Fight the flu

“A flu shot is your best protection against catching the flu,” says Randy Bergen, MD, pediatric infectious disease specialist at Kaiser Permanente. The flu virus changes often. The protection given by the flu vaccine only lasts for about a year, so you need to get a flu shot every year, preferably in the fall.

The Centers for Disease Control and Prevention recommends that children 6 months and older, and every adult, get vaccinated against the flu. Children and adults who have a chronic health condition or weakened immune system, adults 65 or older, or smokers who are between 19 and 64 should also get a pneumonia vaccine. When you come in for your flu shot, ask if you need a pneumonia vaccine.

Flu shots are safe and won’t give you the flu .

What to do if you get the flu

1.Don’t ask for antibiotics, which won’t help because the flu is caused by a virus.
2.Stay home to help avoid spreading the flu to others.
3.Wash your hands often and avoid touching your face.
4.Use home remedies or over-the-counter medications, but don’t give any cough or cold products to children 6 years old or younger.
Protect yourself and family

The flu is more serious than the common cold, so do everything you can to prevent it. A flu shot (or nasal spray) is your best defense. The vaccine is safe, won’t make you sick, and generally has few side effects.

The flu virus changes often, and the protection from the vaccine only lasts for about a year. That’s why you should get a flu shot every year, preferably in the fall.

Who should get a flu shot?
The CDC recommends everyone 6 months and older get a flu vaccination every year.

The flu shot helps prevent you from getting the flu and from spreading it to others. Even healthy people can develop serious complications or even die from the flu — so protect yourself and your loved ones by getting vaccinated.

Vaccination is especially important for:

*people 50 years and older
*children 6 months through 4 years old
*women who are or will be pregnant during flu season
*people with chronic medical conditions or weakened immune systems
*people who live in nursing homes and other long-term care centers
*health care workers
*people who live with or care for anyone at high risk for flu-related complications
*Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

Why kids should get a flu shot
Children can spread the flu easily to adults and other children. Getting vaccinated also helps protect infants (who cannot receive a flu shot), pregnant women, the elderly, and people with chronic conditions.

Make sure your children get all recommended vaccinations on time. Check your child’s immunization record.

Flu shots will be available beginning in early fall 2011.  They are available from your health care provider or at local CVS drug stores & local Safeway stores! Do you have a primary care physician to help you if & when you do get the flu? Dr. Thomas Yatteau is a wonderful physician here  in Sonoma County who offers Concierge medicine.

 Dont forget  or delay- Get your flu shot today!

November is National Family Caregivers Month

Every day, more than 65 million family caregivers in the United States fulfill a vital role on the care team. November is National Family Caregivers Month, a great time to honor the family caregivers who devote their lives to caring for senior loved ones.

Family caregivers need support, which is why the Home Instead Senior Care^® network launched Caring for Your Parents: Education for the Family Caregiver^SM. This family caregiver support series addresses senior resistance to care and features a variety of topics such as choosing an in-home care provider, the signs of aging, long distance caregiving and communicating with aging parents. Materials and videos are available at www.caregiverstress.com.  Tell a family Caregiver about this valuable resource.

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

Help family caregivers through holidays

Give family caregivers a gift this holiday season by inviting them to participate in one of the upcoming “Home for the Holidays” webinars. This hour-long informational session provides family caregivers with information on how to help their senior loved ones manage holiday travel, family gatherings, seasonal depression and other issues that can occur during this busy time of year. The webinar will be offered on:

Tuesday, November 15 at noon Central Time

Click the following link to register for this date and time: https://www3.gotomeeting.com/register/316436230

• Monday, December 5 at 7 p.m. Central Time

Click the following link to register for this date and time:

https://www3.gotomeeting.com/register/321591990

The “Home for the Holidays” webinar is the next installment in the Caring for Your Parents: Education for the Family Caregiver^SM support series and is moderated by the Home Instead Senior Care^® network, hosted by the American Society on Aging (ASA) and co-sponsored by the National Family Caregivers Association (NFCA) and the National Alliance for Caregiving (NAC).

The Caring for Your Parents: Education for the Family Caregiver support series is another way Home Instead Senior Care^® businesses across the country are building trust in communities and supporting clients and their families.  

Why Seniors are Moving from Institution Back Home

After living for three years in a nursing home following a stroke, Gail, 78, went through his life savings paying for the nursing home and eventually qualified for Medicaid. He had always wanted to and intended to move back home, but his condition required that he stay in the nursing home. His ex-wife, Sue, and a social worker at the nursing home informed him about a program called “Money Follows the Person” (MFP), which supports efforts to move institutionalized individuals back home.

In 2009, MFP enabled Gail to move into Sue’s house because she is his main care provider. The program allotted $1,500 for home services, modifications to the home in the form of ramps and a handicap accessible bathroom, 16 hours of personal care services each month, and attendance at adult day care each day. Gail’s health has remained steady, he is able to enjoy more of a routine life, and he is able to get the care he needs at home while surrounded by friends and family.

The U.S. Congress authorized the MFP as part of the Deficit Reduction Act of 2005. MFP was designed to assist states in rebalancing their long-term care systems and help Medicaid enrollees transition out of institutions and back to their communities.

Since 2008 when the first senior moved back home through the MFP program, an increasing number of states have been making stories like Gail’s a reality for seniors and others with disabilities. As of February 2011, 43 states and the District of Columbia participate in the “Money Follows the Person Rebalancing Demonstration Program.”  The significance of this program for seniors is found in its intention for establishing a strong foundation of person-centered, consumer-directed, and community-based services. Seniors are receiving the services they need in an environment that is more comfortable for their recovery and/or daily living. Ultimately, the service model is no longer provider-driven and institution-based, but rather it is more conducive to successful living because of the personalized approach. (Centers for Medicare and Medicaid Services).

More recently, with the passing of the Affordable Care Act in March of 2010, the MFP received a boost in funding and a time extension through September 30, 2016. Additionally, the MFP program expanded the eligibility requirements to include anyone who is in an institution for more than 90 consecutive days. The old restriction was anyone who had been institutionalized for six months to two years. The longer an individual has been institutionalized the more likely they are to have relinquished a community residence and it is often more challenging for them to again establish a community residence. Individuals who have been institutionalized for a shorter period of time may still have a home to which they still have access. 

States have their own methods for identifying appropriate candidates for the MFP program. Once identified, the individual has access to the designated funds for their case for a period of twelve months and receives assistance in achieving the needed transition services.

After the program is complete, the continuity of care in each state will vary. Generally, MFP participants may be able to access existing waivers. Participants will continue to be served through these waivers as long as they continue to meet the eligibility criteria.  Therefore, there will not be a lapse in services for MFP demonstration participants. Check with your state on the plans the Medicaid office has in place for the post-demonstration period.
 
Challenges that Affect the Program
While each state handles their grant money from the MFP program differently, each is working to gain foothold in providing opportunities for their institutionalized citizens to regain status as community members. Implementing a MFP program involves comprehensive and extensive planning at the state level as well as collaboration with Centers for Medicare and Medicaid Services. The two main challenges to the success of the program continue to be available housing and accessibility of community service providers.

Housing – The number of residential units available for Medicaid dependents is limited in any case, and states recognize the squeeze that the MFP program places on this issue. More and more states have launched a concerted effort in conjunction with other government agencies such as the U.S. Department of Housing and Urban Development (HUD) to increase their chances of creating and locating safe and affordable housing arrangements.

Examples of what states are doing specifically to address this problem include: Ohio has a housing specialist under the MFP umbrella whose job it is to build partnerships with housing officials. Michigan has 26 housing coordinators throughout the state who identify housing opportunities for MFP recipients (www.kff.org).

Community services – Already stretched thin, service providers who can provide Medicaid supported home- and community-based services (HCBS) are difficult to find. MFP aligns more individuals with service providers, but without enough service providers, the MFP program recipients may not have access to these services. States are working hard to develop HCBS services using MFP dollars because community services are typically more cost-effective compared to institutional care when measured on a per-person basis.

Examples of the most commonly expanded services that states are employing are: case management to coordinate transition; help with home modifications; and one-time housing expenses such as security deposits, use of assistive technology, and transportation (Kaiser Family Foundation). North Dakota has developed a 24-hour back-up nursing service.

All of these efforts are to create more opportunity for community-based service providers that will support the long-term care of seniors and people with disabilities in their homes by providing the care they need.

Successes for Seniors Now and Long-Term
Each year, the numbers of participants transitioning increases as solutions to barriers are identified and significant technical assistance helps states meet transition goals. As of December 2010, almost 12,000 individuals returned to the community as a result of these demonstration programs, with a reinstitutionalization rate of only about 3–4 percent.

The infrastructure that is creating avenues to affordable housing and HCBS continues to be strengthened through plans customized at the state level to provide support for seniors even after MFP is slated to end. This infrastructure is required if states plan to successfully extend the opportunity of transitioning institutionalized individuals for the long-term.

According to the Kaiser Family Foundation, “MFP is likely to continue to help states reorient their long-term services and support systems toward more community-based care. This program in conjunction with other ACA Medicaid policy options has the potential to expand Medicaid home and community-based services for many more seniors and persons with disabilities who desire to live in the community.” Kaiser Family Foundation expects this trend to extend beyond the life of the MFP program demonstration and have a positive long-term impact for seniors.

Resources:
To find out if you are eligible and to apply for MFP, contact the Department of Social Services or related Medicaid office in your state. To get to your state’s official website, most states follow the website address pattern of www.insertnameofyourstate.gov, i.e. www.colorado.gov.

Centers for Medicare and Medicaid Services:
www.cms.gov 

October is National Breast Cancer Awareness Month

Breast cancer is the second most common cancer in American women behind skin cancer.  Seniors are at an increased risk to develop breast cancer, so take time during National Breast Cancer Awareness Month this October to learn more about this deadly disease.  Here are a few facts regarding seniors and breast cancer, provided by the National Breast Cancer Awareness Month website (www.nbcam.org).

• The risk of developing breast cancer increases as a woman grows older, but the risk increases significantly for women age 60 and older.
• Breast cancer is not common in women younger than age 35, but it can occur.
• There is some evidence to suggest young African-American women are at greater risk for breast cancer than young Caucasian women.
• Medicare covers mammography screening every year for female Medicare .  Eligible women and their doctors may not know about this important benefit, so be sure to share this information with your female clients and their families. A series of publications regarding this benefit are available in English and Spanish.
• For more information about Medicare coverage, contact the Medicare toll-free hotline at (800) MEDICARE or the Medicare Web site, www.medicare.gov.

Join the effort to detect Alzheimer’s early

The Home Instead Senior Care^® network has joined the Alzheimer’s Early Detection Alliance (AEDA) in a nationwide effort to educate people about the warning signs of Alzheimer’s disease and the importance of early detection.  The AEDA is a group of corporations, nonprofits and government entities under the leadership of the Alzheimer’s Association dedicated to making a difference in the fight against Alzheimer’s disease.

There is no cure for Alzheimer’s disease and no way to prevent it. Early detection allows those living with the disease – and their families – time to plan for the future. The Alzheimer’s Association created the following list of warning signs for Alzheimer’s disease and related dementias. Every individual may experience one or more of these symptoms in varying degrees:

1. Memory changes that disrupt daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

If you notice any of these signs in your senior clients, contact the client’s family members immediately.

To learn more about the 10 signs of Alzheimer’s disease, contact the Alzheimer’s Association at www.alz.org/10signs or 877-IS IT ALZ (877.474.8259).

Older adults should guard against over-medication and talk with their doctor about the best ways to manage their health.  Companionship is one.

Q.    As a healthy 75-year-old, I’ve managed without much medication all of my life. My children are always trying to get me to ask my doctors about the newest medications on the market. I think less is more. Am I being unreasonable?  

It’s important to check with your doctor first about any medications you should be on. Never stop taking a medication or reduce your dosage without first consulting your physician.

The Harvard Health Letter points out that with a disciplined lifestyle, seven of the most common senior conditions can be managed without medications. If you’re interested in learning how to continue to keep your meds to a minimum, here’s how. If you’re thinking of incorporating any of these, please discuss first with your doctor:

Arthritis: There’s a good chance that losing weight will make arthritis less painful. Combine weight loss with exercise and you may have less pain and more mobility.

Cholesterol: Your LDL level may drop by 5 percent or so if you keep foods high in saturated fat off the menu. Additional soluble fiber may reduce LDL levels as well. So can margarines fortified with sterols.

Cognitive decline: Memory training and other “brain exercises” seem to help healthy older people stay sharp.

Depression: Studies have shown that regular physical activity can have a potent antidepressant effect.

Diabetes: Regular physical activity is a powerful brake on blood sugar levels as well, because exercised muscle becomes more receptive to the insulin that helps it pull sugar in from the bloodstream.

High blood pressure: Losing weight, getting more exercise, and eating less sodium all lower blood pressure.

Osteoporosis: Weight-bearing exercise puts stress on bones, and bone tissue reacts by getting stronger and denser, fending off osteoporotic processes. Extra vitamin D and calcium top the list of dietary recommendations.

Also, don’t discount the importance of companionship to staying healthy. Make sure that you get out often and socialize with friends. You can make a new friend by hiring a CAREGiverSM from Home Instead Senior Care®. The company’s CAREGivers are often seniors like you who could share many of your hobbies and interests.

For more information about the Harvard newsletter, log on to

www.health.harvard.edu/health