Senior Living

FRIDAY, JANUARY 27, 2017

A special supplement to the AUSTIN DAILY HERALD

Margaret Johnson moves in on a ball during a game of pickleball at the YMCA. Eric Johnson

Pickle of a paddle

A group of women hit the pickleball court for fun and activity

J

Story by Rocky Hulne | Photos by Eric Johnson

anet Hokanson is 76 years old, but she’s not missing a beat, especially when she’s on the pickleball court.

Hokanson is one of 10 Austin women who regularly play pickleball at 5:30 p.m. every Tuesday night at the YMCA. It’s not

a league, but the games allow for a little competition, and a lot of fun.

“If you don’t use it, you’ll lose it,” said Hokanson, a former physical education teacher who coached varsity tennis for eight years.

See PADDLE, Page 3-SL

This story appeared in the January-February edition of Austin Living

Living Well with Chronic Conditions focus of new workshop here

By Deb Nicklay

deb.nicklay@austindailyherald.com

According to the National Institutes of Health, pain affects more Americans than diabetes, heart disease and cancer combined.

But there is help for those who suffer, in the

six-week “Living Well with Chronic Conditions” program, set to begin with helping others to build skills and confidence in managing their conditions while maintaining their health, says Michael Maas, active aging program administrator, and Catholic

Charities.

Workshop sessions will take place at the Mower County Senior Center from 9 a.m. to 11:30 a.m. each Wednesday for six weeks beginning Feb. 1, 2017.

See HEALTH, Page 3-SL

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JANUARY 27, 2017

Senior Living

AUSTIN DAILY HERALD

Group seeks new rules on use of ‘granny cams’ in Minnesota nursing homes

By Chris Serres

Minneapolis Star Tribune

Families seeking to prevent abuse or neglect of their loved ones in nursing homes by using hidden cameras, or “granny cams,” would face more restrictions under reco m m e n d at i o n s i s s u e d this week by a state work group.

The 17-member group was asked to advise the Legislature on ways to regulate the growing use of hidden cameras and other electronic surveillance equipment in senior care facilities, while balancing privacy rights with efforts to deter abuse.

It be g an meeting in June, following several well-publicized cases in which cameras substantiated reports of abuse and neglect at local nursing homes.

The group recommends that electronic monitoring should be allowed only with the informed consent of all the residents in the room under surveillance (or a legal representative if the resident is not competent to do so).

In addition, any resident being monitored should have the right to place limits on when and where the monitoring takes place and to have the device turned off for privacy reasons. And facilities should be prohibited from retaliating against residents who use hidden cameras, according to the work group’s final report.

“This is a huge issue and it should not be viewed lightly,” said Jean Peters, a member of the work group and an outspoken proponent of hidden cameras since her family used one to detect abuse of their mother. “The [senior care] industry doesn’t want

cameras because they’re afraid of getting sued, and because they can’t possibly provide what they promise.”

Currently, Minnesota law is silent on the use of electronic surveillance in senior care facilities. As a result, families suspecting abuse or neglect can install cameras, which cost as little as $80 and can be as small as hockey pucks, inside rooms in senior facilities. Many of the cameras can transmit live feeds to smartphones, enabling relatives to monitor the care of their loved ones remotely.

In many cases, families install the cameras when they detect bruises, weight loss or other visible signs of maltreatment, but have no way to prove it — and find their concerns are ignored, say elder care advocates. Increasingly, the footage is also being used by law enforcement officials and state regulators to substantiate allegations of abuse and, in some cases, bring criminal charges.

Last year, a woman who spotted cuts and bruising on her father installed hidden cameras at a large nursing home, St. Therese of New Hope. The footage showed two caregivers repeatedly punching her father in the face and stomach. It led to criminal charges against the two employees and the dismissal of others for failing to report the abuse.

And a year ago, an aide at a Hopkins senior home was arrested and charged with two counts of assault after videos from a hidden camera showed her repeatedly hitting an elderly patient in the head.

S u z a n n e S ch e l l e r, a Champlin attorney who

specializes in abuse and neglect in senior homes, said Minnesota’s lack of formal regulations is beneficial for families. “It gets the attention of the powers that be, and allows the family member to feel some sense of empowerment,” she said.

Yet Scheller and other advocates fear the new recommendations may be used to create rules and restrictions that impede their use. In Illinois, for instance, a nursing home resident must consent to the use of a camera before it can be installed and must notify the facility of intent to use electronic monitoring. Other states, such as Oklahoma and Texas, require that a notice be posted when such surveillance is occurring.

At least one state is actually encouraging their use.

The New Jersey Office of the Attorney General provides free surveillance cameras for up to 30 days to anyone who suspects inhome abuse The work group, which included state health officials, elder care advocates and industry representatives, failed to reach a consensus on the issue of requiring notice to the facilities. Families and elder care advocates have strongly opposed mandating notification, arguing that cameras are typically used as a last resort when all other attempts at communicating concerns about maltreatment have failed.

“Do we as a state really want to say that we would elevate the right to privacy over suspected maltreatment?” asked Scheller. “That is the tension.”

—Distributed by Tribune Content Agency.

Senior Living

A special supplement to the AUSTIN DAILY HERALD

FRIDAY, JANUARY 27, 2017

3-SL

Paddle: ‘We laugh a lot and get exercise at the same time’ From Page 1-SL “We have to keep moving every day doing something. Pickleball is fun.

We can laugh a lot and get exercise at the same time. It’s wonderful.”

The group was started a couple of years ago when Margaret Johnson organized a group of women from the Hormel Corporate Office to play pickleball outdoors at the Neveln Elementary courts. The group originally had to rent their paddles, but eventually they were able to start playing in the YMCA that provides a year-round place to meet.

Johnson was able to recruit a group of players by sending out e-mails. She also plays pickleball three mornings a week in Albert Lea and she’s grown to love the sport.

“It’s just fun to get together with a bunch of ladies and get out there and exercise,” Johnson said. “Most of us would play every day if we could.”

DeAnne Silbaugh was one of the first players to join the group of pickleball players. She said it’s a great way to stay active in a sport that requires less running, but still requires fast reaction time at the net.

A pickleball is about the size of a baseball and it doesn’t bounce extraordinarily high, which requires players to be quick on their feet.

“I played tennis and racquetball, but as we got older we had injuries and we couldn’t play anymore, so we rounded up all of our tennis friends and we started playing pickleball,” Silbaugh said. “Margaret talked a

few of us into playing. The rest is history.”

Deedee Marx used to teach pickleball when she was a physical education teacher in the 1980s and 1990s and she wants to see the sport continue to spread.

“We’re just trying to bring the sport back,” Marx said. “The rules are a little complicated until you know about them and get used to it.

It’s a good fast-paced game and even we can play it in our 60s and 70s.”

Johnson said the group is looking for more pickleball players and anyone interested in joining can contact Austin Parks, Recreation and Forestry or the YMCA. Anyone interested in playing doesn’t have to bring a partner, as the group usually mixes up teams.

PICTURED LEFT: A paddle and pail of pickleballs rest beside the net, waiting to be used at the YMCA. PICTURED CENTER: Margaret Johnson returns a ball during a game of pickleball at the YMCA. PICTURED RIGHT: Janet Hokanson returns a ball during a game of pickleball at the YMCA.

Health: ‘Chronic conditions can affect your outlook on life’ From Page 1-SL The six-week program is offered free of charge

by Catholic Charities-Diocese of Winona in partnership with the Mower County Senior Center and SHIP (Statewide Health Improvement Partnership). The workshops are limited to 8-15 participants and space is granted on a first-come, first-served basis, Maas said, and is geared toward anyone age 18 or above. For more information, contact Maas at 507-450-1518.

While there are myriad conditions that can be chronic —conditions such as diabetes, arthritis, high blood pressure, heart disease are among the most common — all can have impacts on daily life.

“If I don’t get enough

sleep, it affects my arthritis; if I don’t eat right, it a f f e c t s my a r t h r i t i s, ” said Maas. “Chronic conditions can affect your outlook on life … all parts of your life.”

A n d , ch ro n i c c o nd itions af fect many. The NIH estimates that three in four adults over the age of 65 suffer from two or more chronic conditions.

As a result, they are more likely to use more health care services and “suffer negative outcomes such as unnecessary hospitalizations, adverse drug reactions, declining functional stays and mortality,” according to a NIH article from its website.

Participants in the local program will address specific concer ns and goals for people with ongoing health problems.

Participants will goals a n d m a ke a p e r s o n a l -

ized plan to improve and maintain their health.

T h e w o rk s h o p, M a a s said, is interactive and focuses on peer support.

Mower County Senior Center Executive Director Sara Schafer said the center was interested in this type of session for some time.

“We brainstormed several options,” and finally found the right one in this program.

“In Mower County we have a lot of people suffering; if we can lessen the burden, that’s what w e w a n t t o d o, ” s a i d Schafer. She estimated that many seniors at the center, for instance, have arthritis.

“I think it’s the number one thing our seniors deal with. We want to do our part” in helping management chronic conditions, she said.

Medicare to cover implants of Medtronic’s Micra pacemaker

By Joe Carlson

Minneapolis Star Tribune

Medicare will soon cover implants of Medtronic’s tiny new pacemaker, the Micra, when the device is implanted as part of a long-term clinical study.

The device received U.S. Food and Drug Administration approval last April, to much industry fanfare, but it is often the Medicare payment decision that determines whether a novel technology is financially successful. Medicare is the na-

tion’s largest health insurer, processing more than 1 billion claims a year.

“Medtronic is pleased with the CMS decision to cover leadless pacemakers, which will allow broad patient access to this novel, minimally invasive pacemaker technology,” said a statement from Dr. John Liddicoat, president of Medtronic’s cardiac-rhythm device division. CMS is the federal Centers for Medicare and Medicaid Services.

The Micra Transcatheter Pacemaker System

is less than 10 percent the size of a traditional pacemaker, allowing it be implanted directly inside the heart’s right ventricle without open-chest surgery. The device has no electrical leads and does not require the creation of a surgical “pocket” under the skin, thus avoiding the two biggest sources of complications with traditional pacemakers.

At an FDA hearing last year, some medical experts wondered whether the devices could introduce new risks.

Senior Living Everything you need to know about block grants — the heart of GOP’s Medicaid plans 4-SL

FRIDAY, JANUARY 27, 2017

By Shefali Luthra Kaiser Health News

President Donald Trump’s administration made explicit this weekend its commitment to an old GOP strategy for managing Medicaid, the federal-state insurance plan that covers low-income people — turning control of the program to states and capping what the federal government spends on it each year.

It’s called “block granting.” Right now, Medicaid, which was expanded under the 2010 health law to insure more people, covers almost 75 million adults and children. Because it is an entitlement, everyone who qualifies is guaranteed coverage and states and the federal government combine funds to cover the costs.

Conservatives have long argued the program would be more efficient if states got a lump sum from the federal government and then managed the program as they saw fit. But others say that would mean less funding for the program —eventually translating into greater challenges in getting care for low-income people.

Block g ranting Medicaid is a centerpiece of health proposals supported by House Speaker Paul Ryan and Rep. Tom Price, Trump’s nominee to run the Department of Health and Human Services. This weekend, Trump adviser Kellyanne Conway emphasized the strategy as key to the administration’s health policy.

But what would this look like, and why is it so controversial? Let’s break down how this policy could play out, and its implications — both for government spending and for accessing care.

Q: How would a block grant work?

So far, Trump hasn’t released details on his particular plan. But the basic idea is that states would get fixed federal grants that would be based on the state and federal Medicaid spending in that state. The grant would grow slightly each year to account for inflation. However, the inflation adjustments are expected to be less than the medical

inflation rate.

Currently, states share the cost of Medicaid with the federal government.

Poorer states pay less: In Mississippi, for instance, the federal government pays about three-fourths the cost of the program, compared to 50 percent in Massachusetts.

The federal funding is open-ended, but in return, states must cover certain services and people — for instance, children, pregnant women who meet income criteria and parents with dependent children.

Under a block grant, states would have more freedom to decide who qualifies, and for what services.

How much freedom states will have will depend. Many proposals loosen state coverage requirements, which could mean that if states opted to cap enrollment, for example, people who are technically eligible might not get coverage, noted Edwin Park, vice president for health policy at the left-leaning Center for Budget and Policy Priorities in Washington, D.C. “It’s going to be up to the specifics of any block grant proposal looking at legally, whether there would be certain benefits states would have to provide,” Park said.

“Usually states are given unfettered flexibility, or near unfettered flexibility.”

Q: Is this the same thing as a “per capita cap”?

The block grant differs slightly from that other conservative favorite. Per capita caps have also been endorsed by Ryan. Under those, states also get a fixed amount of money each year, but that sum is calculated based on how many people are in the program. Since block grants aren’t based on individual enrollment each year, the state wouldn’t necessarily get more money to compensate if, say, more people qualified for Medicaid because of an economic downturn. In theory, a per capita caps system would increase funding. But if, say, an expensive new drug entered the market, or a costly new disease emerged, the Medicaid budgets still wouldn’t change to reflect

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that, Park noted.

Q: It seems like both Democrats and Republicans are pretty fired up about this. Why is this such a big deal?

The block grant system is a radical shift from how Medicaid has worked previously. Republicans say it could save the government billions of dollars. But other analysts note those savings could limit access to health care if the funding becomes squeezed. Thanks to the 2010 health law, which led states to expand Medicaid eligibility, more people would face the brunt of those cuts.

The fiscal impact: The non-partisan Congressional Budget Office estimates recent Republican block grant proposals could cut Medicaid spending by as much as a third over the next decade. The cuts would start small, growing larger over the years.

Many Republicans say that, because states will have greater flexibility, they can innovate with their Medicaid programs.

But opponents note that experimentation alone won’t make up for smaller budgets. The fixed grants could mean states cut benefits or force beneficiaries to take on more cost-sharing, for instance.

Some federal requirements are necessary, said Tom Miller, a resident fellow at the conservative American Enterprise Institute.

Block granting could “be great or a disaster,” he said, depending on how it’s implemented. “The ideal model from the view of states is, ‘Give us the money, and I’ll let you know what I did.’

That’s not going to work,” he said.

The potential impact is

significant. More than 10 million who got insurance through Obamacare are on Medicaid and could be affected. That’s also why some Republican governors — particularly in states that embraced the health law’s Medicaid expansion — have joined their Democrat peers in expressing qualms.

Q: You say this is an “old GOP idea.” How old?

This dates back at least until the 1980s. President Ronald Reagan pushed Medicaid block grants in 1981, House Speaker Newt Gingrich in 1995 and President George W. Bush in 2003.

Gingrich’s plan came closest — it passed through Congress but failed to g ar ner approval from then-President Bill Clinton.

He eventually consented to block grant welfare, resulting in the Temporary Assistance for Needy Families program.

Q: I don’t get my insurance through Medicaid.

So why should I care?

Medicaid is a major government program. In 2015, it accounted for 17 percent of the nation’s health care expenditures — money that comes from taxpayer dollars.

Plus, the 75 million people covered make up almost a quarter of the U.S. population. And almost two-thirds of people in nursing homes pay for their care using Medicaid — indeed, most of the program’s spending is on the elderly and disabled. If lawmakers are trying to save $1 trillion over a decade, it’s hard to see how that could happen without touching elderly benefits, noted Matt Salo, executive director of the National Association of Medicaid Directors.

A special supplement to the AUSTIN DAILY HERALD

Dressed in black, seniors ‘mourn democracy’ outside St. Paul Episcopal Homes

By Jaime DeLage St. Paul Pioneer Press

Icy conditions kept them from marching, but a group of senior citizens braved the elements Friday to express their concerns about President Donald Trump outside the Episcopal Homes in St. Paul.

Dressed mostly in black, they carried signs saying “Mourn for Democracy” and “Mourn for America.”

At least one carried a vintage green Paul Wellstone campaign sign.

Organizer Pat West, 81, was the owner of the Wellstone sign. Originally a southerner, West said she and her husband, Henry, a retired Macalester professor, were part of the civil rights movement in the 1950s in Atlanta. She said she would have liked to join the Women’s March on Saturday in St. Paul or Washington, D.C., but she and most of her retiree friends were not up to that.

“I thought we could have our own tiny demonstration at Episcopal,” West said.

She said she’s concerned about health care, the arts and the environment under a Trump administration. She said Trump is not abiding by ethics rules and he appears ignorant of the Constitution.

She carried a sign that

said “Save Our Health Care Now,” while a friend carried her old Wellstone sign.

“The things (Wellstone) stood for are still the things I stand for,” West said. “That each person has to be a good citizen and do what he or she can.”

Former St. Paul City Council member Ruby Hunt, 92, carried the sign mourning democracy. She said she was alarmed by rhetoric from Trump’s campaign that seemed to challenge freedom of expression. Other demonstrators voiced support for pipeline protesters in North Dakota, Planned Parenthood and women’s rights.

“There have been concerns about challenges to the Constitution arising during the course of the campaign,” Hunt said. “We have to be sure that we continue to maintain the basic concepts of our democracy, based on the Constitution.”

West and Hunt said it wasn’t that hard to get about 20 seniors to join the effort, even though polls suggest most older voters chose Trump over Hillary Clinton. The group got supportive-sounding honks from cars passing on University Avenue.

“We didn’t see any protesters object to our being there and expressing ourselves,” Hunt said.