MATURE MARKET HEADLINES POSTED 10/23/98
We're Outta Here: Congress Puts Old on HOLD
Has the "get up and go" of Senior Power finally "got up and went"? The nation's most powerful lobby, the elderly, has been "on the ropes" for some time now in their efforts to support the reauthorization of the Older Americans Act. Now it seems they're "out for the count", at least for the time being. Congress has headed for home districts and the campaign trail without reauthorizing the nation's vehicle for providing the bread-and-butter services so needed by America's elderly.
The 105th Congress came to an end as the House and Senate passed the Omnibus spending measure that had delayed adjournment. allowing members to go home for two weeks of campaigning before Election Day, Nov. 3. The Omnibus bill encompasses eight of the 13 regular spending totaling more than $486.7 billion. However, despite bipartisan support, Congress failed to reauthorize the Older Americans Act.
According to James Firman, President and CEO of the National Council on the Aging, which led the two-year drive to re-enact the measure. "We are deeply appreciative of the untiring efforts of those on the Hill, at the White House and across America who went to the mat for our nation’s frail and disadvantaged elderly." "NCOA members will never give up. We will be back next year and we look forward to a renewed effort on behalf of our nation’s elderly," Firman said.
Two-thirds of the Senate – 66 Senators – signed on as co-sponsors of Sen. John McCain (R-AZ) and Sen. Barbara Mikulski’s (D-MD) OAA reauthorization (S. 2295). In the House, there were 185 co-sponsors of the reauthorization measure introduced by Rep. Peter DeFazio (D-OR) and Frank LoBiondo (R-NJ). Their bills would have reauthorized the OAA for three years by extending the current law through 2001.
Ironically, Congressional support for elderly and disabled immigrants, in earlier action, seemed to sail through without a hitch. Doubly ironical was the fact that the earlier action restored benefits to a group of elders who were not even qualified to receive benefits. Here's a bit of history behind that earlier action. Try and figure it out. I can't. On October 8, the U.S. Senate passed H.R. 4558 by voice vote, restoring Supplemental Security Income (SSI) and Medicaid eligibility to an estimated 12,000 elderly and disabled immigrants whom the Social Security Administration (SSA) codes as "not qualified." The House had approved the measure on September 23. The President is expected to sign the bill into law. The law will restore SSI eligibility to all immigrants who were receiving assistance when the welfare law was enacted on August 22, 1996. In the absence of legislative relief, the immigrants would have lost eligibility for income and medical care on September 30, 1998.
If all this sounds a bit confusing, let me sum it up for you. Congress passed benefits for a group who didn't qualify, then ignored the group of elders who dodged bullets in WWII fighting to preserve the freedoms that make America possible. Why would Congress do such a thing? We could try calling Washington, but like I said, they've already enjoyed their Pork dinner, turned out the lights, and gone home. What a welcome party that should be back in the old home district.
See related articles in the AgeVenture archives.
"Elder Power in the 21st Century"
"90% of Elder Depression Goes Untreated"
"Nursing Homes Ignore Many Elders in Pain"
"National Elder Abuse Findings Released"
AgeVenture News Service, www.demko.com
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Elders' High Cholesterol Gets Low Priority
In an era when many physicians believe that elderly patients are overmedicated, a new study in Winston-Salem and elsewhere finds that many elderly patients with high cholesterol levels are undertreated -- even those who had a history of coronary heart disease. Investigators monitoring participants in the Cardiovascular Health Study (CHS) found that less than 20 percent of those eligible for drugs according to 1993 guidelines of the National Cholesterol Education Panel actually got them, said Curt Furberg, M.D., Ph.D., professor and chairman of the Department of Public Health Sciences at the Wake Forest University School of Medicine.
Heart disease remains the leading cause of death for people over 65. Recent evidence suggests that elevated cholesterol levels remain a risk factor for death from coronary heart disease in the elderly in otherwise good health. "Given the clinical trial evidence for benefit, those aged 65 to 75 years and with prior coronary heart disease appeared undertreated with cholesterol lowering drug therapy," the report concluded.
CHS is an observational study. The health of the participants is monitored regularly, and physical condition, lifestyle, diet are recorded, but diagnosis and treatment is left in the hands of personal physicians. The investigators said they did not know why the participants were undertreated with drugs. "We do not know if study participants did not fill prescriptions for cholesterol-lowering drugs that had been written by their physicians and to what extent the lack of treatment reflected patients' choice."
The goal of the study is to learn as much as possible about the lifestyles and the physical condition of the participants at the outset, see how these factors affect the development of heart attacks and strokes, and to monitor changes in lifestyle and physical condition. Earlier this year, the CHS investigators reported in the Journal of the American Medical Association that even in the elderly, changes in behavior patterns can lead to a longer life. That report showed exercise is linked even in the oldest old -- those over 85 -- with a reduced risk of mortality.
The results demonstrated a stepwise progression, with CHS participants using at least 1,800 calories a week during moderate or vigorous exercise having a five-year death rate of 15.5 per thousand, with death rates rising as level of activity fell. The most sedentary, doing less than 57.5 calories of activity per week, had a death rate of 52.1 per thousand -- more than three times.
See related articles in the AgeVenture archives.
"Fewer Heart Surgery Risks for Elderly"
"Cardiac Disease Still A Heart-Breaker"
"Health Clubs To Monitor Member Hearts"
"Gerontologists Seek Longevity Prescription"
AgeVenture News Service, www.demko.com
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Expert Says 80% of Back Pain Heals Itself
"Take two aspirin, and call me in the morning." Every time I've heard that line from my doctor, I've always felt that he was ... well ... just handing me a line. However, some experts are now suggesting that the doctor just might be offering sound, rather than frivolous, advice. At least that's true, say the experts, when it comes to common back pain. Here's why. "Eighty percent of Americans suffer from back pain at some time in their lives", says Dr. Stephen Hochschuler, co-founder of the Texas Back Institute. That's the bad news. However, continues Hochschuler in this month's issue of New Choices magazine, "eighty percent of those (back) problems will heal on their own". That's because 80% of back pain is muscle-related, and most simple muscle strains get better within two weeks. According to Hochschuler, only 5 to 10 percent of those who suffer from back pain suffer chronically, and even if they do need treatment, it is not likely to require surgery. Here's what the Texas Back Institute suggests you do if your back gets "thrown out".
- Get off your feet.
The most comfortable position is lying on your side with your knees slightly bent.
If that's not comfortable, try lying on your back with a couple of pillows under your knees.
- Take over-the-counter medicine when pain strikes.
Try aspirin or ibuprofen, three times a day.
However, while acetaminophen is effective against pain, it won't relieve inflammation.
- Apply an ice pack for the first two or three days.
The ice helps reduce swelling and inflammation, and numbs sore tissue.
Try applying the ice pack wrapped in a towel to the painful area for 10 to 20 minutes every 2 hours.
After a couple of days, you can either continue to use ice packs or switch to a heating pad.
- Start moving around.
Once you get over the initial spasms, start moving around.
Don't stay in bed for more than a day or two.
Regarding the latter point (moving around), physiatrist Julie K. Silver, M.D. of Massachusetts General Hospital says, "Your body likes to move fluidly because it's the way blood gets to the body's tissue". "People who start guarding their movements get very stiff", adds Silver. That's why she recommends staying active. Even if it hurts when you move around, moderate activity will actually help, not harm, your back.
As I reflected on these suggestions for a new approach to back pain, I wondered if Americans had just become a nation of over-reactors. Maybe we call the doctor all too quickly, no matter what type of discomfort we experience. Anything is possible. It could be that 80% of all calls to the doctor for any reason are unnecessary, over-reactions. But, as a dead-hard hypochondriac, I couldn't help but wonder "how will I know if I'm among the 20% who really should call the doctor?"
See related articles in the AgeVenture archives.
"Back Pain Treatment Enlists Acupuncture"
"Scientists Put Screws to Back Pain"
"AGS Launches Pain Management Guidelines"
AgeVenture News Service, www.demko.com
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Back Pain Treatment Enlists Acupuncture
The incidence of chronic low back pain has reached such epic proportions in American society that modern medicine has become very innovative in its search to bring relief to millions of those who suffer. In this case, their search has produced some very interesting treatment results. And the new treatment is a classic case of the old and new, East-meets-West kind of medicine. The new treatment, called Percutaneous Electrical Nerve Stimulation (PENS), combines the ancient Chinese practice of acupuncture with a newer modern medical technique called Transcutaneous Electrical Nerve Stimulation (TENS). Results on the testing of this combined PENS-TENS technique, conducted by anesthesiologists at the University of Texas Southwestern Medical Center (UTSMC) at Dallas, have proved effective in the treatment of chronic low back pain. The rather impressive test results of the PENS-TENS study were reported at this month's annual meeting of the American Society of Anesthesiologists in Orlando, Florida.
If you are among the millions of adults who suffer from low back pain, this new "East Meets West" medical technique will be a welcome addition to modern medicine's back pain treatment arsenal. Especially since the two most common treatment alternatives, oral or injected pain medication, can have negative side effects. These traditional treatments, says principal investigator Paul F. White, PhD, can include narcotic pain relievers that can cause drowsiness and chemical dependence if used over extended periods of time. Other treatments, says Dr. White, aren't much better. For example, the use of non-narcotic analgesics can interfere with bowel and bladder function. PENS, on the other hand, offers "a highly effective supplement to these traditional pain relievers".
The traditional technique for chronic low back pain relief, called Transcutaneous Electrical Nerve Stimulation (TENS), delivers low levels of electrical current to the nerves supplying the affected area. One theory holds that electrical stimulation helps relieve the pain by interrupting pain signals in the central nervous system. Unlike TENS, which delivers electrical current through special pads positioned on the skin surface, PENS penetrates the skin via a series of ultra-fine, acupuncture-like needles. However, says Dr. White, anesthesiologists use Western, not Eastern, principles of neuroanatomy in determining where to place the acupuncture needles.
The UTSMC test study followed 60 patients suffering from chronic low back pain who received 30 minute treatments three times per week for a period of three weeks. Ninety-one percent of the patients rated PENS as the most effective pain reliever. In fact, patients scored PENS significantly higher than other treatment alternatives because PENS proved superior in its ability to improve physical activity, quality of sleep, and the patient's sense of well-being.
"PENS is more effective than conventional TENS or exercise in improving short-term outcome in patients with low back pain," says Dr. White. "Now we need to look at (PENS) long-term effectiveness." For the time being, however, PENS appears to have earned a position as an integral part of a comprehensive treatment plan for chronic low back pain.
See related articles in the AgeVenture archives.
"Scientists Put Screws to Back Pain"
"AGS Launches Pain Management Guidelines"
AgeVenture News Service, www.demko.com
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National Elder Abuse Findings Released
America's burgeoning elder population has affected every segment of the social, political, and economic landscape. Public debate of the issues surrounding the special needs of the approximately 44 million persons in this country age 60 years and over has heightened national awareness and concern. As a result, public policies relating to issues such as retirement security, affordable long-term care, and quality of life are changing to meet the unique needs of the aging population.
Yet, as the public looks toward improving the lives of the elderly, abuse and neglect of elders living in their own homes have gone largely unidentified and unnoticed. The National Elder Abuse Incidence Study has shed new light on this significant problem with the finding that approximately 450,000 elderly persons in domestic settings were abused and/or neglected during 1996. When elderly persons who experienced self-neglect are added, the number increases to approximately 551,000 in 1996. Additionally, the study identified four major themes of elder abuse.
- Women most at risk
Female elders are abused at a higher rate than males, after accounting for their larger proportion in the aging population.
- Oldest old most abused
Our oldest elders (80 years and over) are abused and neglected at two to three times their proportion of the elderly population.
- Abuser is most often a family member
In almost 90 percent of the elder abuse and neglect incidents with a known perpetrator, the perpetrator is a family member, and two-thirds of the perpetrators are adult children or spouses.
- Self-neglect
Victims of self-neglect are usually depressed, confused, or extremely frail.
The National Elder Abuse Incidence Study (NEAIS) was conducted by the National Center on Elder
Abuse at the American Public Human Services Association and the Maryland-based social science and survey research firm, Westat. The Administration for Children and Families (ACF) and the Administration on Aging (AoA) in the U.S. Department of Health and Human Services jointly funded this research.
The study asked the fundamental question: What is the incidence of domestic elder abuse and neglect in the United States today? In public health and social research, the term "incidence" means the number of new cases occurring over a specific time period. The NEAIS used a rigorous methodology to collect national incidence data on what has been a largely undocumented phenomenon, and it provides the basis to estimate the incidence of domestic elder abuse and neglect among those aged 60 and above in 1996.
See related article in the AgeVenture archives.
"Abuse Raises Elder's Death Risk By 300% "
AgeVenture News Service, www.demko.com
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ACHA Supports LTC Background Checks
The American Health Care Association (AHCA) participated in a hearing of the Senate Committee on
Aging on ways to implement a national system for background checks of prospective long term care employees. AHCA was represented by Lee Bitler, director of human resources for Country Meadows Corporation, Hershey, PA., which owns and operates nursing facilities and assisted living residences across the state. Ms. Bitler outlined AHCA's approach to developing a national criminal background check system.
First, Congress must nationalize the nurse aide registries that contain background information on nurse assistants to provide nursing facilities access to other states' registries. Second, the system should be easy to use, inexpensive and national in scope. And third, education and prevention are essential. Bitler also referred to the partnership between AHCA and the National Association of Attorneys General, which was designed to develop relationship that teams the long term care industry and law enforcement on a national level.
The guiding principles agreed upon between the two organizations support the following. (1) Law enforcement, local and federal government, and the long term care profession will work in a partnership towards reducing and eliminating incidences of abuse and neglect in our nation's long term care system. (2) Nursing facilities and other long term care providers should have the ability to conduct criminal background checks and access a national nurse aide registry through an efficient, one-stop-shopping, and inexpensive national criminal background check system that returns results within 24 hours.
AHCA is a federation of 50 affiliated associations, representing more than 11,000 non-profit and for-profit nursing facilities, assisted living residences and subacute care providers nationally.
See related articles in the AgeVenture archives.
"Nursing Homes Ignore Many Elders in Pain"
"Crime Prevention in Nursing Homes "
AgeVenture News Service, www.demko.com
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Shopping for a Nursing Home? Start Here
A new website allowing consumers to compare nursing homes is the latest evidence of federal regulators responding to pressure to improve the nation's nursing homes, says the U.S. Senate Special Committee on Aging. The website from the Health Care Financing Administration (HCFA) lists inspection records for every nursing home that receives Medicaid or Medicare funding -- the majority of the nation's nursing homes. The site, called "Nursing Home Compare," is far from ideal, but is still a tremendous improvement in the presentation of inspection records to consumers, said Sen. Chuck Grassley, chairman of the committee, and Sen. John Breaux, ranking member.
The senators expressed the need for better consumer information at a July hearing as one of many reforms critical for improving nursing home care. Before this website, consumers had to visit each nursing home to review inspection records or request records from the state. "I said in July that we have to let the sun shine on nursing home inspection records," Grassley said. "These are public documents, and they should be available to the public in a useful, readable way. Americans are good consumers. We like to educate ourselves about what we buy. Nursing homes that care for our family members are no exception. This website is a win for consumers." Breaux said, "Many families don't have the time to visit numerous nursing homes to figure out where they should send their loved ones.
The new HCFA Nursing Home Compare site is one innovative resource for America's families. Using the site, families can begin their search for the right nursing home in any state, at any time." The website allows a consumer to review the most recently available inspection records for each nursing home. A consumer can look up all of the nursing homes in a state or search for a particular nursing home by name. In addition to the nursing home records, the site has information about local resources, such as phone numbers for state nursing home inspectors, nursing home ombudsmen and health insurance counselors.
The site will be helpful not only for consumers, but also for hospital employees who work to place patients in nursing homes and nursing home administrators who want to compare their facilities to others, Grassley said. Also, aging advocates could share the information with those who do not have Internet access, he said. However, Grassley cautioned against over-reliance on the site. While the site is useful and welcome, he said, it is limited and should not be the sole basis for choosing a nursing home. Rather, it should provide a starting point for gathering more information, he said.
An example of a limitation is vague descriptions of each problem cited by nursing home inspectors, Grassley said. One nursing home was cited for not meeting the requirement that a "facility environment must be safe, clean, homelike." A user of the site would have to contact state inspectors to find out details and circumstances. The site address is www.medicare.gov/nursing/home.asp
See related articles in the AgeVenture archives.
"HCFA Champions Quality Elder Care in Nursing Homes"
"Market Watch: Nursing Home Trends"
"Nursing Home Therapy Declared Excessive"
AgeVenture News Service, www.demko.com
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