Number Of Americans Living With Dementia Growing At An Epidemic Rate

ne in seven Americans over the age of 70 suffers from dementia, according to the first known nationally representative, population-based study to include men and women from all regions of the country.

About 3.4 million people, or 13.9 percent of the population age 71 and older, have some form of dementia, the study found. As expected, the prevalence of dementia increased dramatically with age, from five percent of those aged 71 to 79 to 37.4 percent of those age 90 and older.

About 2.4 million of those with dementia, or 9.7 percent of the population age 71 and older, were found to have Alzheimer's disease, the most common cause of dementia, according to the study.

Comparing Long-Term Care in Germany and the United States: What Can We Learn from Each Other?

Though one nation's policies rarely serve to answer another's problems, comparing experiences can help stimulate evidence-based debate and discussion. This AARP Public Policy Institute Issue Paper by Mary Jo Gibson and Donald L. Redfoot examines developments in the long-term care (LTC) systems in Germany and the United States to understand their impact on financing and coverage, consumer options and choice, family caregivers, the LTC workforce, and the quality of services. It also provides a brief overview of LTC reform proposals in both countries.

Caregivers Increasingly File Lawsuits Against Employers Alleging Discrimination

The number of lawsuits stemming from "family responsibilities discrimination," or discrimination against employees who have family care-giving responsibilities at home, has increased by 400% in the last 10 years, according to the Center for WorkLife Law at the University of California, USA Today reports. The U.S. Equal Employment Opportunity Commission also has reported an "upsurge" in cases, many of which result in awards to plaintiffs, and recently has issued its first guidance for employers about the issue.

According to USA Today, the lawsuits -- which usually involve workers who care for a child, elderly parent or spouse with a disability -- "generally fall under three areas":

• Employees claiming an employer denied leave or retaliated against a worker for taking time off to care for a child, which is covered by the federal Family and Medical Leave Act;
  
  
• Employees who allege employers violated the federal Americans with Disabilities Act by denying workers accommodations to care for a relative with a disability; and
  
  
• Employees who allege gender discrimination, such as women with young children who claim they are not given the same treatment as new fathers.

California Fires Trigger Steps To Safeguard More Than 20,000 Homecare Patients

Homecare providers throughout Southern California have been scrambling to respond to the unprecedented fires sweeping through the region. About 20,000 patients served by Apria Healthcare alone have been displaced or face extreme smoke conditions, triggering implementation of their emergency response plans.

"The entire team in Southern California is working on our emergency response in some capacity, either by staffing the disaster shelters, conducting patient inquiry calls, or delivering oxygen and medical equipment directly to homes," said Steve Foreman, Apria's regional VP of operations for Southern California.

The company first contacted critical care patients in the region - for example those on ventilators or pediatric patients who require oxygen. "We reviewed the evacuation shelter list and equipment needs with them, such as assessing the status of their back-up batteries and portable suction units. Then we contacted or attempted to reach all respiratory patients to make sure that they had adequate supplies until we could get to them," said Foreman.

Homecare Stakeholders Present Recommendations To CMS Administrator Kerry Weems, USA

Senator Arlen Specter (R-Pa.), the American Association for Homecare, other homecare stakeholders held a meeting with Centers for Medicare and Medicaid Services (CMS) Acting Administrator Kerry Weems. The meeting focused on Medicare program integrity, power mobility issues, the new competitive acquisition program, and home oxygen therapy.

Tyler J. Wilson, president of the American Association for Homecare, commented after the meeting, "We talked about our frustration that CMS has not taken more measures to strengthen program integrity in Medicare and to stem fraud at the front-end. We told the Administrator that we want to collaborate to prevent fraud from happening in the first place."

Evercare Unveils Details Of Nation's First Alzheimer's Disease Special Needs Plan In Phoenix

Evercare, one of the nation's, and Arizona's, largest health care coordination programs, today unveiled the details of the first-ever Medicare Advantage Special Needs Plan designed exclusively for people with Alzheimer's disease and chronic dementia. Residents of Maricopa County, Ariz. will be the first in the country to have access to this innovative health plan with tailored benefits and services, including special prescription drug coverage and the Alzheimer's Association Safe Return® program. Evercare Care Managers will collaborate with memory disorder specialists from the prestigious Phoenix-based Banner Alzheimer's Institute, with the goal of enhancing Evercare's innovative model of care.

30+ Resources For US Politics On The Web

The United States election for President is over a year away (November 3rd, 2008), but from the fervor in the press, one might think it’s tomorrow. With the primaries still looming, now is the time to start looking in to the information out there on the web, and we’ve gathered 30+ tools to help you do just that!

Bed Sores Can Be Stopped With Proper Care In Nursing Homes Medicare Project Shows

A diligent and sustained focus on preventing serious bed sores in nursing home residents was remarkably effective according to the results of a project sponsored by the Centers for Medicare & Medicaid Services.

Results of the project have just been published in the Journal of the American Geriatrics Society.

"Reducing pressure ulcers-the clinical term for bed sores-is a priority for CMS and quality improvement organizations (QIOs) nationwide," said Kerry Weems, acting administrator of CMS. "It is also one of the most important goals of the voluntary Advancing Excellence in America's Nursing Homes campaign, of which CMS is a founding member.

The nationwide project stopped more than two-thirds of the residents' serious bed sores - a dreaded complication of frailty and disability in old age - in the thirty-five nursing homes that reported data from the project, the paper reports.

Nursing home advocates demonstrate outside Carlyle's headquarters -- again

Washington Business Journal - by Neil Adler Staff Reporter

A national caravan of caregivers and advocates for seniors arrived in D.C. to hold a demonstration on Monday outside the headquarters of private equity giant The Carlyle Group, which is taking over nursing home chain Manor Care Inc. for $6.3 billion.

A large health care workers union, SEIU Healthcare, is organizing the demonstration. The union, which held a similar demonstration outside Carlyle's headquarters about a month ago, is concerned about the buyout's effect on seniors, taxpayers and nursing-home workers.

At Monday's demonstration, nursing-home workers, family members of patients and seniors advocates spoke about the need for safe staffing levels and improved care. On Tuesday, they plan to visit Capitol Hill and lobby Congress to hold hearings on private equity ownership of nursing homes.

Toledo, Ohio-based Manor Care (NYSE: HCR) runs about a dozen nursing homes in the Washington area and hundreds more nationwide. The acquisition is expected to close by the end of November, Carlyle said in a statement.

The protesters want Carlyle executives discuss their specific plans for Manor Care. Officials with SEIU Healthcare say they are worried about the fate of nursing-home workers and are afraid that care may deteriorate.

They also say Carlyle's purchase will result in a windfall of millions of dollars for top Manor Care executives, and Carlyle stands to reap fees on the deal that could total hundreds of millions of dollars.

On Monday, Carlyle pledged a commitment to quality care at Manor Care. The pledge emphasizes education and training of caregivers, staffing levels that ensure proper clinical care is given, appropriate capital investment to maintain facilities and technology, and abiding by federal and state requirements.

"Meeting the care needs of Manor Care's patients and residents is our top priority," said Karen Bechtel, a Carlyle managing director and head of its health care team, in the firm's statement. "Manor Care is poised to become an even stronger health care provider under Carlyle's ownership."

SEIU Healthcare leaders say the pledge is a public relations tactic designed to help the private equity firm get the deal wrapped up.

"SEIU caregivers, senior advocates, and community leaders will continue to work to hold the Carlyle Group accountable for improving care and staffing at Manor Care," said Gerry Hudson, executive vice president of SEIU Healthcare, in a statement released by the union.

Nursing homes take in mentally ill

CLEVELAND (AP) -- Some northeastern Ohio nursing homes use a Medicaid loophole to accept hundreds of mentally ill patients discharged from hospital psychiatric wards, spending millions of taxpayer dollars to house patients who often do not qualify for nursing-home care, a state investigation found.

Mentally ill patients are eligible for nursing home care paid for by Medicaid if they need 24-hour supervision or hands-on assistance, but an investigation by the Ohio Department of Mental Health found that 60 percent of the psychiatric patients admitted into Cuyahoga County nursing homes don't need such intensive care, The Plain Dealer reported.

Medicaid pays about $148 a day to house such patients, about three times what it would cost to care for the patient in a group home.

Tags: LTC, mentally ill patients

S.1233 - Veterans Traumatic Brain Injury and Health Programs Improvement Act of 2007

A bill to provide and enhance intervention, rehabilitative treatment, and services to veterans with traumatic brain injury, and for other purposes.

H.R.1783 - Elder Justice Act

To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes.

H.R.1809 - Medicare Independent Living Act of 2007

To amend title XVIII of the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs.

The Effects Of Caregiving Examined By USC Study

new study from the USC Davis School of Gerontology found that caregivers of different ethnicities showed few negative mental or physical health effects as a result of tending to a family member with dementia.

The findings, which appeared the journal Aging & Mental Health, analyzed mental health and physical health differences between African-American and white caregivers.

U.S. Senate Finance Committee Takes New Steps To Hold Carlyle Accountable

FOR IMMEDIATE RELEASE

CONTACT: Andrew McDonald - 202-730-7338
Andrew.mcdonald@seiu.org

October 18, 2007

SEIU Applauds Bipartisan Leadership of Sen. Finance Committee in Push for Greater Oversight of Private Equity Takeovers of Nursing Homes

On the day after Manor Care shareholders approve $6.3B Carlyle Group buyout, top oversight committee asks Carlyle, other buyout firms, for info on nursing home ownership, management


WASHINGTON, DC – The nation’s largest healthcare workers union applauded the bipartisan leadership of the Senate Finance Committee today as it took new steps to hold private equity firms accountable for the care, staffing, and conditions at nursing homes they own.

“On the eve of the largest nursing home takeover in history, increased efforts by Congress to hold buyout firms accountable are timely and necessary,” said Gerry Hudson, Executive Vice President of SEIU Healthcare, the nation’s largest healthcare workers union. Yesterday, shareholders of the nation’s largest nursing home chain, HCR Manor Care voted to approve a $6.3 billion buyout by the Carlyle Group, in what will be the largest-ever private equity takeover of a nursing home chain. For more info, visit http://carlylefixmanorcarenow.org/behind-the-buyout/

Hudson continued, “Medicare and Medicaid resources that are intended to support vulnerable Americans are being diverted to the private benefit of wealthy executives and investors. CEO profits cannot come at the price of patient safety and care. The Senate Finance Committee is right to exercise bipartisan leadership to hold the Carlyle Group and other private equity firms accountable for the impact of their actions on people’s lives.”

Today the Chairman and Ranking Member of the Senate Finance Committee – the committee with oversight over Medicare, nursing homes, and private equity-related issues -- sent letters to the Carlyle Group and other four other private equity firms asking for information related to their ownership and management of nursing homes. Sens. Baucus (D-Mont.) and Grassley (R-Iowa) also sent a letter to the Centers for Medicare and Medicaid Services (CMS) asking the federal agency responsible for overseeing nursing home inspections to account for a report of higher health and safety violations in nursing homes that have been bought by private equity investors.

In their letters, the committee cited a recent front page exposé by the New York Times detailing how cuts to staffing and operations at nursing homes bought by private equity firms across the country have enriched top executives and buyout firms but left nursing home residents worse off. Read the article here.

On October 2, 2007, SEIU sent letters to the Senate Finance Committee and three Committees in the House of Representatives calling on Congress to take action to improve the quality of care and hold private equity firms accountable for their ownership of nursing homes. The SEIU letters requested that each committee hold hearings, exercise oversight authority, and consider new legislative reforms related to private equity ownership of nursing homes. Copies of the letters are available at www.CarlyleFixManorCareNow.org

Pending Carlyle Takeover of HCR Manor Care Largest-Ever

With more than 37,000 resident beds, HCR Manor Care is the largest nursing home provider in the country. The $6.3 billion Carlyle takeover deal will result in a windfall of as much as $250 million for top Manor Care executives and directors, including as much as $186 million for Manor Care CEO Paul Ormond. Carlyle stands to reap fees on the deal that could total hundreds of millions of dollars. Much of the money going to fees and executive compensation is from taxpayers: Manor Care receives approximately two-thirds of its revenue in taxpayer funded payments, such as Medicare and Medicaid.

In recent years, large private investment groups have agreed to buy 6 of the nation’s 10 largest nursing home chains, containing over 141,000 beds, or 9 percent of the nation’s total. Private investment groups own at least another 60,000 beds at smaller chains and are expected to acquire many more companies as firms come under shareholder pressure to sell, according to the New York Times article by Charles Duhigg, “At Many Homes, More Profits and Less Nursing,” published September 23, 2007.

www.CarlyleFixManorCareNow.org

Kaiser Family Foundation Offers New Tool For Examining Presidential Candidates' Health Care Proposals

2008 Presidential Candidate Health Care Proposals: Side-by-Side Summary, Kaiser Family Foundation: The Foundation has released an interactive tool that compares the health care proposals of presidential candidates by summarizing positions in four overall categories: access to health care coverage, cost containment, improving the quality of care and financing. Users can create customized side-by-side comparisons of up to four candidates, as well as all Democrat or all Republican candidates' health care proposals. The new tool is part of health08.org, a website operated by the Foundation providing analysis of health policy issues, regular public opinion surveys, and news and video coverage from the campaign trail (Kaiser Family Foundation release, 10/16).

CCA Hearing Update

The House Energy and Commerce staff contacted us yesterday, and Reps. Dingell
and Pallone now say they will schedule the hearing after the Thanksgiving
break, in the first part of December.  Dingell is the Chair of the full Energy
and Commerce Committee and Pallone is Chair of the Subcommittee on Health (the
Subcommittee that will be having the hearing).

Thanks to all who emailed, faxed, called and wrote!  Great work.

We will keep you posted, as we know more.  All things can change, in this
Congress anything can happen, so stay tuned.

NATIONAL ADAPT MAILING LIST - Adapt Community Choice Act List http://www.adapt.org

The Senior Alliance

Dedicated to preserving and enhancing the independence of older persons and individuals with disabilities in
western and southern Wayne County, Michigan

HARKIN, KENNEDY INTRODUCE BILL TO PUT HOME CARE WORKERS ON EQUAL FINANCIAL FOOTING WITH OTHER DOMESTIC WORKERS

WASHINGTON, D.C. – A longtime advocate for workers’ rights, Senator Tom Harkin (D-IA) today introduced legislation to ensure that home care workers receive the same minimum wage and overtime protections as most other domestic workers do. The Fair Home Health Care Act of 2007 extends the protections of the Fair Labor Standards Act (FLSA) to home care workers to ensure these caregivers receive fair pay.

As America faces a shortage of qualified home care workers, this new legislation will help to meet Americans’ growing demand for home-based health care by protecting those who provide it. This bill is co-sponsored by Senator Ted Kennedy (D-MA), Chairman of the Senate Health, Education, Labor and Pensions Committee, as well as Senators Patty Murray (D-WA), Barbara Boxer (D-CA), Maria Cantwell (D-WA), Bob Casey (D-PA), Hillary Clinton (D-NY), Christopher Dodd (D-CT), Barack Obama (D-IL), and Chuck Schumer (D-NY).

“Older Americans and people with disabilities are requiring help at home now more than ever, creating a high demand for qualified domestic care workers,” Senator Harkin said. “Our bill allows these employees to do their jobs under the same rules that cover others. This is not only the fair thing to do, but it is the smart and necessary action we need to ensure that Americans have first-rate care.”

State legislation regarding wages and benefits of home care workers: Thirteen promising practices

Introduction/Background

The number of people in the United States that need personal assistance or home health services is steadily increasing with projections indicating the demand will double from 13 to 27 million by 2050 (Kaye et al., 2006: 1113). With the growing demand, the workforce that provides non-institutional personal assistance and home health services tripled between 1989 and 2004, going from 264,000 to 894,000.

Union calls for good care of nursing home residents

Patient care — not profits — should be the prime concern when an investment group purchases a large nursing home company, a union representing health-care workers said Wednesday.

The Carlyle Group, an investment company, is nearing completion of a $6.3 billion takeover of HCR Manor Care, which has 27 nursing homes with 3,902 beds in Illinois and about 350 facilities nationwide. It operates under the names of ManorCare Health Services, Heartland and Arden Courts.

“We want to make sure that the residents are taken care of properly when Carlyle takes over,” Tim Thomas, secretary-treasurer for Local 4 of the Service Employees International Union, said at a Statehouse news conference.

He and others pointed to a Sept. 23 analysis by the New York Times that showed staffing levels and patient care often suffer when investment firms purchase nursing home companies.

Medicaid Spending Increased By 10.7% In First Half Of 2007

Medicaid spending increased by 10.7% in the first six months of 2007 -- the largest increase since 2001 -- and likely will reach $330 billion this year, according to a USA Today analysis of data from the Bureau of Economic Analysis. USA Today attributed the increased Medicaid spending in part to:

• Efforts by states to extend health insurance to more residents through Medicaid and SCHIP;
  
  
• Increased enrollment in Medicaid after a temporary decrease in 2006 that resulted from implementation of new proof-of-citizenship rules; and
  
  
• Increased Medicaid reimbursements for health care providers.

New Book Empowers People Living With Dementia

"It's a very come and go disease," writes Cary Henderson, a man with Alzheimer's Disease. "When I make a blunder, I tend to get defensive about it. I have a sense of shame for not knowing what I should have known. And, for not being able to think things and see things that I saw several years ago, when I was a 'normal' person. But everybody, by this time, knows that I'm not a normal person. And I'm quite aware of that."

Henderson is not alone.

Tags: Dementia, empowerment

Study Examines Multiple Chronic Conditions Among Medicaid Beneficiaries

"The Faces of Medicaid II: Recognizing the Care Needs of People With Multiple Chronic Conditions" Center for Health Care Strategies: The study examines the patterns and prevalence of multiple chronic diseases among Medicaid beneficiaries. The study also examines how greater understanding of such patterns can lead to the development of more appropriate guidelines, care models, performance measurement systems and reimbursement methodologies for Medicaid (Kronick et al., "The Faces of Medicaid II: Recognizing the Care Needs of People With Multiple Chronic Conditions," October 2007).

Tags: Medicaid, chronic condition

Grassley Requests Information From Long-Term Care Insurers

Senate Finance Committee ranking member Chuck Grassley (R-Iowa) this week asked 11 long-term care insurers to provide information on their business practices in response to "troubling data," the New York Times reports. In a letter sent to Genworth Financial, Conseco, Penn Treaty American and eight other insurers, Grassley asked for detailed information on the procedures that the companies use to process policyholder claims, inquiries and denials, and whether employees receive rewards for claims denials.

The letter cited data collected by the National Association of Insurance Commissioners that found a 92% increase in complaints about long-term care insurers between 2001 and 2006. In addition, the data found that a majority of complaints related to claims denials resulted in the reversal of the denials. According to NAIC, "This is a pattern of error not typically found in other lines of health-related insurance." Many long-term care insurers have announced plans to increase premiums because they underestimated the number of claims that they would receive. Genworth officials said that they will cooperate with the request from Grassley. Conseco and Penn Treaty declined to comment. Grassley this week also asked the Government Accountability Office to examine whether the purchase of nursing homes by private investment groups has affected conditions and care provided at the facilities (Duhigg, New York Times, 10/3).

Tags: Senator Grassley, LTC insurance

New Study Spotlights Growing Role Of Medicare In Propping Up Nation's Medicaid Program

The Alliance for Quality Nursing Home Care said a new BDO Seidman study of the nation's Medicaid program released today draws much needed attention to a chronic and worsening problem: Medicare's cross-subsidization of increasingly inadequate Medicaid payments for nursing home care.

Noting that the influential Medicare Payment Advisory Commission (MedPAC) is meeting in Washington this week to consider a number of Medicare funding matters, Alan Rosenbloom, President of the Alliance, urged the agency to consider more carefully the substantial Medicaid losses nursing homes face in formulating recommendations to Congress. He also urged Congress to evaluate the relationship between government payment programs -- which together pay for roughly 80% of nursing home patients -- in making decisions regarding Medicare payments to nursing homes.

Tags: nursing homes, medicare, medicaid

Depression, Aging, And Proteins Made By A Virus All Linked To Heart Disease

Researchers here have linked an increase in two immune system proteins essential for inflammation to a latent viral infection and proposed a chain of events that might accelerate cardiovascular disease.

The same process may be involved in a host of other ailments plaguing the elderly.

The findings also suggest that chronic depression may play a key role in starting the cascade that can lead to the buildup of plaques clogging coronary arteries.

Tags: depression, elderly, heart disease

Ending Two-Year Waiting Period For Medicare

Ending the Medicare Disability Waiting Period Act of 2007 (S 2102), offered by Sen. Jeff Bingaman (D-N.M.), would provide much needed assistance to those under age 65 diagnosed with early-onset Alzheimer's who lose their jobs and their employer- based health insurance.

There are as many as 500,000 individuals under age 65 with early-onset Alzheimer's or a related dementia who may qualify for Medicare benefits under Social Security Disability Insurance (SSDI) but must suffer through the 24 months after the date their SSDI begins for Medicare benefits to start. Over a 10-year period, this legislation would phase out the waiting period and would also, in the interim, create a process by which those with life-threatening diseases like Alzheimer's could get an exception to the waiting period.

Tags: dementia, LTC, Medicare waiting period

Duh! of the Week

Older People Are Human Beings - Not Objects Or Numbers, Says Help The Aged, UK

Responding to the Dignity in Care report from the Healthcare Commission, Paul Cann, Director of Policy at Help the Aged, says:

'Older people are human beings - not objects or numbers. It's nearly ten years since we first exposed the shortcomings in hospital care and dignity for older people1, yet we are still hearing all the time about shocking abuses of dignity. This important report shows there is some progress - but only five of the 23 trusts complied with all dignity in care standards. This is intolerable.

'This report echoes our own recent research which will form the basis of our own dignity challenge2. A challenge which sets out what needs to happen, by whom, where and by when. The Government, hospital and care providers must take up this challenge immediately. The Government's new end of life care strategy and review of the law on fairness for older people would be two good places to start.'

Tags: elderly, dignity, UK