“Adults with dementia and delirium may soon have a way to combat their delirium, thanks to a$2.4 million, five-year grant from the National Institutes of Health.

“Delirium is prevalent in people with dementia,” said Ann Kolanowski, Elouise Ross Eberly Professor of Nursing, Penn State. “We found in our pilot study that many older adults who have dementia and experience a medical problem often develop delirium, and it doesn’t necessarily resolve by the time they are discharged from the hospital.”

Delirium, defined as a state of mental confusion, occurs in over half of all hospitalized older adults with dementia. If delirium continues, it can interfere with patient rehabilitation and there is a very high risk of permanent institutionalization, said Kolanowski.”

Find out more at Penn State Live.

Sen. Pat Vance, a former nurse, decided she had heard enough about how Pennsylvania’s gaping budget deficit could be fixed by squeezing waste out of Medicaid and welfare programs.

And so when the Cumberland County Republican spoke at a York County Chamber of Commerce luncheon earlier this month, she set out to change minds that welfare isn’t wasteful spending when two-thirds of it goes to the elderly and disabled.

“I think it needs to be squeezed, but realistically, how much can it be squeezed when you look at the number of people utilizing it who are either disabled or are in a nursing home?” Vance said later.

Pennsylvania may find out.”

Read more from the Centre Daily Times

If you were checking out adult day cares to decide where to place an aging loved one, here’s what you’d find on recent state inspection reports for Lehigh Valley area centers:

Lack of timely fire drills and fire inspections. Lack of staff training, or failure to document training. A dirty restroom. Food served at improper temperature. Failing to require, or to document, that clients have physicals and tuberculin tests.

That’s the kind of stuff you’d want to know, right? And you’re entitled to because inspection reports are public.

But they’re not easily accessible. They’re not online like other state inspection data are, making it hard to check out a center.

To get the reports, you have to ask the facilities or the state Department of Aging. The department says it knows people want the information, and it plans to put the records online later this year.

”It’s just a matter of time,” spokeswoman Jane Crawford said.

The Department of Health already posts nursing home inspections online at http://www.health.state.pa.us . It’s under the ”facilities, providers and managed care plans” tab.

And the Department of Public Welfare posts the results of its personal care home inspections at http://www.dpw.state.pa.us , under the ”provider information” tab.

If people want adult day care reports now, Crawford said they should write to Kevin Longenecker, Pennsylvania Department of Aging, 555 Walnut St., Harrisburg, PA 17101.

She said there will be no charge for the documents.

Read more.

Along with a growing elderly population, area nursing homes may face challenges in providing quality care as Medicare funding decreases and legislators propose more cuts.

In early October, the federal Centers for Medicare and Medicaid Services adjusted its Medicare rates, cutting approximately $12 billion nationwide over the next ten years.

Proposed Congressional bills could intensify the Medicare cuts by trimming additional funding to skilled nursing facilities over the same time period.

The leading House bill, HR 3200, would cut $2.1 billion to Medicare in Pennsylvania alone, according to a study by the American Health Care Association.

A bill sponsored by the Senate Finance Committee would cut $14 billion to skilled nursing facilities, said U.S. Rep. Glenn Thompson, R-Pa.

Thompson said that will be a major blow to nursing facilities that normally operate with a profit margin between 1 and 3 percent.

“Those operations are lean at this point,” said Thompson, who has spent 28 years in the health care industry.

He added it’s the governments responsibility to serve those who can’t help themselves.

George E. Leonhardt, president and chief executive officer of Bradford Regional Medical Center, said it’s unclear what cuts may or may not occur in health care reform.

“Proposed Medicare cuts to hospitals, skilled-care nursing homes and other health care providers can only be addressed and planned for when they occur,” Leonhardt said.

Read more at the Bradford Era.

A surprising number of frail, elderly Americans in nursing homes are suffering from futile care at the end of their lives, two new federally funded studies reveal.

One found that putting nursing home residents with failing kidneys on dialysis didn’t improve their quality of life and may even push them into further decline. The other showed many with advanced dementia will die within six months and perhaps should have hospice care instead of aggressive treatment.

Medical experts say the new research emphasizes the need for doctors, caregivers and families to consider making the feeble elderly who are near death comfortable rather than treating them as if a cure were possible — more like the palliative care given to terminally ill cancer patients.

“We probably need to be offering a palliative care option to many more patients to make the last days of their lives as comfortable as possible,” said Dr. Mark Zeidel of the Beth Israel Deaconess Medical Center in Boston, who was not involved in the studies.

Palliative care focuses on managing symptoms of a disease and a main goal is to relieve pain at the end of life.

End-of-life care became a divisive issue in the national health care reform debate this summer after one proposal included Medicare reimbursement for doctors who consult with patients on end-of-life counseling. Critics called the counseling “death panels” and a step toward euthanasia. The Obama administration denied those claims, yet has signaled the Medicare benefit will be dropped.

The new studies are published in Thursday’s New England Journal of Medicine.

Find out more at WGAL.

In hundreds of meetings with millions of its members to promote a health care overhaul, AARP, the huge organization for older Americans, has often found itself forced to referee a battle between generations.

Its 40 million members are split about evenly between those who have access to Medicare, the federal government’s health program for the elderly, and those who are too young to be eligible for such benefits. The younger members, or those between the ages of 50 and 64, sometimes face terrible choices in the private insurance market, with age and declining health status making premiums high and benefits poor.

But members 65 and older get among the most secure medical benefits in the country, and many are in no mood to share.

…

For AARP, the nation’s largest advocacy organization, this divide mirrors a larger generational debate. Proposals on Capitol Hill to expand health care coverage largely rest on forcing younger and healthier people to get insurance, expanding the money available to subsidize care for the elderly. But the proposals also count on about $400 billion in savings over 10 years in the Medicare program. In effect, the young and the old are being asked to sacrifice for the middle-aged.

For AARP, bridging this generational divide has become a delicate task. Some of AARP’s older members are furious, and tens of thousands have resigned in protest. But organization leaders say that much of their efforts are focused on strengthening Medicare and that they must also be mindful of the needs of younger members. Further, the departures represent a fraction of 1 percent of the organization’s members, who pay annual dues of $16.

Read more at the NYT.

In Miami next year, seniors once again won’t have to pay any monthly premiums for a Medicare health plan sold by HMO giant Humana Inc.

Meanwhile, in Philadelphia, seniors will pay premiums of $52 – up from zero – for the least expensive HMO plan from Independence Blue Cross.

The new information underscores the drastic differences in how seniors will be affected – depending on where they live — by federal funding cuts next year to private Medicare health plans known as Medicare Advantage.

On average, beneficiaries who are currently enrolled in Medicare Advantage plans can expect to pay an average premium of about $39 a month, a $7 increase from this year, according to the data released Thursday by the Centers for Medicare and Medicaid Services.

The benefits details also showed that about 660,000 seniors – nearly 7 percent of Medicare Advantage members — will have to change plans or enroll in traditional Medicare because some insurers are dropping coverage. Nearly all of those seniors are enrolled in private fee for service plans, which are being subjected  to much tighter regulations because of consumer complaints.

Most seniors in Medicare Advantage are enrolled in HMOs or preferred provider organizations.

Major changes in some Medicare Advantage plans were expected because of a previously announced 4 percent cut in federal funding for the plans next year. But not all seniors are affected. In areas where Medicare pays the highest rates to health plans, such as Miami and New York, seniors will be the least affected and continue to receive the richest benefits.

Find out more at Kaiser.

Employees at Montgomery County’s geriatric facility in Upper Providence will not be wearing sandwich boards.

However, they will soon be sporting larger name tags.

The county commissioners have agreed to contract with Indenticard Systems Worldwide Inc. of Lititz, Lancaster County, for the purchase of a system to produce photo identification cards for the facility’s 700-plus employees as well as for its 460 residents.

The system will cost $11,080.

Explaining how the purchase fits in with the county’s current austerity program, county Chief Operating Officer Robert W. Graf explained that the state soon will mandate the larger photo identification badges for center employees.

The purpose of the larger name tags is to aid elderly residents at the center in identifying their caregivers, said Graf.

Also, in cases of abuse, the residents can more readily identify their alleged abusers, according to Graf.

Communications Director John A. Corcoran said residents also will be provided with photo identifications.

Concerned about insurance fraud, many doctors and medical service providers are requiring that their patients provide them with some type of photo identification, said Corcoran.

Many of the residents at the geriatric facility no longer have driver’s licenses and need some other type of photo identification, he said.

Graf said the state will reimburse the county for the cost of the photo identification system

Writes Barth:

“In light of Pennsylvania’s mammoth problems with increasing health care costs, expensive regulations and a growing senior population, it’s time for an honest dialogue that will finally establish a system of senior services that is accessible to and affordable for all citizens.

The current government solution (if you want to call it that) is this: Providers are told by the state that they are going to have to sharpen their pencils and devise a way to pay the cost of current requirements as well as fit expensive and onerous regulations into their budgets while, at the same time, payments for services for low-income seniors will be reduced.

It’s easy for the governor and the Legislature to say the state doesn’t have any money so they’re going to pay less, but they never indicate what services they would like reduced or which seniors they no longer want served.

Nursing facility providers already have suffered with funding that is nearly $300 million less than their costs during the last three years.

While we don’t have the same figure for home and community-based care providers, their plight is just as dire.

Providers have run out of pencils to sharpen. In the end, providers can only shave so much from their budgets when government doesn’t live up to its funding responsibilities. As they say, someone has to pay.

The buck is being passed to residents and families who pay for their own services, and also to health care-giving professionals who are, at best, seeing their compensation being cut and, at worst, losing their jobs.

This process should enrage all Pennsylvania families who have watched their parents or grandparents save their entire lives only to see those savings drained to help pay for regulations that add cost but not quality.”

Read the rest of Barth’s piece.

Joined by dozens of not-for-profit senior service providers today in the state Capitol, PANPHA President Ron Barth echoed the message he delivered to the House Appropriations Committee – that Pennsylvania must use the opportunity provided by the federal stimulus funds to improve the way our state cares for its aging population. He urged state leaders not to ignore an important opportunity to maximize the federal stimulus funding to overhaul Pennsylvania’s long-term care infrastructure.

“We’re at the point in Pennsylvania where the sheer care and service need of our aging population is larger than the provider network or existing funding framework can handle,” Barth said. “The Governor’s proposed spending plan tried to maintain the ’status quo’ for vulnerable seniors and those who provide their care. Unfortunately, since the Governor announced his spending plan, the state budget picture has done nothing but get worse, with the shortfall expected to exceed $3 billion by year’s end.”

Adding to the difficulty is a Senate-passed budget that would cut an additional $66 million from senior care and services, attempting to offer a spending plan for the fiscal year 2009-10 budget without a tax increase.

“The Senate budget does nothing to fix the problem, but rather makes things worse by cutting $66 million in state funding for senior care services, costing us an additional $112 million,” said Barth. “It’s like throwing money out the window at the very time when we need every available dollar to care for our growing senior population.”

Barth said the spending level proposed in the budget passed by the Senate is like a tax increase on those who can least afford it. A 6-percent reduction in Medicaid funding will force seniors who privately pay for services to pay even more to make up the shortfall. A 6-percent reduction in Medicaid funding will reduce the wages and benefits of hardworking caregivers who are the front lines in caring for our frail elderly.

Find out more on PANPHA’s position.