The Diabetes Prevention Program is a new system that is aimed at helping the elderly who are at risk to suffer from Type 2 diabetes help keep track of their weight and manage any pre-symptoms of the disease. Known as a "lifestyle modification program," this simple system is showing amazing results for its participants and has the potential to help millions of seniors across the country.
Diabetes Prevention Program
The Centers for Disease Control (CDC) began to roll out a national Diabetes Prevention Program in 2012. Now, 527 organizations around the country that includes healthcare providers, community groups, colleges, churches, and employers offer this program in every state, often in multiple sites. The newest development in the program is an experimental online version, and it may be the largest national health effort that no one has ever heard of.
The results for the participants in the Diabetes Prevention Program have been impressive. A large clinical trial in 2002 showed that this type of program and the resulting weight loss reduced the incidences of diabetes by 58% in 1,000 participants in the trial compared to those who did not. For people over the age of sixty, that number rose to 71%.
The CDC estimates that in its first two years nearly 50,000 Americans have enrolled in one of its diabetes prevention programs. They are aimed at people who have blood glucose levels, weight, or other factors that suggest that they may have an increased risk of developing diabetes. Not intended as a diet or as a fad, this prevention program is aimed at helping people lose weight, adopt new habits, and look at eating healthy and exercising as a new way of life.
How the Program Works
Participants in the program meet once per week in a room at a local YMCA, church, or other common site. They step on a scale and show the program leader their logs where they record what they have eaten for the past week in addition to the amount of exercise that they have gotten. Then, the participants sit around a table and discuss what worked for them and what did not over the previous week. It gives the participants a chance to get suggestions in addition to offering advice to others.
Most participants of the program are in their fifties and sixties; however, it is not uncommon to see someone in their eighties taking part. The curriculum involves sixteen weekly sessions and monthly follow-ups for a year. The goal of these programs, in addition to an hour and a half of exercise per week, is significant weight loss. At a four percent reduction in body weight, there is a reduced chance of diabetes. This program aims to get participants down between five and seven percent.
Why This Program Works
Experts believe that this prevention program is working for a variety of reasons. For one, seniors tend to be more engaged in these types of programs. They realize the direct effects that a prevention program like this one can have. Another reason is that many seniors see the effects of diabetes in their friends and loved ones. Almost ten percent of the U.S. population has Type 2 diabetes, and for people over the age of 65, over one-quarter of the population has the disease. With 86 million Americans that are pre-diabetic, the need for diabetes prevention programs will continue to grow.
The Diabetes Prevention Program is a new system that is aimed at helping the elderly who are at risk to suffer from Type 2 diabetes help keep track of their weight and manage any pre-symptoms of the disease. Known as a "lifestyle modification program," this simple system is showing amazing results for its participants and has the potential to help millions of seniors across the country.
According to researchers at Georgetown University and Penn State University, over seventy percent of seniors in America over the age of 65 will need some type of long-term care in their lifetime, either at an assisted living facility or nursing home. However, according to a new study only a fraction of those people should be purchasing long-term care insurance, and the authors boldly claim that "individuals should not buy insurance." So how should an elder decide if long-term health insurance is the right course of action?
Long-Term Care Insurance Study
According to the study published by Boston College's Center for Retirement Research, only nineteen percent of men and 31% of women should purchase long-term care insurance. The reasons for this bold statement come from a variety of factors. In addressing the discrepancy between men and women, females are statistically likely to live longer so they are also more likely to need to purchase the insurance.
In addition, relatively few people incur enough wealth in their lifetimes that the catastrophic financial burden of long-term care would have such an effect as to need protection from it. Moreover, because of the structure of Medicare and Medicaid most seniors can rely on those government-sponsored programs for the majority of their long-term care.
In order to quantify the odds of needing long-term care insurance, the researchers used government data to calculate the monthly probability of people over the age of 65 transitioning among various stages of health. This regression showed that 44% of men and 58% of women will eventually need some type of nursing home care. However, most of those stays were only short spells. Men spend on average only a year in a nursing home and women on average stay for a year and four months.
Because many short-term stays in nursing home facilities are covered by Medicare - those that last 100 days or less following a hospital stay of three days or more - half of all men and forty percent of women fall into the window where Medicare pays their costs. If a stay lasts longer, Medicaid pays for those who run out of money.
Who Should Buy Coverage?
According to the Boston College study, seniors with significant assets should most seriously consider purchasing long-term care insurance. If a couple's assets exceed a couple hundred thousand dollars or more they should look into purchasing a policy. Specifically, the target market for long-term care insurance is people who have a sizeable amount of household financial assets and would be unlikely to qualify for Medicaid, but who have little enough that long-term care would be catastrophic to their finances.
It is important to note that this study only looked at the numbers for single individuals, who make up over 75% of nursing home residents. And while nineteen percent of men and 31% of women can benefit from the purchase of this type of coverage, only thirteen percent of seniors in America over the age of 65 have bought a policy.
With the number of elderly people in the United States growing at a fast rate, it is becoming common knowledge that most seniors wish to stay out of nursing homes and similar facilities as long as possible. In addition, research has shown that seniors who stay in their own homes or communities tend to stay the healthiest, physically and mentally, longer on average than those who do not. As a result, one of the hottest new trends in real estate is having the added amenity of an in-law apartment.
For domestic and foreign buyers alike, a growing trend in real estate amenities is to have an in-law unit - an apartment carved out of an existing home or a separate dwelling built on the property meant specifically for aging parents and in-laws. The benefit is tri-fold: the adult children get the peace of mind of having their parents nearby, the elderly parents get to remain out of nursing home facilities, and the extra accommodations are adding value to the property.
Otherwise known as accessory dwelling units, in an analysis of real-estate listings the units with in-law apartments were priced on average around sixty percent higher than similar properties without them. The analysis covered all new listings that occurred in major cities over the last four years. Putting aside the jokes about living with an in-law, in 2012 a survey of 550 homeowners with one or more living parents a total of 32% of respondents stated that they expected to have an aging parent live with them in the future.
Until recently, many homeowners were not allowed to build in-law units on their properties because of local regulations that made them illegal or too complex to build. However, efforts by lobbyists for the AARP and other elder organizations have resulted in loosened regulations in many states.
Responding to the Need
Architects and home builders have responded by creating a variety of options for in-law units. One option is a stand-alone unit that is built on the property. Another option builds a unit onto an existing home, and some are attached to the main home but have their own separate entrance. Community developers are now focusing on building neighborhoods that have large single-family homes in additional to smaller residences that are designed for empty-nesters and aging parents.
Adult children and their parents have gone about implementing an in-law unit in a few different ways. Some elderly parents pay for the renovation or construction themselves, while some adult children that can afford it will pay for it themselves. In addition, some parents pay rent to live in the in-law unit while other parents do not.
Dealing with the Transition
Many adult children and senior parents that have made the move to in-law apartments have found that there is a transition period, but having family that close makes it easier. One of the biggest issues is downsizing furniture and possessions from a larger home into a smaller space. Another issue for some is dealing with the health problems of some parents. Many children are unaware of the effort it takes to keep up with the health demands of the elderly. Still, most families that have utilized the in-law apartments agree that the benefits of having family close by far outweigh any issues that come with aging.
For many seniors around the country who still live at home, the biggest challenge in keeping from going hungry is not having the money to buy food or being able to prepare it, but being able to chew. The first of its kind, a pilot program is aimed at researching and helping fix seniors' oral health. Being called "eye-opening," the program is offering firsthand knowledge of what experts had only guessed at being elderly dental concerns.
Oral Health Study
The nonprofit food delivery service Citymeals-on-Wheels joined with the Columbia University College of Dental Medicine to conduct the study on seniors' oral health. The pilot program has been funded by a $50,000 grant from the National Institutes of Health, and it involves both phone interviews in addition to dental house calls for low-income seniors. Many of the participants in the study have not seen a dentist in years, and some in decades.
Before this study, very few researchers focused on the dental health of homebound seniors, and the majority of dental research has been primarily focused on the needs of children. However, in the first phase of their study, the program found that over forty percent of the 300 participants interviewed said that they had difficulty eating and researchers believe that the actual number may be even higher.
How the Program Works
The program begins with the phone interview, which is meant to elicit basic information like what a participant can or cannot eat. This in turn informs the researchers about possible issues with nutrition and dental health. For example, a participant who says that they cannot chew meat may have a protein deficiency. The researchers also asked participants if they modify their food to make it more edible because pureeing foods can dilute the nutrition.
The home visits then allow for both a dental examination of the homebound senior in addition to direct observation of their specific challenges regarding oral care and mobility. This not only allows researchers to pinpoint the root of some hunger problems, but it also allows them to make referrals for treatment to the seniors as needed.
Highlighting Problems in Elderly Oral Care
The research being performed by the pilot program is also serving to highlight the multiple challenges that the elderly face when getting oral care. Many are unable to leave their homes without the help of others. Once out of the house, many still need help driving or getting to some form of public transportation to see a dentist for their oral needs.
Another huge barrier to elderly oral care is the accessibility of insurance. A lot of seniors lose dental coverage after they retire, and routine geriatric dental care like cleanings, fillings, and dentures are not covered well by Medicare and Medicaid, if covered at all. But even home dental care cannot be taken for granted. A lot of homebound seniors have issues with grip strength, making things like holding a toothbrush or opening bottle of toothpaste difficult.
There are also many misconceptions that seniors have regarding dental care. The researchers are using the home visits as a chance to educate seniors about their oral health and dental care. The final step in this pilot program will be to see whether the interviews and home visits had an effect, and if the seniors that participated in the program see an increase in their dental health and nutrition.
As people age and children leave the house, many parents entering retirement age use the opportunity to downsize their home and belongings. Rather than downsizing all at once, a growing trend among seniors is to do so in steps over a period of years. In earlier generations, the elderly usually downsized all at once and only once. Now, an overwhelming number of older people are taking a more gradual approach to downsizing, choosing to reduce a house or career but not doing so all at once.
Trends in Downsizing
Rather than selling the house and moving to a warmer climate, many downsizing elders are opting to stay in the same neighborhood or at least the same town. A survey by the AARP's Public Policy Institute found that 87% of those age 65 years old and older, and 71% of those ages 50 to 64, preferred to stay close to their longtime neighborhoods instead of making the traditional choice of packing up and moving to a resort area or assisted living facility.
As the elderly are living longer, healthier, and more productive as they age the opportunity to retire and downsize multiple times increases. In addition, there are signs that the more gradual approach involving many moves is becoming established behavior.
Reasons for Multi-Step Downsizing
Researchers have said that multi-step retirement may be more common for the Baby Boomer generation for a variety of factors. First, there are more two-earner families doing significant work. More women hold jobs that they find aspirational, thus delaying a final major downsizing or making smaller steps in downsizing.
Another reason is for multiple step downsizing is that as seniors live longer, they feel the need to continue to work in some capacity in order to have enough money. Many seniors retire, rethink their finances, downsize, go back to work, and then retire again. On the other hand, some seniors feel their mortality and just jump on something for a while before really downsizing.
Examples of Downsizing
One couple who had just retired thought that they should prepare for the future by moving from their large family home into something smaller, a few miles away from their original home. After a couple of decades, the couple decided to downsize again into a retirement facility with the amenities and help that they need.
Another couple cut back their working hours once at retirement age and took an exciting opportunity to work abroad. Upon returning, they moved into a smaller home that was also less expensive. After a few years of not working, the couple decided to go back and take part-time jobs. A few more years later the couple decided to retire for good.
A third couple had already taken some smaller steps to retire when the husband had a triple bypass surgery. Since then, the couple has traveled around the country in a recreational vehicle for six months at a time and alternating six months at home. They travel around the area of their campgrounds and are trying to see a baseball game at every major league park.
Caregiving is about more than just tending to the physical needs of an elderly parent. If your parent is also dealing with dementia or another degenerative disease, you must also prepare to cope with effects on both the body and mind. In the event that your parent becomes incapacitated, you need to decide whether your or someone that you trust will fill the decision making role. The ability to do so comes in the form of a Power of Attorney document.
How to Make a Power of Attorney
It is vitally important that you and your parent discuss and designate a power of attorney before incapacitation occurs. A power of attorney (POA) is a formal, legally binding agreement between the person who needs it ("grantor") and the person designated to act on the grantor's behalf ("agent"). An experienced attorney will be able to draft a POA for you and your parent, especially if there are financial matters or assets that may complicate decision making.
While there are some POA forms available to be downloaded off of the internet, many states do not recognize them as legally binding. Some states require that the document be notarized and witnessed in the proper manner. The best place for that is in an attorney's office or where the grantor banks.
The most important aspect of creating a POA is that the grantor must be completely competent when the agreement is made. If or when competency comes into question the legality of the POA agreement can come into question, too.
Types of POA
There are many different types of POA agreements, and most likely your parent will need to execute many, or all, of the agreements before any type of incapacity strikes. The different forms of POA include:
POA for Healthcare
This type of POA agreement is also known as a healthcare proxy. The agent is given the right to make all health care decisions for your parent when they are unable to do so. This document should be shared with your parent's primary care doctor, and if admitted to a hospital, included in the hospital records.
This type of POA grants the agent limited powers and/or time to act in a specific situation. For example, a limited POA might allow the agent to sell your father's lifelong collection of baseball cards or manage your mother's move from her current home to an assisted living community. The limited POA expires when the task is completed or the timeframe ends, whichever comes first.
This type of POA grants the agent access to and management of financial accounts and resources specifically listed in the POA. Some financial POAs split up the responsibilities among multiple people, giving one individual access to accounts used for bill paying and another person management of stock and investment accounts, and so on.
This type of POA grants the agent the right to manage all aspects of your parent's life and finances, and health care, when it is specified. It goes into effect when it is signed and stays in effect until your parent cancels it or dies.
This type of POA "springs" into place in the case of an emergency where your parent becomes incapacitated and unable to express their own opinions. When, or if, the crisis is over and your parent regains the ability to speak, the POA ceases to be in effect.
In decades and centuries past, when people got old their children and younger relatives would care for them until they died. Now, when elderly Americans are too old to care for themselves and assisted living is not an option for financial, physical, or mental reasons many are sent to live in a sterile, hospital-like nursing home. However, one geriatrician is working on developing another option for where frail seniors can live and thrive: Green House homes.
Green House Project
Dr. Bill Thomas helped to create and develop the Green House project, a model for long-term care that nurtures the elderly and helps frail seniors thrive. The project was co-founded by Dr. Thomas and Steve McAlilly of Mississippi Methodist Senior Services in 2003, and it has since spread to 27 states.
Residents of the Green House homes have their care financed by Medicare, Medicaid, or private funds. They live in private cottages with their own room and bath. When they can, residents participate in food preparation and eat in a communal space that feels more like a dining room than a cafeteria. And unlike the regimented meals of a nursing home, Green House residents are free to choose when they want to eat.
So far, there have been 167 Green House homes built by 39 different organizations, and a total of 1,735 residents live in these homes across the United States. Another 108 Green House homes are currently in development. A new documentary, "Homes on the Range," is being produced that documents the development and mission of the Green House project. In addition, the Media Policy Center developed a 25-minute film that documents life in one Green House home that is shown to potential sponsors for similar homes across the country.
Nursing Homes in America
There has been a boom of nursing home development over the last few years, with a current total around 16,100 facilities across the United States. Yet, of the 1.5 million people residing in a nursing home, very few actually want to stay there. The common belief is that a nursing home is where you elderly loved ones go to die.
Dr. Thomas refers to nursing home treatment as "medicalization of old age," treating aging as a disease for which there is no cure, and treatment provided in an institutional setting like a nursing home facility. Too often, sterile and impersonal institutions like nursing homes lead to an accelerated physical and mental decline in residents, where residents routinely becomes rapidly helpless, non-communicative, and catatonic.
Green House Home Difference
The Green House homes are meant to be a place where debilitated seniors can come back to life. The atmosphere is homelike, the staff is dressed in street clothes, and the seniors are treated more like residents than patients. As one staff member put it, "People who were in wheelchairs are walking again. People who weren't eating real food are eating again. People who weren't talking are talking again. People who were losing weight no matter what we did are gaining weight."
On December 8, Frank Mercado, 77, was a resident of a small nursing home in the Bronx where he had lived for the last four years. Unable to see clearly and suffering from dementia, Mr. Mercado was helpless as one of the employees at the home beat him to the ground. He was impaled on a metal protrusion from an overturned table and died hours after the beating.
Last week, the Bronx District Attorney's Office said that the employee responsible for the beating, Cherrylee Young, 41, had been charged with negligent homicide, fatal assault, and endangering the welfare of an adult. This death highlights the vulnerability of nursing home residents in New York, where rates of substandard care, elder abuse, and neglect are high in almost every major study that has been released.
University Nursing Home
The facility where Mr. Mercado was attacked was University Nursing Home, a small facility of only 46 beds, but it is part of a larger consortium of nursing home facilities called Centers Health Care. This particular facility scored high on federal rankings, but those rankings have been called into question when state officials have found numerous violations there in recent years.
Over the last four years, New York officials have found nineteen life safety code deficiencies in University Nursing Home, compared to the state average of eleven. Filthy rooms, broken equipment, and failing to report resident injuries were all on the list. In one case, an 86 year old woman had her hand cut open by nails sticking out of a wardrobe, and in another an 81 year old man suffering from dementia complained of shoulder pain, where bruises had mysteriously emerged, but it was never investigated.
The nursing home has also received poor ratings for a number of other care benchmarks. In total, 74% of patients had depressive symptoms, compared with an 11.7% statewide average and 6.2% nationwide. In addition, sixteen percent of residents lost too much weight while staying at the facility which is almost three times the state average. Finally, 4.8% had catheters inserted into their bladders and left there compared with a state average of only 2.6%.
Nursing Home Ratings
Twenty percent of all nursing home communities receive top ratings from the Medicare system, but those ratings rely heavily on self-reported data that is not verified by the government, can be incomplete, or misleading. Because of the recent backlash on the poor ratings system, Medicare has made changes that will become effective in January to try and correct the issues that come with self-reporting.
This also highlights the importance of doing research and legwork before choosing a nursing home facility for your loved one. While checking the Medicare rating is good, also research how many state violations the facility has received. Check to see if there are any lawsuits pending against the nursing home or if it has made the news for negligent care.
Finally, visit the nursing home yourself, and try to do so multiple times at different times of the day. It can give you an understanding of how the facility operates at all times, and not just when the staff thinks that someone is watching.
One common concern for seniors living alone is the lack of community and companionship. Not only can it be dangerous for an elderly person to live alone, but loneliness can have a physical, emotional, and mental toll on someone of advanced age. However, in order to combat the issues associated with living alone, a growing trend amongst the elderly is the concept of cohousing.
Cohousing is different than a retirement home or assisted living facility. A cohousing, or "coho" community, combines private apartments or homes designed around a communal space. The common area typically includes the kitchen, large dining room, laundry facilities, and recreational areas.
Hundreds of coho communities have sprung up all across the country, and most have added benefits for their residents close by. This can include libraries, farmers markets, YMCA or other fitness clubs, parks, shops, restaurants, hospitals, and senior care centers within walking distance.
Cohousing is a grassroots movement happening in the elder community. The residents typically take part in the design of their community and tailor them to the particular needs, interests, and values of each group. For example, one community in North Carolina developed a coho community because the residents were tired of suburban anonymity, wanted to reduce their carbon footprint, and all had a common interest in participating in civic engagement.
Benefits of Cohousing
There are many benefits to cohousing over the typical options for seniors to live alone or in a nursing home facility. Cohousing offers a more autonomous alternative to traditional retirement communities, which often impose strict rules on residents, and instead of having a board set decisions from the top down, cohousing community members typically decide issues by consensus.
In addition, there can be cost-savings benefits to coho communities. The typically smaller, more energy-efficient homes, along with shared community resources, can lower the cost of living for each resident. Seniors who need caregiving can even save money by going in together to hire those services such as nurses or equipment.
One of the most important benefits of cohousing is the sense of community and belonging. Each resident in these communities can feel cared about and care for others that they cohouse with.
How to Choose a Cohousing Group
If you are considering a cohousing group, the most important thing is to choose a community that shares your common interests, needs, and values. The website Cohousing.org contains valuable information that can help you make the decision about whether cohousing is the best option for your or your elderly loved one.
For retirees that want to enjoy their twilight years with others while also maintaining a sense of independence, cohousing is an excellent option. When evaluating communities, consider the following:
· Do the goals of the group reflect your values?
· Do the location and the size of the community match your preferences?
· What is the group's process for making decisions and sharing responsibilities?
· Will the community be intergenerational or for retirees only?
In multiple surveys and studies, senior Americans and retirees have not scored well on retirement literacy tests. In the latest study, U.S. citizens between the ages of sixty and 75 who were polled had an eighty percent failure rate of the retirement literacy test. The results of the poll and subsequent survey were released this week by the American College of Financial Services.
Results of the Study
The poll was conducted by the American College of Financial Services through online interviews of 1,019 people between the ages of sixty to 75 who had at least $100,000 in household assets. The participants were asked a series of 38 questions regarding retirement literacy basics. This included questions about Social Security, life expectancy, IRAs and other retirement accounts, life insurance, investments, and how bonds work. Only two in ten participants had passing grades.
The researchers behind the study admitted a lack of surprise at the fact that many retirees do not know a lot about retirement income planning; however, even they admit that they were shocked by just how poorly the participants did.
Other Retirement Literacy Studies
The poll released by the American College of Financial Services is not the first to raise concerns over the readiness of our nation's retirees. In the 2011 report, "Financial Literacy and Retirement Planning in the United States," done by the National Bureau for Economic Research similar shortcomings were discovered, albeit not to the same degree.
Their report concluded that "the findings from the National Financial Capability Survey paint a troubling picture of the current state of financial knowledge in the United States. Many respondents lack key knowledge of financial concepts and fail to plan for retirement, even when retirement is close at hand, only 5-10 years off. This is important since being able to develop and implement retirement plans are key to retirement security: those who do not plan reach retirement with half the wealth of those who do."
Highlights of the Latest Study
Experts agree that most retirees and seniors living in America did not have the best financial role models in their parents. Nor is there much formal training or teaching in the area of investments, Social Security, retirement accounts, and other related topics. Some of the highlights of the latest study include:
· Only one in four people between the ages of sixty and 75 have a written financial plan, even though a written plan leads to better financial planning and financial decisions.
· A significant minority have never figured out how much they need to accumulate to retire securely.
· Only 31% know that $4,000 is the most that they can afford to withdraw per year from a $100,000 retirement account in order to make it last for thirty years.
· More than half underestimate the life expectancy of a 65 year old man, which suggests they may not realize how long their assets must last.
· Only 54% realize that Social Security benefits increase each year that you delay up to age seventy, and a similar percentage know that it is best to wait until seventy to claim Social Security if you expect to live to ninety years old.
Since 1998, the Commonwealth Fund has been publishing an annual report comparing the healthcare systems of industrialized countries. The United States has repeatedly done poorly with its report card within the study because of the high proportion of uninsured people. However, this year the report focused on people over the age of 65, a segment of the population with almost universal coverage and access to care.
Elder Care Issues in America
Some of the countries that routinely rate highly for their senior healthcare include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. So how does the United States stack up in terms of senior care? "It's definitely a better picture than when we look at the U.S. population generally; that's a pat on the back for Medicare."
However, the survey of 15,617 respondents from the United States reveals that there are still large lapses and problems despite spending more on healthcare than any other country in the world. For one, our older population is sicker and leads the list in the proportion of people over the age of 65 who have two or more chronic diseases as well as who takes four or more prescription drugs. A total of 68% reported two or more chronic diseases and 53% reported four or more medications. In comparison, only one-third of participants in the United Kingdom reported two or more chronic conditions.
Seniors in the United States also struggle to pay for healthcare. In the last year, nineteen percent of participants in the U.S. stated that cost was a barrier that prevented them from seeing a doctor, undergoing a test, or filling a prescription. Only one other nation had numbers in the double digits in this area.
Among American seniors, 21% had out of pocket medical expenses that were over $2,000, and eleven percent said that they had problems paying for their medical bills. In comparison, Norway and Sweden only had one percent had problems paying, and in Germany that number was three percent.
Elder Care Successes in America
On the bright side, the United States also scored among the highest in other areas of elder care. A total of 86% of participants surveyed from the U.S. stated that their doctors spend enough time with them, and 81% said that their doctor encourages questions. The U.S. also rates the highest among countries where healthcare professionals talk to seniors about healthy eating and exercise.
Americans are also more likely than seniors in most countries to receive good guidance in managing their chronic illnesses. In addition, elderly Americans do better than almost every other country in terms of advance planning for long-term healthcare. Americans over the age of 65 were most likely to say that they have discussed having a healthcare proxy at 78% as well as to have actually named one at 67%. United States seniors also rank second around the world in having a written plan describing their end-of-life wishes at 55%.
MobileHelp first began its foray into the elder care technology industry with a system that allowed its customers a way to seek help through pushing a button on pendants worn around their necks. But in only a few short years, this company has expanded its offerings of elder care technology to include medical alert technology that can detect falls without the use of a button and can help prevent them, as well.
MobileHelp was founded in 2006 at the research park at Florida Atlantic University and today has more than 100,000 customers in all fifty states across the country. The company generated nearly $18.7 million in revenue in 2013 and sales growth of 3,305% over the last three years. To support its rapid growth and new ideas, the company has raised another $15 million from investors this year.
The overarching vision of MobileHelp is to empower the elderly to live more safely on their own while simultaneously easing the worries of their loved ones. "We wanted to move away from being a completely reactive system to being more proactive and really providing service to the customer besides just waiting for a bad event to happen," said Robert Flippo, CEO of the company.
When MobileHelp started, research showed that nearly half of elderly falls occur outside of the home. It moved away from stationary home-based stations like what is used in LifeAlert and towards a more mobile solution. The company became the first in the industry to introduce a mobile device for seniors who wanted to access emergency assistance but who were also active.
Within the last year, the company also introduced a new product, the Fall Button. Worn as a neck pendant that possesses motion signal processing technology, it can detect a fall immediately. No press of an emergency button is required. This technology was key for the company because research has shown that in eighty percent of elderly falls the person cannot press the button for help.
New MobileHelp App
The company is expanding its medical technology through the development of its new app, MobileHelp Connect. The new application for smart phones can alert authorized family members or caregivers of emergencies, provides location information to caregivers, and can even offer verbal notifications to take medication for its customers. The app's most recent update added a new feature for its customers: a tracker that monitors activity levels and gives caregivers reports.
Medical Alert Industry
According to industry research, the medical alert industry is expected to grow from $1.23 billion in 2013 to $2 billion in 2020. Personal alert systems that offer wellness-focused monitoring systems as well as social connectedness technologies are predicted to grow in market share from fifteen percent in 2012 to 61% in 2017.
This makes sense given the current underlying trends of the U.S. elderly. In the United States, there will be more than 74 million people aged 65 or older by 2020, and seniors continue to become more tech-savvy. In addition, the Affordable Care Act has hospitals and health networks looking for ways to maintain medical oversight for their patients while simultaneously keeping them out of the hospital.
According to Kiplinger's, elder financial abuse has been named the "crime of the 21st century," and according to a new study in the Journal of General Internal Medicine, as many as twenty percent of America's elderly population may be victims. However, new efforts by attorneys are being made to train people in this profession to spot and report potential elder financial abuse and fraud.
The Elder Investment Fraud and Financial Exploitation prevention program (EIFFE) was launched by a joint effort between the American Bar Association (ABA), nonprofit Investor Protection Trust, and its sister organization the Investor Protection Institute. The goal of EIFFE is to curb the increasing levels of elder financial abuse and exploitation by teaching attorneys how to spot the warning signs.
The program is focused on attorneys because they are helping seniors with estate planning, wills, powers of attorney, and other legal documents and are in a position to spot a person at risk of financial exploitation. The program so far has been met with enthusiasm, and ninety percent of the attorneys surveyed by the groups before launching the program said that they would be willing to participate as part of a continuing education program that is about "detecting preventing and redressing elder investment fraud and financial exploitation."
How the Initiative Works
The program is set up as an option for continuing legal education for attorneys. Lawyers will be taught how to recognize a client's possible vulnerability due to mild cognitive impairment or incipient dementia in addition to identify clients who are victims and report suspected instances of elder fraud and exploitation to authorities. This initiative complements the interactive, online curriculum just launched by the Department of Justice to teach attorneys how to identify and respond to all kinds of elder abuse.
The Importance of the EIFFE
Lawyers need help detecting signs of potential elder fraud problems; however, spotting, preventing and responding to financial exploitation is not an area where many attorneys are effectively trained. Roughly one-third of elderly Americans over the age of 71 have some kind of cognitive impairment, and that number is expected to rise. This type of impairment makes people more likely to make financial errors or be less able to evaluate potential financial risk.
According to the New York State Elder Abuse Prevalence Study, for every case of elder exploitation reported, as many as 44 other cases go unnoticed. In addition, the survey by EIFFE organizations found that 91% of attorneys find elder investment fraud and financial exploitation a serious problem, and as many as 34% said that they believe that they are or may be dealing with such victims on a daily, weekly, or monthly basis.
Attorneys will start taking the EIFFE education course in five states at the end of the year, and the program hopes to spread nationally by next spring. Attorneys that participate in the program are not just helping their elderly clients, but they are protecting themselves, too. Lawyers who fail to detect and report elder financial abuse can become unwitting participants in the exploitation. This opens them up to civil, criminal, and professional penalties for their part in the abuse.
The increase in the number of elderly Baby Boomers has also meant an increase in the number of seniors abusing medication, other drugs, and alcohol. There are many delicate issues that arise in treating the elderly for addiction. However, efforts are now being made to screen and treat instances of elderly addiction in hospitals, nursing homes, and other treatment programs.
Elderly Addiction Statistics
Experts agree that as the population of seniors grows so does the number of those addicted to harmful substances. In 2009, a study was published that found that because of the large size "and high substance abuse rate" of the Baby Boomer generation, the number of Americans over the age of fifty with addiction abuse problems was expected to reach 5.7 million by 2020, double the number from 2006.
Seniors are getting addicted to multiple types of drugs and for a variety of reasons. Some turn to substances because of a fear of aging, chronic pain, or other debilitating cause. Many seniors turn to alcohol, but others are overprescribed powerful pain medications or other narcotic drugs. In addition, many family members, friends, and even doctors can miss the signs of addiction and mistake it simply for old age.
The Jewish Home Lifecare nursing home in New York City's Bronx neighborhood has started a treatment program for seniors suffering from addiction. Patients that are age sixty or older who come to the nursing home for rehabilitation after a hospital stay are screened for addiction and offered a chance for treatment. As of now, eight beds inside the nursing home are set aside for addicted seniors, and the facility expects to get as many as 480 patients for the program per year.
Alcoholics Anonymous is also offering services specifically tailored to seniors. The organization is hosting special meetings in nursing homes, offering transportation to frail members or even bringing meetings to the homebound. In addition, the Odyssey House has residential and outpatient treatment for elderly addicts and the Betty Ford Foundation has an addiction treatment "track" in Florida called BoomersPlus. In that program, all of the addicts are ages fifty and older.
How Treatment Works
For many addicted seniors that have taken part in an elderly-specific treatment program, they say that being with others their own age helps quite a lot because it is easier to dismiss people younger and with less life experience. This has been particularly effective in programs like Alcoholics Anonymous and Narcotics Anonymous.
In the Jewish Home Lifecare center, the addiction treatment program combines physical, occupational and psychological therapy with counseling. Patients discharged from hospitals to the nursing home for medical rehabilitation stay for an average of only 23 days. This is typically because Medicaid will not pay for addiction care beyond the medical care needed.
Therefore, for Jewish Home Lifecare a lot of importance is placed on discharge plan for their addicted elderly. The recovery plan includes putting a support team in place, arranging transportation to AA, or having a visiting nurse keep an eye out for signs of relapse. The nursing home hopes that other facilities will soon copy their treatment program elsewhere and get even more addicted seniors the help that they need.
Very few caregivers are ever asked by their loved one's doctors or other professionals how they are coping with the care of another. Questions like whether the caregiver is eating properly, exercising, sleeping enough, become depressed, or getting any free time is often overlooked. Thankfully, some physicians and other healthcare professionals have noticed the lack of care given to the actual caregivers, and they are doing something about it.
The Invisible Patient
Dr. Ronald D. Adelman, co-chief of geriatrics and palliative medicine at Weill Cornell Medical College recently gave a talk in addition to publishing an article about "the invisible patient," the caregivers of the elderly. He contends that doctors should be assessing caregivers when they check on their elderly patients.
The invisible patient refers specifically to a person supporting an elderly family member with dementia, heart disease, diabetes, or all of the above. Currently in the United States there are over 43.5 million people providing this type of care to a loved one over the age of fifty.
Recommendations for Caregiver Assessment
Dr. Adelman recently published an article in the Journal of the American Medical Association discussing the burden of caregivers with the objectives of providing strategies to diagnose, assess, and intervene for caregiver burden in clinical practice as well as evaluating evidence on interventions intended to avert or mitigate caregiver burden and related caregiver distress. He found that physicians have a responsibility to recognize caregiver burden. In addition, caregiver assessment and intervention should be tailored to the individual circumstances and contexts in which caregiver burden occurs.
Some of the risk factors for the invisible patient that should trigger assessment by doctors include:
Being a woman
The number of hours of care provided
The complexity of medical tasks such as dealing with wounds, catheters and complex medication routines
Transitions from one kind and location of care to another, like from home to hospital, to rehab, to skilled nursing care or to hospice
Level of cognitive impairment in the patient
A less educated caregiver
A caregiver who lives with the patient
A lack of choice in assuming the caregiving role
The recommendations given in the article for treating physicians are fairly straightforward. It includes asking a caregiver a simple question like how they are doing, to more complex questions about making other arrangements for care if something were to happen to the caregiver. The article also encourages doctors to use a toolkit to assess the needs of the caregivers provided by the Family Caregiver Alliance.
Resources for Caregivers
In larger teaching hospitals, there are usually social workers and other professionals on staff to assess caregivers when their loved ones are brought in for treatment. Some hospitals are requiring that all medical students spend at least one rotation on the geriatric floor, regardless of their career aspirations, in order to understand and appreciate the warning signs for caregivers.
Doctors in the private practice are already used to making referrals to medical specialists, but this recent study encourages the development of a network for nonmedical referrals, too. Community agencies, visiting nurse services, geriatric care managers, elder care lawyers, and the like can all be utilized to help the invisible patients care for their loved ones.