1012 RM Senior Health Guide

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health guide Help and hope for Alzheimer’s disease page 4

Affordable Care Act 101 Page 6

Senior nutrition Page 10

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Help and hope for Alzheimer’s Disease

An early diagnosis allows you to take advantage of services and treatments and make accommodations

M

ary Daniels still thinks of her sister everyday, even though her sister died of Alzheimer’s disease more than two years ago.

She recalls their family road trips squished in the back of dad’s sturdy Ford, their plaid school uniforms and how they never quite covered their knobby knees, and their greatest adventure of all—moving from the Midwest to Colorado where they become school teachers.

But she also remembers not too long ago when her younger sister told her, through tears, that she felt something was wrong with her.

“She even said that she thought she had dementia,” Daniels says. “I gave her a hug and we talked a little bit. But looking back and knowing what we do now, and what I know about the disease, I could have done more. I wish I would have.”

That was in the early ‘90s, two decades ago. It was before Alzheimer’s disease would be defined as one of the most prevalent and feared illnesses around the world. It was also before the fact that every 68 seconds someone is newly diagnosed, and before the Obama administration would pledge to commit $100 million to increase awareness and to finally find a cure.

For Daniels, her sister’s diagnosis was before she knew what resources, support and expert guidance would be available.

“I could have helped her plan for the rest of her life, “ Daniels says. “I think I could have made it easier than it was.”

Early diagnosis And that is the cause that Emmalie Conner, the Northern Colorado Regional Director of the Alzheimer’s Association, champions everyday.

“Admittedly, many people don’t want to find out if they have Alzheimer’s disease, because they believe that there is nothing that can be done,” Conner says. “But that isn’t true. An early diagnosis can open the door for a jour

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Julie Piotraschke

ney where the best options—medical, social and financial—can be considered and put in place. And that can make a huge difference when it comes to quality-of-life issues.”

It has for Janet Neubauer, who lives in Berthoud. After her boss pointed out mistakes she was making at work, she went for a medical consultation and found out she had Alzheimer’s disease.

“Finding out early is important,” Neubauer says. “It means getting a jump start on the medications that do help slow down the progression of the disease. Having the extra time with fewer memory problems has given me the time to enjoy things that mean a lot while I still can.”

Support groups The diagnosis also opened the door to access support groups offered through the association. Together with her husband, they quickly joined the conversation and share life strategies with others.

“The support group is probably

what helps me cope the most day to day,” she says.

Often those support groups are what provide solutions and ideas for others who are also facing similar challenges.

Throughout the different stages of disease, the Alzheimer’s Association provides support groups for caregivers as well as social programs.

“We are here to provide and enhance care for all those who are affected by the disease,” says Conner.

For Neubauer, an early diagnosis has given her a renewed commitment to her philosophy: Slow down in life and smell the roses while you can.

“Undoubtedly, a diagnosis of Alzheimer’s disease can be frightening,” Conner says. “But there is support and knowledge out there that can definitely make it easier for individuals and families.”

Julie Piotraschke is the media liaison for the Alzheimer’s Association, Northern Colorado Region

Ten warning signs of Alzheimer’s Disease Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks at home, at work or at leisure Confusion with time or place Trouble understanding visual images and spatial relationships New problems with words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work or social activities Changes in mood and personality

Get help:

The Alzheimer’s Association: (800) 272-3900, www.alz.org.

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Affordable Care Act 101

Patient Bill of Rights, low-cost screenings, closing the donut hole, and more...

By Kyle Moyer

O

ne of the most hotly debated issues in the current political climate is the Patient Protection and Affordable Care Act (ACA). Everywhere people gather, the primary question seems to be the same: What does it all mean?

Written by Congress at the urging of President Obama, the Act was passed in March 2010. The bill was met with both excitement and dissonance, and it created a partisan battleground.

One of the significant challenges the bill met was whether or not it was legal to charge Americans a fine if they failed to comply with the mandate of purchasing health insurance. The U.S. Supreme Court deliberated on this aspect of the bill’s legitimacy during the beginning of 2012 and in June 2012 found it to be constitutional.

There also has been a sizable discussion as to the bill’s feasibility especially given our nation’s financial and economic issues. The concerns regarding the cost and spending of the Act are hard to comprehend without actually reading the entirety of the bill – all 2,400+ pages of it—and the numerous reports on how spending will occur under the bill.

Critics contend the Act will increase the federal deficit. Many assert the bill will add billions or maybe even trillions of dollars to the deficit, and/or irreparably damage the very core of Medicare and Medicaid. Proponents of the Act claim it will be financed by money already in the system and that it won’t cut services to patients, but rather expand them.

A recent study by the Institute of Medicine shows roughly $750 billion in waste in the health-care industry, much of which is related to overpayment for procedures, too many nonessential procedures performed and non-communication between providers leading to duplication of tests and services. In a recent article for The Washington Post, correspondent Sarah Kliff neatly outlines the waste spend

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ing in health care, especially health care related to the elderly.

“There’s a lot of space for waste.

Not enough preventive care happens, meaning that costly complications may develop.

Self-management is a challenge, with seniors literally taking dozens of prescriptions. A lack of coordination between doctors compounds problems later down the line.”

The expansion of services through and policies of Medicare due to the ACA attempt to address these issues.

Winds of change As with any large scale regulatory makeover, the Affordable Care Act was designed to be implemented over a period of time, rather than all-atonce, to ease the burden of transitioning to new practices and procedures.

Components of the bill were designed to be phased in over a four-year period, which began as soon as the bill was signed into law. Seniors on Medicare have undoubtedly noticed some of the changes already; the most predominant aspects of Medicare reform occurred throughout 2011, namely closing the prescription “donut hole.”

While there have been great strides made in recent years to increase the availability of generic replacements of medications, in many cases this coverage is not enough when name brand drugs are the only option.

Pre-Affordable Care Act, this problem has been coined the “donut hole,” a literal

gap in prescription coverage for a significant portion of Medicare users. The ACA has several strategies for closing the “donut hole.” In 2010, Medicare users within the “donut hole” received a one-time, tax-free, rebate of $250 to augment spending on medication within the coverage gap. In 2011, discounts for prescription drugs were extended to Medicare Part D patients.

There now is an automatic 50percent discount on covered namebrand prescriptions for those on Medicare who fall into the coverage gap. There also is a seven-percent discount for generic medications under the same criteria. This is one of the farthest-reaching components of the ACA as it is intended to continue adding discounts on prescription medications annually through 2020.

In 2014, Medicare recipients who also qualify for Medicaid will notice changes. People who previously weren’t eligible for coverage will get benefits related to their income. Both programs, Medicare and Medicaid, will expand as ACA phases in millions of new patients.

By the end of that year, the law is intended to put individuals, families, small businesses and the whole of the American public in charge of their own health.

One of the more innovative features of the law is that of the “Patient’s Bill of Rights.” The Bill provides 12 amendments outlining rights and protections for health-care consumers, and provides the incentive and encouragement for individual’s to advocate for their own health.

Specifically related to seniors, are

four amendments that bolster their rights:

• C overage for Americans with preexisting conditions • No lifetime limits on coverage • Removal of barriers in accessing emergency services outside of coverage networks • A guaranteed right to appeal for coverage. Each amplifies seniors’ voices in their own health care.

Additionally, the bill provides many specific services for seniors on Medicare, most notably preventive services, which fill important roles in health and well-being. Annual wellness exams are integral to the program because they provide doctors and physicians the time and space to screen for possible health problems. The annual exam is free of charge and subsequent related visits will only require a small co-pay. And there are a number of no- or low-cost screenings that will be available.

The screenings cover a wider variety of health risks to Americans over 65 and include: • • • • • • •

B one mass measurement Cholesterol and cardiovascular screenings Diabetes screenings Flu, pneumonia, hepatitis B shots Mammograms Prostate cancer screening Nutrition education and management for diabetes or kidney disease

Another addition to the services for seniors under the Affordable Care Act is that of the “Community Care Transitions Programs.” The bill’s authors recognized one of the biggest health risks to seniors is post-hospital care. Making this kind of care part of a streamlined program, which will be available to all those on Medicare if programs are in place in their area on a state-by-state basis, the “Transitions” program is designed to increase communication between medical professionals following hospitalizations to “avoid unnecessary readmissions.”

Health-care pundits seem to agree that this is a reasonable enhancement to the Medicare system that will undoubtedly help seniors safely rehabilitate following hospital stays.

More benefits for seniors The ACA contains three more provisions directly aimed at improving the quality of health and life of our nation’s elderly. The first is the Community First Choice option, which is a system designed to provide home-based care as an alternative to nursing-home care. The second is the Elder Justice Act, which recognizes and responds to the significant problem of elder abuse in places of live-in care. Through the use of forensics judicial investigation of wrongdoing by care providers, as well as extended education for nursing staff, the Act provides a strong ally for seniors in nursing homes. The final addition is the expansion of home-based care provided by medical professionals. This third component is an extension of preventive care emphasis of ACA, which stresses the importance of communication and treatment to keep seniors out of the hospital.

For more information about the ACA, visit www.healthcare.gov and www.medicare.gov.

Kyle Moyer is a freelance writer based out of Fort Collins.

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Glaucoma:

What Do I Need to Know?

Glaucoma is a leading cause of blindness in the world. It is a disease that results in a degeneration of the optic nerve, the nerve that carries visual information from the eye to the brain. As the optic nerve degenerates, vision loss occurs, usually beginning in the peripheral vision and moving centrally. Visual field tests are used to monitor the amount and rate of vision loss. Optic nerve scanners and photographs are used to monitor change in the structure of the optic nerve.

Most commonly, glaucoma is caused by an elevated eye pressure. Glaucoma is diagnosed by your eye doctor by a complete eye exam. Once glaucoma is diagnosed, depending on the severity, glaucoma checks can be required up to four times a year.

Treatment for glaucoma reduces eye pressure through the use of medications, laser, or surgery.

The medications used to treat glaucoma are most commonly given in the form of an eye drop.

Drops are taken 1 to 4 times each day. Consistency is the key to maintaining a low, steady eye pressure to slow the progression of nerve damage. Medications work by decreasing the amount of fluid made in the eye, or by increasing the outflow capacity of fluid from the eye. There are 4 common classes of medications and while some patients’

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glaucoma is controlled with one drop, many require one from multiple classes or even one from each class.

Laser surgery is another option for controlling glaucoma.

Selective laser trabeculoplasty, or SLT, is a common treatment for glaucoma and can be used before medications if desired.

The laser is applied to the filtering meshwork in the eye to help enhance the outflow of fluid and lower the intraocular pressure. The laser is effective in 70-80% of patients and while the effect varies for each individual, it is a relatively safe way to treat glaucoma. Medications and laser can be used together.

Surgery is another option for treating glaucoma. There are many different types, and there are many new, innovative surgical procedures currently in clinical trials. The most common surgery for glaucoma involves a hole, or stent that creates a new drainage pathway out of the eye. Typically a lower pressure can be achieved with surgery than with drops.

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As with all surgery, there are risks which include bleeding, infection, a pressure that is too low, or a pressure that is too high. While many filtering surgeries last for years, some will slowly scar closed and need to be re-opened or repeated.

Cataract surgery alone has been shown to lower the eye pressure in some people. In some cases, glaucoma surgery can be performed in conjunction with cataract surgery.

Glaucoma is a disease that can lead to blindness. With consistent testing and treatment, glaucoma damage can usually be slowed or stopped.

As our understanding of glaucoma increases more people are preserving vision for their lifetime.

Kent Bashford, DO Fellowship-Trained Glaucoma Specialist

For additional information on Glaucoma and other vision threatening conditions, please visit us online at

www.eyecenternoco.com

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The senior nutrition challenge Balancing the essentials with a little room left for dark chocolate Lana L. Olsson

E

ating properly has special challenges in senior years. We strive to stay active and fit, yet our physical activity tends to decrease. We need to get all of our vitamins, minerals, protein, fiber and fat—with fewer calories. Our vitamin and mineral needs do not decrease with decreased activity.

How can we continue to enjoy rich desserts, fried foods, candy, sugary sodas, and alcoholic beverages?

First we must acknowledge that if we have reached senior status in good health, then we must be doing something right! We don’t need make radical eating changes late in life, unless our survival depends on it.

If you suspect that you are not meeting your basic nutrient needs, your best bet is to simplify. Focus on getting enough calcium, fiber, and protein—and the necessary vitamins, minerals, and nutrients will probably follow. If you enjoy cereal, choose one that is fortified with 100 percent of essential vitamins and a significant amount of minerals and fiber. When you add milk to that cereal, you will get a serving of calcium, which is essential for bone health, nervous health and blood-pressure control.

Calcium is best obtained from food (and not pills); primarily milk, yogurt, cheese and canned fish with bones.

Foods made from milk, such as pudding, custard and chowders, are equally good calcium sources.

Calcium-fortified beverages are available in most supermarkets; including orange juice and soy beverage.

Yogurt with live bacterial cultures has an added benefit of introducing good bacteria into the intestines, which provides a barrier to disease.

Dietary fiber is more than an antidote to constipation. Fiber fosters the growth of good bacteria in the intestines and defends against infection. One of the richest sources of fiber is the legume (pinto, navy, garbanzo, lentil, kidney, small red, cannellini, etc.).

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The American diet tends to be rich in protein. Protein works best when consumed at each meal, starting with breakfast; as it helps to stabilize blood sugar, and is truly the body’s building block.

The highest-quality proteins are found in animal products. Plant proteins also contribute to meet protein requirements.

Americans are now cautioned to reduce salt and sodium intake and we know that most sodium we consume comes from additives used in processing. Cooked lentils are virtually sodium free, but a canned lentil soup may have 500 mg of sodium per serving (1/4 of recommended daily intake).

Lightly salting your homemade soup recipe is not a problem. Only 5 percent of people’s salt intake comes from the saltshaker.

You should consume twice as much potassium as sodium. Consuming half of your meal or plate as vegetables will help you get plenty of potassium and this strategy will help to control blood pressure.

The healthy American plate looks like this: half full of vegetables; onefourth full of protein rich foods—such

as fish, meat, poultry, eggs, cheese and legumes; and one-fourth with grains— such as bread, pasta, rice, barley, corn, kasha, and quinoa. (Legumes are unusual because they serve as a grain serving and a protein serving). The healthy monoand polyunsaturated fats and oils— including olives, nuts, and seeds are added to the meal. A serving of fruit and a calcium-rich dairy product are found to the side of the plate at the meal. Are you now asking, where’s the red wine and dark chocolate? Remember to consume these healthy choices judiciously.

The nutrition challenge is to eat three or more meals a day as recommended, flavoring with herbs, using small doses of sugar and salt, and then to consider what, if anything, you are truly missing.

All foods can fit when enjoyed moderately and as part of a healthy lifestyle.

Lana L. Olsson is a registered dietitian, board certified in gerontological nutrition. Lana consults for The Hillcrest in Loveland, and is the dietitian for a V.A. home based primary care team based in Greeley, CO.

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