursing homes are alarming. “Anger,” “helplessness” and “heartbreak” were common reactions, conveyed in the survey compiled in the Journal of Aging & Social Policy.

The situation became so untenable for 30 of the caregivers surveyed that they pulled their parent or family member out of a facility and brought them home to live with them.

Four themes pervaded their descriptions of what their loved ones were going through: social isolation, cognitive and emotional decline, inhumane care, and a lack of oversight at the long-term care facilities.

The source of many caregivers’ concerns were nursing homes’ decisions to confine residents to their rooms to prevent contagion. But one caregiver said that while her mother’s facility went to great lengths to keep her healthy, the staff did little to ease her isolation: “Almost no effort has been made to ensure [her] mental health due to the isolation. Staff rarely stay and visit with Mom, no special in-room activities or stimulation has been attempted.” …Learn More

Retirees Can’t Afford Hearing, Dental Care

Hearing loss can amplify cognitive decline by isolating retirees and forcing them to divert precious brain power to participate in a conversation. People who lose teeth have trouble eating, sacrificing their health. And poor vision, uncorrected by cataract surgery or the proper magnification in eyeglasses, is dangerous when driving at night.

These problems are facts of aging. But Medicare doesn’t cover their often-expensive solutions such as hearing aids, dental implants, or eyeglasses. A report by the Kaiser Family Foundation identified a gap between need and access is wide.

Among the 16 percent of Americans over 65 who said in a survey that they couldn’t get hearing, dental or vision services, nearly three out of four couldn’t afford them.

Three charts, based on Kaiser’s analysis of the survey data, show the average out-of-pocket spending for hearing and dental care was around $900 for the Medicare beneficiaries who used the services in 2018. The cost of vision care was significantly less, averaging $230.

Retirees usually don’t need all three services in a single year. For example, dental implants cost thousands of dollars, and an individual might get one or two in a lifetime. But when retirees do get the expensive dental care, a new Kaiser report shows the bill can really pack a wallop – and become an obstacle to getting the necessary care. …Learn More