Monthly Archives for June 2001

The Best of…Elder Abuse and Neglect on the Increase

Published June 25, 2001, Pawtucket Times

Although numerous federal studies and Congressional hearings have put the public spotlight on elder abuse and neglect over the years, a Special Senate on Aging panel calls for the nation to get serious to tackle this all-to-common tragedy, called by some “the dark side” of aging.

“With the senior population skyrocketing, incidents of elder abuse will only continue to rise,” warned Democratic Chairman John Breaux of Louisianato his panel colleagues at the June 14th hearing.   At the hearing Senator Breaux took over the reins of the Aging  Committee from the former Chairman Republican Larry Craig ofIdaho, with the Senate majority tipping to the Democrats.  Initially it was Senator Senator Craig who had planned and put the hearing on the Senate schedule.

At the  hearing, Chairman Breaux estimated that more than 820,000 older and developmentally disabled individuals are subjected to abuse, neglect and exploitation.  Meanwhile, throughout  the hearing “Elder Abuse, Neglect, and Exploitation: A Hidden National Tragedy,” several witnesses testified that this number is too low because of underreporting and there are no universal definitions of what is elder abuse and neglect.  To combat abuse, Chairman Breaux and the witnesses called for more funding to be provided to adult protective services, better training for medical personnel to identify the problem early and more resources for caregivers to help them with their caregiving responsibilities.

Despite the fact that many believe that elder abuse and neglect take place in nursing facilities and assisted living facilities, most often times it occurs in a person’s home where nearly 95 percent of all domestic long-term care is being informally provided by family members and community-based caregivers, noted Chairman Breaux.

Summing up testimony from hearing witnesses, a Senate Aging Committee staffer told The Times that elder abuse can be caused by social, medical and legal factors.

“We are expecting families to provide a large amount of long-term care and we give only minimal assistance and support to them,” the Senate staffer said.  To deal with social factors causing elder abuse and neglect, “we need more respite care and training in care giving skills.” he added.

As to medical factors, the Senate staffer added, “it is crucial that better training be made available to physicians and nurses to recognize the early signs of elder abuse itself.”  If this occurred there could be much quicker interventions, he said.

Finally, legal factors, specifically the lack of funding for elder protective services, reduce the effectiveness of prosecuting persons who financially exploit elderly.

So what’s happening inRhode Island?

According to Wayne Farrington, Chief of Facilities Regulation,Rhode Island’s Department of Health, elder abuse is on the increase in nursing facilities and assisted living facilities across the state.  “This year we have had about a 15 percent increase in reports of abuse, neglect or mistreatment,” he says.  Farrington speculates that the rise in reporting is a result of a better informed public who know where to register complaints combined with increased publicity over the staffing shortage in nursing facilities and community-based provider agencies.  The shortage of nursing assistants, who provide most of the direct patient care, along with nurses oftentimes results in the facility not being able to provide the needed care.

“Because neglect abuse and mistreatment are criminal matters they are turned over to the Rhode Island Office of the Attorney General for further investigation and prosecution, Farrington says.  “If we find that facilities have violated regulations that have resulted in the abuse or neglect we will cite the facility with deficiencies that may be tied to civil monetary penalties.

According to Medicaid Fraud Unit Chief Bruce Todesco, of the state’s Office of the Attorney General, there are really no accurate statistics or numbers that tell the incidence of elder abuse and neglect inRhode Island.  “A lot of information comes from different sources,” he said, stressing that it would take a lot of work to pull together meaningful statistics.

Adds, Genevieve  Allair-Johnson, Special Assistant Attorney General who serves as Elderly Affairs Liaison for Criminal Division, in the Attorney General’s Office, elder abuse and neglect cases may be under reported because the elderly person does not want to proceed against the child and competency issues often times come into play.

“We work closely with the Department of Elderly Affairs and local police departments and provide them with legal assistance in their investigations, Allair-Johnson says.  “When discussing a case sometimes it comes up that additional inquiries will have to be made to bring about charges.”

Allair-Johnson states “Many times criminal charges will not be filed in cases because high standards must be met.”   Rather than filing criminal charges for elder abuse or neglect other options are in place like removing the elderly person from a home, or seeking a court ordered guardianship.

Over the last few years the Office of the Attorney General has developed effective partnerships with the local police departments, Department of Elderly Affairs, and the Alliancefor Better Long-Term Care,” Allair-Johnson says.  “There are a host of state agencies and resources that are beginning to pull together to resolve this elder abuse issue. We’re going in the right direction.”

To obtain materials on elder abuse, including the pamphlet “The Elder Victims Guide to the Criminal Justice System,” or to seek information about consumer issues or to report elder abuse, neglect and financial exploitation, call the Attorney General’s Senior Line at 888-621-1112.

If one has a reasonable knowledge and suspects an elderly person has been abused neglected or mistreated in a nursing facility call the Division of Facility Regulation at 222-2566.

Herbert P. Weiss is a Pawtucket, Rhode Island-based  free lance writer covering aging, health and medical care issues,  This article appeared in the June 25, 2001 in the Pawtucket Times.   He can be reached at hweissri@aol.com.

Many Seniors Struggle with High Cost of Medications

Published in the Pawtucket Times on June 18, 2001

Many seniors are struggling to pay the spiraling cost of prescription drugs as a politically divided Congress seeks a solution by crafting a bipartisan prescription drug benefit tied to Medicare.

Until this issue is addressed, a tragedy occurs in many communities across the nation.

Often, the high cost of prescription drugs has forced seniors on fixed incomes into not taking their medications at all or using only partial doses.

Noncompliance in taking medication can lead to hospitalization, nursing home admission or premature death.

According to the Families USA study released in June 2001, costly prescriptions continue to hit seniors hard in their pocketbook.

The report found that 50 of the most heavily prescribed drugs for seniors on average rose more than twice the rate of inflation in the year ending January 2001.

On average, the researchers found that prices increased by 6.1 percent from January 2000 to January 2001, though the rate of inflation excluding energy in that time period was 2.7 percent.

Furthermore, the 18-page report stated that seniors are most affected by any prescription drug price  increase.

Although older persons represent just 13 percent of the total nation’s population, they account for 34 percent of all prescribed medications dispensed and 42 percent of all prescription drug spending.

Of the 50 drugs used more frequently by seniors, the average annual cost per prescription as of January 2001 was $ 956, the report noted.

Drug prices rose significantly over the one-year period of the study.

The report findings revealed that the cost of Synthroid, a synthetic thyroid agent, rose by 22.6 percent; 22.5 percent for Alphagan, commonly used to treat glaucoma; 15.5 percent for Glucophage, prescribed for treating diabetes; and 12.8 percent for Premarin, used estrogen replacement.

While rising drug costs are national, Rhode Island fiscal nets are in place to make prescription drugs more affordable to low-to-moderate income seniors, says Susan Sweet, consultant and advocate for a variety of nonprofit agencies and minority groups.

Many aging advocates and state legislators know Sweet as “the mother of the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE).”

“Rhode Island is one of a handful of states that has responded to senior’s concerns and anxieties about the high cost of prescription drugs,” Sweet says.

In 1985, the Rhode Island General Assembly moved to assist elders with rising prescription drug costs by enacting RIPAE.

Initially, the RIPAE program covered only medications purchased by low-income seniors to treat hypertension, cardiac conditions and diabetes.

In the past fifteen years, the General Assembly has expanded the program,” Sweet adds, to over the cost of prescription drugs to treat glaucoma, Parkinson’s disease, high cholesterol, cancer, circulatory insufficiency, asthma, chronic respiratory conditions, Alzheimer’s disease, depression, incontinence, infections, arthritic conditions and prescription vitamins and mineral supplements for renal patients.

Additionally, the RIPAE Plus Program, proposed by Lt. Governor  Charles Fogarty with House and Senate leadership, allowed moderate income seniors to purchase prescription drugs at a lower rate that is negotiated by the state.

The state also pays a portion of the remaining cost of the drug based on the senior’s income level.

“The innovations in RIPAE have made Rhode Island a leader in assisting seniors to stay healthy and independently,” Sweet says.

With the end approaching to this year’s session of the General Assembly, lawmakers are considering legislation to again expand the RIPAE Program, states Fogarty, who authored the legislation.

Fogarty’s RIPAE Next Step would cover all FDA-approved prescribed drugs, excluding cosmetic and experimental drugs, cap out-of-pocket expenses at $ 1,500 annually, and open up the program to people age 55 and over who are receiving Social Security Disability Insurance.

While no one really opposes the passage of RIPAE expansion this year, ultimate passage of the entire legislative proposal is really a question of competing budget needs and limited state dollars, Sweet comments.

House Finance Chair Tony Pires (D-Pawtucket) remembers a time in the mid-1990s when Governors Bruce Sundlun and Linc Almond attempted to roll back the RIPAE program by calling for an increase in the senior’s co-pay and limiting access to benefits.

“The General Assembly made it very clear that it did not want to reduce state support, but rather moved to increase benefits,” Rep. Pires said.

“This year we’ll be expanding the list of drugs to include prescription drugs used to treat osteoporosis,” Rep Pires tells The Times, adding that House leadership also supports an out-of-pocket prescription drug cap of $ 1,500 annually.

With the RIPAE Next Step’s price tag of $ 3.5 million dollars. “We can’t afford to pay for an open formulary program yet because of budgetary limitations,” Rep. Pires states.

In upcoming legislative sessions, coverage for gastrointestinal drugs will seriously be considered, he adds.

“In the upcoming years the state’s pharmaceutical assistance program will remain a top priority to the General Assembly, Rep. Pires says. “There will be an expansion of coverage to a full formulary when more state monies become available, he adds.

Currently, Lt. Governor Fogarty estimates that more than 170,000 Medicare beneficiaries in Rhode Island, who do not meet the state’s pharmaceutical assistance program’s income eligibility requirements, lack comprehensive prescription drug coverage.

With an aging population, Congress and state lawmakers must roll up their sleeves to find innovative ways of making prescription drugs affordable.

The Best of…Seniors to Become Computer Savvy

Published June  11, 2001, Pawtucket Times

           More than 50 years ago, Richard Walton received a Smith Corona portable typewriter from his parents for his 21st birthday.   Over the years the journalist and writer Walton, now age 73, touched typed eleven books on that bulky machine.  From his college days in the late forties until the early 1990s, he continued to use the antique typewriter.                 

         Today Walton has gone through three computers, his present system is a Compaq Presario, Model 7470.  “It pretty much has all the bells and whistles,” Walton says.  As a journalist he loves his computer because “you don’t have to retype entire pages.”  With his Smith Corona, any typos forced him to retype entire pages.   Now paragraphs can be moved around with ease, to view and change before the final draft.

         Walton gets other bennies from using new computer technology.  “I communicate with people everywhere using e-mail” he say,noting that when he needs to research topics for his articles its simple, just cruise the World Wide Web.

       Walton is one of growing number of seniors who are using the computer to keep in touch with family and friends, word processing documents, keeping the checkbook, making electronic purchases for a vast variety of items, from books, drugstore purchases to travel packages.  Seniors can also tap into this evolving technology to research and buy stocks and to do their banking and pay their bills. 

      Stacy Dieter, vice president of Business Development for SeniorNet, a nonprofit San Francisco-based company that teaches seniors to use computers and the internet, calls seniors “savvy” when it comes to operating computers.  “May be younger people are more use to maneuvering the mouse, but seniors can quickly pick up how the use the computer technology,” she says.

      Older adults are the fastest growing audience online, Dieter tells The Times.   According to Jupiter Communications, Dieter notes that by the year 2003, it is estimated that 27.3 million people over age 50 years old will be using the Internet regularly.”

       Adds Dieter, computer ownership is also slowly increasing too.   A SeniorNet and Charles Schwab & Company 1998 market research study found that 40 percent of all seniors now own a computer at home compared with 29 percent in 1995.  Meanwhile, seniors spend more time per month online (38 hours) than any other age group, with more than 83 percent making daily visits to the Internet, she says.

      Senior centers are also moving into the computer age by making computers more accessible to their older participants.   With assistance from the state’s Department of Elderly Affairs (DEA), a growing number of senior centers acrossRhode Islandare opening up computer labs. 

      With two Compaq computers provided by DEA, one donated by a Rhode Island  Dot.Com company, FindRI.Com, and one surplus City of Pawtucket computer, Joan Crawley, Director of Pawtucket’s Leon Mathius Senior Center, pieced together her equipment, bringing the computer age Pawtucket’s seniors.

        Beginning in June, a small multi-use room in the Senior Center, originally used for health promotion activities, was transformed into a computer lab.   The City of Pawtucket provided the expertise to install the computers with Internet access.

       “We’re in the organizational phase right now,”Crawley says, adding that her waiting list of seniors wanting to learn how to use computers and the Internet has grown to more than 30.

         Although Pawtucket’s Senior Center Director expects the computer lab to be up and running and courses taught by the fall, the computers are now available for use by those who are knowledgeable about their use.  Half and hour time slots will be made available to these individuals.

          Meanwhile, volunteer instructors are now being recruited to teach the basics (using computer’s key board and mouse) to learning computer software programs and how to surf the Internet.          “The perfect volunteer might be someone who has recently retired and wants to share their expertise,”Crawley says.  The more volunteers will allow the computer lab to have extended hours. .

          Why a computer lab?   “We want our seniors to use the Internet to look up information on health care, Social Security or even about Medicare. Crawley notes that a social worker will be available to assist the computer user in culling the needed information from the targeted web sites.

          Crawley adds, “Ultimately we would like to get an e-mail address so that seniors can talk to their love ones who live are far away.”  Additionally, she believes that savvy senior computer users can save money too, by not spending money for newspapers and magazine subscriptions.  They can just use the Internet to seek out information in hundreds of thousands of newspapers or magazines published around the world.

          By adding a computer lab to the Senior Center’s programming, “We’re very excited about bringing Pawtucket’s senior population into the 21st century,Crawley says gleefully.

          SeniorNet is the world’s largest trainer of adults over 50 on computer technology and the Internet with 220+ SeniorNet Learning Centers in 38 states as well as the best on-line community for older
adults at http://www.seniornet.org.

           Herbert P. Weiss is a Pawtucket Rhode Island-based writer covering aging, health and medical care  This article appeared in June 11, 2001 in the Pawtucket Times. He can be reached at hweissri@aol.com.