By Emily P. Walker, Washington Correspondent, MedPage Today
Published: August 16, 2011

The researchers expected that seniors, when faced with mounting out-of-pocket costs, would switch to cheaper generics. In fact, that was one of the main arguments behind the coverage back when Medicare’s drug benefit was created in 2006. If seniors saw how much drugs cost, they’d be more thrifty consumers and seek out cheaper drugs, some reasoned.

But the current study shows that hasn’t been the case.

Rather than seeking cheaper alternatives to prolong entry into the doughnut hole, some seniors just stop taking their prescriptions once they reach the coverage gap or alter their dosing regimen to make their medication last longer.

The Affordable Care Act (ACA) will eliminate the doughnut hole by 2020 and until then, the law takes measures to help seniors defray the costs of the coverage gap.

For example, in 2010, many seniors received $250 checks in the mail, and this year 900,000 Medicare beneficiaries have already received a 50% discount on prescription drugs while in the doughnut hole.

But until the doughnut hole is truly closed in 2020 “beneficiaries may still be at risk of decreased drug utilization and adverse clinical consequences,” the authors wrote.

“In contrast to blunt cost-sharing approaches such as the coverage gap feature, more nuanced, clinically informed insurance strategies that specifically promote the use of drugs with high benefit and low cost may hold the most promise for governments and insurers seeking to improve the health of their citizens while reining in drug costs,” they concluded.

One alternative strategy, the authors wrote, would be to encourage the use of generic drugs from the outset in order to forestall entry into the coverage gap.

The study was funded through grants from the National Institute on Aging, the National Institute of Mental Health, the National Heart, Lung, and Blood Institute, Robert Wood Johnson Foundation, and CVS Caremark.

The study authors reported a number of conflicts of interest, including that lead study author is a consultant for a company that contracts with the Centers for Medicare and Medicaid Services; another author is a consultant to United Healthcare, which sells Part D plans, and receives research funding from CVS Caremark, Aetna, and Express Scripts, which all have Part D business. Another author worked at CVS Caremark during the study, and CVS Caremark provided funding and data for the study.

 Primary source: PLoS Medicine
Source reference:
Polinski JM, et al “Changes in drug utilization during a gap in insurance coverage: An examination of the Medicare Part D coverage gap” PLoS Med2011; 8(8): e1001075

Caregiving Costs U.S. Economy $25.2 Billion in Lost ProductivityNearly one-third of working caregivers miss at least six work days each year

by Dan Witters

This is part two in a special series of in-depth articles on what it means to be a working caregiver in the United States. Part one revealed the demographics of working caregivers in the United States. Part three will look at how caregivers report spending their time and specifics of who they are caring for.

WASHINGTON, D.C. — Working American caregivers — those who work at least 15 hours per week and help care for an aging family member, relative, or friend — report that their caregiving obligations significantly affect their work life.
 

The majority of caregivers say that caregiving has at least some impact on their performance at work. Based on a five-point scale, where five is a great impact and one is no impact, 10% of caregivers choose five and 44% pick somewhere between two and four.

Additionally, 24% of caregivers say that providing care to an aging family member, relative, or friend keeps them from being able to work more.

Most caregivers also report missing entire workdays as a result of their caregiving responsibilities. Thirty-six percent report missing one to five days per year because of caregiving duties, while 30% say they missed six or more days in the past year.

Overall, caregivers reporting missing an average of 6.6 workdays per year. With approximately 17% of the American full-time workforce acting as caregivers, this amounts to a combined 126 million missed workdays each year. This absenteeism costs the U.S. economy an estimated $25.2 billion in lost productivity per year. Including caregivers who work part time in the equation would cause absenteeism costs to climb even higher.

These findings are from a special survey of Americans who self-identified as caregivers in Gallup-Healthways Well-Being Index surveys throughout 2010. Gallup recontacted those self-identified caregivers and interviewed 2,805 who were also employed at least 15 hours per week for a Pfizer-ReACT/Gallup poll specifically about caregiving. All respondents answered affirmatively to the question, “Do you currently help care for an elderly family member, relative, or friend, or not?”

Most Working Caregivers in Professional Roles

Nearly one-third of all working caregivers are in a professional occupation, with another 12% each in service and management roles. Less than 5% of caregivers work in other professions such as installation/repair, transportation, and construction.

Most caregivers (71%) indicate that their employer is aware of their caregiving status, but another 28% believe that their employer is unaware. Furthermore, an analysis of knowledge of workplace support programs shows that about one-quarter or less of working caregivers have access to support groups, ask-a-nurse-type services, financial/legal advisors, and assisted living counselors through their respective workplaces.

Implications

Many caregivers face significant physical and emotional challenges on a routine basis. Given the significant effect that caregiving can have on workplace absenteeism, business leaders should be mindful of the unique realities that caregivers encounter.

Ultimately, providing an organized support system for these employees may prove to be a fruitful investment for businesses, given the high percentages of working caregivers who would like to work more if they could. Many working caregivers are likely interested in seeking support in work-life balance to help them meet their responsibilities as caregivers and employees alike, and the accessibility to assistance could potentially go a long way toward greater productivity in the U.S. workplace.

Survey Methods
Results for this Pfizer-ReACT/Gallup poll are based on telephone interviews conducted Dec. 28, 2010-Jan. 9, 2011, with a sample of 2,805 adults, aged 18 and older, who self-identified as caregivers and were working at least 15 hours per week, living in all 50 U.S. states and the District of Columbia. Respondents had previously self-identified as caregivers in Gallup Daily tracking surveys conducted throughout 2010 and were recontacted to participate in this survey.

For results based on the total sample of caregivers, one can say with 95% confidence that the maximum margin of sampling error is ±2 percentage points. For smaller groups, such as full-time employed caregivers, the maximum margin of sampling error is ±2.3 percentage points.

Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking.

Samples are weighted by gender, age, race, Hispanic ethnicity, education, region, adults in the household, and phone status (cell phone only/landline only/both, cell phone mostly, and having an unlisted landline number). Demographic weighting targets are based on the March 2010 Current Population Survey figures for the aged 18 and older non-institutionalized population living in U.S. telephone households. All reported margins of sampling error include the computed design effects for weighting and sample design.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For more details on Gallup’s polling methodology, visit www.gallup.com.

Happy Monday Morning!

 As CAREGivers caring for seniors in our community, every day we are reminded of no matter how great or small our acts of kindness or helping helping hands enabling older adults to remain independant in their homes… we can make a difference every day!

Here is another great thing I found in this ever shirking Internet world that I thought I wanted to share with you all today.I hope you enjoy these positive words of encouragement…because there are days we all can use some!

remember you have no idea the impact just a smile can make on a strangers life!

Monday Mojo: Today I Will Make A Difference
 
By Tom Tognoli | July 25th, 2011

This week, I’m pleased to bring to you some “guest MOJO,” from our very own J. Shoop.

J. Shoop as one of Intero Real Estate’s  top producing Area Sales Managers for Western Bancorp, he is also an author, coach, and aspiring professional speaker. His first co-authoring project is set to be released on July 15th, and is available now on Amazon.com!
We welcome J’s insights for this week’s installment of Monday Morning MOJO!

Every day we are faced with a multitude of choices.

In my opinion, one of the greatest freedoms human beings enjoy is the freedom to choose our thoughts. We can choose to focus upon and think about what’s right in our world, or we can choose to focus on what’s not.

One of my favorite inspirational authors, Max Lucado, wrote a book over 15 years ago called “On The Anvil.” The excerpt below is from his book.

Today I will make a difference. I will begin by controlling my thoughts. A person is the product of his thoughts. I want to be happy and hopeful. Therefore, I will have thoughts that are happy and hopeful. I refuse to be victimized by my circumstances. I will not let petty inconveniences such as stoplights, long lines, and traffic jams be my masters. I will avoid negativism and gossip. Optimism will be my companion, and victory will be my hallmark. Today I will make a difference.

I will be grateful for the twenty-four hours that are before me. Time is a precious commodity. I refuse to allow what little time I have to be contaminated by self-pity, anxiety, or boredom. I will face this day with the joy of a child and the courage of a giant. I will drink each minute as though it is my last. When tomorrow comes, today will be gone forever. While it is here, I will use it for loving and giving. Today I will make a difference.
I will not let past failures haunt me. Even though my life is scarred with mistakes, I refuse to rummage through my trash heap of failures. I will admit them. I will correct them. I will press on. Victoriously. No failure is fatal. It’s OK to stumble…I will get up. It’s OK to fail…I will rise again. Today I will make a difference.
I will spend time with those I love. My spouse, my children, my family. A man can own the world but be poor for the lack of love. A man can own nothing and yet be wealthy in relationships. Today I will spend at least five minutes with the significant people in my world. Five quality minutes of talking or hugging or thanking or listening. Five undiluted minutes with my mate, children, and friends.

Today I will make a difference.

I’d like to encourage you to start each day reading aloud the words above. I assure you that you will notice an immediate impact in your attitude, and it will fortify you for the day ahead.

Thank you,

J. Shoop

 ~ so well said! Thank you for sharing your wise words & positive insight  to Tom  Tognoli from Intero Real Estate & J.Shoop of Western Bancorp. Happy Monday everyone!!

I don’t have to tell you that Alzheimer’s is a worldwide epidemic.  Currently, five million people in the U.S. have this disease, and there are more than 35 million globally.  By 2030, those numbers will double, and by 2050, they’ll more than triple.  Last year the worldwide cost of Alzheimer’s was more than $600 billion – if it were a country; it would be the 18th largest economy in the world.  That’s because it costs about four times as much to care for a senior with Alzheimer’s.   And there is no cure in sight, sadly.   

But what occurs to me is that until that cure is found, Home Instead CAREGivers ARE the treatment for Alzheimer’s.  Quality home care is the future.  Home Instead trains our CAREGivers to deliver on that care for your family! Our training program is paramount to your parent’s best quality of life & quality of care.  There is no greater differentiators for hiring a Home Instead CAREGiver we could offer today than our specialized Alzheimer’s program. 

  We have partnered with David Troxel, Dr. Amy D’Aprix and the University of North Carolina at Chapel Hill – to take gathered information and add their expertise to create a training that directly responds to family needs and is custom tailored to our Home Instead CAREGivers.  

If you have a family member suffering from Alzheimer’s and you are looking for some help at home, please visit our web site to learn more about Home Instead CAREGivers or call our office and ask us about our training programs. We’d be more than happy to share our expertize with you. You are not alone, We are your home care & Alzheimer’s Solution!

www.homeinstead.com/sonoma

Monitor your health, and  the health of your family~ with your SmartPhone!

Today you can find an app for just about anything & everything you want for your smart phone. The I-phone now has an app by  FitNow Inc. what allows you to keep track easily of the calories you consume and burn each day. This could be vital information to help you reach your weight loss or maintence goals! It’s a FREE app so go ahead & download it. I just did!

Lose it!  also has an online socail networking  feature that can connect you with “friends” to share your progress & encourge one another along the healthy fit porogram  you have choosen. Hey when life’s this hectic & crazy why not have an app that actuly is good for you! 

 Stay well & live healthy!

Stages of Senior Care
AN EDUCATIONAL SERIES PROMOTING HEALTH & WELLNESS

FRIDAY, JUNE 17, 2011       FROM 1:00-5:00PM
at The Lodge at Paulin Creek
2375 Range Avenue • Santa Rosa, CA 95403

Reception and guided tours to follow program at The Lodge of Paulin Creek

Caring for our seniors has changed almost beyond recognition over the past generation. A few decades ago, there really were only two choices for protecting our parents and other older adults in their declining years: we cared for them ourselves at home , or they went into a nursing home. the choice was clear, but definitely an agonizing one as well.

The task of dealing with all the decisions of caring for either yourselves or your aging parents can seem to be overwhelming. But it doesn’t have to be that way. To help you navigate through this critical time in life,  Paul and Lori Hogan the co- founders of Home Instead Senior Care,  decide to write this book “Stages of Senior Care” to guide families in order to make the best senior care decisions. 

Our wish for you,  is to attend our Free and Open to the public for all Sonoma county residents,  talk on June 17th,2011 from 1pm- 5pm at  The Lodge of Paulin Creek. I hope the information we will provide is the best and  most appropriate senior care for those you love.  As a result your family will have the satisfation of  knowing you did your best for those you love the most!

We have gathered for you 6 Elder Care experts in their fields to dicuss such topics as: Planning for your future, Estate planning, Wills, Trusts,  How to hire a CAREGiver, the 40/70  &  50/50 concepts,  Hospice , Depression and Mood disorders, Difficult situations, and Aging in a Village.

Click on the link below and print out our  flier & place it  on your refridgorator, so you will remind yourself of this Wonderful oppertunity to gather all your inofrmation on all levels of senior care under one roof & in one location!  Hand outs will be given by ALL 6 Experts who will be hosting the Stages of Senior Care Talk. Please stop by and say hello. Hope  to see you there!

click link below to view flier

http://homeinstead.com/392/Documents/HISonoma_StagesofSeniorCare_FINAL.pdf

Wheather you live in historic Petaluma,  Santa Rosa, charming Rohnert Park, Windsor, the Sebastopol countryside or on a vineyard in sunny Healdsburg, you can listen to KSRO radio and Kira Reginato on Fridays from 12:30pm to 1 in the afternoon! Kira hosts gifted, talented & educated experts in Elder Care every week. You can now also hear her Sun. on KFRC too!

 There are archived shows on Podcasts so you dont ever have to miss a beat from Kira. You can even listen to shows I have been on with Kira talking about Home Instead’s ” Be a Santa to a Senior” program, or on how to hire home care, or our LIFECATCHING program and how we care for Alzheimer’s clients in Sonoma County. Below is the list of experts coming on Aprils shows with Kira. Give her a listen!

The Elder Care Radio Show  April 2011 Dear Listeners,    Baby Boomers are becoming senior citizens at the rate of almost 8000 each day!  They are grappling with the prospect of Social Security and when to apply for it, Medicare, and what the future holds for their financial security and social well-being.  April’s guests will discuss options available, steps to take and when, and mending broken family relatioinships to create support system insurance.  I hope you will give yourself a 30-minute break each week to tune in to the live show or to a podcast.  Take good care, Kira Reginato
	Lowell Kepke Deputy Communications Director Social Security Administration    Find out when you’re eligible and how to apply for Social Security.  Social Security is the largest source of income for most elderly Americans today, but it was never intended to be the only source of income after retirment.  Some project that Social Security funds will be drained by 2037.    KSRO 1350 AM:  Friday, April 1, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 2, 8:30 – 9:00 a.m.   Julie BennettHICAP Community Outreach Specialist We’ll talk about Medicare, Medicare D,  supplemental insurance plans, and why you might need one.  HICAP (Health Insurance Counseling and Advocacy Program) provides free and objective information and counseling about Medicare.  Volunteer counselors can help you understand your specific rights and health care options.KSRO AM 1350:  Friday, April 8, 12:30 – 1:00 p.m.KFRC AM 1550:  Saturday, April 9, 8:30 – 9:00 a.m.  Yvonne BaginskiOwner/PublisherBorn to Age Directories   April 16 is National Healthcare Decisions Day.  Yvonne is a senior advocate who publishes widely on caregiving, aging, chronic illness and community resources.  We will discuss the importance of Advance Healthcare Directives, the POLST form, and ways to ensure that your health care wishes are carried out.    KSRO 1350 AM:  Friday, April 15, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 16, 8:30 – 9:00 a.m.  Carol NelsonRetired R.N.Charles NelsonRetired Profesional Handyman  Listeners have heard me refer to my parents on past shows.  Now is their chance to be heard!  I will ask them how they set about their plans for retirement and find out how they now spend their time.  Their open discussion and disparate examples will provide food for thought about “real retirement.”   KSRO 1350 AM:  Friday, April 22, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 23, 8:30 – 9:00 a.m.  Jane IddingsAttorney and Elder Mediator   Cate Griffiths Executive Director RECOURSE Mediation Services What happens when you are in the hospital and the staff asks who they can call to get help returning you home?  Has it been years since you’ve spoken to your son or your sister?  If you are estranged from family, we will be getting advice on how to restore relationships so you have a support system in place. KSRO 1350 AM:  Friday, April 29, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 30, 8:30 – 9:00 a.m.
	About Kira ReginatoKira Reginato, host of The Elder Care Show, is a San Francisco native who has worked with older adults and their families to navigate the challenges of aging for more than 20 years.  She and her guests offer pragmatic advice and create an on-air community where listeners realize they’re not alone in facing the often difficult decisions of aging.  Kira brings insight, a compassionate personality, and humor to subjects that can be difficult to address.As President of Living Ideas For Elders, a consulting and case management firm she founded in 2007, Kira has been active in geriatric care professional associations, serving three years as chair of the Sonoma County Section on Aging, chair of the Petaluma Senior Care Connection, and co-chair of the Bay Area Chapter of the Western Regional National Association of Professional Geriatric Care Managers.  In 2010, the Petaluma Chamber of Commerce presented her with the Award for Excellence in Service to Seniors.
Weekly Downloads and Podcast Archives  Archives of The Elder Care Show are available on podcast at www.lifegcm.com/podcast.  To subscribe for weekly downloads, go to http://itunes.apple.com/us/podcast/the-elder-care-show-kira-reginato/id344595102.

 http://online.wsj.com/article/SB10001424052748703529004576160310708653034.html

When the time came for Kathy Peel’s mother and father to consider moving into an assisted-living facility, Ms. Peel tried reasoning with them, citing examples of friends who were happy they had made the move.

 
Morris and Kathryn Weeks helped write a ‘strategic plan’ before deciding to move to a senior-living community in Memphis.
.When that didn’t work, she took a business approach. Ms. Peel and her husband Bill convened a conference at her parents’ kitchen table in Memphis and helped them write a three-page “strategic plan.” Her parents, Morris and Kathryn Weeks —both retired businesspeople in their late 80s—joined in, talking about their goals and helping list dozens of pros and cons to staying in their home.

Among the pros the family agreed on were the Weeks’ “positive attitude” and desire to share care for each other. But the cons loomed large, including the fact that no family members lived nearby to provide emergency care in a crisis. Ms. Peel had been forced to make 10 trips to Memphis from her home in Dallas in 2009 to help her parents with health problems, from her mother’s heart ailment to her father’s failure to notice her bout with dehydration. Ms. Peel printed the plan, and after mulling it for a few weeks, the Weeks agreed to move to a senior-living community in Memphis.

It’s an agonizing discussion for adult children: whether elderly parents can no longer live on their own. Some 42% of adults between ages 45 and 65 cite the topic as the most difficult one to discuss with their parents, according to a 2006 survey of 1,000 people by Home Instead Inc., an Omaha, Neb., provider of in-home care. And 31% said their biggest communication obstacle is getting stuck in the parent-child roles of the past.

“We take on old family roles,” says Paula Spencer, a senior editor at Caring.com, a caregiving website, and a speaker on elder-care issues. “We don’t want to rock the boat. We’re concerned about parents’ privacy, worried about the consequences, thinking, ‘Maybe Dad will hate me if I move him to assisted living.’ ”

 
Kathryn and Morris Weeks socializing at Town Village at Audubon Park, their Memphis senior community.
.Related
Work & Family Mailbox: Guides For Gap Years
The Juggle
.While many seniors do fine at home, others need long-term care facilities or a home aide. It’s good to start such conversations early, says Paul Hogan, chairman of Omaha-based Home Instead Senior Care, which provides in-home caregivers. A good principle is “the 40-70 rule; if you are 40, or your parents are 70, it’s time to start talking,” he says.

Make time to discuss issues without rushing. Research shows adult children who feel hurried during conversations about their parents’ changing care needs may tend to push them toward the most efficient option, such as getting more help or moving to an assisted-living facility prematurely, rather than taking the time to encourage them to work on staying independent as long as possible.

About 70% of people over 65 are expected to need some long-term care services at some point in their lives, such as help with dressing or bathing, in-home services from an aide or nurse, or care in an assisted-living facility, according to 2008 federal data. More than 40% will spend time in a nursing home. While the average time seniors need help is three years, 20% are expected to need long-term care services for more than five years.

Take time to assess a senior’s entire situation before jumping to conclusions about their weaknesses or desires, says Jake Harwood, a professor of communication at the University of Arizona, Tucson. A parent whose husband dies may suddenly seem unable to care for herself, failing to clean the house or keep up with bills. But the bereaved spouse may simply need more contact with friends and social support to get motivated again.

Also, adult children sometimes misunderstand parents’ reluctance to move, says Kenneth Robbins, a clinical professor of psychiatry at the University of Wisconsin in Madison. “They may resist leaving the house because they think their kids and their grandkids are going to miss the house,” or they fear that a close neighbor will be left alone, says Dr. Robbins, who is also a senior medical editor at Caring.com. Seniors also may fear having to leave cherished belongings behind or being unable to make friends in a new setting. And some see leaving their homes as an acknowledgment of their increasingly frailty—and mortality.

Robin Joy, of San Francisco, says she helped her widowed mother Gail, 77, hire a professional organizer after figuring out that cleaning out the family’s Evanston, Ill., home of 30 years was an obstacle to her moving. Gail says she put her name on a retirement home’s waiting list, but passed up a couple of opportunities to move in because the need to sort through all the papers and belongings “seemed overwhelming.”

The organizer has since helped Gail get stacks of papers and stuff under control, and she is planning to move soon.

Dementia, of course, raises added issues. People with dementia may “no longer be able to make decisions in their own best interests, and they begin to misinterpret what other people are trying to do for them,” Dr. Robbins says. Seniors with dementia may become paranoid, depressed, or so confused that “life becomes a minefield of dangers,” he says.

Appealing to a parent’s values can help in such cases. Barbara Meltzer of West Hollywood, Calif., says that when her father died several years ago, her aged mother, who was living in Florida and had dementia, resisted Ms. Meltzer’s plea to bring in a home health aide. The aide “would call and say, ‘Your mother sent me home,’ ” Ms. Meltzer says.

So she turned the conversation with her mother to, “Please do it for me, Mom, because I’m worried about you.” She also mentioned to her mother that allowing the aide to stay helped her by providing a job. “That worked, because my mother was a giver. She was Mother Earth. With her, it was always about helping somebody else,” Ms. Meltzer says.

Eventually, she used the same approach to persuade her mother to move to California to live near her and other family members. “We love you so much and it’s important to us that you’re here,” Ms. Meltzer says she told her. Her mother lived nearby for several years before dying last year at the age of 93.

Meanwhile, Kathy Peel’s parents have moved into Town Village at Audubon Park, an independent senior living community in Memphis. The pros and cons in the plan they compiled with Ms. Peel and her husband have proven true. Ms. Peel travels often to see them, and the Weeks are considering moving again in the future, to Dallas, to make it easier for the Peels to help them out. “They have realized they really do need us,” Ms. Peel says.

Each week or so, we feature a senior living retirement community in Sonoma County.  This week we are showcasing the Varenna at Fountaingrove, a gated retirement community in Santa Rosa.

If you are looking for the ultimate in retirement communities, consider visiting the Varenna at Fountaingrove, located at 1401 Fountaingrove Parkway, Santa Rosa, CA 95403.

It is, in a word, luxury. The surroundings are gorgeous, the grounds resort-like.  Residents can enjoy a heated outdoor swimming pool and Jacuzzi outside, and the main building, a 75,000-square-foot complex called the Villetta, offers a private movie theater, fitness room, spa, business center and much more. 

It’s like being on vacation, only you get to live there.

Varenna is nestled inside of 29 peaceful acres in Sonoma County. It’s gated for security and showcases a complex of Mediterranean-style buildings.  Residents are also minutes from local shopping, world-class medical facilities and vibrant cultural and recreational venues.

Apartments at Verenna feature high ceilings, large kitchens, decks or patios, and range from 850 to 3,400 square feet. Assisted living and dementia care services are housed in a separate building and are available on a priority basis – offering residents a certain peace of mind for the future.

Oh, and did we mention there is 5-star dining, along with Bubba’s Lounge for more casual nights out?

For more information, call the Varenna at 707.623.1916. You can also follow this link to request a brochure.

And, for more information on how Home Instead Senior Care can help keep you or a loved one living independently at home, wherever home may be, please call us in our Sonoma County home care office at 707.586.1516. You can also take a look at our website, or view our digital brochure here: http://hisc392.digbro.com/.