February is National Heart Month so now is a  great time to celebrate our amazing cardiovascular systems and learn a little bit more about how to keep our hearts healthy. Even if you have heart disease or have suffered a heart attack or stroke, there is a lot you can do to keep your system as healthy as possible. Aging Wisely’s patient advocates are here to help with information, resources and health management services.

HEART facts…did you know?

• Every day, your heart beats about 100,000 times, sending 2,000 gallons of blood surging through your body (a kitchen faucet would need to be turned on all the way for 45 years to equal the amount of blood pumped by the heart in an average lifetime).
• Laughter really may be great medicine: a good belly laugh can send 20% more blood flowing through your body.
• Don’t ever claim men don’t have big hearts! An adult woman’s heart weighs about 8 ounces, an adult male heart about 10 ounces.

Prevention, health management and safety are all part of a smart heart plan. Here’s a holistic plan for keeping heart healthy and some ways we can help in each area:

• Eat a healthy diet. A well-balanced diet keeps your body strong and your cardiovascular system healthy. This shouldn’t feel overwhelming…even small changes can make a big difference and a healthy diet can be a tasty one. The American Heart Association recommends: eating an appropriate number of calories for your activity level, eating a variety of foods from all the food groups (emphasizing whole grain foods/fiber, fruits and vegetables and getting at least a couple servings of fish/week), and eating less nutrient-poor foods. These tips are especially important as we age because our calorie and nutrition needs change. Nine out of ten Americans consume too much sodium, which increases risk for high blood pressure–check out this infographic about sodium consumption and ways to reduce intake. Aging Wisely’s patient advocates can refer you to professionals who can create a nutrition plan for you, can set up meal delivery or home caregiver services to ensure you have easy access to healthy meals that you enjoy and can help you monitor your nutrition intake and make changes.
• Get sufficient physical activity. We work closely with In-Home Fitness, a great group of personal trainers who specialize in older clients and helping individuals rehabilitate. We’d love to set up a consultation with them for you. We can also help with all kinds of resources for staying fit and set up caregiver visits to help keep you on track with regular activities. Some of our EasyLiving home care clients go out dancing each week or get a ride to their local fitness center or swimming pool. We want to keep you doing what you love (and staying physically and mentally healthy at the same time)!
• Manage stress and lifestyle factors. Quitting smoking is an important component of better health. If you need help with smoking cessation programs and support, we can offer advice and resources. As holistic care managers, we emphasize quality of life and overall well-being. Small changes in your lifestyle and connecting to healthy activities can be a vital part of a healthy, happy life. Physical activity and creative outlets can protect against stress.
• Be knowledgeable and know where to go for help. Check out the information from the American Heart Association: know the signs of a heart attack and stroke, prevention guidelines and understand your conditions (we’ll be bringing you the key information throughout the next month in our blogs and newsletter). We help filter through the information available to bring you reputable sources, expert referrals and the latest health news.
• Get good heart and medical care. Practice preventative medicine (did you know Medicare now covers most preventative care and screenings with no copay?) and talk to your providers about your risk factors. We can refer you to specialists and help you prepare for doctor’s appointments. Coordinated care produces better outcomes…that’s what we’re here for!
• Get help when you need it. Every individual should have a Vial/File of Life prepared so that emergency medical providers can access the information they need to help you. You might also want to consider a personal emergency response system for your home. If you live in an assisted care facility, your care manager can help ensure your chart is updated and key contacts are listed so your family and providers are notified if there is a problem or changes. We can help you when there is an emergency, with on-call services for Aging Wisely clients. There is nothing worse than trying to navigate a medical emergency without help and support. We can be there throughout the emergency, hospitalization (and discharge planning) and rehabilitation to help guide the way and ensure you understand what is happening and your options.

Give us a call at 727-447-5845 for help in any of these areas! We welcome your comments about what information you would like to see about heart health (and if you have not already signed up for our monthly Wise Words newsletter, you can sign up right on our home page or contact us with a request or comment).

Aging Wisely’s team of patient advocates brings you the latest news and information relevant to caregiving, healthcare and disability care. Our weekly blog posts are designed to inform and answer some of the most frequently asked questions we get from families. We also send out a monthly “Wise Words” newsletter, and if you’d like to receive it you can contact us online with a request.

As we wrap up 2013, we thought we would share some of the top news stories we reviewed this year and their implications for you.

Healthcare Reform and Obamacare

Obamacare was one of the stories that clearly got a lot of press in every type of media outlet. A lot of the current/coming changes related to Obamacare are not directly related to most seniors, however. All the press about the changes did have one negative effect on some seniors, however, in that scammers used it to their advantage. They preyed on the confusion over Obamacare in order to obtain personal information or extract unnecessary fees from elders.

Seniors who are covered under Medicare are not affected by Obamacare mandate. There were various changes made to the Medicare program with the health reforms, such as the gradual closing of the Part D doughnut hole and expanding preventative care benefits. Medicare recipients do not have to choose new healthcare plans under the exchanges, as they will continue to be covered by Medicare. As usual, Medicare recipients have annual opportunities to make changes to plans and there likely will be some changes to the Medicare Advantage landscape as incentives/pay structure changes. To read more on this subject, check out “What to Expect from Medicare in 2014” and “The Aging Wisely Medicare 2014 Fact Sheet“.

On the other hand, Aging Wisely’s patient advocates work with many disabled, chronically or critically ill clients who are not currently covered under Medicare. Some of the Obamacare changes offer new options for these clients. You can get an overview of the changing healthcare landscape here and contact us if you need help navigating these issues.

Assisted Living Exposé Reveals Problems in the Senior Living Industry

PBS Frontline did a piece entitled “Life and Death in Assisted Living” which exposed information behind several lawsuits against Emeritus Senior Living. The piece examined the larger picture of regulation and consumer protections in this massive industry. As we know as advocates, there is good and bad care in any setting. These types of issues have been uncovered in hospitals, nursing homes, in-home care and all types of institutional care over the years. Much of the financial abuse and neglect that elders face is actually perpetrated by family members, but this special did uncover some issues within this industry that should not be ignored. Assisted living was virtually non-existent 30 years ago so this is still a relatively new industry adapting to a drastically changing clientele. The population in most assisted living facilities is now much older and sicker than originally envisioned.

In our article on this topic, we focused on what we think is most important to families about this story. Rather than simply instilling fear, we hope to provide concrete ideas of how you can better evaluate care options and advocate for your loved ones. As long time elder advocates, we provide some of our key advice on finding quality assisted living care and ensuring quality eldercare after moving in to assisted living.

The World’s Aging Population

Florida has been a unique place for our Aging Wisely team to work. Our demographics in Florida have been “ahead of the curve” with a large elder population well ahead of the much discussed Baby Boom/Age Wave. Clearwater and St. Petersburg, Florida lead the statistics in terms of elder populations among similar cities of their sizes. We also have a large demographic of people who have retired to Florida from other locations, often with family members living elsewhere. These types of demographics are becoming more widespread as the Baby Boomer generation ages and society becomes ever more mobile. On a larger scale, this phenomenon is international in nature. While developing nations may still have lower life expectancies and higher birth rates, many nations are facing an aging population and drastically lower birth rates as people marry later and have fewer children.

In the European Union, for example, life expectancy (which rose by eight years between 1960 and 2006) could continue to increase by a further five years between 2006 and 2050 and would thus result in a larger proportion of people surviving to the ages of 80 and 90. The average number of children per women stands at 1.5 whereas the replacement level is 2.1. Immigration is offsetting these lowered population numbers in many countries. Therefore we are looking at very different dynamics in terms of issues like pensions, the makeup of the working population and family caregiving.

Japan has the world’s highest percentage of population over age 65 and this occurred in the shortest time span (again related to both higher life expectancy and lower birth rates). China is a different case, where declining birth rates have been, at least in large part, caused by government policy (the “one child policy”). Of course, rapid economic/lifestyle improvements have impacted the other side of the equation, with greatly extended life expectancy. This has led to what is known as 4-2-1 conundrum, in which each (only) child has four grandparents and two parents to care for. Filial piety is a traditional value and many families live in multi-generational households, but migration and the one-child policy have put strains on this system of family care. China has been dealing with this in various ways, from a policy in which parents can sue children for not visiting to small subsidies for elders whose only child died or is disabled. Institutional and private care options are also beginning to develop, with home care companies providing in-home support, the first private assisted living facilities opening, and Buddhist temple-based nursing homes. There is also an interesting eldercare volunteer program being tested.

With globalization and shared information, nations should be able to learn from each other and determine the best options to care for their older citizens. The U.N. began looking at these issues in 1982. In 2002 the Second World Assembly on Ageing in Madrid led to the plan of action on ageing which “called for changes in attitudes, policies and practices at all levels to fulfill the enormous potential of ageing in the twenty-first century.  Its specific recommendations for action give priority to older persons and development, advancing health and well-being into old age, and ensuring enabling and supportive environments.”

We want to extend our wishes for a happy, healthy 2014 to all our clients and friends! We hope that 2014 will be a year of good news and progress toward active aging and improved quality of life for all. We encourage you to check back with us for the latest news and information and contact us any time we can help!

You can reach our advocacy team via online contact or by calling 727-447-5845. We’re here to help with your Florida elder and disability care questions, patient advocacy issues, Medicare and much more!

As our previous blog post points out, the hospital discharge process is a key transition time. Without proper support and resources as well as good understanding of follow up instructions, many individuals will return to the hospital for reasons that could have been avoided. No one wants this, and it can be especially dangerous for elders and persons with chronic conditions.

If you are a family caregiver and an elderly loved one is hospitalized what can you do to ensure a safe transition after the hospital stay?

• Consider the discharge process as beginning at the start of the hospital stay. Find out who is responsible for discharge planning and introduce yourself, explaining that you will be involved and giving relevant information about the patient’s living situation, supports and concerns. Discharge may not seem like a top concern at the beginning of a hospital stay, but with shorter hospital stay lengths, good groundwork starts as soon as possible.

• Keep good records. An online personal medical record system is an ideal way to manage your loved one’s health history, medications, and store key contacts so this information can be readily available. You can also use a notebook or file to store the information, as long as you have it available and provide good information to new providers. Make sure you communicate information that is vital to your loved one’s health, such as medications that really should not be changed or typical complications or concerns that arise during hospitalization or procedures.

• Get to know the medical staff and check in about what is going on throughout the stay. Ask questions (and keep records as per above) about procedures, tests, expected outcomes, medications.

• Understand that you or a designated patient advocate will need to take charge in being the centralized hub of information. This includes ensuring you understand instructions, what will happen after discharge, and the functional status of the person (and therefore what support might be needed). Ask questions and anticipate concerns that might arise and do not hesitate to voice them.

• Consider using a professional patient advocate for consulting or assessment during this process. Aging Wisely’s Care Managers know the discharge process, use a systematic approach and can help families anticipate needs and find resources to help. If you are caregiving from a distance, this support is vital as it is very difficult to manage the discharge process from afar.

• Plan for the immediate transition time. The first day or two after discharge can be particularly problematic. Think about practical issues such as getting new medications, food and personal items while needing to attend to a person in a weakened state. Will you be able to help the patient from bed to bathroom? Services such as Medicare home health care and medical equipment rarely arrive immediately and are not meant to fulfill “custodial” needs, so you may need additional home caregiver support.

• Find out about the options for services and rehabilitation after the hospital stay. There are essentially three rehabilitation options: inpatient (i.e. at a skilled nursing facility/rehabilitation center), home health care (for someone who is considered homebound) and outpatient rehabilitation (going to a clinic or center to receive therapy). We will cover these in more depth in a future post, including the insurance ins and outs & we invite you to contact us if you have immediate questions.

• Ask for thorough discharge instructions in laymen’s terms and explain that you would like to be there when they are reviewed with the patient. Make a list of questions and help ensure you and your loved one are clear on instructions and who to contact if there is a problem later. Here is one example of a simple discharge form that you can provide if the hospital does not have one.

• Know your patient’s rights, including the option to appeal a discharge if additional planning needs to be done to ensure a safe discharge.

Our next blog post will contain a checklist of items to consider and ask about when preparing for your elderly family member’s discharge, as well as more on resources to help during the transition of care.

Contact us if you have immediate questions. Our Florida geriatric care managers serve as your professional patient advocate, providing caregiver support and consultation, as well as geriatric assessments and resources.

A professional patient advocate is someone trained to help individuals (and their families) navigate the often complex healthcare system. Many family members and friends act as an advocate on a regular basis as a loved one faces a hospitalization, health crisis or chronic illness and treatment path. However, a professional advocate such as a care manager offers experience, training and in-depth knowledge of how to ensure the best care and pathway to good health and quality of life.

As stated by the Professional Patient Advocacy Institute, “The cost of healthcare increasingly is the responsibility of the individual consumer, which has made consumers more and more cognizant of the true cost of services and the value of traditional sources of care and information. Yet still today, the healthcare system is not set up like other commodities where comparisons can be made easily. To provide advice when faced with healthcare challenges, an emerging group of healthcare professionals known as patient advocates are positioned to assist consumers in making informed decisions while providing guidance, advice and direction in navigating the complex healthcare system.”

What are some of the ways a professional healthcare advocate helps?

*Providing a professional assessment and recommendations for resources, education and care plan options.
*Reviewing your chart and medical records to identify any concerns, questions and to help you and your family understand your health situation and options in lay terms.
*Accompanying a patient to appointments, treatment, ER visits for care continuity. Helping to formulate questions for providers and ensure good communication.
*Helping organize your medical information and create an online, personal health record.
*Assisting during key transition periods (such as hospital discharge, transfer to a care facility, or a switch in providers, where most problems occur) to ensure continuity and anticipate and avoid concerns.

When does someone use a professional patient advocate?

*When recently diagnosed with a chronic illness or acute problem–to locate good providers, evaluate options for treatments and handle the emotional and practical impacts of the diagnosis.
*During key transitions or health crises such as an Emergency Room (ER) visit, hospitalization, hospital discharge to home, inpatient rehabilitation or choosing a care facility.
*On an ongoing basis, especially when managing a chronic illness, multiple diagnoses or some form of dementia, to ensure continuity of care and be a liaison between providers, patient and family.
*To help in organizing records, putting together a care plan, creating an online personal medical record and to generally get a better handle on one’s medical situation and be proactive in managing chronic conditions.
*During end of life care, to support patient and family in decision making, emotional support and navigating options.

What are the benefits of a professional patient advocate?

*When you work with an independent advocate, such as our geriatric care managers, you get an independent assessment, someone who works for you and can ensure you get what you need.
*Expertise in the healthcare system (as well as eldercare, social services and related support services).
*Professional training and specialized expertise in the areas you need–someone who can quickly point you to resources and has knowledge of some of the issues you might not even anticipate.
*Emotional support for you and your family. Health crises can be emotional and it can be difficult to manage the practicalities and make clear decisions when facing these emotions. A professional advocate is your sounding board.

Who are professional patient advocates?

Patient advocates come from a variety of backgrounds within the medical world. Some may work for insurance companies, employers or healthcare systems or providers. Others, like our Aging Wisely care managers, work directly for the individual and family–objectively, independently–navigating a range of healthcare systems and providers and providing patients with continuity.

Our Florida geriatric care managers not only have strong professional backgrounds (both academic and experiential) in social work, gerontology, and case management, but continue to pursue specialized training areas. Our team offers experts in areas such as end of life care, Multiple Sclerosis (MS), Alzheimer’s/dementia, transitions to care facilities and much more. To read more about our professional care management and patient advocacy staff, we invite you to review our team section.

Contact us today so we can answer all your questions about patient advocacy and to find out how we can help if you or a loved one is facing chronic illness, a healthcare crisis, or just want to be assured the best quality of care.