Hillary Clinton Puts Family Caregiving on the Political Front-Burner

For the first time in years, maybe for the first time ever, a major presidential candidate has put family caregiving on the political front-burner. Over the weekend, Democratic presidential frontrunner Hillary Clinton proposed a package of ideas aimed at assisting those who are caring for aging parents or other family members.

Her ideas are modest and won’t provide the level of help many family caregivers need. But she made the issue of caring for frail parents or younger people with disabilities a key plank in her campaign. She’s talking about it. And that will force other candidates to talk about it. That is an enormous step forward.

Building Better Long-Term Care Insurance

Can the US do a better job of designing long-term care insurance? The answer is yes, according to two important new studies. With hard work and political will, we can develop better ways to help pay the enormous cost of long-term supports and services.

The new research is a big step towards improved financing of these services. It did not find a “magic bullet.” But it did show how various options differed from the current system and from one another: There are big differences between voluntary and mandatory insurance, and smaller, but important, distinctions among the voluntary programs. To learn more about the main study, take a look at this article in the journal Health Affairs (which I helped write) or this more technical paper.

Will Renaming Senior Housing Boost an Industry or Enable Consumer Denial?

Would you rather live in a Life Plan Community or a Continuing Care Retirement Community (CCRC)? The market research folks have the answer: Most older adults, especially those under 65, would much rather live in a Life Plan Community than a CCRC.

Even though they are exactly the same thing.

Are Seniors Getting Too Much Medical Treatment?

Older adults are getting too much medical treatment.

No, I am not suggesting we ration treatment for seniors or empower the mythical death panels. Rather, the health system should replace aggressive but ultimately useless medical interventions with more care.

This means rethinking the way we care for older adults with chronic disease. We should organize care around the goal of improving their quality of life rather than on aggressively treating their specific medical conditions. Rather than doing that third scan on the same body part, we could better spend our dollars on home delivered meals or an adult day program for an otherwise homebound senior. Every decision should be based on the answers to two simple questions: Is it what the patient wants? Will it improve her quality of life?

The Challenges Of Caring For A Loved One With Dementia

Family caregivers help loved ones suffering from many illnesses, from heart disease to severe arthritis. But a new study shows that one condition—dementia—places an outsized burden on those family members. They spend more hours, do more difficult work, and provide assistance for more years than family members caring for older adults without memory loss.

An article in the journal Health Affairs reports that while people with dementia account for only about 10 percent of older adults living at home or in residential care, 41 percent of family caregiving hours are spent assisting loved ones with Alzheimer’s and similar diseases.

Should You Stay In Your Home As You Age Or Move To A Senior Community?

Older adults may be better off living in age-segregated communities than in neighborhoods or buildings filled with young adults or families with kids. They may have better support, access to more services, and even a better sex life. That, at least, is the conclusion of University of Florida professor Stephen Golant, an environmental gerontologist and expert in the housing of aging populations.

Golant is no shill for senior communities. And he notes that many older adults end up in age-segregated communities through simple inertia rather than moving to formal senior living. Often, they age in place surrounded by other older adults doing the same thing. Big cities, for example, are full of apartment buildings populated by widows who were once young mothers. Their children moved on, their husbands died, but they stayed.

Untangling the Medicare Premium Mess—And What It Means For You

If the government doesn’t act soon, nearly one-third of Medicare beneficiaries face a 50 percent increase in their Part B premiums for 2016, while more than two-thirds will pay no premium hike at all. Most beneficiaries will pay the same monthly premium next year as they paid this year–$104.90. But others making the same income will pay $159.30. And some high-income retires will pay as much as $509.80.

Even worse, the big premium increases could encourage many seniors to take Social Security benefits earlier than they otherwise would—a policy that would only increase the burden on the federal retirement system. The premium hikes would also stick state Medicaid programs with an enormous unanticipated bill.

Americans Want Docs to Talk About End-of-Life.

The public overwhelmingly thinks doctors should have end-of-life conversations with older patients. It even thinks Medicare ought to pay for those talks. It just doesn’t want to have them, at least not yet.

Those are results of a new Kaiser Family Foundation poll, which found that 89 percent of respondents felt physicians should discuss end-of-life choices with them. But only 17 percent of all those surveyed, and about one-in-four older adults, said they have talked about death and dying with their doctors. The better news: About one-in-three people who have a debilitating disease have had “the conversation” (to borrow the title of Angelo Volandes book).

When $500,000 in Social Security and Medicare Benefits Isn’t Enough

A typical American turning 65 this year is in line to receive about $500,000 in lifetime Social Security and Medicare benefits. That’s more than $1 million for older couples. But many still won’t have enough money to pay for out-of-pocket medical care and long-term supports and services.

While the wealthiest seniors will have the resources to pay these hefty out-of-pocket costs, most older adults won’t come close. As with the overall population, there is an enormous gap between the incomes and assets of the best off and everyone else.

Easy and Inexpensive Ways for Older Adults to Prevent Falls

Falls are the leading cause of injury-related death among people 65 and older. One-third of older adults will fall, many will be hospitalized, and some will die. You’ve probably heard the common story: A frail senior is doing relatively well until she falls. She breaks a hip, everything seems to go downhill, and she dies.

But many falls are preventable. Two articles, one in the Journal of the American Medical Assn. and a one from the Harvard Medical School, provide some terrific, low-cost, low-tech ways to avoid dangerous falls. I’ve supplemented their advice with ideas from other sources. They all are based on two simple sets of solutions: changing behavior in small but important ways and changing your home environment.