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More People are Dying at Home and in Hospice, But They are Also Getting More Intense Hospital Care

More people over 65 are dying in hospice care and fewer are dying in hospitals. But this good news is tempered by a very different story. People are also being hospitalized more frequently in the last three months of their lives, are more likely to spend time in intensive care units, and are often receiving hospice care for just a [...]

By |2013-02-06T19:49:40-05:00February 6th, 2013|Aging, End of life, Hospitals, nursing homes|0 Comments

A Right Way and Wrong Way to Confront Elder Abuse

Elder abuse is a serious and growing problem we know too little about and, worse, too often ignore. It comes in many forms—physical, financial, and emotional. Yet, even as society focuses on addressing child abuse, it has fallen far behind when it comes to responding to elder abuse. Here are a couple of examples of the right way, and the [...]

By |2013-01-30T20:48:19-05:00January 30th, 2013|Aging, elder abuse, nursing homes|4 Comments

How Teamwork Across the Health System Can Keep Seniors Out of the Hospital

Broad-based, integrated, community-wide initiatives can help keep seniors out of the hospital, says an important new study from the Journal of the American Medical Association. The study, done by a team led by Dr. Joanne Lynn of the Altarum Institute’s Center on Elder Care and Advanced Illness is new evidence that by working together, hospitals, physicians, social workers, nursing homes, [...]

Learning the Right Lessons from Hospice

Health policymakers love the idea of hospice. Yet Medicare seems to be learning exactly the wrong lessons from the success of the program, which provides well-integrated patient-centered comfort care to people with terminal illness. Instead of trying to understand why hospice is growing in popularity, Medicare is instead making it harder to enroll. As often happens in its regulation of [...]

By |2013-01-18T17:16:59-05:00January 18th, 2013|Aging, End of life, Medicare|4 Comments

What Could Congress’ Long-Term Care Commission Accomplish?

On New Year's Day, as part of the law that kept the nation from toppling over the fiscal cliff for two months, Congress quietly repealed the Community Living Assistance Services & Support (CLASS) Act, and created a new commission to recommend broad long-term care reforms that could affect financing, delivery and care workers. I was, and continue to be, very skeptical about the commission's ability to [...]

Fiscal Cliff Deal Repeals CLASS Act, Creates Long-Term Care Commission

The New Year's budget agreement to avoid the fiscal cliff includes two key measures that could be critical to people receiving long-term supports and services and their caregivers. The first repeals the Community Living Assistance Services and Supports (CLASS) Act. The second creates a new national commission to develop a plan for better financing and delivery of long-term care services. Unfortunately, there may be [...]

The Promise and Risks of Medicare Managed Care

In 2012, about 13 million seniors participated in Medicare Advantage (MA) managed care plans—about 27 percent of the Medicare population and twice as many as were enrolled just seven years ago. This rapid shift to managed care by seniors may be just a first step towards a fundamental change in the way Medicare is delivered and financed. And it has the [...]

By |2012-12-26T16:36:45-05:00December 26th, 2012|Care Coordination, Health Care, Medicare|0 Comments

Do You Really Want to Give Away Your Assets to Become Eligible for Medicaid Long-Term Care?

A new insurance company survey of financial advisers reports that four-in-ten have clients who ask about giving away their assets so they can become eligible for Medicaid long-term care.  Oddly, though not surprisingly, the same advisers report their clients say that a key goal of their long-term care planning is “maintaining control.” The online survey, by Nationwide Financial, questioned a [...]

By |2012-12-21T01:02:23-05:00December 21st, 2012|Aging, long-term care financing, Medicaid, nursing homes|1 Comment

States Expand their Medicaid Community-Based Services but Their Benefits Vary Widely

Slowly but surely, more people who receive Medicaid benefits for long-term supports and services are getting their care at home rather than in nursing facilities. Still, only about 3.3 million seniors and younger people with disabilities who require long-term care get such help at home—about 1 million more than in 2000. Overall, the program now spends about $50 billion or [...]

How Senior Communities Can Connect with Their Neighbors

Too often, we stash our elders away in institutional residential care facilities. And, sadly, even many active seniors choose to separate themselves from the broader world, opting for what they see as the safety and security of gated communities.   This week, I spent a couple of days in Rochester, N.Y., where the St John’s Living Community has developed two [...]

By |2012-11-30T21:16:28-05:00November 30th, 2012|Aging, aging in place, nursing homes, Senior housing|3 Comments