Tag Archives for National Council on Aging

Better Understanding of Strokes Can Help Seniors Protect Their Health

Published in Pawtucket Times on May 19, 2003

Even if Americans know about the negative impact of their lifestyle choices, that knowledge may not be enough to change their behaviors, especially those behaviors that lead to strokes.

According to a new survey released by the National Council on Aging (NCOA), Americans understand that those who have had a stroke are at a greater risk for a future one, ye stroke survivors are not taking all the possible steps to protect their health.

Strokes can result from a sudden interruption of blood flow to any part of the brain, which can ultimately injure or kill brain tissue.

Strokes can lead to severe impairments, including debilitation from paralysis, short-term memory loss and even speech and vision problems. About one-third of all strokes are recurrent, even though there are lifestyle changes and medications available today that can help to reduce that risk.

In this telephone survey, which was funded by a grant from Sanofi=Synthelabo and Bristol-Myers Squibb, 66 percent of the survey respondents said they knew someone who had suffered a stroke, but many of those who survived were not exercising regularly (32 percent), refraining from smoking (19 percent) or watching their diet (18 percent). These simple lifestyle changes are known to help prevent future strokes.

“Those who have already had a stroke can make changes to their everyday routines  to lower their risk for a second stroke or heart attack,” Mark Alberts, M.D., professor of neurology, at Northwestern University Medial School in Chicago, stated in a NCOA release.

“It is particularly important that stroke survivors and their families or caregivers work closely with their physicians to develop an individualized treatment plan, which will often include medication,”  says Alberts.

Along with the basic lifestyle changes, taking appropriate medications can also reduce the risk of recurrent strokes.

For instance, the researchers say many patients may benefit from antiplatelet therapy that prevents blood platelets from sticking together and clotting, helping to reduce stroke risks.

According to the NCOA study, after surviving a stroke, men have a 42 percent chance of having another within five years, and women a 24 percent chance during that same time period.

The general public seems to be confused regarding what stroke risks factors and symptoms are, the researchers found.

The NCOA survey findings indicate that many Americans incorrectly identified excessive stress (87 percent), overexertion while exercising (56 percent), dehydration (38 percent), asthma attacks (24 percent) and wearing constrictive clothing (16 percent) as risks factors for stroke.

Additionally, survey respondents also mistakenly selected shortness of breath (53 percent) and heart palpitations (50 percent) as stroke symptoms. Nearly two-thirds of those surveyed failed to recognize that age increases stroke risk, especially for those over age 65.

Although seniors are at the greatest risk of having a stroke, they seem to show little concern, researchers noted. While two-thirds of all strokes occur among those ages 65 and older, only 12 percent of those surveyed in that age group noted they are more concerned about suffering a stroke, given other choices like Alzheimer’s disease and diabetes.

A whopping 70 percent of the olde respondents told researchers they never talked to their doctors about stroke risk.

”For older Americans, strokes pose a significant health risk so it is alarming to us that so few seniors have discussed their personal risk for stroke with their doctors,” said James P. Firman. NCOA’s president and CEO. “Better education is clearly needed to help all Americans understand their risks of stroke to protect their health.”

Robert Marshall, Ph.D., who serves as assistant director of health at the state Department of Health, gave All About Seniors his thoughts about the NCOA research study.

He said strokes are the number-three killer in Rhode Island – in 2000, 964 Rhode Islanders age 50 and over died of stroke.

“We call these preventable deaths’ because we know that by reducing risk, such as smoking, obesity, lack of exercise, uncontrolled high blood pressure, many  people can avoid death and disability from stroke, adds Marshall.

“It is unfortunate, but not surprising, that so many strokes are recurrent,” said Marshall. “Human nature being what it is, many people find it difficult to change the behaviors that got them into trouble in the first place- things like smoking and lack of exercise,” he notes.

“We all need to do a better job supporting stroke survivors and helping them use the experience as a springboard to a longer healthier and happier life,” Marshall added.

Older Rhode Islanders can easily take charge of reducing their chances of having a stroke or a recurrent stroke.  Positive lifestyle changes (e.g., more exercise, a better diet, giving up cigarettes, and taking prescribed medications are key lifestyle changes to protecting your health.

Report Examines Myths, realities of Consumer -Directed Services

Published in Pawtucket Times on March 17, 2003

Eighty-nine-year-old Lillian Brannon raves about the Arkansas-based “Independent Choices (A Cash and Counseling Demonstration Program) that allowed her to stay independent and at home with the assistance of four aides.

The program “has really changed my life so much,” she says. “It has really helped me to live more independently than I have ever have …I would not trade it for anything.”

Tammy Svihla, who suffers from MS gives a thumbs-up to the New Jersey-based “Personal Preferences” programs that has allowed her to more creatively used Medicaid funds. Svihla notes she was able to purchase a “Lazy-boy” lift chair, usually not covered by Medicaid. It was logical for Svihla to purchase the lift chair because it was difficult for her to get up from her couch because of soft cushions.

These two  testimonials, among three others, set the tone for a newly released report that examines the myths and realities that now surrounds the philosophy of consumer-directed services.

The orientation allows consumers to make choices about the services they receive, assess their own needs, and determine how ad by whom these needs should be met, and then  monitor the quality of services they have received.

“The Myths and Realities of Consumer-Directed Services for Older Persons,” authored by Marie R. Squillace, PhD., federal project officer, National Family Caregiver Support Program with the U.S. Department of Health and Human Services, and President and CEO James Firman, Ed.D., of the National Council on Aging, attempts to build upon current knowledge obtained from research and demonstration projects to make   consumer direction “an integral part of the options available for all older persons who may need long-term care.”

Throughout the 24-page report the authors use personal experiences, case studies, and research to dispel 12 myths about the philosophy of consumer-directed services.

Let’s take a look at three of the myths.:

Squillace and Firman urge the reader to not believe the myth that consumer-directed services are not appropriate for seniors with disabilities or for those with cognitive impairments.

Here’s the reality: studies of programs like California’s In-Home Supportive Services (IHSS), show that many elderly can express daily preferences for care and can benefit from that control. For more than 30 years, low-income persons over age 65 who are enrolled in the IHSS program have  hired, fired, trained, scheduled and supervised individual providers.

Moreover, the Family Caregiver Alliance in San Francisco adds research indicates that persons with early to moderate cognitive impairment still can express daily preferences for their care, sharing their values and preferences.  For those with significant cognitive disabilities, a University of Maryland Center on Aging report suggests family caregivers, a circle of friends, or close associates who know the consumer well can interpret the person’s non-verbal expressions.

Another myth of the Squillace and Firman report is that “self-directing consumers will “misuse funds” or “be exploited.”

Not true, say the authors, citing “Cash and Counseling Programs” that will allow consumers to use their alliances to purchase needed services so they can stay in their own homes with the assistance of a fiscal intermediary organization (FIO).

In reality, the authors note most prefer to have their funds held by the FIO, which conducts bookkeeping and accounting services to help them manage their individual helpers and pay taxes for their workers. The management can minimize concerns about misuse of funds and financial exploitation of vulnerable individuals while diminishing the administrative responsibilities placed on self-directed consumers, the report says.

Finally, some spread the myth that consumer direction is just an experiment, noting more, nothing less. But Squillace and Firman say this philosophy has progress “far beyond the experimental phase.

A growing number of consumer advocates, program administrators and policy makers are now embracing this philosophy.”

The authors recite a 2001 survey that identified 139 consumer-directed service programs that were operating across most of the nation, except Tennessee and the District of Columbia. “The estimated total number of people being served by these programs reached about half a million.

Squillace and Firman state: “Consumer direction is not a sliver bullet or a panacea for the nation’s long-term care challenge, but it is an important part of the solution.”

I believe that.

If they haven’t, hopefully the directors of the Department of Elderly Affairs and Human Services will develop programs that encompass the philosophy consumer directed services.  Enhanced quality of life can be a result of aging baby boomers and seniors controlling the choice over the purchase of their long-term care services. Ultimately, it is all about empowerment.

For more information about consumer-directed care, visit www.consumerdirection.org.

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The Best Of…Former Sen. Moss’ Advocacy Commitment Will Be Missed

Published on February 3, 2003

            Last Wednesday evening, former U.S. Sen. Frank Moss of Utah died.

            After he received his law degree in 1937 from Washington, DC-based George Washington University, Moss briefly worked on the legal staff of the U.S. Securities and Exchange Commission.

           Throughout his legal career, he would sharpen his legal skills by working in a variety of settings.  Initially, clerking at the Utah Supreme Court, he would ultimately win an election putting him on the bench of the Salt Lake City Municipal Court in 1940.

         During the World War II, he would serve on the Judge Advocate General’s staff of the U.S. Armory Corps in England.  After the war, Moss would be elected in 1950, reelected in 1954, to serve as Salt Lake County attorney.

         Two years after his unsuccessful bid for Utah Governor, in 1956, Moss would run for Senate and win, by less than 40 percent of the vote.

         Obituaries in newspapers stated that the liberal three-term Senate Democrat was best known for his environmental work that included the establishment of national parks and recreational areas in Utah.  Moss was also recognized for drafting a series of bill protecting consumers, ranging from mandating labeling on cigarette packages about the health hazards of smoking, banning cigarette advertising on radio and television, to developing minimum safety requirements for automobiles.

           But for me and many of my colleagues in the field of aging, we will always remember Moss as being a true advocate for the nation’s elderly.

           Moss worked closely with President Kennedy, Vice President Lyndon Johnson, who would later become President, Hubert Humphrey and Claude Pepper getting Medicare and Medicaid enacted into law.

          Moreover, Moss will always be remembered for being the driving force behind the establishment of the Senate Special Committee on Aging in 1961.

          He also played a major role in establishing the House Committee on Aging with the late Rep. Claude Pepper.  The two special committees would later put the spotlight on aging policy issues, generating both the public and political will to bring about the needed policy changes.

          Throughout his Senate Career, in addition to authoring legislation that would require federal minimum standards for nursing homes and helping to create  the Medicare and Medicaid home health care benefits. Moss held the first hearing on hospice care and introduced legislation authorizing payment for hospice care.

           More than 40 years ago, the Special Committee on Aging, chaired by Moss, began to hold a series of hearing s on nursing homes.  It became extremely clear to his committee through its hearings, generating 1,300 pages of testimony, that both nursing home standards and enforcement by state regulatory agencies varied drastically.  Moss noted that these hearings helped to shape the Medicare and Medicaid programs, and that they also lead to series of reforms in 1967.

         Ultimately, a series of 30 hearings held between 1969 and 1976 eventually lead to the publication of a 12-volume report, entitled “Nursing Home Care in the United States: Failure in Public Policy.”

        In 1977, Moss, with coauthor Val Halmandaris (who at the time was responsible for research of the Subcommittee of Long-Term Care, but now serves as executive director of the National Association of Home Care) wrote “Too Old, Too Sick, Too Bad: Nursing Homes in America,” detailing the plight of America’s elderly.

       More than 10 years later, in a 1998 speech to the National Council on Aging, Moss expressed his concerns that American’s elderly were losing ground from all the gains they had achieved in the late 1960s and 1970s.  Congress has yet to enact a pharmaceutical drug program to put the brakes on spiraling drug costs.  Elder abuse is still running rampant throughout the nation.  Medicare expenditures are being slashed to nursing homes, home and hospice care.

        It is now time for Congress to get serious about tackling the multitude of problems thrust upon the nation by an aging society.  Moss’ advocacy comment to the nation’s elderly will be sorely missed, and his shoes will be hard to fill.

        Herb Weiss is a Pawtucket-based freelance writer who writes about aging, health care and medical issues.  He can be reached at hweissri@aol.com.