Aging Parent Hospitalizations and Observation Status

Just when you think that you have settled the most significant adult child-aging parent issues — when you and your parents have spoken about medical care support, finances, and the range of their end-of-life wishes — along comes another concern to worry about, and it’s one that may be completely out of our control.

Medicare ObservationWe now need to be concerned about the possibility of a parent entering a hospital and assigned to observation status for several days. Observation means that, rather than being officially admitted as a patient, the person is there to be watched, sort of like an out-patient, but not really an out-patient. The problem is, it’s difficult to discover what status a hospital assigns a patient  — the two look almost alike with nurses, doctors, hospital rooms, blood pressure checks, etc.  Admission and observation do not look that different to the patient and family, and apparently many hospitals are not especially  forthcoming with the information.

Why is patient status significant? It’s simple, really. If your parent needs to enter a skilled nursing facility or nursing home after three days of observation status, Medicare will not pay and the family will be required to pay all of the bills, including the hospital costs. For Medicare to pay the bills, a family member must be admitted as a patient for at least three days and not assigned observation status.

Over the past year newspapers and medical or health journals have carried stories about elders and observation, and I share them here so that you can learn as much as you can.

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Great Green House Homes Article in Mass General Hospital Publication

Green House Homer MGHAn in-depth article about the Green House Home model appeared in the Fall 2013 edition of Proto Magazine, a publication of Massachusetts General Hospital (MGH) in Boston. The article, The New Nursing Home, by Cathryn Delude, describes the Green House model at the  Leonard Florence Center for Living in Chelsea, MA. The report also goes into considerable detail about the Green House Homes model, quoting Dr. Bill Thomas who came up with the concept in 2003.

The MGH Proto article also includes facts about the cost of building a completely new Green House community and provides an overview of the elder care culture change that is happening in other parts of the country. Author Delude points out that widespread success in culture change may depend on the staffing issues in elder care communities. Factors such as the huge turnover of elder care staff, their low pay, and the way that for-profit facilities maintain a staff that is about a third below the number of people that a non-profit nursing community hires.

Most Interesting Quote from the Article                  Continue reading

Do We Owe Our Parents?

I’ve just finished reading an interesting article, What Do We “Owe” Our Parents?, over on Next Avenue. In the September 12, 2013 online article author Suzanne Gerber discusses the motivations of adult children when it comes to aging parents and caregiving roles and describes a nationwide on-line survey conducted for More magazine, a publication aimed at mature women.

More info graphic

One small section of the info graphics. Read the description of the survey and see more info graphics in the magazine or visit the More website.

Intrigued by the Next Avenue article, an NBC Today Show interview about the survey, and More magazine’s brief on-line description (the full results will not be posted on-line until late October), I purchased the magazine. The most interesting survey result is that 81 percent of the 751 participating men and women say that they expect to help their parents when the time for helping out arrives.                             Continue reading

Should Physicians Ask Fragile Elders About Guns in Their Homes?

Some time ago I read a newspaper article written by an elderly man who was caring for his wife, who had Alzheimer’s disease. He was doing much of her care at home, and his article spoke of their history, how they had met, his family, and much more about their life together. He was sad but upbeat. A few months later, in the same paper I read an obituary for that man who had shot his wife and committed suicide.

The two articles, juxtaposed, made me feel great sadness. It drove home to me just how helpless and depressed people become — especially those who had great control over their lives — when confronted by a family member who has one of the dementia brain diseases.

The July 9, 2013 issue of the Annals of Internal Medicine features a journal commentary, Geriatric Patients, Firearms, and Physicians, recommending that physicians evaluate an elder’s firearms risk just like they evaluate other risks such as driving and living alone. The author, Marshall B. Kapp, JD, MPH, points out that the “use of firearms, has become the most common suicide method for both geriatric men and women.”

The Recommendations in the Article?                Continue reading

iPads for Seniors? My Dad Knows How Cool It Is!

Early on iPad training with my dad.

Early on iPad training with my dad.

iPads for seniors as a way to decrease isolation and stimulate intellectual curiosity?  You bet! After writing over 20 iPad for Dad columns about my dad and his iPad, I could have told them so and my dad can, too.

I know that Steve Jobs was not thinking about seniors in the elder years of their lives when he conceived Apple’s iPad, but it’s the perfect tool for them — lightweight, easy to use, intuitive, connected to a world of resources, and after just a bit of training, it enables seniors to do things that they want to do (check news, watch movies, connect electronically with family members, etc.).

An article in today’s Washington Post (July 14, 2013), Successful Program to Help D.C. Senior Citizens Use iPads to Prevent Isolation Will Expand, that describes a District of Columbia pilot program, funded by the AARP Foundation, that distributed 55 iPads to seniors and offers classes on a regular basis. According to the report, no one has dropped out of the training and no iPads have been lost. Now the program is doubling.

We live in a connected world — in fact we take it for granted. People who do not have access may experience isolation. Moreover, many elders either do not have access to the Internet, or if they do, there’s not get enough training to get started with life’s  technology tasks. As they age into later years, elders are still eager to learn — lifelong learners, actually –  and they can be well served if their adult children or their communities help them gain access to technology tools and entre to the required training.

I’d love to know where else there are other successful iPad programs for seniors.

Google Flu Trends, Aging Parents, Epidemiology and a Few Resources

Flu is here and for the next couple of months or so many of us will need to take precautions to prevent, if possible, getting sick.

Some influenza seasons are worse than others, and this year appears to be more severe than the last few flu seasons. But no matter what year it is, it’s doubly important to help aging parents avoid influenza exposure as much as possible — for elders every season is a severe flu season, and no senior of any age should get very far into the fall months without getting a vaccination at a physician’s office, pharmacy, or local clinic.

Google TrendsToday I went to Google Flu Trends to learn where in the United States influenza is hitting the hardest, and right now this dynamic mapping site indicates that the flu is everywhere. Google collects its data by keeping track of internet searches for symptoms such as fever, headache, or sore muscles. The collected search statistics turn out to be good predictors of what parts of the country are experiencing influenza-like illnesses.

Right now, January 12, 2013, the Google flu map shows that the flu is widespread — almost every state in the U.S. is the same bright read color, indicating that lots of people are sick with the flu and searching to learn more. A user can click in each state to look at the influenza-related searches from there. Click on the map to visit Google Flu Trends. Continue reading