Senior Moments: How big of a problem is social isolation among older adults?

             
                                                                                     

Senior Moments from H.O.M.E.

How big of a problem is social isolation among older adults?

Bigger than you might think. One just has to look at some of the news articles to know that social isolation is a trend that is only getting worse.

I had the pleasure of presenting Rush Generations members last month, where both Dr. Alexander Sasha Rackman and I both addressed social isolation from our individual perspectives: Dr. Rackman being a geriatrician and myself being a gerontologist and social worker.

Let me first start by saying that social isolation is not just a problem experienced by older adults. It can occur among younger and older people alike.

So, I hope that the take-aways you get from this post will help you initiate a dialogue with friends or family or a primary care physician that helps get someone on the path of either reducing or even preventing social isolation from happening.

I have found that people who are socially isolated often do not even recognize it is happening to them, before it is too late.

Dr. Rackman made a very important distinction between isolation and loneliness.

He described loneliness as subjective in that it is how people perceive their situation and whether they feel isolated.

Hence, one might feel lonely but not be isolated.

Someone who is isolated lacks meaningful and unfulfilling relationships in their lives, has a minimal number of social contacts, and doesn’t feel like they belong.

Some of the risk factors for social isolation include:

a decrease in mobility that limits engagement in social activities
less exposure to opportunities for building relationships
fear of falling or unmanaged incontinence that causes one not to leave their home
limited family or friends, family or friends who live at a distance, being unmarried, and living alone

These risk factors may come as no surprise, but what is surprising is that social isolation is on the rise. Yet, these risk factors have the potential to be addressed if only people were aware of the issue and addressing the issue.

The challenge is that social isolation can go unnoticed if no one is paying attention.

Reports vary with the number of older adults who are social isolated. Some numbers have been as high as forty-three percent (Nicholson, Molony, Fennie, Shellman, & McCorkle, 2010; Smith & Hirdes, 2009).

The Administration on Aging reports that about twenty-nine percent of older adults live alone. Well, since we know that living alone is a risk factor, we, as a society should be thinking of ways to engage and connect these individuals.

If the previous numbers don’t “jump start” you to begin paying attention to yourself and those around you, perhaps the following findings will:

Social isolation is twice as likely to cause premature death in older adults. The mortality rate of socially isolated older adults is comparable to that of smokers.
Social isolation is both bad for one’s health and is costly. AARP and Stanford University found that that the lack of social contacts among people with Medicare cost an estimated $6.7 billion in additional Medicare spending. 
Forty percent of adults admit to being lonely. Reducing isolation could possibly reduce loneliness and vice versa.

intergenerational_theresnoplacelikehomeHere are a few resources to help an older adult stay connected:

CJE SeniorLife’s Virtual Senior Center

H.O.M.E.’s Good Life Senior Residences

Mather Lifeways Telephone Topics

Little Brother’s Friends of the Elderly

H.O.M.E.'s Intergenerational Housing Program is designed to offer engagement that reduces isolation and increases quality of life. As a result, our residents often report that their health improves after they move into our buildings. Residents are also offered opportunities to attend community outings including movies, museums, and shopping. In many instances, our residents refer to residential managers, coordinators, and neighbors as the “H.O.M.E. family,” an extension of their own family and support system.

Posted by Tricia Mullin on Sep 3, 2018 3:06:00 PM

About H.O.M.E.

Founded in 1982, has helped thousands of low-income seniors in Chicago maintain their independence by providing a home repair service, shopping bus, moving program, and three affordable apartment buildings where seniors can live comfortably in an intergenerational environment.

Best-selling album of all time says about baby boomers’ spending power

                                  What the best-selling album of all time says about baby boomers’
                                   spending power     

Sept 2, 2018 10:06 a.m. ET

 
They’re not the ‘Take It Easy’ generation


Michael Jackson fans worldwide are celebrating what would have been his 60th birthday this week, a testament to his enduring reign as the king of pop.

But that title took a hit this month.

Classic rockers The Eagles dethroned Jackson’s 1982 masterwork “Thriller” as the top-selling album of all time when the band’s “Their Greatest Hits 1971-1975” surpassed 38 million copies sold.

Regardless of what it says about their relative musical talents, the milestone is evidence of the awesome spending power of the generation that’s just a few years older than Jackson’s Generation X fan base: baby boomers.

‘You can check out any time you like, but you can never leave’
Representatives for the band and its music label didn’t have an exact demographic profile of Eagles fans available, but the band formed in 1971, and it’s safe to assume that the bulk of the band’s fans are baby boomers, the group born between 1946 to 1964 and now in their mid-50s to early 70s.

Research has shown that musical taste freezes in your early 30s. That’s how old millions of boomers were when the Eagles were churning out chart-toppers like “Hotel California,” which included the immortal lines “You can check out any time you like, but you can never leave.”

Most people (69%) who like similar artists of that era — including Eric Clapton, The Grateful Dead, Fleetwood Mac, and Paul McCartney — are 45 and older, said Russ Crupnick, managing partner of the research firm MusicWatch. And those fans have had ample opportunity to buy the record-setting Eagles’ greatest hits album again and again.

“The millennials may represent the future of marketing, but the future isn’t here yet,” Hubbell said. Millennials are still five to 15 years away or so away from their peak earning years. Hubbell has seen some long-established companies panic when they realize their core customers are now in their 70s and awkwardly try to pivot to selling to millennials. “That’s a wrong move,” Hubbell said. “They should be going after the people who actually have money.”

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Moving? Should You Buy or Rent?

                                                                   

By Jane Bryant Quinn, AARP Bulletin

To rent or buy again? That is the question retirees face when it comes to real estate and downsizing.
It's zero hour. You've decided to sell your house and move to something smaller or to another town. As a homeowner, you naturally think of buying again — a house or maybe a condo. But should you? Maybe you should rent instead.

Ownership is solidly entrenched among retirees. They weren't even shaken by the real estate collapse. From the peak of the housing bubble in 2006 to the present, the rate of homeownership for people 65 and up has held steady at about 80 percent, the Census Bureau reports. It runs to over 90 percent among married couples in which one person is 65 or older.

For those 55 to 64, however, it's another story. The portion who own the place where they live has dropped to 76 percent, compared with 81 percent in 2006. Some in this age group switched to renting because they couldn't manage a mortgage anymore. Others, however, rent by choice.


That leads to the question of how to dispose of the proceeds when you sell a house. You can use part or all of it to buy another house or condo, with or without a mortgage. That pot of money is now tied up. You could tap it at some point in the future, by taking a home equity loan or reverse mortgage, but that probably isn't your plan.

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Press Release Study: Medicaid work requirements and health savings accounts may impact people’s coverage, access to care

                                         

                                               Harvard T.H. Chan School of Public Health


                                              Harvard T.H. Chan School of Public Health.
For immediate release: June 20, 2018

Boston, MA – Current experimental approaches in Medicaid programs—including requirements to pay premiums, contribute to health savings accounts, or to work—may lead to unintended consequences for patient coverage and access, such as confusing beneficiaries or dissuading some people from enrolling, according to a new study from Harvard T.H. Chan School of Public Health.

The study will be published online June 20, 2018 in Health Affairs.

“There’s been a lot of recent research showing that expanding Medicaid leads to improved access to care and better quality of care—which suggests that any expansion will be better for public health than not expanding,” said Benjamin Sommers, associate professor of health policy and economics at Harvard Chan School and lead author of the study. “But our findings suggest that some of the benefits of expanding Medicaid may be at least partially compromised by some of the current innovations in use.”

Under the Trump Administration, which has prioritized increased flexibility for state Medicaid programs, some states have been experimenting with new approaches. Most recently, the Centers for Medicare and Medicaid Services (CMS) approved proposals from Kentucky, Arkansas, and Indiana for the first-ever work requirements in Medicaid, and other states, including Kansas, have expressed interest in following suit.

The researchers sought to assess views about new Medicaid approaches in three Midwestern states with different policies: Ohio, which has a traditional Medicaid expansion without premiums and with minimal cost-sharing; Indiana, which expanded Medicaid coverage in 2015 but which requires enrollees to pay premiums and contribute to health savings accounts; and Kansas, which did not expand Medicaid and where only very poor parents and disabled adults are eligible.

The researchers conducted a telephone survey in late 2017 of 2,739 low-income adults in the three states. The survey gathered respondents’ views on health insurance, access to and quality of care, financial well-being, experiences with the Affordable Care Act (ACA), health savings accounts, work requirements, and private vs. public insurance coverage.

The study found:
In 2017, health insurance coverage rates were significantly higher in the Medicaid expansion states (Ohio and Indiana) than in the non-expansion state (Kansas).
Cost-related barriers to care were more common in Indiana than in Ohio. Indiana’s health savings accounts were confusing for many enrollees, with nearly 40% saying they had never even heard of the required accounts and only 36% making regular required payments—meaning that two-thirds of beneficiaries were at risk of losing benefits or coverage for non-payment.
In Kansas, 77% of low-income individuals said they supported Medicaid expansion. Although Kansas is considering work requirements for its Medicaid program, most potential enrollees in the state were either already working or had a disability that prevented them from working. Only 11% of potential enrollees said they would be more likely to seek work if required to do so by Medicaid.


“For both work requirements and health savings accounts, the policies may operate as intended for modest numbers of Medicaid beneficiaries who understand or react to the incentives. But there’s a real risk that even greater numbers of low-income adults will be adversely affected because they don’t understand the new policies, can’t afford them, or get tied up in administrative complexity. For these reasons, it’s critical that there be ongoing independent monitoring of these approaches,” Sommers said.

Other Harvard Chan School co-authors of the study included Carrie Fry, Robert Blendon, and Arnold Epstein.

Funding for the study came from the Commonwealth Fund and the REACH Healthcare Foundation.

“New Approaches in Medicaid: Work Requirements, Health Savings Accounts, and Health Care Access,” Benjamin D. Sommers, Carrie E. Fry, Robert J. Blendon, Arnold M. Epstein,Health Affairs, online June 20, 2018, doi: 10.1377/hlthaff.2018.0331

Visit the Harvard Chan School website 

University Study Public Release - 'Good cholesterol' may not always be good"

                                                       

                                                     PUBLIC RELEASE: 19-JUL-2018
                                               'Good cholesterol' may not always be good
                     UNIVERSITY OF PITTSBURGH SCHOOLS OF THE HEALTH SCIENCES


PITTSBURGH, July 19, 2018 - Postmenopausal factors may have an impact on the heart-protective qualities of high-density lipoproteins (HDL) - also known as 'good cholesterol' - according to a study led by researchers in the University of Pittsburgh Graduate School of Public Health.

The findings, published today in Arteriosclerosis, Thrombosis, and Vascular Biology, a journal of the American Heart Association (AHA), indicate that this specific type of blood cholesterol may not translate into a lowered risk of cardiovascular disease in older women--bringing into question the current use of HDL cholesterol in a common equation designed to predict heart disease risk, particularly for women.

HDL is a family of particles found in the blood that vary in sizes and cholesterol contents. HDL has traditionally been measured as the total cholesterol carried by the HDL particles, known as HDL cholesterol. HDL cholesterol, however, does not necessarily reflect the overall concentration, the uneven distribution, or the content and function of HDL particles. Previous research has demonstrated the heart-protective features of HDL. This good cholesterol carries fats away from the heart, reducing the build-up of plaque and lowering the potential for cardiovascular disease.

"The results of our study are particularly interesting to both the public and clinicians because total HDL cholesterol is still used to predict cardiovascular disease risk," said lead author Samar R. El Khoudary, Ph.D., M.P.H., F.A.H.A., associate professor in Pitt Public Health's Department of Epidemiology. "This study confirms our previous work on a different group of women and suggests that clinicians need to take a closer look at the type of HDL in middle-aged and older women, because higher HDL cholesterol may not always be as protective in postmenopausal women as we once thought. High total HDL cholesterol in postmenopausal women could mask a significant heart disease risk that we still need to understand."

El Khoudary's team looked at 1,138 women aged 45 through 84 enrolled across the U.S. in the Multi-Ethnic Study of Atherosclerosis (MESA), a medical research study sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH). MESA began in 1999 and is still following participants today.
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Just for laughs - Older Women

                                                   

                                                                  Phyllis Diller


Maybe age is kinder to us than we think. With my bad eyes, I can't see how bad I look, and with my rotten memory, I have a good excuse for getting out of a lot of stuff.
Erma Bombeck

I've always felt there are two things a woman should never do after the age of thirty-five: stand in natural light and have a baby.
Erma Bombeck

"You know you're old if your walker has an airbag."  Phyllis Diller

"Photos of me don't do me justice. They just look like me. " Phyllis Diller


"The best way to get rid of kitchen odors is to eat out." Phyllis Diller


"I really don't think I need buns of steel. I'd be happier with bus of cinnamon.""You should never assume.You know what happens when you assume. You make an ass out of you and me because that's how it's spelled." Ellen DeGeneres

"There's lotion for your face,lotion for hands. lotion for your fee, lotion for your body. What would happen in you put hand lotion on your feet? Would your feet get confused and start clapping?" Ellen DeGeneres

"If you want to get rid of stuff, you can always do a good spring-cleaning. Or you can do what I do. Move."  Ellen DeGeneres