The Senior Scene

A new report shows Washington’s long-term care system ranks second in the nation, but AARP and other aging advocates caution that budget pressures threaten to turn the clock backward on Washington’s high quality and cost effective approach.
The state-by-state “scorecard” from AARP was issued with support of The Commonwealth Fund and SCAN Foundation, national organizations that are advocates of long-term care. The report finds that Washington does better than most states in providing choices and opportunities for people to stay in their own home or communities and to avoid expensive or unnecessary hospital or nursing home stays.
While the report gives Washington an overall high ranking, AARP officials said it also sheds light on key weaknesses in the system and points to needed reform in key areas including support for unpaid family caregivers, quality of care in nursing homes, and affordability.
“Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers” (longtermscorecard.org) is an update of the inaugural 2011 scorecard, AARP officials said It ranks each state overall and within 26 performance indicators along affordability and access, choice of setting and provider, quality of life and quality of care, support for family caregivers, and effective transitions. New indicators this year include length of stay in nursing homes and use of anti-psychotic drugs by nursing homes, which can raise serious concerns about the quality of institutional care, according to AARP.
“We have a strong track record in our state of finding ways to help people live independently at home as they age,” said Ingrid McDonald, advocacy director of AARP, which serves more than 920,000 members age 50 and older in Washington. “Since the mid-1990s, our state has been very intentional about moving people away from expensive institutional care and toward more cost-effective and popular home and community based services. While the Scorecard ranks us second in overall choice and quality, it is notable that we rank 34th in the country in long-term care spending per capita. As a result, our system is both better and cheaper than other states.”
McDonald said the state must avoid going “backward on this success. Throughout the great recession, AARP fought back against budget proposals to reduce home and community based services. These cuts would simply push people back towards expensive nursing home care. We anticipate more budget pressure in 2015 and once again will urge lawmakers not to make decisions that are penny wise and pound foolish.”
The new scorecard reports that Washington is doing well serving people in the community but illustrates there is more work to be done and we don’t have time to stand idle. For example, the report shows that Washington ranks 38th in the nation on a measure of caregiver well-being.
Unpaid family caregivers provide the bulk of care for older Washingtonians, in part because the cost of long-term care remains unaffordable for most middle income families. In Washington, more than 850,000 residents help their aging parents, spouses and other loved ones stay at home by providing assistance with bathing and dressing, transportation, finances, and medical tasks such as wound care and injections. The value of the unpaid care totals about $10.6 billion, according to the study.
“When it comes to helping older Washingtonians live in the setting of their choice, this silent army of family caregivers assumes the lion’s share of responsibility,” said McDonald. “Many juggle full-time jobs with their caregiving duties. Others provide (24-hour) care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes (that are) most often paid for by Medicaid. They have earned some basic support.”
According to the state Scorecard, 60 percent of family caregivers in Washington face a degree of stress and worry. The state needs to do more to support family caregivers, McDonald said.
AARP is calling for an expansion of the Family Caregiver Support Program. The program provides support for caregivers such as counseling, referrals and respite so they can have time to take care of their own needs. Research shows that it allows people to remain self-reliant and delays their need to turn to the Medicaid program for support, McDonald said.
The Scorecard also points to the quality of care in nursing homes as a key area of improvement. Washington ranks in the middle on indicators such as residents with pressure sores and use of antipsychotic medication, and significantly lower than most states in the area of nursing home staff turnover rates. McDonald said AARP is working with nursing home provider associations and the State Long Term Care Ombudsman to improve these indicators and ensure quality of care for all vulnerable elders in our state.
Paying for long term care is a growing challenge. The Scorecard reveals that only 66 people out of 1,000 age 40 and up have private long term care insurance policies. Without insurance, the cost of care is prohibitive. According to the Scorecard, care is particularly expensive in Washington:
• The median annual nursing home private pay cost is more than two times the median income of people age 65-plus.
• The median annual home care private pay cost is nearly 90 percent of median household income for 65-and-up age group.
Without private insurance, many people have no other option other than to spend down to poverty to qualify for Medicaid assistance. AARP supports proposed legislation to study alternative financing options, McDonald said.
“This Scorecard gives us a snapshot of how well Washington serves our older residents, those with disabilities, and family caregivers – and shows us where we must sharpen our focus to better assist hard-working Washingtonians,” said McDonald. “With the age wave upon us, now is the time for policymakers to act.”
Long-term care (also called long-term services and supports) is designed to help older people and those with disabilities. Services can be provided in a person’s home, in a community setting such as an adult day center, or in a group residential facility like a nursing home.

More than 41,200 people across the nation were injured in 2012 while working in their gardens, reports the U.S. Consumer Product Safety Commission. Conversely, many common flowers and plants have healing properties that can help gardeners treat their injuries.

Made from plants, as well as animals and minerals, homeopathic medicines offer some of the safest options for self-treatable conditions — and can be great for ailments and injuries that befall home gardeners. Because the risk of interaction with other drugs, supplements and herbs is minimal, experts say these natural medicines are a good first choice for early symptoms.

Easily found in health food stores and pharmacies, these non-prescription medicines work naturally with the body instead of masking a problem, which is important if a more serious condition should arise.

With that in mind, here are some homeopathic treatments for common gardener ailments:

• Allergies: Relieving allergy symptoms provides a good example of the principle behind homeopathic medicines. Chopping a red onion has a “toxic” effect, causing eyes to water and burn until exposed to fresh air. When similar symptoms appear from allergies or a cold, a micro-dose of the red onion helps relieve those same symptoms. The red onion in this homeopathic form takes the Latin name of its source, Allium cepa.

Try Ambrosia (Ragweed) for watery nasal discharge with eyes that tear and itch and Sabadilla (Cevadilla) for hypersensitivity to the smell of flowers or itching in the back of the mouth. A good general allergy medicine is Histaminum, which is derived from histamine.

• Sore, Stiff Muscles: For gardeners suffering back and knee injuries, Arnica montana can be an essential gardening tool.

Commonly known as the Mountain daisy, Arnica’s healing properties were first recognized in the 16th century. Legend has it mountain climbers chewed the plant to relieve sore, aching muscles and bruises from falls. Today, this homeopathic medicine is used by professional athletes and surgeons for muscle pain and stiffness, swelling from injuries and bruising. For more information visit www.Arnicare.com.

• Sunburn, Blisters and Other Skin Conditions: In its homeopathic form, Calendula (Garden marigold) is one of the most versatile aids for skin irritations. Try a Calendula cream or ointment for blisters and calluses, cuts and scrapes, rashes, and chapped skin caused by wind, dry or cold air, or sun.

Used for centuries as a natural healing and soothing substance, Calendula’s wound-healing properties are due to essential oils, saponins, flavonoids and alkaloids. These compounds have skin healing properties.

• Bug Bites: To help relieve bee and wasp stings, as well as gnat, black fly or mosquito bites, take five pellets of Apis mellifica (Honey bee) every 30 minutes for up to six doses. And apply Calendula topically.

• Take Breaks and Relax: While many plants help us nurture our health, remember to practice common sense. Prepare properly by stretching and wearing sun block. Don’t overdo it. Take breaks. End your day with a soaking bath.

Relieve conditions at the first sign of symptoms before they grow out of control, so you can continue your gardening activities.

Source: StatePoint

If you don’t know much about kidney health and treatment, it’s important to get informed. Kidney disease is common and can be deadly.
In fact, kidney disease is the ninth leading cause of death in America, according to the National Kidney Foundation, and the Centers for Disease Control and Prevention estimates that one in three Americans are at risk for kidney disease.
Risk factors include high blood pressure, diabetes and a family history of a kidney disease.
Certain lifestyle changes can help promote healthy kidney function. Your doctor may prescribe a well-balanced diet low in cholesterol, sodium, processed foods and sugar. Get plenty of physical activity. Stay hydrated. Avoid unhealthy habits such as smoking.
Talk to your doctor about your risk and preventive steps you can take.
In a healthy body, kidneys clean the blood by removing excess fluid, minerals and wastes. However, for patients with kidney failure, kidneys don’t function properly and they need a medical treatment called dialysis to clean their blood.
More than 430,000 people in the U.S. undergo dialysis at home or in clinics yearly, according to the United States Renal Data System.
There are two types of dialysis: peritoneal dialysis and hemodialysis. Peritoneal dialysis uses a cleansing fluid that is instilled into the patient’s peritoneal cavity, the fluid-filled gap between the walls of the abdomen and organs, and then drained after a prescribed period of time. The patient’s own peritoneal membrane acts as a natural filter for removing excess fluids and wastes.
Hemodialysis requires the patient to have a permanent access site to his or her cardiovascular system and uses a machine to remove blood from the patient, pump it through an artificial kidney that removes toxins and excess fluids, and then return the blood to the body.
For those undergoing hemodialysis, there is good news. At home care can benefit patients looking for more control of their care.
Traditionally, patients on hemodialysis receive treatments at a dialysis clinic three days per week, lasting between three and five hours per visit. And patients must comply with the clinic schedule, requiring them to manage their treatments around the clinic’s availability.
For some, home hemodialysis (HHD) may be a better alternative. With HHD, patients and care partners perform dialysis at home after successfully completing HHD training with a nurse.
Although home hemodialysis is not a new treatment option, many patients and physicians are unaware of its benefits.
“Improvements in technology have allowed more patients to bring dialysis treatment home, which means more flexibility to maintain their normal routines,” says Mark Costanzo, President of the Renal Therapies Group at Fresenius Medical Care, a manufacturer of renal care products.
To learn more about one of the fastest growing treatment options for kidney failure in the U.S., visit www.fmcna.com.

(This article was produced by StatePoint Media)

A free, information-only presentation about extended healthcare for older adults and people with disabilities will be held May 20 under the sponsorship of Pierce County’s Aging and Disability Resource Center and Health Care Providers Council of Pierce County. The event is set for 6:30 p.m. at the Pierce County Library Administrative Center, 3005 112th St. E. in Tacoma.
Topics include in-home care, elder law, adult homes, memory care and assisted living.
“Life is fragile,” said Aaron Van Valkenburg, manager of Aging and Disability Resources. “For some people – even the youngest and healthiest individual, life can change in a blink with an accident or illness. For others, the gradual onset of disabilities may lead to need for extended care. In either case, knowing about community resources and how to tap into them is crucial.”