Wednesday, February 29, 2012

Hear We Go! Gender and Hearing Loss

Photo by Simon James
Age is the strongest predictor of hearing loss. A population-based study of 3,556 participants in Beaver Dam, Wisconsin showed the hearing loss in increasing percentages by age bracket:

21% of 48-59 year olds
44% of 60-69 year olds
66% of 70-79 year olds
90% of 80 to 92 year olds

(Data adapted from Table 5)


Aging is often a gendered experience. As women age, they are at greater risk of living alone, being in poverty, suffering from depressing and developing certain physical problems such as osteoporosis, hypothyroidism, and fibromyalgia. Men, however, experience a greater risk for hearing loss. There are various hypotheses for why men are at greater risk. Men often participate in recreational activities and occupations that have high decibel levels, including military service.

Thursday, February 23, 2012

Label Clothing for Nursing Home Residents

Photo by Bruce Guenter
If a person has moved into a skilled nursing center--for a short stay post-surgery or as a permanent move--it means they are having trouble managing day-to-day tasks, including laundry.  

Residents can have family members do their laundry for them; however, many residents rely on the laundry services provided at the nursing home.  

It's important to label items clearly with a laundry pen or by affixing an iron-on or sew-on label. 
By checking a few online Q&A sites about labeling clothes for nursing home residents, kids going to summer camp, and children in daycare, I found this information:  

Permanent Markers (i.e., Sharpies).
These are convenient, but they only last for about four washings.
Fabric Markers.   The ink lasts longer than permanent markers, but fabric markers are a little harder to find.  If your grocery store doesn't carry them, try a craft store or buy them online.
Iron-on Labels.   These are easy to apply if you know how to wield an iron, but these iron labels do not adhere well on some fabrics.  You can pay to have these printed or run them through your computer.
Sew-on Labels.  These are more expensive and more time consuming to sew on, but they are sturdier and have a longer life than marking with a permanent marker or a laundry pen.

Wednesday, February 22, 2012

Bingo--More Than Meets the Eye

Photo by Kimberly Malvar
The large windows in the dining room reveal storm clouds rolling in from the west. A kitchen worker removes the remnants of the lunch dishes while two activity directors put bingo cards at each place setting.

Over the next thirty minutes, the room fills with residents. Some move purposefully with the aid of a walker, wheelchair or scooter. Another resident comes in chatting with the certified nurse assistant who pushes his wheelchair. Constance arrives early so that she can lay claim to the best set of bingo cards. Her gaze shows great concentration. Is she using numerology to select the cards? Or does she feel the degree of luck contained in each?

Tuesday, February 21, 2012

Easing into Retirement

Photo by s_falkow
Very few baby boomers will move into full retirement directly after of forty years at the same company. Changes to our economy have made the relationship between employer and employee more fluid. More employers are hiring subcontractors, part-time employees or temporary workers.

Older workers are enjoying better health and they are working more often in the service industry—which is less physically demanding than the agricultural or manufacturing jobs that their grandparents worked. Consequently, they have the physical capacity to work into their seventies. The Bureau of Labor Statistics reports that the percentage of increase in older workers between 1977 and 2007 rose 85% for those 65-69, 98% for those 70-74 and 172% for those 75 and older.

Friday, February 17, 2012

Age-Related Changes to How We Write

Photo by Marc Moss
With the boomers moving into late adulthood, many are posing questions about what constitutes healthy aging in a variety of areas such as cardiovascular health, respiratory health, and cognitive health.

Unfortunately, more research to date has been done with diseased older adults as opposed to healthy older adults. Older adults would benefit from learning what changes might be disease related and what changes are normal and expected as part of healthy aging. Gerontologists and other scholars are now starting research to rectify this ommission in the literature. Nevertheless, some research exists here and there that describes healthy aging.

For example, T. L. Mitzer and S. Kemper published a study in 2003 that analyzed the biographical statements of 118 older women (ages 78 to 91) in an effort to find an explanation for what contributed to stronger writing samples. Strong writing samples did not correlate to the writer's age. Instead, strong writing was produced by those who were in better physical condition, had higher educational levels and higher cognitive status. The high-level writing samples had the following characteristics: less-varied vocabulary, longer utterances, more clauses per utterance, more grammatically complex structures, fewer fragments.

Monday, February 13, 2012

Does an Aspirin a Day Keep the Cardiologist Away?

Photo by and parsecs to go
Over the last decade, I have heard several people casually mention the benefits of taking aspirin daily as a way to prevent a heart attack or stroke. The only side effect mentioned was the risk of stomach ulcers.

Note: I am not a doctor. Please consult with a licensed medical professional about the medications you are taking, even over the counter medications. 

Recently, I have found that people need to weigh the benefits against multiple risks of taking aspirin daily. My concern is that people often take aspirin on their own initiative without consulting with their physician.

Last week, two dozen of my fellow graduate students and I had the assignment to research, share, and discuss research-based articles on the topic. (The links here are more consumer friendly for the more part.) These readings warned of these risks:

· Stomach ulcers
· Abdominal bleeding
· Bleeding all along the GI tract
· Further bleeding to the brain during a hemorrhaging stroke
· Ringing in the ears
· Hearing loss
· Cataracts
· Allergic reaction
· Interactions with various prescription drugs such as steroids, anticoagulants and other NSAIDs
· Interactions with dietary supplements

Friday, February 10, 2012

Manifold Factors for Rising Medicare Costs

Photo by Tyler aka trpO
Election year chatter includes discussions of ballooning costs of Medicare. Outlays for Medicare spending are projected to grow from $524 billion in 2010 to $938 billion in 2020.

Because many articles in the popular press about Medicare start with statistics about the graying of America, I assumed that the astronomical increases in Medicare spending are due to increases in the life expectancy in the United States. In 1900, the average life expectency beginning at birth was age 47; now it's 77. For those who reach age 65 today, they can expect to live another 18.6 years on average.

In addition to living longer, older adults constitute a larger percentage of the population: “About one in eight Americans are age 65 or above today, compared to one in 10 in the 1950s. By 2030, one in five Americans will be 65 or older, roughly the same as Florida today. The number of people age 65 or older will nearly double between 2000 and 2030.” (Source: Population Resource Center)
Closer inspection reveals multiple causes for Medicare cost increases. The Central Budget Office (CBO) prepared a report for Congress in January of 2008 that shares the results of three major studies. These three studies found slightly different percentages among 5 to 7 forces contribute to rising Medicare costs. The findings--combined into rough percentages--show that use of new technology (tests, devices, services, newly developed drugs, etc.) is easily the biggest contributor to rising costs:

· Technology-Related Changes in Medical Practice (50%)
· Personal Income Growth (16%)
· Prices in the Health Care Sector (13%)
· Changes in Third-Party Payment (11%)
· Administrative Costs (8%)
· Aging of the Population (2%)
· Defensive Medicine and Supplier-Induced Demand (scant, not even rounding to 1%)

(Source: Adapted from Table 2, Estimated Contributions of Selected Factors to Growth in Real Health Care Spending Per Capita, 1940 to 1990. Technological Change and the Growth in Health Care Spending, CBO, January 2008)

Wednesday, February 8, 2012

Glasses, Hearing Aids, and Dentures Not Covered by Medicare



Photo by Kent Landerholm
While Medicare does provide many benefits to older adults, there are several tests, items and services that are not covered by Medicare. This link leads to a webpage that provides a searchable list so that you can determine what Medicare does and does not cover.

Notably, Medicare does not cover the cost of hearing aids, dentures, or eye glasses (with the exception of one pair of glasses fitted after cataract surgery). This is unfortunate because of the following facts:

  •  CDC reports that About 25 percent of adults 60 years old and older no longer have any natural teeth.
  • People 65 plus have visual impairments at 3x the rate of people under 65: 18% vs 6%. 
  • About 1/3 of Americans between the ages of 65 and 74 have hearing problems. About 1/2 the people who are 85 and older have hearing loss. 

These items are vital for communication, but as the facts above show, they are commonly required.  Also,  they need to be replaced frequently, either because of changing need or because they are lost. They are easily misplaced in the home, but they can also turn up missing during hospital stays. Perhaps these factors played into the decision that individuals must pay for these items as one way to control Medicare costs. This may be an inelegant analogy, but car insurance does not cover the costs of replacing air filters and fan belts perhaps for parallel reasons.

Beneficiaries and their family members should remain aware of these exceptions and others in order to reserve funds for these much needed items. Go online or contact your local Area Agency on Aging to receive additional information about what Medicare does and does not cover. Also, consider subscribing to this blog SHICK in a Jiff, which provides short, easily understood information about Medicare coverage.

Added 8/8/2012. Since writing this, I have learned about AUDIENT, a program to help cover the cost of hearing aids.

AUDIENT helps low income people nationwide access quality hearing aids and related care at a significantly lower cost. AUDIENT income qualifies families to be eligible for a discount on brand name hearing aids available through the AUDIENT Alliance's national network of dedicated hearing care providers. Brand selection includes Oticon, Phonak, Siemens, Widex, & Unitron hearing aids. Any age – Income Test is 250% of FPL – size of household counts - http://www.audientalliance.org/index.php

Related:

Overcoming Communication Disorders Senator and Mrs. John Glenn Inform
Hear We Go: Gender and Hearing Loss
A Detached Retina Needs Immediate Care

Tuesday, February 7, 2012

Talking with Older Adults: Serving as a Witness

Photo by ClockworkGrue

As a life-long reader and a decades’ long teacher of English, I love to read. I cherish the information conveyed by the pages of a book. For similar reasons, I enjoy talking with older adults. They are dynamic storehouses of history. I delight in hearing of their experiences from the 1950s, 1940s, 1930, and even the 1920s--decades before my birth.

Yesterday, I had the privilege of talking with Gladys Bever, a woman who will turn 102 this summer.  Talking with her about  her childhood allowed me a glimpse into events from the 1910s. I visit her almost every Monday, and our conversations are often about the events of her week: what she had for lunch, who visited her on the weekend, a new photo added to the collection on her windowsill, the status of her newspaper that often takes an indirect route to her room at the nursing home. In an effort to open a new topic of conversation, I pointed out that we are both from California.

With that prompt, she talked about the presence of horses in her life during her childhood in a town 30 miles north of Sacramento. She and her older brother used to ride in a horse-pulled cart to school. After describing the horse, she then mentioned that she and her family traveled--sometimes by horse, sometimes by train--to the city of San Francisco where her aunt worked as a physician. She enjoyed the sites of that grand city and her time playing in some of the public parks.

Then she casually mentioned that she attended the World’s Fair held there in 1915, the year that she turned five.

Friday, February 3, 2012

Outrunning Father Time and the Grim Reaper for Those 50+

Photo by Rita T 
When I hit my late 40s, I became crushingly tired. I asked my doctor to run a series of tests in an effort to find the cause: Anemia? Thyroid problems? Diabetes? The labs came back with no evidence of a disease or disorder. I ended up talking to a number of middle aged women and doing a little reading. I concluded that the aging process was zapping my energy levels, and this was only going to affect me more each year. I now understand from first-hand experience that older adults need to expand their fitness regime to include the following:

· Cardiovascular /Aerobic Exercise (walking, elliptical, swimming)
· Strength Training / Weight Lifting (weight machines, free weights, hand weights)
· Flexibility /Stretching (yoga, pilates, calisthenics)

I had practiced yoga regularly in my early 40s, which helped me with flexibility and with stress management. However, it did not increase my muscle mass the way strength training does. By lifting weights, I increased the amount of muscle I have, which improved my metabolism. Cardiovascular exercise not only addresses heart health. It helps with cognition, balance, digestion, and more. Even with adding strength training and cardio to the flexibility workouts did nothing for "the middle aged spread." My weight that was not coming off even with upping my cardio to two hours a day, five days a week.