Wednesday, March 31, 2010

More March 2010 Eldercare Notes

  • MedPage Today reports that family support doesn't necessarily lower seniors' anxiety about death.
    Surprisingly, in an ethnically diverse population of adults ages 65 and older, the presence of more relatives available to help actually increased extreme fears about dying by 13.4% (P<0.05), Ann Bowling, PhD, of University College London, and colleagues reported in the April Postgraduate Medical Journal. Their analysis of national surveys of older adults in the general population and in an ethnically-diverse British population showed a modest 2% to 8% reduction in extreme fear of death with higher quality of life across groups (both P<0.001).
  • Paula Span highlights adult day programs in this March 31 New Old Age blog post.
    Though almost 4,000 such programs around the country serve older adults who are frail, isolated, chronically ill or demented, I still think these adult day centers constitute one of the better-kept secrets in elder care.

    People who might otherwise sit home alone with the remote, or who might move into a facility because they can’t stay home alone, instead spend several days a week being active, social, stimulated, well nourished and — at health-oriented adult day programs like this one — monitored by nurses. At the end of the day, though, the participants go home to familiar surroundings, and the centers often provide the vans that take them there.
  • HemOnc Today and MedPage Today both reported on an Australia study that shows advance care planning among people 80 years old or older results in increased satisfaction with end-of-life care for both patients and their families.
  • This New York Times' Patient Money column offers guidelines and considerations to help families make decisions about what level of care your aging parents needs and can afford.
    In 2008, Duthie was one of 7,590 board-certified geriatricians in the United States. The Alliance for Aging Research says the country will need 36,000 geriatricians by 2030. In that year, there are expected to be 72 million Americans who are 65 and older.

    The geriatrician shortage is unlikely to be filled. The field is not as financially rewarding as others in medicine - geriatricians in private practice earned a median salary of $161,888 in 2006. That's less than half the median salary of those in specialties such as radiology and orthopedics.

    Geriatricians train one year longer than primary care physicians, a huge financial burden for students who emerge from their medical training with tens of thousands of dollars in debt. Little surprise, then, when fellowship slots go unfilled.
  • The New Old Age blog posts about the Community Living Assistance Services and Supporters Act (CLASS Act).
    The Class Act, a legacy of Senator Edward M. Kennedy, the Massachusetts Democrat whose widow and son were present to see the president sign it into law, sets up a voluntary government-run long-term care insurance program available through employers. Those who participate will pay monthly premiums. After five years, they’ll be covered and can receive benefits if they need care — whether they are 20-somethings in snowboard accidents or 80-somethings with Parkinson’s disease.

    The program is not designed to pay the entire cost of long-term care, which can reach horrifying levels, but it will provide substantial help. And because participants will receive cash — $50 a day or more, depending on how disabled they are — they can buy the kind of assistance that makes sense to them. One person may choose to retrofit his home so he can remain there; another may hire a home care aide or a family member who wants to help but can’t afford to forgo income. People can use their Class benefits for assistive devices, adult day programs, assisted living or nursing homes.