Growing old in America can be wrought with legal problems arising from health concerns, long-term care, and the need for appropriate housing.
The good news is that there are tools and products and strategies that older Americans can use to live as well as possible in the last decades of their lives.
So, what are some of the more common problems older Americans face, and how might they solve or at least alleviate them?
Who will make decisions for you when you are no longer able to make them yourself? According to Bernard Krooks, a partner with Littman Krooks and chair of that firm’s elder law and special needs department, the best way to address this problem is by searching for and retaining a certified elder law attorney who can draft the appropriate documents that you’ll need, including durable power of attorney, advance health care directives and the like.
A change in a Medicaid waiver reimbursement system for the state’s special-needs population has left some health providers without enough funding to sustain their services.
Changes to the home- and community-based services waiver — which affects approximately 5,000 Iowans who have traumatic brain injuries, developmental or intellectual disabilities — moved the payment model from a fee-for-service model to a tiered rate system, effective Dec. 1, 2017.
While Iowa Department of Human Services officials say this change will create more stability to the reimbursement system, it leaves some such as Jean Sturtz, who care for those covered by the waiver, concerned for their loved ones’ future.
A new report from the National Academies of Sciences, Engineering, and Medicine examines to what extent and in which ways health care utilization — such as in-patient hospitalizations, emergency department use, and hospital readmission — reflects disease severity, disability, and ability to perform gainful activity. The committee that conducted the study was unable to find an association between health care utilization and disease severity as it relates to the Social Security Administration’s (SSA) determination of severe impairment — an impairment or combination of impairments severe enough to prevent a person from performing any gainful activity regardless of age, education, or work experience.
Types of health care utilization vary with combinations of health conditions, and although there might be a connection between some types of utilization and impairment severity or disability, the committee could not make that specific connection on the basis of available data.
The SSA administers two programs that provide benefits based on disability. The Social Security Disability Insurance (SSDI) program provides disability benefits to people under the full retirement age who are no longer able to work because of a disabling medical condition or a terminal illness. The Supplemental Security Income (SSI) program is a means-tested income-assistance program for disabled, blind, and aged people who have limited income and resources regardless of their prior participation in the labor force.
“Edith + Eddie,” a short documentary vying for an Academy Award Sunday, is a gripping look at a couple in their 90s caught up in an intense family conflict over caring for an aging parent. As a columnist who covers aging, I’m familiar with such stories. But as I immersed myself in the details of this case, I found myself reaching a familiar conclusion: real life is more complicated than in the movies.
On my first viewing, the events depicted in the 29-minute film were unsettling. It begins in the fall of 2014 with Edith Hill, 96, and Eddie Harrison, 95, who were married only a few months before, enjoying a series of intimate moments — dancing together, holding hands, exercising and chatting comfortably. It ends months later with the couple being separated by Edith’s court-appointed legal guardian, with police on the scene, and Edith taken off abruptly to Florida. Shockingly, Eddie died only a few weeks later.
For people living with both Type 2 diabetes and heart failure, taking an aspirin each day appears to lower the risk of dying or being hospitalized for heart failure, according to research being presented at the American College of Cardiology’s 67th Annual Scientific Session. But the data also reveal aspirin use may increase the risk of nonfatal heart attack or stroke, a somewhat contradictory finding that surprised researchers.
The study is the first to assess aspirin as a preventive measure for patients who have both diabetes and heart failure. Aspirin, a blood thinner, is strongly recommended for patients who have previously had a heart attack or stroke, but guidelines are unclear regarding its use as a preventive measure for patients who have cardiovascular risk factors but no history of heart attack or stroke. Previous studies in people who have not had those types of health events have shown conflicting evidence of aspirin’s potential benefits in the general population. In patients with heart failure, some studies suggest a daily aspirin may even be harmful.
About 27 million people in the U.S. have Type 2 diabetes and about 6.5 million U.S. adults have heart failure, a condition in which the heart becomes too weak to pump enough blood to meet the body’s needs. Each condition is associated with an elevated risk of cardiac events, including heart attack and stroke. This study sheds new light on the potential risks and benefits of aspirin for people with both conditions.
Helyn Guerry, 88, of Houston, looks around her room but struggles to make out the objects directly in front of her. Macular degeneration, a common eye condition among older adults, seriously blurs her central vision.
Driving is no longer possible for Guerry. Fortunately, she has a support system in place. “I have a grandson who’s very near and dear, and he comes once a day,” she says. He helps her catch up with paperwork and takes her to the grocery store because she can’t read labels now. She also has occasional professional help from an aide who accompanies her on visits to the doctor.
Guerry can’t read print books anymore. When she recently picked up her Kindle, she noticed her eyesight had deteriorated a bit more. Now she uses a machine that reads books aloud. Fortunately, she says, her hearing is still good.
Even though we would like to think we can, it’s impossible to handle all of life’s nuisances on our own. In fact, many of history’s most successful people attributed their successes to knowing when to seek the help of others. This goes for all areas of life whether it be business, education or dealing with a problem. For me, dealing with a major problem is where I finally learned this significant life lesson.
Trying to always handle things myself, I came to a road block when a huge problem arose within my family. After recently putting my grandmother in a nursing home, she made us aware that things really weren’t going so well. She was complaining to us that the food seemed to be making her sick. My family and I shrugged her complaints off for a while and just thought she was being dramatic and trying to get taken out of the home. However, as time went on, we realized that she was right. She looked worse than ever, seemed a lot thinner and didn’t have much energy. The staff started to give her more medications to help her stomach which ended up having a whole host of negative side effects.
Numbers are important to Jan Sirota, a retired investment banker who lives in Sarasota, Florida. Sirota just celebrated 11 years of marriage, he cycles 40 miles per day, mentors four high school students and races cars 150 miles per hour in High Performance Driver Education events. The number that doesn’t seem to matter? His age.
“I’m 75, and it’s irrelevant to me,” Sirota says. “There’s no reason to say that I’ll slow down because I’m getting older.”
Many older adults do slow down, however, when faced with chronic disease, disability or isolation. So why is it that some people, like Sirota, can escape that fate and live vibrantly later in life? “Certainly genetics play a big part in this, and then of course luck. However, I don’t want anyone to think we can’t fight destiny a little bit,” says Dr. Patricia Harris, a geriatrician and professor at the David Geffen School of Medicine at UCLA.
February is American Heart Month. According to the American Heart Association, approximately 85 million adults (greater than 1 in 3) have cardiovascular disease; more than 43 million adults age 60 and older are impacted. Additionally, about two-thirds of cardiovascular disease-related deaths occur in people age 75 and older.
With support from the Administration for Community Living (ACL), organizations across the country are offering proven programs to help people better manage chronic conditions such as cardiovascular disease. Since 2010, more than 340,000 individuals have participated in chronic disease self-management education (CDSME) and self-management support programs. More than 60% of participants indicate having multiple chronic health conditions, including nearly 42% with hypertension and approximately 15% with heart disease.
As the “gray wave” of aging baby boomers crowd into the country’s creaking long-term care system, many of them may unexpectedly end up in nursing home where anti-psychotic medication, rather than comprehensive social and mental health services, have become a standard way for some residential institutions to maintain order.
Yet, according to human rights investigators, anti-psychotic drugs are often administered to residents not with a doctor’s prescription, but the management’s. So-called “chemical restraints” have become a routine “fix” for behavioral problems, such as those who “resist” staff’s orders, or for dementia patients with a habit of wandering off. In reality, deliberately over-medicating elderly patients is not designed to help them as much as to help an overwhelmed workforce of clinicians struggling to care for too many patients with too little time and funding.
But the seemingly efficient solution comes at the expense of seniors’ human rights.