As most of society is aware of healthcare is a hot topic and it is an issue that affects most everyone, from newborns to centenarians. I am going to show what issues affect most of our seniors in regards to mental challenges, cognitive degeneration, and physical health issues. In addition I am going to show how these changes jeopardize the independence and safety issues of seniors who live alone. I will show various ways of counteracting the different healthcare concerns that can restrict the effects of a disease or limit the symptoms of various illnesses.
No matter how one feels about healthcare it is both a negative and a positive and essential to our physical and mental well-being. I will attempt to show how the health care industry is trying but failing in protecting not only seniors, but everyone in regards to proper coverage, preventive care and continuing care. Keywords;Medicare,coverage,disease,dementia Seniors are a class of people of which some have debilitating mental, physical, and cognitive health issues and a government that is ill- prepared to rectify the situation.
A senior citizen is defined as a person who is over the age of 50 but for the sake of this argument, I will encompass information pertaining to persons at least 60-65 years of age. According to an article by Jennifer Brock published by G. S. U. in their online magazine, the over 85 age group is the fastest growing sector of the population and by 2020 this population will have grown to roughly 115 million. With this many seniors or geriatrics as they are also known, one can only imagine the physical, mental, social, and cognitive issues many of these people will face.
One of the major concerns for the geriatric generation is the lost of their freedom or independence. Imagine a person has been self reliant or independent for years and now suddenly or maybe gradually, they have lost that independence due to cognitive decline. Becoming unable to care for yourself is devastating enough, but coupled with a loss of memory of how to do simple tasks or how to do personal care is heartbreaking not only for the person experiencing it, but for the loved ones who has to helplessly watch as a once vibrant person who was possibly everything to them, become the infant who needs everything done for them.
Contrary to popular belief, dementia is a not a specific disease but more of an umbrella term for a group of disorders that affects the brain. It can cause problems with simple tasks such as getting dressed, eating, personal care or they may have problems controlling their emotions. One of the most common causes of dementia is Alzheimer’s disease. It is believed by some researchers that as many as half of all people over the age of 80 will develop Alzheimer’s disease (webmd. com). Symptoms progress from mild to severe in regards to the onset and inclusion of the disease.
In the mild stage of Alzheimer’s, a person could experience delayed reactions or poor judgment making decisions. They can also experience problems handling money and or financial obligations. In more moderate stages of the disease, one can experience getting lost, disoriented, or confused about their surroundings or where they were going, having problems recognizing friends and family or they may even become hostile towards others. This is extremely unsafe for them as well as others who may be subjected to this hostility while trying to help or assist the person with personal care.
In the extreme cases of Alzheimer’s the person cannot communicate using words, loses the ability to chew and swallow, and becomes incontinent. This is not only frightening for the person experiencing the confusion, but for their family as well. While the end result of Alzheimer’s is death, a diagnosis of the disease does not mean an instant death sentence or automatic severe impairment of functioning. Some people function very well with the disease and have minimal disruptions, whereas others deteriorate relatively quickly.
The average length of time a person usually lives with this incapacitating disease is about 8-10 years. While there is not a known cure at this time, there are things that can be done that will assist more positive, aging process and lessen the effects of Alzheimer’s. One suggestion that greatly reduced falls in seniors, which is a component of the disease was exercise. Participants who engaged in a fall prevention program, not only suffered fewer falls but increased cognitive functioning as well. Another suggestion according to Drs.
Michael Jansen and Mark Liponis is to take the coenzyme q10, which is necessary for energy production. It helps protect not only against Parkinson’s and Alzheimer’s, but it also help fight heart failure and lower blood pressure. Actively participate in activities that engage or stimulate the mind such as reading, writing, playing the piano, working crossword puzzles, learning a new language or even playing chess or checkers. Of course, eating fresh fruits and vegetables is always a good counter agent in fighting the effects of any disease.
A surprising fact that came to light in a study done in 2005 that found that healthy people who consumed more than 400 micrograms of folate, a B vitamin, which is found naturally in many foods, cut their risk of developing Alzheimer’s in half! Testing in now going on to see if the results would be the same if a person already had the demential decline. Also under the umbrella of cognitive decline is Parkinson’s disease. This disease affects more than a million people in the United States. It is believed that Parkinson’s disease is caused by the death of neurons in the brain that control movement.
Our brains secrete a chemical called Dopamine which helps in controlling muscle action, in the realm of a person afflicted with Parkinson’s it is believed that the cells that contain the Dopamine either die or the person had fewer of these cells to begin with at birth. We as human beings move whenever the need or desire hits us, but for people with Parkinson’s disease imagine having to concentrate on wanting to move or even after concentrating one is not able to move as freely as they please.
Parkinson’s symptoms that make voluntary movements almost impossible are tremors, slow movements, and stiffness of the limbs, short shuffling steps, and stooped posture. Later symptoms that become engaged are hearing and visual hallucinations, loss of contact with reality, frozen muscles, and a progressive deterioration of intellectual functions. A troubling aspect of this is that some medications for treatment of this disease can also cause some of these symptoms. While there is no cure for Parkinson’s, there are various treatments that can slow the rate of growth of the symptoms.
Some of the treatments available are exercise, physical, speech, language and occupational therapies, and in some cases surgery. Late breaking news has just been released that states that new research found that when certain neurons become stressed they die and their death causes Parkinson’s disease. According to a new Northwestern Medicine study published November 10 in the journal Nature, the dopamine releasing neurons in a region of the brain called the “substantia nigra” lead a lifestyle that requires a lot of energy, which creates stress that could lead to the neuron’s premature death.
Preclinical research is in the process of being done to show the results of using a drug already approved for human use for treatment of high blood pressure. The drug named Isradipine, has shown promising results of reducing the stress in the dopamine releasing neurons. Medicinal scientists are currently conducting a clinical trial to find out if this drug can safely be used and tolerated by patients with Parkinson’s disease. A symptom that can tie into Parkinson’s but can be an aspect of mental decline is depression.
The National Institute of Mental Health considers depression in seniors to be a major health problem, yet one rarely hears about it as seniors are expected to slow down and this slowing down may not be looked at as a symptom of depression. About 6 million Americans aged 65 and older are affected by depression. There are several different forms of depression and they affect different age groups in different ways. In the elderly, the depression can be compounded or coupled with loss of a spouse, adult child, grandchild, and retirement, loss of a job or home and even confirmation of an illness.
Long term, continued depression can lead to suicide in not only seniors but other age groups as well, but in seniors aged 80-84 the suicide rate is twice that of the general population. There are numerous ways to treat depression such as antidepressant medications, psychotherapy and counseling. Medications may take longer to start working in older people than younger ones and the treatment time line is longer for seniors than younger victims of depression. Psychotherapy is usually combined with antidepressant medications, while encompassing a wide range of functional and social consequences.
Counseling can help bring out any issues and/ or situations that may not be thought of as a cause or factor of the depression. Another devastating disease that affects over half of Americans over the age of 65 is arthritis. There are two forms of arthritis; osteoarthritis and rheumatoid- arthritis. Both are equally painful and debilitating. Of these two, osteoarthritis is the most common; it is also known as DJD or degenerative joint disease. This disease affects over 20 million people in the United States alone. It has been said that osteoarthritis probably affects every person over the age of 60 to some aspect, although the ymptoms are usually mild and or tolerable. It affects only certain joints, such as the hips, hands, knees, feet, spine, and neck. When the hands or fingers are affected it causes bony growths also known as spurs to form in the joints. Heberden’s nodes are the name of the joints that occur in the end joints of the fingers, whereas Bouchard’s nodes are the name of those that grow in the middle of the fingers. If the feet are affected the detriment will be the large joint at the base of the big toe. This can be aggravated by wearing tight shoes or high heels.
In the knees, the knee is stiff paired with a catching or grating impression when moving the knee. I regards to the back or spine, there is stiffness and possible pressure on the spinal cord itself. It is essential to pay attention to any numbness or weakness of the extremities or difficulty with bowel and bladder control as this may be a sign of osteoarthritis as well. Rheumatoid arthritis is inflammation of the lining of the joints, which causes chronic pain, loss of function and it can lead to long term joint damage. It usually begins earlier and usually develops more rapidly.
Another trait of rheumatoid arthritis is that it usually affects the same joint on both sides of the body, such as knees or ankles. In addition to the general pain and other irritants rheumatoid arthritis usually coincides with fatigue, weight loss, fever, and an all over general feeling of sickness. Rheumatoid arthritis is also a systemic disease which means it can affect other organs in the body. One suggestion for alleviating the pain and frustration of suffering with rheumatoid arthritis is to not place undo weight on the joints as the added weight could cause extra pressure on already weakened joints.
In some cases, surgery has been a successful option. Some of the positive components of surgery could include realigning the joint, fusion of the joints, removing joint spurs or even joint replacement. As many seniors do not want to undergo surgery or may not be a good candidate, there are medications to help alleviate the pain and symptoms or rheumatoid arthritis such as known as nonsteroidal anti inflammatory drug (NSAID). This reduces the pain and inflammation, but DOES NOT slow the progression of rheumatoid arthritis. The other medication for rheumatoid arthritis is called a disease modifying antirheumatic drug (DMARD).
There are two versions, biological and non biological and they DO help slow or stop the progression of rheumatoid arthritis. Health insurance is a necessity whether someone is a newborn or a centenarian. Medical insurance costs are extremely expensive especially if someone has private insurance, but medical insurance for just basic care is excessive. If someone has a pre existing condition, there is a chance that they cannot be covered as fully as their condition warrants. As most everyone knows healthcare is a hot topic in the news right now and everyone will be affected in some way.
Medicare and Medicaid are governmental health insurance programs that cover most health insurance needs. Medicare is coverage for most people over the age of 65 and/ or long term disabilities. Medicaid is health insurance coverage to low income people and people under the age of 65 and/ or those who have exhausted their Medicare benefits. Most seniors have Medicare or Medicaid as their only form of health insurance. As anyone with a debilitating illness or anyone who needs long-term medications for medical conditions knows, the medications are not cheap.
For example, the biologic disease- modifying antirheumatic drugs DMARDs mentioned above as a possible treatment for rheumatoid arthritis are more effective at reducing symptoms and slowing the progression of rheumatoid arthritis than the non biological DMARDs, but they are also up to 100 times more expensive. In this regard, according to Jennifer M. Polinski of Brigham and Women’s Hospital in Boston “patients assume up to 28% and Medicare assumes more than 58% of the costs of biologic DMARDs. ” It has been estimated that the typical older couple may need to save $300,000 to pay for health care costs not covered by Medicare!
The reasons stated for the staggering increases in Medicaid and Medicare costs are three- fold. First, health care costs have grown an astounding 2. 7% faster than the economy as a whole since 1960 and this expected to continue to grow at an average rate of 1% per year over the next seven decades. Secondly, in 2008, the first of the 78 million baby boomers began to collect retirement benefits under Social Security. Third, beginning in 2011, the oldest baby boomers will be eligible for Medicare benefits According to seniorjournal. om, health care costs increased significantly from $9,224 in 1992 to $15,081 in 2006 and out of pocket spending for health care services increased in the poor/ near poor income category from 12% to 28%. In addition, the number of Medicare prescription drug plan beneficiaries increased from 18. 2 million in June 2006 to 22. 2 million in December 2009. This is a 6% increase in only 3 years. Those are sobering facts to show the rate at which our government funded health care is expanding. Added to that, over the next 25 years the segment of society 65 years of age and older is projected to increase from 12% to 20%.
According to Kathleen Sebelius, the secretary of Health and Human Services, the health care act passed in Congress known as The Affordable Care Act and signed into law by President Obama will provide greater savings and increased quality health care while guaranteeing that you, your family, and your doctor have greater control over your health care as opposed to the health insurance companies, additionally the governmentally insured will see new benefits, cost savings, and a heightened focus on quality to be sure that the care one receives is the best care possible.
Immediate improvements include a $250 rebate check for those who have out of pocket drug expenses in addition to a monthly check to help close the gap of any prescription costs not covered by Medicare, and gradual reductions of overpayments to insurance companies. Beginning next year, if there is a gap in coverage when name brand prescription drugs are required the enrollee will receive a 50% discount on the cost. Also beginning in 2011, participants can receive preventative care services, such as colorectal cancer screenings and mammograms all at no cost to the patient.
In addition, a free annual physical will be offered to encourage a personal prevention plan based on current health needs, which in turn will allow a quicker plan of action for any health concerns or needs. Over the long range, of the next 10-20 years, the new law will protect Medicare Advantage member by taking strong steps to make certain that at least 85cent of every dollar these plans receive is spent on health care instead of insurance company profits, and administrative costs.
Additional savings for medical coverage and prescription drugs will be added until the coverage gap is closed in 2020. Since Medicare will be reducing waste, fraud, and abuse, spending will grow at a reduced rate which in turn will prolong the life of the Medicare trust fund by 12 years and provide additional savings to those on Medicare. As elder abuse has become a significant topic among nursing home and long term care facilities, the new law will also fight elder abuse and neglect and improve nursing home quality.
The law also begins the commencement of a new voluntary insurance program called CLASS, which will help pay for long term care and support at home, alleviating the possible neglect and abuse which occurs in nursing facilities. In regards to persons with pre existing conditions, insurance companies will not be allowed to deny coverage due to a pre existing condition for children, which began September and for adults beginning in 2014. In a big triumph, insurance companies were banned from placing lifetime and annual limits on coverage beginning in September.
With many of today’s society being members of the sandwich generation, that is caring for both their parent(s) and children, along with full time employment, these seem to be needed and desired accomplishments regarding the state of health care in America, but some seem not so quick to be swayed with these benefits of a better health insurance for all. For instance, in a report release by the federal Centers for Disease Control and Prevention, stated that among adults with at least one disability and insurance, 16% said they had skipped or delayed a recommended medical coverage in the past year due to concern about cost.
Beginning December 1, many doctors are scheduled to take a 23% reduction in pay and two thirds will stop taking new patients due to the leftovers of the 1990’s budget balancing law. Although these cuts have nothing to do with Obama’s healthcare system, he has to deal with the possibility of the healthcare system being thrown into chaos because of the timing of the cuts. The timing is just when the first baby boomers become eligible for Medicare. In addition to these cuts, Tricare which furnishes health care to military service members, their families, and retirees would be in jeopardy because Tricare’s payments are connected with Medicare’s.
Stephen Bloom, vice president and chief underwriter for New York Life Insurance explains a vicious circle that states that depression can leave one unable to get life insurance coverage. Severe depression and dementia such as Alzheimer’s are considered psychological conditions that when severe can lead to suicide. If a person has had severe, major depression, lots of hospitalizations and lots of suicide attempts, that individual would not be rated as favorable and possibly not insurable for life insurance.
In addition, someone living in a nursing home or facing major surgery is not a good candidate for life insurance with New York Life. Although he states this is the practice for a 40 year old man, it makes one wonder. Shawn Tully states in an article on money. cnn. com writes in an article the 5 key freedoms we will be lose in the health care reform. They are; the freedom to choose what is covered in our plan, the federal government will impose a minimum list of benefits that each plan is required to offer.
The freedom to be rewarded for healthy living, such as if your employer rewards your non smoking or healthy lifestyle with reduced premiums. The freedom to choose high-deductible coverage, at the current time numerous companies offer Health Savings Accounts (HSA), where workers can deposit tax free money and get a matching contribution from their employer to basically “save” the money for major medical costs, in the new plan patients would be prevented from choosing stripped down plans that cover only major medical expenses and other prescription, mental health, and substance abuse services.
The freedom to keep your existing plan, in losing this plan, one will lose the comfort of the freedom of spending their own money for a policy that covers the newest drugs and diagnostic tests. The last freedom we will lose according to Mr. Tully is the freedom to choose your doctors such as selecting our own cardiologist or urologist under your company’s Preferred Provider Organization plan.
Everyone will be assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists. The danger of this is that doctors will be financially rewarded for denying care. So in essence we will be somewhat back where we started 10 years ago with the HMO’s.
Being a senior today has its good points as people are living longer healthier lives and bad points, with health insurance coverage, abuse and neglect being on that list. Seniors today instead of enjoying their golden years are wading through the raging waters of health insurance. Where is the medical, mental and social support that is supposed to keep them healthy and active in the sunset of their lives?
