Heart Failure Program Has Reduced Readmissions by 30 Percent

Since July, Mochun Li has been hospitalized at the U.C.S.F. Medical Center three times. On some nights, Ms. Li had struggled so hard to breathe that she had not been able to sleep.

Ms. Li suffers from heart failure; her heart cannot pump enough blood to her organs and tissues. Shortness of breath, fatigue and fluid retention are common in patients with the condition. So are frequent hospital stays.

Now Ms. Li, 89, is at home and breathing more easily, thanks in part to the heart failure program at the University of California, San Francisco. The program is an effort to reduce repeat hospitalizations by giving patients plenty of information and support to help them after they are discharged. Since the program began three years ago, the hospital’s readmission rate has dropped by 30 percent.

The hospital says the program has also saved Medicare at least $1 million a year. Originally for heart failure patients 65 and older, the program is being expanded to all cardiology patients as well as to neurology patients.

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Growing Demand for Sandwich Generation to Step Up to Elder Care Role

With the struggles of today’s economy and the life expectancy of the population increasing, there are huge demands surfacing for caregivers of the elderly. A popular term and the primary demographic for senior caregiving is the Sandwich Generation, the adult children of seniors.

The Sandwich Generation has been asked to care for their nuclear families as well as taking responsibility for their aging parents. Most feel stretched thin at best and are often left wondering how they can help alleviate the growing burden of caring for their parents. As an alternative to nursing homes or long-term care facilities, many families are opting to keep aging loved ones in the home. While the senior in your life might love the idea of staying in the home, as a close family member, caregiver or friend there are many considerations and worries that go along with this decision.

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The Silver Tsunami

As the baby boom generation approaches retirement age, millions of Americans are facing one wrenching question: What to do about Mom and Dad?

The country is approaching a “silver tsunami,” as millions of families reach a new stage of life. According to AARP, there are almost 66 million family caregivers in the United States — nearly 30 percent of the entire U.S. population. Seven out of 10 care for older adults.

This week, “ABC World News with Diane Sawyer” launches a special series, focusing on the sensitive issues surrounding eldercare.

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Retirements Swallowed by Debt

A majority of older Americans face the very real possibility of starting retirement in the red.

Study after study shows that more elders are living with heavy credit card debt, regularly swiping cards to pay for things like gas and groceries. And as the balances pile up, the elderly cope in a number of ways. Some, like Mr. Freedman, permit their adult children to step in, while others seek outside counsel in an effort to preserve their independence. Some elderly debtors are trapped in limbo, too proud to ask for help but too strapped to pay off the debt.

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An ER Just for Older Patients

“Senior emergency rooms” provide doctors and nurses trained in geriatrics

The surge of older patients with their special needs is spawning “senior emergency rooms” in hospitals.

Park Plaza Hospital and Medical Center in Houston debuted its senior emergency department in October. Since July, Trinity Health, which operates in seven states, has opened eight ERs in Michigan for patients age 65 and over.

Senior ERs offer quiet private rooms, dimmable lights, extra-padded mattresses, nonglare floors and blanket warmers.

Doctors and nurses are trained in geriatrics. Patients are screened for a variety of risk factors, and a geriatric social worker or nurse follows up with a call after the visit.

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Mediators increasingly try to help families resolve conflicts over aging parents

The elderly man became increasingly alarmed as the battles among his five grown children grew acrimonious.

His two daughters, worried that he wasn’t taking proper care of himself, wanted him to move to a retirement community. His three sons balked, insisting that he was managing fine in his own home. At a family meeting their father made this jarring announcement: I’m nearing the end of my life, and you are making me so unhappy that it might be easier if I killed myself and ended the fighting.

His threat shocked the warring siblings into resolving their dispute, according to lawyer Karolyn Blume of Arlington, who was present at the meeting. Blume did not represent any of the parties but served instead as a new kind of geriatric specialist: an elder-care mediator.

Unlike lawyers who are hired to advocate for one side, elder-care mediators function as impartial observers in a voluntary process designed to be less adversarial – and cheaper – than a court proceeding.

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Giving Alzheimer’s Patients Their Way, Even Chocolate

PHOENIX — Margaret Nance was, to put it mildly, a difficult case. Agitated, combative, often reluctant to eat, she would hit staff members and fellow residents at nursing homes, several of which kicked her out. But when Beatitudes nursing home agreed to an urgent plea to accept her, all that changed.

Disregarding typical nursing-home rules, Beatitudes allowed Ms. Nance, 96 and afflicted with Alzheimer’s, to sleep, be bathed and dine whenever she wanted, even at 2 a.m. She could eat anything, too, no matter how unhealthy, including unlimited chocolate.

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Empathy 101

Jessamyn Conell-Price, left, and Moira Nichols chatting at Mrs. Nichols’s apartment in Oakland, Calif.

Ms. Conell-Price, 26, is a first-year student in the University of California, Berkeley — University of California, San Francisco Joint Medical Program. Like many young people in an age-segregated culture, she barely knows anyone older than 60 except her own grandparents.

Mrs. Nichols, who’s 89 and a longtime resident of Piedmont Gardens, a retirement community in Oakland, Calif., describes herself as a fan of inclusion. “I really like knowing and being friends with people of all ages,” she told me. So she had signed on for the elder-mentor program offered by the universities, which matches new medical students with independent seniors.

By the end of the three-year program, involving 16 incoming students each year, “they will have some insight into what it’s like growing old,” Mrs. Nichols said. “I think that will be very useful to them.”

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8 Questions for your Medicaid planning advisor

If you decide to hire an attorney or other advisor to help you plan for Medicaid eligibility, we suggest you ask the following questions when interviewing.

1. Do you guarantee Medicaid eligibility?

2. Can you provide tax and estate advice for both the applicant and the receiver of any gift transfers?

3. What happens if they change the Medicaid regulations and I need the money or property after I make the transfer?

4. If I transfer my money and property to my children how can I be sure that they will use the money for my care? What if we create a large period of ineligibility by transferring assets but I become ill soon after. Who will pay for my care if I’m not eligible for Medicaid but my children no longer have the funds?

5. How do I know I will get a bed in the assisted living facility or nursing home of my choice? Will I have my own room at the assisted living or nursing home?

6. What if I want more care than Medicaid will provide? How will I pay for this care if I’ve transferred my assets?

7. I want to age in place. Will Medicaid arrange for 24 hour care in my own home or must I move to a nursing home if my care needs so warrant?

8. What if my family doctors and specialists don’t accept Medicaid as a form of payment? Once I become eligible for Medicaid, should I ever need rehabilitation or therapy can I choose where and from whom I want to receive these services?

5 Major Money Issues for Seniors in 2011

Here are five big money issues that will affect seniors in 2011:

1. Social Security COLA
2. Medicare Policies
3. Tax Rates
4. Estate taxes
5. Interest rates

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