Over the last twelve months, my colleagues and I have spoken at length with close to one hundred Native American seniors across the state of New Mexico about their health care and health insurance. Since November 2016, these seniors have expressed profound apprehension about the future of health care and insurance coverage under President Donald Trump’s administration, both for themselves and for their friends and relatives. As one elderly woman put it, “I have care, but is [Trump] going to take that away from us?”
Most Americans assume that regardless of any changes to the Affordable Care Act (Obamacare), the healthcare needs of seniors will be covered by Medicare, which serves individuals who are 65 years of age or older and who have paid into the Medicare system via payroll taxes. In fact, even if the current Medicare system remains in place, Obamacare repeal will have profoundly harmful effects on older people, especially those under 65 who have low-incomes, live in rural areas, or are in need of long term care or help to stay in their homes. In fact, seniors are among the most likely people to be hurt by plans to replace Obamacare.
How Obamacare Has Benefited Seniors
Seniors age 55 and over make up an increasing part of the U.S. population and their healthcare needs are extensive and complex. The National Council on Aging estimates that 92% of older adults suffer from a chronic illness, such as diabetes or heart disease. Seniors also have high rates of cognitive health problems, including Alzheimer’s and dementia. A growing number of older adults experience mental health and substance use problems. Even as they face such health problems, many seniors have limited incomes and struggle with the costs of housing, food, and health care.
Although Obamacare is often seen as an effort to increase insurance coverage among younger and healthier people, it has also provided numerous benefits to seniors. These benefits are not only endangered by current replacement plans, they appear to be specific targets of Republican proposals. For instance, Obamacare’s prohibition of annual and lifetime limits on insurance coverage – as well as its limits on the ways insurance companies can raise prices for people with preexisting conditions – have made it possible for older adults with a variety of health problems to get affordable insurance and care.
Seniors have also benefitted from Obamacare’s expansion of Medicaid, which extended eligibility to adults at or below 138% of the federal poverty level. According to the Kaiser Family Foundation, more than six million seniors have received new coverage from Medicaid, including older adults under 65, Medicare beneficiaries with low incomes, and seniors who do not qualify for Medicare because they did not pay enough into that program during their working years. This last group includes elderly adults who are homeless or disabled, as well as those who were previously farmers, ranchers, and homemakers.
What is more, Medicaid covers long-term and in-home care services not covered by Medicare. These services allow seniors with serious medical concerns to receive high-quality care, either in a nursing facility or their own homes. In fact, the Kaiser Family Foundation estimates that 6 in 10 nursing home residents are covered by Medicaid.
In addition to extending these critical benefits to seniors, the Medicaid expansion has generated new revenues for providers of healthcare services that many elders need – including mental health and substance addiction services, transportation services, and help to purchase medical equipment needed by adults who wish to remain at home throughout their elder years. These improvements are especially important for seniors in rural areas, where service providers are sparse and patients must travel long distances to find care. As our research in the rural state of New Mexico reveals, healthcare providers report that Obamacare has helped them address the complex health issues faced by aging patients.
Obamacare has also significantly improved Medicare – by ensuring access to no-cost preventive care and screenings and expanding prescription drug coverage. Crucially, Obamacare addresses the previous Medicare gap in prescription drug coverage, where insurance did not pay for drug costs after an individual reached a certain level of costs. Obamacare discounts drug prices for seniors who fall into that coverage gap and aims to close the gap by 2020. Repeal of the law would significantly increase the cost of prescription drugs, disproportionately affecting seniors.
How Republican Plans Will Hurt Seniors Overall
Not only will repealing or reducing core benefits of Obamacare disproportionately hurt seniors, Republican proposals include provisions that will specifically penalize seniors, such as those that would let insurance companies charge older people up to five times more for insurance than younger adults. Families USA estimates that this could put marketplace insurance financially out of reach for 3.3 million people over the age of 55. Proposed caps on lifetime benefits and the elimination of regulations regarding the essential benefits that insurance plans must cover will put seniors at risk of “running out” of coverage as they age or being unable to afford insurance that will actually cover their medical needs.
Whether or not Obamacare is ultimately repealed, cuts to Medicaid – a core part of U.S. health insurance since 1965 — remain likely and will have especially harmful effects on the numerous seniors who rely on the program for long-term care, including the estimated one-third of American seniors who fall below 200% of the federal poverty line. In addition, reductions or caps to federal funding for state Medicaid programs will serve to deepen existing inequities in care for poor, older, and disabled people in the poorest and sickest states.
Better Care for Seniors Helps Everyone
Ultimately, while seniors have specific and complex needs, ensuring their health is important for everyone in all parts of the United States. When older people cannot get health insurance or adequate care, the burdens are often shifted to their adult children and grandchildren. Many seniors also care for their children and grandchildren, many of whom get help from Obamacare’s benefits for all low-income adults and children. Although Obamacare has very real limitations, the prospect of repeal is already plunging seniors into a state of fear and uncertainty. All Americans should join senior citizens in worrying about the drastic downsides for families and communities, especially in rural areas, if current Republican plans become law.
Music: The Secret to Mental Health and Balance While Aging
No matter where you travel, you’ll notice one universal truth — music has a very particular and powerful hold on us all. Cultures everywhere make and love music. This has been the case throughout history. We have used music to relax, communicate and celebrate — the human brain is hard-wired to react to music. According to Kimberly Sena Moore, a neurologic music therapist, “Your brain lights up like a Christmas tree when you listen to music.”
The magic of music goes much further than entertainment — there a surprising number of health benefits for the elderly, and there is a lot of evidence to support the fact that music is a secret weapon when it comes to maintaining optimal mental health and balance in our old age.
Boost Memory by Learning to Play an Instrument
If you want to ensure your memory is strong well into your winter years, consider picking up an instrument. Regardless of what you prefer to play, the act of learning how to play will sharpen your memory recall. This is because the process of learning and playing an instrument requires a great number of complex tasks, such as reading musical notes and knowing where to place your fingers. In time, this expands your working memory capacity and your ability to multiprocess without feeling overloaded. You will also be able to remember information for longer periods.
Music Can Act as a Stress Reliever
Coping with stress can become more difficult as we get older. We have less resilience to it, and it can affect us differently, which is stressful in and of itself. On top of changes in response to stress, we can experience changes in triggers as the years go by, so it is important we all find a way to cope.
There have been many studies to show music has a notable (and positive) effect on our stress and blood pressure levels. In fact, this is the case even if we’re not conscious. One study involving surgery patients found the use of music before an operation reduced stress levels to an even greater degree than anti-anxiety medication. The act of singing sends small vibrations throughout the body, which lowers cortisol (the stress hormone) levels and releases endorphins, thereby helping to keep you calm and collected in trying times.
Music Can Reduce Falls in the Elderly
Remarkably, studies show when the elderly exercise while listening to music, it helps them maintain balance and reduce the risk of falling. Falling is a huge concern for those over the age of 65, and music might well be the answer. According to a 2011 Swiss study, where participants were trained to walk and perform certain movements in time to music, they experienced 54% fewer falls when compared to the control group. The study also found that walking speed and stride length increased as a result.
A Good Drum Beat Can Kickstart Brain Function
The brain instinctively syncs to a rhythm. Because of this, therapists use drumming to get through to patients with severe dementia who don’t normally respond to external stimulus. When dementia patients hear music, you can detect a noticeable shift. They show more of an interest in their surroundings, they clap to the beat or even sing. This is because music can stimulate many parts of the brain simultaneously. Music which was popular when the patient was between the ages of 18 and 25 generally gets the most positive response.
Music Can Soothe Physical and Emotional Pain
Swedish researchers have found your favourite music can be a great pain reliever, as it can distract us and boost positive emotions. Interestingly, by evoking nostalgia, music can help us get through the pain, both physical and emotional.
Music Can Combat Depression and Boost Happiness
A serotonin imbalance in the brain causes depression. When you listen to music, you experience a boost in serotonin, so music can be used as a tool to combat depression in the elderly. Doctors claim the simple act of singing can release oxytocin, providing a significant mood booster. So while music alone may never entirely relieve the symptoms brought about by depression, it can certainly do its bit to enhance wellbeing.
Music Provides Opportunities for Social Interaction
Music can provide an essential source for social contact, which promotes interaction and a sense of belonging. This is increasingly important as we age. By incorporating music therapy and joining a choir, the opportunities to socialise and collaborate let us make new friendships and create new bonds.
Music Can Improve Quality and Quantity of Sleep
Many seniors don’t get as much sleep as they need, which can cause serious medical issues in time. Lack of sleep has been shown to have a profound and negative impact on mental health and wellbeing. A 2009 meta-analysis found music can improve the quality and quantity of sleep. Of course, the benefits may not happen overnight. But if you persist, in as little as three weeks, you should notice a pay off from this relaxation technique. Some of these include falling asleep faster and remaining asleep for longer.
Four Calming Techniques to Improve Your Mental Health
If you are like me and the other nearly 325,000,000 trillion people in the U.S., you have experienced stress. From raising kids, dealing with your boss or handling a health issue, you can feel overwhelmed. But there’s good news! Learn how to create peace and take control of your life.
Determining the Type of Stress
Most people do not realize stress, a response to stimuli comes in two varieties which is good stress and bad stress. Bad stress or distress happens when your perception of an event is threatening. According to Stress Management Society, “Through the release of hormones, such as adrenaline, cortisol…the caveman gained a rush of energy…”. This onset of biological and emotional reactions resulted in the need to fight or flight.
Good stress or positive stress is the opposite response. It is marked by feelings of happiness and a sense of confidence. Your thoughts are focused and the energy is motivating.
Four Paths to Calm
Now that you know more about stress, you can start to manage it. Try these tips to make stress ignite your creativity and passion. Make stress work for you.
1. Keep It in Perspective
So, how do you transform your bad stress into good stress? Change your perception. If your job causes you to relocate, consider it a career opportunity. If the throbbing in one of your molars means you need a root canal, don’t panic. Discuss it with an emergency dentist Calgary. Consider it an investment in your health.
2. Calm the Monkey
Your mind races with thousands of thoughts all day. Anxiety builds as you obsess about future concerns. What if this happens, what if that happens? Stop!
Just breathe. As you mindfully count from 1 – 10, inhale and exhale slowly. Feel your heart rate decrease.
The Buddhists used this breathing method for quiet meditation to conquer the Monkey Mind or frenzied mental condition. In Mindfulness: Taming the Monkey Mind by Mitchell Wagner, the author states, “It is not possible for the mind to be open…when it is consumed by anxiety.”
3. Choose the Right Foods
What do yogurt, pistachios, and spinach have to do with relaxation? They contain key ingredients which affect your mood.
Spinach & Avocado
The folate found in this green leafy vegetable produces dopamine, a chemical producing feelings of pleasure. Folic acid improves memory in adults experiencing stress. Avocados are also high in folate and vitamin E.
This comfort-inducing snack is filled with probiotics. It delivers healthful live bacteria in the gut linked to good mental health.
Strawberries, Raspberries, & Blueberries
These fruits are high in vitamin C which helps fight stress.
4. Become a Yogi
Yoga is a tradition dating back 300 years ago. Yoga is low impact and is a synergy of mind, body, and soul.
The International Journal of Yoga published “Exploring the therapeutic effects of Yoga and its ability to increase the quality of life” and found “Yogic practices enhance muscular strength…reduce stress, anxiety…”. Bikram, Hatha, and Kundalini are some of the best forms of yoga for beginners.
Invest in Stress Management
Consult with your doctor. Read books and attend local exercise classes. Stay up-to-date about trends.
Stress is a part of life. Learn stress management. Anticipate the unexpected and choose a strategy challenging you to do your best. Then, sit back and relax.
Loneliness Found to Be High in Public Senior Housing Communities
Older adults living in public senior housing communities experience a large degree of loneliness, finds a new study from the Brown School at Washington University in St. Louis.
Nevertheless, senior housing communities may be ideal locations for reducing that loneliness, the study finds.
“There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities,” wrote Harry Chatters Taylor, doctoral student at the Brown School and lead author of “Loneliness in Senior Housing Communities,” published in the Journal of Gerontological Social Work.
The study was co-authored by Yi Wang, doctoral student at the Brown School, and Nancy Morrow-Howell, the Bettie Bofinger Brown Distinguished Professor of Social Policy and the director of the Harvey A. Friedman Center for Aging.
The study examines the extent of loneliness in three public senior housing communities in the St. Louis area. Two of the three complexes were in urban neighborhoods, and the last was located in a suburban neighborhood. All were publicly funded under Section 202 Supportive Housing for the Elderly Program. Data for the project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement and social support.
Results showed approximately 30.8 percent of the sample was not lonely; 42.7 percent was moderately lonely, and 26.6 percent was severely lonely. In analyzing the data, researchers found loneliness was primarily associated with depressive symptoms.
“We speculate that loneliness may be higher in senior housing communities for a few important reasons,” Taylor said. “The first is older adults residing in senior housing communities often have greater risk for loneliness. In order to qualify to live in these senior housing communities, older adults must have a low income, and having a lower income is a risk factor for loneliness.
“Additionally, most of the residents we interviewed identified their marital status as single, which is another risk factor for greater loneliness. Many older adults living in senior housing communities also have greater health and mental health vulnerabilities, which increases the likelihood that an older adult will experience loneliness.”
Despite all that, the study finds, senior housing communities may be better suited to combat loneliness than traditional residential homes.
“We believe that senior housing communities could become ideal locations for reducing loneliness among older adults,” Taylor said. “Senior housing communities are embedded in communities with peers who may have similar age and life experiences. There are occasional activities and support from senior housing management to encourage the building of friendships, bonds and social support among senior housing residents.
“Most senior housing communities also have a common space or multipurpose room available for use, which can also help facilitate building bonds between residents. Senior housing communities are frequently located close to public transportation, which provides access to transportation for residents without automobiles.”
Still, loneliness is frequently a stigmatized condition, he said.
“We often do not like to talk about our feelings of loneliness,” Taylor said. “For practitioners, it is important to be patient when working with older adults, and it could take a while for an older adult, regardless if they reside in a senior housing facility, to admit they are feeling lonely.
“Whether you are a child, relative or family member to an older adult, or provide services to older adults, be patient when discussing issues of loneliness and mental health with older adults.”
Medicare For All – Protection for Your Retirement Plans
An unexpected medical emergency, a life-changing diagnosis, or a car accident are a number of countless situations that can land us in the emergency room, setting off a chain reaction of diagnostic tests, follow-up appointments, prescriptions, treatments, and more. Of course, this all has a significant implication on your pocketbook, and even if you have insurance, the bills can still be staggering.
Health insurance is supposed to be an investment, a sort of safety net to minimize your financial obligations in the event of a significant health illness or injury. But rising premiums, high deductible plans, and coverage exclusions have rendered comprehensive, quality, affordable insurance plans a thing of the past.
This can have significant implications for older adults nearing or at retirement age. A car accident, a cancer diagnosis, or any number of other health issues can quickly drain away savings, including retirement plans.
Health Care Costs Threaten Retirement Plans
Amassing a retirement savings large enough to provide a comfortable living for decades is no small feat. Because seniors tend to see increased health issues and health care costs in their latter years of life, a significant portion of their retirement plan needs to be able to cover those increased costs.
According to a study performed by Fidelity, a 65-year-old couple retiring in 2017 will need to cover approximately $275,000 in health care costs throughout their retirement. That amount reflects a 6% increase over the 2016 figure of $260,000. However, that estimate has increased more than 70% when compared with the initial estimate ever performed by Fidelity back in 2002.
Simply saving up enough money to be able to retire can be a challenge, especially when you encounter unexpected health issues and emergencies earlier on in life. According to a survey by Bankrate, only 41% of adults say that they have enough money in savings to be able to pay off an unexpected cost. However, 45% of survey respondents indicated that they’d had a major unexpected expense in the past 12 months.
And if a family has a high-deductible insurance plan, a single visit to the ER can cost tens of thousands of dollars. Families without adequate savings may feel pressured to reach into retirement savings to fund the emergency, leaving them with even less savings than they’d had initially.
A Compounding Problem
The issue of health care costs depleting retirement savings becomes even more urgent when you consider the seniors who can’t afford to retire at all. The U.S. Jobs Report indicated that the retirement age is increasing, with almost 19% of United States seniors aged 65 or older were working at least part time during the second quarter of 2017. Additionally, 19% of 70- to 74-year-olds were still working.
Working later into life leads to increased retirement savings, but this isn’t a practical option for many seniors. Health issues force many seniors to quit their jobs even if their retirement savings aren’t yet large enough to provide them with long-term security.
Simply finding a job can be a challenge, since employers may be more reluctant to hire seniors (despite age discrimination laws). Seniors may find themselves with fewer job options and may have to settle for lower-paying jobs with poor health insurance policy offerings.
Medicare for All: Protecting Retirement Savings
Medicare for All could be a solution to this growing problem. With single-payer health care, all Americans could enjoy protection against unexpected large medical bills. Americans wouldn’t need to dip into their retirement savings for health-related emergencies. And with reduced health care costs, they could put more earnings into their retirement plans.
If more Americans were able to put aside more retirement savings, they could retire at age 65 without having to worry about extending their employment into their senior years. They could enjoy reduced stress and could focus on healing after a health crisis, rather than worrying about the massive bills that would follow.
With access to the medications and treatments that they need, Americans could enjoy better health, happiness, and an improved quality of life. Isn’t that what we want for our seniors, our retirees, and all American citizens?
Social Workers Can Now Learn Medicare Online and Earn Continuing Education Hours
Social workers can now earn continuing education hours while they learn Medicare at their own pace, anytime and anywhere with Medicare Interactive (MI) Pro, an online Medicare curriculum powered by the Medicare Rights Center.
MI Pro provides the information that social workers and health professionals need to become “Medicare smart,” so they can help their clients navigate the Medicare maze. The online curriculum contains information on the rules and regulations regarding Medicare—from Medicare coverage options and coordination of benefits to the appeals process and assistance programs for clients with low incomes.
“For over 25 years, social workers have been turning to Medicare Rights’ helpline counselors for clear and concise information on how to help their clients access the affordable health care that they need,” said Joe Baker, president of the Medicare Rights Center. “Now social workers can enroll in MI Pro and learn—or enhance—their Medicare knowledge at their convenience while fulfilling their continuing education requirements.”
The Medicare Rights Center, a national nonprofit consumer service organization, is the largest and most reliable independent source of Medicare information and assistance in the United States.
Licensed Master Social Workers and Licensed Clinical Social Workers can earn continuing education hours when they successfully complete any of the four MI Pro programs: Medicare Basics; Medicare Coverage Rules; Medicare Appeals and Penalties; and Medicare, Other Insurance, and Assistance Programs. Each MI Pro program is comprised of four to five course modules.
All MI Pro programs are active for one year following registration.
MI Pro courses are nominally priced. Additionally, social workers who purchase all four programs at once will receive an automatic 20 percent discount.
Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.
Available only through the Medicare Rights Center, Medicare Interactive (MI) is a free and independent online reference tool that provides easy-to-understand answers to questions posed by people with Medicare, their families and caregivers, and the professionals serving them. Find your Medicare answers at www.medicareinteractive.org.
The Critical Role of Caregivers, and What they Need from Us
Caring for loved ones who have aged or become disabled is not a new concept. Many of the services provided in hospitals, clinics and even funeral homes were once provided by families at home. Particularly in communities where traditional cultural beliefs are highly valued, taking care of an aging parent or grandparent is still a responsibility that families (usually women) are expected to take upon themselves. Inner discord can arise when caregivers challenge these traditions which can lead to guilt and in some cases lawsuits.
For example, proceedings from a roundtable hosted by the National Hispanic Council on Aging revealed that caregiver stigma is prevalent among Latinos, which can prevent them from seeking support and resources. Without help, the risk for burnout increases.
Results from a 2015 study by the National Alliance for Family Caregiving and AARP revealed that “an estimated 43.5 million adults in the United States have provided unpaid care to an adult or a child in the prior 12 months”. This number is likely to increase in the coming years due, in part, to an aging population.
Family caregivers perform a variety of services, including helping with ADLs, dispensing medications, managing finances, attending doctor appointments and advocating. Many do so while maintaining full-time employment outside of the home.
Respite is Essential, but lacking
The physical cost of caregiving is staggering, and there are few opportunities for respite. Even when respite is available, caregivers must consider the care recipients’ safety, and their desire to leave home. A person who has a disability or is ill can still make decisions regarding their care. So when they say no to respite care, it can’t be forced upon them. Desperate for a break, some caregivers have gone to extreme measures such as dropping off their loved one at the emergency room for respite. This is a problem that should be addressed in the years to come. But how?
Changes in the workplace
More companies and organizations are beginning to understand that caregiving without support can negatively impact worker productivity. In response, some companies have revisited their policies regarding family leave, allowing flexible work schedules and work from home opportunities. As employers seek new talent, they may find that policies such as these are attractive to job seekers. Two major companies, Deloitte and Microsoft, made headlines after incorporating paid time into their family leave policies. Other companies have adopted similar models.
As the nation grapples with how to provide better support to caregivers, it will need to improve major areas like extending paid leave to family caregivers, creating financial stability for those who need to provide full time care, and providing necessary training and respite to ensure the mental and physical well being for both the caregiver and the recipient. These changes require a shift in how we think about providing care, and changes in policy.
Caregivers are operating on tight schedules and don’t always have time to attend in person support groups. So having the option of connecting with others through online chats and support groups is more convenient for some caregivers. In addition, they could benefit from ongoing training and resources that will help them to more effectively and safely care for their loved one. This past September, the U.S. Senate passed the RAISE Act, which would require the development of a national strategy to address the growing challenges and economic impact of caregiving. The bill must now go before the House of Representatives.
The financial costs of caregiving cannot be ignored, and the average social security beneficiary does not earn enough to shoulder the burden of the financial costs they incur. Most caregivers likely work not only to maintain a sense of identity but also out of necessity.
Caregivers can face stressful decisions when it comes to choosing between work and providing care, particularly when their loved one is seriously or terminally ill. Too often, relatives are not eligible to be a paid for their time. And when they are, the earnings are not enough to make ends meet. Unfortunately, many caregivers often place their loved ones in skilled nursing facilities, simply because they cannot afford to care for them at home.
The question of who should provide care and how they will provide is one that has yet to be answered. While they wait, however, caregivers are facing stress and financial burden with few desirable options for support. And care recipients aren’t getting the care they so desperately need.
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