Senior Living • Spring 2014

WEDNESDAY, APRIL 30, 2014

A special supplement to the AUSTIN DAILY HERALD

This photo shows a silhouette image of a boy featured in KSMQ’s “Embracing Grief.”

Photos provided by KSMQ

Stories of hope

KSMQ, Worlein partner on video about dealing with grief the video to their customers, support groups and anyone it will help.

“We want it to be a tool,” said Mary fter losing a 29-year-old daughter to a brain tumor, Kittelson, Worlein’s community services director who lined up the one area family used families for the video. the money they would Worlein has the video available at have spent on her Christmas and their website and is offering it to any birthday presents to buy gifts for nonprofits in town. children.

“This is something that they can That’s one of the stories shared watch in their own home,” Hagen on “Embracing Grief,” a video made said. “Because everybody does through a partnership by KSMQ Public Television and Worlein Funeral something different in how they handle grief.”

Home.

The producers aren’t focused on The 29-minute video features six profit, as Worlein said the main goal families sharing their stories about is for the video to be a resource for losing a loved one and coping with loss. The speakers talk about the “new everyone coping with grief.

“It’s not a money making affair at normal” families experience after the all,” he said. “It’s just for people’s death of a loved one. benefit.”

“What this does is give people hope Hagen said the video will resonate that they’re not the only one that’s with people who are middle-aged or going through this process,” said older.

KSMQ’s David Hagen, who works in Worlein praised KSMQ’s Production underwriting and development.

Engineer Charles Czech and Eric Paul Worlein, a funeral director at Olson, KSMQ’s president and CEO, Worlein Funeral Home, and Hagen for their work in putting the video had coffee and started discussing the project about a year ago to help people together.

Worlein and Hagen are looking into going through loss.

“It should help anyone who is going options for the video, and it could be aired statewide or even nationally. through grief,” Worlein said.

Copies of the video can be picked up “Embracing Grief ” first aired last at Worlein Funeral Home, KSMQ, and year and won a national Telly Award.

Worlein Funeral Home is now offering the video was posted on Youtube.

By Jason Schoonover

jason.schoonover@austindailyherald.com

A

Watch the video at www.austindailyherald.com/?p=611768

On KSMQ’s “Embracing Grief,” several speakers share stories and memories about losing a loved one.

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APRIL 30, 2014

Senior Living

AUSTIN DAILY HERALD

Who really pays for health care?

By Jay Hancock, Kaiser Health News

Eight million people have signed up for subsidized private health insurance under Affordable Care Act, President Obama said this month. Millions more obtained new coverage through the Medicaid program for the poor.

Full implementation of the health law, and its wider coverage, new taxes and shifting subsidies, has renewed discussions of winners and losers, makers and moochers.

Here’s a corrective to common misconceptions about who pays for health care.

Before Obamacare we had a free-market health-care system Government has been part of the business of medicine at least since the 1940s, when Washington began appropriating billions to build private and government hospitals. The drug industry and its customers owe much to federally funded research.

Of course Medicare for seniors and Medicaid for the poor, which both began in the 1960s, represent direct government transfers from some taxpayers to others.

States have set rules for health insurance for decades.

If you’re insured through an employer that files an income-tax return your coverage is heavily subsidized by the feds.

Tax deductions for private medical coverage cost the Treasury $250 billion a year.

Some would argue that private health insurance is own kind of subsidy. What the healthy pay in premiums finances care for the sick. Few patients except foreign potentates have paid their own medical bills for a long time.

payroll taxes would be far higher and your take-home pay would have been far lower.

Premiums from my paycheck fund my company health plan Probably not entirely. Or even mostly.

For family coverage, which costs an average of $16,351 last year, the average worker paid only 29 percent of the premium. For single-person coverage, workers paid only 18 percent of the (lower) total cost.

Although premiums and out-of-pocket costs have been soaring for consumers, costs have been rising for employers, too — up by nearly 80 percent in a decade.

Business spends more than half a trillion dollars annually on employee health care.

Government and employers pay for almost all health care.

But give workers and consumers credit. In 2012 households still paid the largest single share of health costs, according to federal actuaries. Part was premiums paid through employers and directly to insurers. Part was out-ofpocket expense.

The household portion of the health-spending pie shrank from 37 percent in 1987 to 28 percent in 2012. But it’s still larger than the federal government’s 26 percent share or business’s 21 percent.

The insurance company is always the bad guy

Human resources pros like to trash-talk the company’s insurance plan when they tell employees the doctor network shrank, the deductible rose or certain procedures aren’t covered.

But more than half of all workers with health coverage are enrolled in “self-insured” plans where the employer pays medI fully paid for Medicare ical bills directly. The insurance company through taxes deducted from only processes claims.

If your company has at least 500 workers it my salary Scholars at the Urban Institute have is probably self-insured.

In such plans the employer is the insurcalculated that the typical Medicare beneficiary who retired in 2010 will cost the ance company. And it’s the employer calling system more than twice as much in health the shots. costs than she and her employer paid in Medicare taxes.

Kaiser Health News (KHN) is a national It’s another subsidy. If Congress had de- health policy news service. It is an editorially signed Medicare to pay for itself rather independent program of the Henry J. Kaiser than add to the budget deficit every year, Family Foundation.

Study: costly breast cancer treatment more common at for-profit hospitals, clinics

By Roni Caryn Rabin Kaiser Health News

Older breast cancer patients who received radiation treatment after surgery were more likely to undergo a more expensive and somewhat controversial type of radiation called brachytherapy if they got their care at for-profit rather than nonprofit hospitals, a new study reports.

Among the oldest group studied – women in their 80s and early 90s who are least likely to benefit from the regimen – the odds of receiving the more expensive brachytherapy were significantly higher at for-profit hospitals, the study found.

The research, funded by the National Cancer Institute and the Robert Wood Johnson Foundation, was published Monday in the May issue of the journal Surgery.

“We wanted to see whether for-profit hospitals, which arguably have a greater incentive to provide returns to their shareholders, would be more likely to adopt a higher-reimbursement therapy than a nonprofit hospital — and that’s exactly what we found,” said Dr. Cary P. Gross, a professor of medicine at Yale University School of Medicine and the paper’s senior author.

“This reinforces the idea that reimbursement is a significant driver of the adoption of new cancer therapies, which is a shame,” Gross said. “Evidence should be the main driver.”

Brachytherapy is a newer type of radiation therapy for breast cancer that involves implanting a radiation source into the lumpectomy cavity of the breast. It is a shorter course of treatment than standard radiation and can be completed in one week instead of four to six weeks. But it costs about twice as much as the standard treatment, and recent studies have questioned its effectiveness and whether its harms may outweigh its benefits.

The retrospective study looked at the care 35,118 women between the ages of 66 and 94 covered by the government’s Medicare pro-

gram received after breast-conserving surgery for breast cancer in 2008 and 2009. The women had surgery at 2,684 hospitals in the United States; only 8 percent were treated at for-profit hospitals.

Among the patients who underwent radiation treatment, 15.2 percent received brachytherapy at nonprofit hospitals, compared with 20 percent of those treated at for-profit hospitals.

There was no association between the hospital’s status and overall radiation treatment for women aged 66 to 79, although women in that age group who received radiation at a for-profit hospital were also more likely to get brachytherapy.

Among women aged 80 to 94, who benefit least from radiation therapy because they are unlikely to live long enough for their cancer to recur, 58.9 percent received radiation at for-profit hospitals, compared with 53.9 percent at nonprofits, while 12.4 percent received brachytherapy at for-profit hospitals, compared with 8 percent at nonprofits.

For these patients, “who may not have gotten radiation to begin with, brachytherapy is driving an overall increase in the use of radiation,” Gross suggested.

The study notes that a driving factor in using brachytherapy is the attempt to enhance convenience and tolerability. “However, it is unclear why patient preferences for radiation modality would vary with hospital ownership,” it said.

Gross said the take-home message for patients is that treatment recommendations vary from provider to provider, and they should always get a second opinion. Both physicians and members of the general public tend to become “enamored” with new treatment options, he said, even when the evidence is limited or lacking.

“Don’t just ask the doctor which type of treatment you should get,” he said. “Ask the doctor, ‘What happens if I don’t get this treatment? How does this affect the outcome?’”

A special supplement to the AUSTIN DAILY HERALD

Senior Living

WEDNESDAY, APRIL 30, 2014

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A new generation of assistance

Connecting hearing aids with iPhones could add cachet for aging baby boomers

By Julio Ojeda-Zapata Pioneer Press

ST. PAUL — Aging baby boomers, increasingly suffering from hearing loss, often are reluctant to wear hearing aids, which they associate with, um, aging.

A bit of Apple cachet could change that, and two Twin Cities-based hearing-aid manufacturers are collaborating with the tech giant on a generation of iPhone-connected hearing devices.

These hearing aids achieve a wireless connection with an iPhone or other iOS mobile device directly, much as consumer cellphone headsets do.

Eden Prairie-based Starkey, which is among the world’s leading hearing-aid manufacturers, recently began selling one of the new devices, called Halo.

GN ReSound, a Bloomington-based hearing-aid maker, recently began offering a similar product — LiNX. GN ReSound is part of the Denmark-based audio-technology company

GN Store Nord.

Both companies have worked closely with Apple Inc. in recent years to fashion the new class of iOS-compatible hearing aids.

Recent upgrades to Apple’s iOS mobile operating system include audio technology that enables the new hardware, which the device maker is dubbing “Made for iPhone Hearing Aids.” The hearing aids also work with iPad tablets and iPod Touch media players.

The devices use Bluetooth wireless technology, which is what cellphone headsets typically use. Apple’s refinements specific to these hearing aids boost their audio quality while preventing the medical devices’ batteries from being drained too quickly.

This effectively turns the hearing aids into Bluetooth headsets, allowing users to engage in routine tasks such as making and taking calls, listening to music, engaging in video chats and heeding driving-navi-

“When (Starkey) showed me that for the first time, I was pretty blown away by that.”

-Dusty Dorey, a Minneapolis software trainer with lifelong hearing loss gation prompts.

Starkey and GN ReSound apps essentially turn the Apple mobile devices into hearing-aid control panels.

With Starkey’s app, Halo owners can record audio, use their iOS gadgets as microphones, fine-tune how the audio sounds in their ears and create noise-filter presets for different environments, such as cars and restaurants.

They can even use their iPhones to find their misplaced hearing aids by using GPS. Dusty Dorey, a 29-yearold Minneapolis software trainer with lifelong hearing loss, has been testing the Halo hearing aid and is delighted with it.

The technology’s high

degree of adjustability has allowed him to fine-tune it for situations he finds problematic, such as highpitched voices or people speaking softly. In the past, he would have needed to visit his audiologist to have such adjustments made.

He’s also impressed with how the Halo app can recall places he’s visited and the corresponding hearing-aid settings, and activate them automatically as required.

“When (Starkey) showed me that for the first time, I was pretty blown away by that,” Dorey said.

The GN ReSound app for use with the LiNX hearing aid works on a similar principle. It lets LiNX users set volume levels, tweak treble and bass settings, and as-

sign automated sound settings to frequently visited places like home, work and favorite restaurants.

Another U.S. hearing-aid company, Chicago-based Beltone, also is run by Denmark’s GN Store Nord and provides a LiNX-style hearing aid with another name, Beltone First. Users control that medical device using a HearPlus app installed on their iOS gadgets.

According to Beltone, the app remembers the places users visit and automatically switches to their preferred settings for those locations. The app also finetunes treble and bass, and has a “Find My Hearing Aid” feature.

The iOS-ready hearing aids will not come cheap, typically running into the thousands of dollars.

Hearing-aid users previously had been able to use smartphones, but they needed to use clunky “relay” devices stuffed into their pockets or dangling from their necks to get their phones to work with

their medical devices.

More than 36 million Americans have a hearing loss, but only one out of five people who could benefit from a hearing aid actually wears one, according to the National Institute on Deafness and Other Communication Disorders.

Boomers, the post-WWII generation long associated with youth, are notorious about avoiding hearing aids, often waiting seven years after the onset of hearing loss to seek technical assistance, according to Starkey. About 12 million baby boomers are suffering from some kind of hearing loss, the company estimates.

“By associating our product with Apple, we’re hoping to get hearing aids on people sooner,” said Ky l e A cke r, S t a rke y ’s manager of education and training.

Such “Apple acceptance” can be a powerful motivator, Acker said.

—Distributed by MCT Information Services

Utilities companies use guide to help customers with light choices Austin Daily Herald

newsroom@austindailyherald.com

More than 90 electric utilities, including Austin Utilities, are helping customers understand new lighting options with customized versions of the “Right Light Guide,” a two-page document that uses graphics to educate people about the brightness and color of bulbs.

“I’m looking forward to sharing the new guide with our member utilities and their customers,” said the Southern Minnesota Municipal Power Ag ency’s John O’Neil in a press release.

The “Right Light Guide” lets customers compare the pros, cons

and costs associated with using compact fluorescent light (CFL) and light emitting diode (LED) bulbs against incandescent bulbs. Switching to energy-efficient bulbs, for instance, can save 85 percent in costs when electricity cost, bulb cost, and replacement cost are taken into account.

“Who’d think that picking out a light bulb could be so overwhelming?” said St. Paul resident Cari Michaels in a press release. “I have to reeducate myself each time I head out to the store for a new bulb. The Right Light Guide helped me make sense of all the details.”

Lighting accounts for 5 to 10 percent of total energy use in the average American home and costs $50 to $150 per year in electricity. That might not sound like a huge amount, but multiplied by the more than two million households in Minnesota, it adds up fast.

Due to federal legislation and vast improvements made by the lighting industry, people now have many more choices when they walk down the lighting aisle. In the last two years, CFL bulbs have become more reliable and CFL bulb costs are nearly as low as incandescent bulbs.

In the same two years,

A free copy of the “Right Light Guide” can be downloaded at www.austinutilities.com/ files/pdf/2012%20CERTs_ RightLightGuide_Austin.pdf.

Another version is available at www.cleanenergyresourceteams. org/lighting/guide.

LED technology has advanced significantly and LED light bulb prices have dropped four-fold.

But all of these changes have not made the decision-making process any easier.

“We want Minnesotans to know they can light their homes with the same amount of light for less money,” said Alexis Troschinetz of the Clean

Energy Resource Teams in a press release. “We know there are a lot of lighting choices out there today, and we know it can be confusing, so we based our ‘Right Light Guide’ on what consumers said t h e y n e e d e d t o k n ow and the questions they had about the different bulbs.”

In the past two years, thousands of Minneso-

tans have used the “Right Light Guide” to make smart lighting choices. A newly updated guide will reach even more consumers.

“I find the ‘Right Light Guide’ to be a very useful tool for our customers,” said Dave Opsahl of Willmar Public Utilities in a press release. “It makes my job easier and I appreciate that.”

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MNsure chief using offseason to regroup Associated Press

ST. PAUL — The man who runs Minnesota’s online health insurance marketplace says there is plenty of work ahead as it prepares for a new round this fall of trying to get as many residents signed up for coverage as possible, as smoothly as possible.

MNsure stumbled out of the starting gate last Oct. 1 with a balky website and lengthy waits for help from its call center. It was running much better, but not perfectly, by the time open enrollment ended March 31, thanks to extensive technical fixes and a beefed-up call center staff. Now its interim CEO, Scott Leitz, is using the offseason to regroup for a new round of open enrollment that starts Nov. 15.

Leitz, 48, said in an interview Wednesday that MNsure is counting on a study by Deloitte Consulting to provide “a really clear pathway forward for us.” He

said the top priority in MNsure’s first several months was fixing the parts that consumers use. Much of the attention now will turn toward providing a stronger operation behind the scenes for the counties, insurers, brokers and navigators who help consumers sign up, he said.

“There’s a lot of back-end things ... that a consumer might not see as they’re going through the website but that are very, very important to being able to ensure that they have a good experience,” Leitz said.

More than 200,000 Minnesotans have now enrolled for coverage via MNsure, which Leitz claimed as a success. MNsure will be working with University of Minnesota researchers in the coming months to try to determine just how big of a dent the federal Affordable Care Act and the exchange actually put in the ranks of Minnesota’s uninsured, he said.

Leitz also claimed success because MNsure offered consumers some of the very lowest premiums in the country. He said it will be interesting to see if the insurance companies compete as aggressively in the next open enrollment period.

MNsure’s board of directors turned to Leitz, who had been an assistant commissioner of human services in charge of the state’s Medicaid program, after MNsure’s original CEO, April Todd-Malmlov, resigned abruptly last December. She came under fire for taking a two-week topical vacation while MNsure’s problems remained unresolved.

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Senior Living

WEDNESDAY, APRIL 30, 2014

A special supplement to the AUSTIN DAILY HERALD

House of the rising sun After 30 years living in Japan, Peggy Keener has instilled a culture she loves into her Austin home

By Trey Mewes

trey.mewes@austindailyherald.com

P

eggy and Glen Keener are ready to settle down after their 28th move.

Peggy, who grew up in Austin, was ready to settle back in town in a lovely Chicago-brick home in the southwest side of the city after a lifetime of adventure overseas. After all, the Keeners spent more than 30 years in Japan, and it shows as their home is full of memories and memorabilia from the whirlwind years they spent teaching English and working in the military.

“We’re settling down right here,” Peggy said.

“There are so many wonderful memories here.”

For Peggy, the home was an opportunity to display the memorabilia she and Glen collected over the years, as well as to change a beautiful home to suit their needs. The home, spread over three lots, was built in the 1970s and remodeled in the ‘90s, according to Peggy. Yet when the Keeners moved in toward the end of February, Peggy knew the house would need more changes.

So she spent about three weeks remodeling her new home.

“I’ve done something to every room to the house,” she said with a laugh.

Peggy took down wallpaper throughout the home and repainted it all in white, adding a simple, clean elegance to every room. She replaced the carpet in certain rooms and at one point, contractors removed a sink that sat only a few feet away from a bathroom.

“We’re not sure why that was there,” Peggy said.

Perhaps the biggest change was when the Keeners converted what used to be a sun porch into a gorgeous, luminous viewing room on the north side of the

Peggy Keener lived for 30 years in Japan and the culture she loves so much has come to Austin with her as furniture and signs from the Land of the Rising Sun can be found everywhere. Photos by Eric Johnson/photodesk@austindailyherald.com

OUT NOW

This story originally appeared in the MayJune edition of Austin Living. See the magazine for additional photos from this story and several more stories. home overlooking Turtle Creek. The room, which catches the sun at almost every time of day, is also temperature controlled so the Keeners can enjoy a view of the trees or

watch a little TV whenever they want.

“It’s reverse-cycle heating,” Glen explained. “It heats in the wintertime but cools in the summertime.”

The contractor raised the ceiling and added insulation throughout the sun room, while new carpet was put in and Peggy added a few touches of her own — a daruma (a large statue of the founder of Zen Buddhism, which is seen as good luck and a talisman of encouragement in Japan) here, comfortable chairs there.

“It just made no sense to me to have a room that you couldn’t use everyday,” Peggy said.

“That was a concept I just couldn’t imagine.”

Peggy had the countertops and sink replaced in the kitchen and the gold-colored fixtures in the bathroom with silver, to match her sensibilities. In the basement, she decided to use what used

to be the recreation room as an office and alternate guest bedroom for her grandchildren. To that end, she recreated her favorite version of a desk — a 20-foot island spanning one side of the wall.

It’s something she has put in several of her previous homes, always using kitchen desk cabinets “to get the right height.”

With just four of those, she not only has foundations to hold up the twofoot island, she also has storage space and plenty of room for her sewing and writing.

She has plenty to write about, after all. She, her husband and their children went to Japan in the 1960s after Glen accepted a military contract to serve there. While Glen stayed busy, Peggy found herself as a TV personality on the NHK, Japan’s national network. She carved a career out of teaching English on TV, through radio programs, in several books and on

nationwide lecture tours.

Her first memoir, “Potato in a Rice Bowl,” was released in 2010 and has earned six international awards thus far. Keener is already working on her second memoir, of course.

There is a lot of inspiration inside the Keener home. Peggy can point out each large cabinet, hutch and decoration and recite its story. As she explains it, the Japanese didn’t mass produce furniture, so more often than not she either commissioned certain pieces

or picked up items that are hundreds of years old. She developed a passion for pieces built from the 1860s to 1912, during the Meiji period. During that time, politicians overthrew the previous Tokugawa shogunate, a military dictatorship of sorts, and gave much of Japan’s governing power back to the imperial throne.

Under Emperor Meiji’s rule, Japan opened its borders to trade with the west after a 200-year self-imposed exile, which caused Japanese tradition to blend with Western ideals and technology in all facets of life, including carpentry.

“I think I must have lived in the Meiji Era, in a previous life,” Peggy said. “I just love things from that period.”

There are banners sewn into pillows, medical equipment and tea pots, baskets and trinkets, shop signs with bawdy backstories and ornate chests that were once filled with treasures inside the Keener residence. All of which Peggy and Glen plan to pass on one day, either to museums or to their children and grandchildren.

“There’s a lot of history in this house,” she said.

For now, Peggy and Glen are excited to be back in Austin and share their stories with the community. For Peggy, who graduated from Austin High School, there’s simply no place quite like her hometown.