2000 - Summer by Arkansas Blue Cross and Blue Shield

~SENIOR Health Information Inside~

living longer living well Summer 2000

Wanted: Ageless Heroes 2000 Nominations Many of today’s “ageless heroes” have a quality of inner strength that allows them to accomplish anything. Each serves as a role model, demonstrating the value of staying active and vital in mind, body and spirit. Now is the time to thank them for their insight and wisdom by nominating them for the Ageless Heroes 2000 Awards Program. The nomination process will be held from now until July 28. The Ageless Heroes 2000 search is on to find seniors who are leading quietly by example and inspiring others to be like them. They are parents, grandparents, teachers, neighbors and friends — age 65 and older — who serve as role models for us all. The Ageless Heroes Awards Program was created in 1998 to celebrate the spirit and vitality of our nation’s seniors and to showcase Blue Cross and Blue Shield’s commitment to healthy aging. Arkansas Blue Cross and Blue Shield and Health Advantage Medi-Pak HMO are again sponsoring the Arkansas Ageless Heroes Awards program.

Individuals may nominate their hero by completing the nomination form below, along with a 150-word essay stating how that special senior’s passion and commitment has affected them. There are six nomination categories to choose from in 2000 (see form for more detail). Each Arkansas nominee is eligible for both the national and state Ageless Heroes Awards program. If selected as a national winner, honorees and their guests will be invited to Chicago to participate in the national awards ceremony to be held Dec. 5. All nominees will receive an Ageless Heroes certificate. All nominations must be postmarked by July 28. Please complete the nomination form below, attach your 150-word essay, and mail the information to the address indicated. If you would like to nominate your hero on-line, visit the Blue Cross and Blue Shield Association Web site at www.bluecares.com. If you have questions, please call toll-free, 1-888-440-9988.

Nominate Your Ageless HeroSM Today! NOMINATION FORM What to do: Simply complete the details about you and your Ageless Hero, remembering to choose one category. On a separate piece of paper, tell us — in 150 words or less — why your nominee is an Ageless Hero. Mail it with this nomination form by Friday, July 28, 2000, to: Ageless HeroesSM Awards Program, P.O. Box 1948 Little Rock, AR 72203-1948 Questions? Call toll-free: 1-888-440-9988 or visit: www.bluecares.com for an online nomination form. About your Ageless HeroSM. (Please print)

About You.

Name

Age (65+)

Address

City/State/Zip

Telephone

E-mail

Choose one category which best describes your Ageless HeroSM. ____ Vigor & Vitality — demonstrates extraordinary physical or mental talents or abilities. ____ Community Involvement — shows strength in commitment to a community and its members. ____ Love of Learning — pursues or shares knowledge gained through study or experience. ____ Bridging the Generations — earns the special admiration of a grandchild or other younger person. ____ Against the Odds — overcomes all obstacles, whether disability or hardship. ____ Business Champion — a business or organization that fosters healthy, active aging through business practices, products or communications.

Customer Service Numbers Category

Little Rock Toll-free Number (501) Number

State/Public School Employees

378-2437 1-800-482-8416

e-mail: publicschoolemployees@arkbluecross.com stateemployees@arkbluecross.com Medi-Pak (Medicare supplement)

378-3062 1-800-338-2312

Medicare (for beneficiaries only): Part A (hospital benefits) Part B (physician benefits)

378-3151 1-877-356-2368 378-2320 1-800-482-5525

UniqueCare, UniqueCare Blue, Blue Select® (individual products) 378-2010 1-800-238-8379 Group Services

378-5579

1-800-421-1112

BlueCard®

378-2127 1-800-880-0918

Federal Employee Program (FEP)

378-2531 1-800-482-6655

Health Advantage

221-3733 1-800-843-1329

Medi-Pak HMO (Health Advantage) 954-5200 1-800-354-9904 USAble Administrators

378-3600 1-800-522-9878

Numbers to call for information about obtaining coverage: Category

Little Rock Toll-free Number (501) Number

Medi-Pak (Medicare supplement)

378-2937 1-800-392-2583

UniqueCare Blue, Blue Select® (individual products)

378-2937 1-800-392-2583

Medi-Pak HMO (Health Advantage) 378-6987 1-800-588-5706

Regional Office locations: Central Northeast Northwest South Central Southeast Southwest West Central

Little Rock Jonesboro Fayetteville Hot Springs Pine Bluff Texarkana Fort Smith

Customers who live in these regions may contact the regional offices or call the appropriate toll-free telephone number listed above.

is published four times a year by the Arkansas Blue Cross and Blue Shield Advertising and Communications Division for the company’s members, health care professionals and other persons interested in health care and wellness. Opinions expressed herein do not necessarily reflect the views of Arkansas Blue Cross and Blue Shield or any of its publics.

INSIDE THIS ISSUE

~SUMMER 2000~

Eating better ............................................. 4-5 Get moving ................................................ 6-7 Heart attack/stroke information .................. 7 An ounce of prevention ................................ 8 Healthy aging ............................................... 9 Managing medication ................................ 10 Diverticulosis & Diverticulitis .................... 11 Incontinence, Prostate Alert, Advance Directives .................................... 12 Coping with Alzheimer’s ............................ 13 Help for the caregiver ........................... 14-15 Grandparenting, Arthritis ........................... 16 Focus on Seniors’ Health (menopause, hearing loss, osteoporosis)........................................... 17 Leading the way (get to know some of Arkansas’ legislators) ....... 18-19 Operation KidCare ...................................... 20 BlueAnn Ewe “rocks,” MTM ...................... 21 Health Advantage news for members ......... 22 Blue & Your Community ............................. 23 Clearly Blue (a terminology guide) .................... 24 Vice President of Advertising and Communications Patrick O’Sullivan Editor Kelly Whitehorn Designer Gio Bruno

Contributors Mark Carter, Janice Drennan, Damona Fisher and Kathy Luzietti

Did you know ... ?

• Between now and 2050, the 65plus population will increase from 13 percent to 20 percent of all Americans. • Beginning in 1985, there have been more Americans over age 65 than teen-agers each year. • The number of people over age 100 in the United States exceeds 70,000. • The average couple today has 1.9 children, but more than three living parents, including grandparents. • Approximately 10 percent of Americans over age 65 have children who are at least 65 years old. • Persons age 85-plus are the fastest growing segment of the American population, and the numbers should reach 15 million by 2050. • Only 4 percent of older Americans live in retirement communities, and only 5 percent live in nursing homes. • In 2010, many of the baby boomers will reach retirement age. — Sources: The Health Care Financing Administration (HCFA) and the Blue Cross and Blue Shield Association.

You are what you eat Food is fuel. Without the proper food, you won’t feel like exercising or performing everyday tasks. Eating well brings rewards. It will increase energy and build muscle. It also may help prevent or delay some diseases associated with growing older. Consuming enough fiber in the form of fruits and vegetables reduces your chances of getting diverticulosis, heart disease and colon cancer. Avoiding fats lowers cholesterol and reduces your chances of getting heart disease and high blood pressure. The best nutrition plan for a person of any age is to follow the U.S. Department of Agriculture’s Food Guide Pyramid. Anyone with a chronic disease or health problem should consult a physician to see if a special diet is needed. Food Pyramid Bread, Cereal, Rice & Pasta Eat six servings per day. A serving is a slice of bread, 1/2 cup of cooked rice, pasta or cereal, one ounce of ready-to-eat cereal. Fruits and Vegetables Eat five servings per day, especially those vegetables that are brightly colored. A serving is one small piece of fruit; 1/2 cup of a cooked vegetable or canned fruit; 3/4 cup of fruit juice. Milk, Yogurt & Cheese You need two to three servings

from this group per day. A serving is one cup of milk or yogurt or 1 1/2 to 2 ounces of cheese. Buy low-fat or skim dairy products. If you cannot tolerate dairy products, substitute fortified soy or rice milk.

Meat, Poultry, Fish, Dry Beans, Eggs & Nuts Select two to three servings per day. A serving is two ounces of lean meat, fish or poultry; one cup of cooked dried beans; two eggs; four tablespoons of peanut butter. Fats, Oils, Sweets Eat very little from this group. Don’t forget to drink six to eight glasses of liquids — water, soup, milk or juice — every day. Read food labels. Try to choose foods low in fat, salt and sugar. Normally, expensive nutrition supplements are not necessary if you follow the food pyramid. If you don’t get the recommended amount of

— so eat healthy! fruits and vegetables, however, you might want to consider an FDAapproved multivitamin-mineral supplement.

Special Problems If you have trouble chewing, try these foods. Instead of: fresh fruit — fruit juices; soft canned fruits, such as applesauce, peaches and pears. raw vegetables — vegetable juices; creamed and mashed, cooked vegetables. meat — ground meat; other highprotein foods such as eggs, milk, cheese, yogurt, peanut butter; tuna; milk products such as yogurt, pudding and milkshakes. bread — cooked cereals, rice, pudding and soft cookies. If your appetite is weak, increase flavor by adding spices and herbs. Marinate meats in fruit juices or Italian dressing. Ask your doctor to review your medications to see if any of those are adversely affecting your appetite. You might feel more like eating if you share some meals with family or friends or go to group meals at churches and senior citizen centers. If you don’t feel like cooking, buy foods that require no preparation or are microwaveable, such as frozen dinners, canned fruits and vegetables and cereals. Some churches or aging agencies will deliver meals to your home.

If shopping is a problem, ask grocery stores whether home delivery is available. Some offer free delivery. Some home health agencies, social agencies or churches can arrange for someone to shop for you; but you may have to pay for this service. Give yourself permission to rely on family, friends and neighbors. Many people will help if they know a need exists. Money is often a problem where nutrition is concerned. Shop wisely. Many low-cost foods are actually healthier than higher-priced ones. Dried beans, store-brand cereals, rice and pasta are examples. When you cook, freeze what you cannot eat in a couple of days to reheat later. Clip coupons from the Sunday paper or ask your relatives to do this for you. Shop for groceries on senior-discount days. Churches often deliver food baskets to elderly residents in their communities. You may be eligible for food stamps. Look in the blue pages of your telephone book under county government for the number to call. The Elderly Nutrition Program of the Administration on Aging provides Meals-on-Wheels to homebound people over the age of 60. Volunteers deliver the midday meal five days a week in communities across the country. Priority goes to those in greatest economic or social need, particularly low-income, minority older adults.

Ask your doctor to review your medications to see if any of those are adversely affecting your appetite.

6 The good news is that people can exercise into their 90s.

Get up Y

ou are never too old to exercise — and it’s never too late to begin. It’s okay to start with a little exercise and advance at your own pace as you build strength and endurance. If you are over age 50 and have either a chronic disease or risk factors for a chronic disease, you should consult a physician to ensure that your exercise program is safe and appropriate. Regular exercise reduces the risk for coronary heart disease, noninsulin-dependent diabetes, hypertension, colon cancer, osteoporosis and other disorders. It decreases symptoms and might reduce episodes of anxiety and depression. Regular physical activity improves physical fitness (cardiorespiratory endurance and muscle strength); reduces body fat; and builds and maintains healthy bones, joints and muscles. It enhances strength, balance and coordination. These benefits are particularly important in preventing falls and maintaining independence in older adults. The benefits of exercise should be enough to motivate you to do it, but people often wait until they have a heart attack or another warning until they take action. Humans weren’t meant to be couch potatoes. If you don’t use your muscles, they waste away. As you age, your muscles lose the ability to regenerate. An 80-year-old person has half the muscle mass of a 40-year-old. Through exercise, an 80-year-old can rebuild muscle and bone. Bones that don’t rebuild become porous, a condition known as osteoporosis. The good news is that people can exercise into their 90s. One study by Tufts and Harvard University researchers found that people in their 80s and 90s increased their muscle mass 180 percent in six weeks through weight training. Once they quit exercising, however, they lost muscle mass. A major benefit of exercise for older adults is that it strengthens muscles around

joints, giving them more stability and flexibility. Stronger muscles result in better balance and posture. Because muscles burn more calories than fat, increasing metabolism, exercise helps keep weight and blood sugar in check. Unfortunately, no one type of exercise is going to give you all these benefits. You need three types of exercise: 1. Aerobic exercise for cardiovascular fitness and endurance. Swimming, walking and dancing are lowimpact aerobic activities. Jogging and jumping rope are high impact. You need 20 to 40 minutes of aerobic exercise three times a week. 2. Weight training for strength (also called strength training or resistance training). Your goal should be 20 minutes three times a week for weight training. 3. Flexibility exercises that involve bending and stretching. It only takes about 10 minutes of this type of exercise, which ideally should be done every day. You can alternate the types of exercise you do each day. Try aerobics on Monday, Wednesday and Friday and weight training on Tuesday, Thursday and Saturday. In weight training, start with a light weight you can lift without too much effort five times. Rest a few minutes and do another set. You should gradually increase the number of repetitions with each session. Once you can lift a weight 15 or 20 times without tiring, it’s time to move to a heavier weight. If you’ve never done weight training, ask

and get going someone at the Y or community fitness center to show you how to lift weights without damaging your joints. Aerobic exercise raises the number of heartbeats per minute. To determine your maximum heart rate, subtract your age from 220. Then aim for 70 percent of that. If you are 60 years old, your target heart rate is about 112 beats per minute. When you begin an exercise routine, you might aim for 60 percent; gradually working up to 80 percent. To measure your rate, count your pulse immediately after exercising for 10 seconds. Multiply that number by six to find the number of beats per minute. Be aware of early signs of potential injury, such as increasing muscle soreness, bone and joint pain, excessive fatigue and performance decrements. You might need to cut back until symptoms diminish or cease your exercise program temporarily, depending on the severity of the injury. Warning signs of overexertion include an inability to talk, dizziness, nausea or pains in your chest, upper back, left shoulder or arm. To help avoid injury, warm up for five minutes

before working out and cool down for five minutes afterward. A sudden stop in motion can cause lightheadedness or muscle cramping. A good way to warm up or cool down is muscle stretching. Don’t “go beyond the pain.” Stretching is not supposed to hurt. As you become more flexible, stretching will be easier. The success of your exercise program depends on becoming motivated, setting reasonable goals and finding activities you enjoy. Having an exercise buddy is a good idea. The more you exercise, the more you will realize the benefits and want to continue. You will be proud of your harder, stronger body and improved posture. You will feel less stressed and more independent. The National Institute on Aging and NASA sponsor an excellent Web site on exercise for older adults at http:// weboflife.arc.nasa.gov/exerciseandaging.

How to reduce your heart attack risk To reduce your risk of a heart attack, remember the following: • Do not start smoking. If you smoke, quit. • Recognize and treat high blood pressure and diabetes. • Don’t drink too much alcohol. • Be physically active. • Eat a healthful diet. • Have regular medical checkups.

~~~~~~~~~~~~~ Stroke risk factors Stroke is the No. 1 cause of disability and the third leading cause of death in the United States. Stroke risk factors you can’t control include increasing age, family health history, race, gender and prior stroke. Risk factors you can change, treat or modify include high blood pressure, smoking, diabetes, heart disease, high blood cholesterol, physical inactivity and obesity.

Preventive Health Guidelines (for Health Advantage members 65 years & up)

The Winter 1999 issue of Blue & You featured Preventive Health Guidelines for Health Advantage members. As a reminder, we have recapped those guidelines for those members 65 and older. Arkansas physicians reviewed the schedule of services, which were adopted from national preventive health guidelines. The goal of this quality initiative is to improve your health through prevention. This chart serves only as a guideline for care. Members should coordinate health care needs with their primary care physician.

Screenings & Immunizations

Frequency

Height, Weight, Physical Exam, Blood Pressure

Clinical discretion

Tetanus-diphtheria (Td)

Once every 10 years

Influenza Vaccine Pneumococcal Vaccine

Annually Once. Booster in 5-10 years at clinical discretion

Non-Fasting Total Blood Cholesterol

Clinical discretion

Urinalysis

Clinical discretion

Visual Acuity, Hearing & Hearing Aids

Clinical discretion

Pap Smear Clinical Breast Exam Mammogram Sigmoidoscopy Fecal Blood Occult Bone Mineral Density

Every 1-3 years Periodic evaluation, annually or as appropriate Annually Every 4 years Annually Clinical discretion

Prostate Specific Antigen (PSA)

Every 12 months (Medi-Pak HMO only)

Digital Exam

Every 12 months (Medi-Pak HMO only)

You may be at risk for the flu and/or pneumonia

if you are in one of the following categories. Take preventive measures and get your flu and pneumococcal vaccines. • Persons aged 65 or older. • Persons aged 2 to 64 who have chronic illnesses such as cardiovascular disease [including congestive heart failure (CHF), cardiomyopathies and chronic obstructive pulmonary disease (COPD)], recurrent bronchitis, emphysema, diabetes mellitus, alcoholism, chronic liver disease, cirrhosis, cystic fibrosis, functional or anatomic asplenia and sickle cell disease. • Persons who are smokers. • Persons age 2 to 64 who are in special environments such as nursing homes or other long-term care facilities. • Persons age 2 and older who have functional or anatomic asplenia (including sickle cell disease), Hodgkin’s disease, lymphoma, leukemia, multiple myeloma, chronic renal failure and other conditions such as organ transplantation, cancer treatments and drug regimens causing immunosuppression, and HIV infection. If you are in one of the above risk categories, you will receive a reminder card from Health Advantage encouraging you to get your vaccines. Both vaccines may be taken at the same time at the onset of the flu season (early October). See your primary care physician with questions or for more information. If you have ever had influenza (better known as the flu), you know it is no fun. Flu symptoms include: fever, cough, nasal discharge, headache, muscle aches and weakness, shortness of breath, chills, sweating, fatigue and appetite loss. To prevent the flu, get a flu shot. The vaccine has a 70 to 90 percent success rate in preventing illness in a healthy person under age 65. Pneumonia can affect anyone at any age. Symptoms include: cough, chills with shaking, fever, fatigue, chest pain, headache, loss of appetite, nausea, vomiting, general discomfort, shortness of breath, excessive sweating, clammy skin, rapid breathing, coughing up blood and abdominal pain. If you are at high risk, it is important that you get vaccinated to prevent the illness and any further complications. Most people will need

An ounce of prevention

(Flu, continued on Page 10)

Take the high road to healthy aging With advances in public health, medical care and technology, people are living longer. They have more time to accomplish life goals, more time to enjoy loved ones. Often, however, with aging comes fear — fear of poor health, isolation, poverty, loss of independence and loss of mental ability. Aging doesn’t have to be a negative experience. Many older adults today report that they feel good and are happier than ever. • Most 75-year-olds report feeling at least 10 to 15 years younger than their actual age. • Nearly one-fourth of all seniors exercise daily. • Only 10 percent of Americans over age 65 show any significant memory loss. • Seventy percent of seniors describe themselves as healthy and energetic. • Sixty percent of senior Americans describe themselves as “very happy.” “Preventive care is one key to healthier aging,” said Steven L. Thomason, M.D., who practices at the Baptist Health Family Clinic in Little Rock. “Preventive care is not something most people 65 and older, who lived through the Depression and World War II, think about. They don’t often think of doing things that do not seem necessary. It’s a tremendous educational curve for them to realize the value of mammograms, Pap smears, prostate screenings, regular checkups and immunizations.” The problem is compounded by a health care system that is “designed to be reactive,” Dr. Thomason said. Common practice is to wait until there is a problem before seeking treatment. Screenings are an important part of healthy living. According to Dr. Thomason, “Physicians are educators, and we need to help this group learn about preventive care. “A generation ago, people died of pneumonia. Now we have conquered many diseases that used to be fatal. People are living longer,” he said. And although the elderly may

To be 70 years old is like climbing the Alps. You reach a snow-crowned summit, and see behind you the deep valley stretching miles and miles away, and before you other summits higher and whiter, which you may have strength to climb, or may not. Then you sit down and meditate and wonder which it will be.

— Henry Wadsworth Longfellow, 1859

face diseases for which there are no cures right now, great strides are being made in understanding and treating diseases such as Parkinson’s, dementia, arthritis and heart and lung ailments. Understanding and planning for what lies ahead will help you age well. Here are 10 things you can do.

10 Tips for Healthy Aging 1. Eat a balanced diet, including five helpings of fruits and vegetables a day. 2. Exercise regularly. Check with your doctor before starting an exercise program. 3. Get regular health checkups. 4. Do not smoke. 5. Practice safety habits at home to prevent falls and fractures. Always wear a seat belt in a car. 6. Stay in contact with family and friends. Stay active through work, play and community. 7. Avoid overexposure to the sun and the cold. 8. If you drink, moderation is the key. When you drink, let someone else drive. 9. Organize personal and financial records to simplify budgeting and investing. Plan long-term housing and money needs. 10.Keep a positive attitude toward life. Do things that make you happy. — Sources: National Institute on Aging (www.aoa.dhha.gov/ elderpage.html) and The Blue Cross Blue Shield Association.

Managing the cost of your medication

T he cost of prescriptions and new medications

can be an issue of great concern for many senior citizens. Many older Americans must pay out of their own pocket for medicine, while others who have insurance to supplement Medicare must pay part of the cost. Fortunately, there are ways to cut pharmacy costs. ❍ Ask for a senior citizens discount. It never hurts to ask, and pharmacies that do have such a discount may not remember to apply it unless you remind them. ❍ Ask for a generic equivalent. Generic medications, unless otherwise noted by your doctor, are just as effective. You can also ask your pharmacist for more information on generic equivalents. ❍ For new prescriptions, buy just a few pills — don’t get the whole bottle. The new medication may include side effects. Wait and see if it does, so you won’t be stuck with an entire bottle of medicine you can’t take. ❍ Buy your medications (those which you know you can tolerate) in quantities of 100, if you can. They are less expensive in large quantities (remember to make sure you can use all of a medication before its expiration date). ❍ Shop around for the lowest price, because pharmacy prices can vary. If you find a cheaper price at another pharmacy, ask your regular pharmacist to match the price. ❍ Ask your doctor for free drug samples. Doctors get free samples of drugs from pharmaceutical companies. This is a good way to try out a new prescription. ❍ Ask your pharmacist or physician about splitting pills. Buying larger pills and cutting them in half can save money. Your pharmacist can cut them in half for you. But remember to ask your doctor or pharmacist first. The American Pharmaceutical Association recommends consultation with your pharmacist and physician before splitting pills, and consumer health group Families USA advises against pill splitting unless done by the pharmacist. ❍ Contact the local chapter of the AARP or diseaserelated organizations, such as the American Diabetes Association, American Cancer Society, etc., for available drugs at discount prices. ❍ Look into mail order companies. Some mail order

pharmacies can provide bulk medications at discount prices (this practice is recommended for long-term drug therapy only because it can take a few weeks for delivery). It’s also important to ask questions of your doctor after you receive a new prescription. Some good questions to ask include: ❍ What is the precise name of the drug and what is it designed to do (and is it generic or name-brand)? ❍ How do I take it, and how often? ❍ What do I do if I forget to take a dose? ❍ What side effects should I expect? ❍ How long will I need to be on this drug? ❍ Does this drug require special storage (such as refrigeration)? ❍ Should I take this drug on an empty stomach or with food (and what specific foods or drinks, if any, should I avoid when taking this drug)? ❍ Will this drug interact with other medications that I am currently taking? A little initiative and a few questions can help take much of the sting out of going to the pharmacy and can help ensure you stay on the road to better health. — Sources: WebMD and the Associated Press. (Flu, continued from Page 8) one shot that will immunize them for the rest of their lives. However, others may need to have another vaccine after five years. Remember: • In 1997, the Arkansas Health Department reported that influenza/pneumonia was the sixth leading cause of death among Arkansans, with seniors accounting for more than 90 percent of the deaths. • Influenza is a significant cause of death. Between 1977 and 1987, at least 10,000 deaths occurred in seven separate influenza epidemics, with 80 to 90 of the deaths occurring in individuals age 65 and older. — Sources: Prevention and Control of Influenza: Recommendations for the Advisory Committee on Immunization Practices; Prevention of Pneumococcal Disease: Advisory Committee on Immunization Practices; and the Arkansas Health Department.

Q &A:

Diverticulosis and Diverticulitis

By Daniel Rowe, M.D.

Internal Medicine â&#x20AC;&#x201D; Hot Springs Medical Group Medical Director â&#x20AC;&#x201D; South Central Region in Hot Springs, Arkansas Blue Cross and Blue Shield

Q. What is diverticulosis? A. Diverticulosis is tiny pouches or sacs that protrude through weak points in the colon. Q. How many Americans are affected by diverticulosis? A. Nearly half of all Americans between the ages of 60 and 80 will have it, and almost everyone over the age of 80 will have it. Q. What causes diverticulosis? A. Unknown, but it is thought to be related to increased pressure inside the colon. Q. What causes the increased pressure? A. It is thought to be related to a lack of dietary fiber, which in turn generates harder stools, which in turn require more pressure to pass. This condition is rare in populations with high fiber diets. Q. What are the symptoms of diverticulosis? A. Generally, none. Occasionally, there can be some mild cramping abdominal pain mainly in the left lower abdomen. Q. If that is all there is to it, why should I be concerned about diverticulosis? A. Fifteen to 20 percent of people with diverticulosis will develop diverticulitis. Q. What is diverticulitis? A. Diverticulitis is inflammation of the pouches or sacs, which will sometimes develop into abscesses. Q. What causes this inflammation? A. Unknown, but it is thought to be related to infection in the sac. Q. What are the symptoms of diverticulitis? A. Similar to painful diverticulosis, but with more severe pain plus fever, nausea and sometimes vomiting, chills and constipation.

Q. What is the treatment for diverticulitis? A. For mild cases: oral antibiotics, rest and a liquid diet. For more severe cases: hospitalization with IV antibiotics. Your doctor should make that decision. Q. What happens if it is not treated? A. The outcomes can be very similar to appendicitis because if the abscess ruptures, then peritonitis can ensue with major complications, including death. For severe episodes surgery also may be required. Q. How do I prevent diverticulitis? A. It is recommended to eat 25 to 30 grams of fiber each day, and drink at least 8 cups of fluid a day to avoid constipation. In addition, many physicians have recommended avoiding foods with very small seeds, such as strawberries and tomatoes, or even very hard foods, such as nuts and popcorn, because of the belief that these particles could lodge in the sacs and cause inflammation. This point is being debated. The bottom line is to increase fiber in the diet. Q. How do I prevent diverticulosis in the first place? A. The answer is basically the same as for diverticulitis. That is to increase the fiber in the diet and drink more fluids. Q. Will diverticulosis ever go away? A. No, once you have it, it is yours for life, but with proper preventive measures, there is an excellent chance you will never have problems from this. Q. Is diverticulosis/diverticulitis associated with colon cancer? A. No, but the symptoms of these two may be similar. Always check with your doctor if you have a prolonged unexplained change in bowel habits. Q. Where may I get more information about this? A. Contact your physician. If you have more questions about diet specifics, ask your physician for a referral to a dietician.

INCONTINENCE HELP — increasing muscle control

f a sneeze has ever caused you to experience incontinence (an involuntary loss of urine), you are not alone. Studies have shown that approximately 50 percent of all women have occasional incontinence; and if you are over 75 years of age, you may be in the 20 percent of women that experience daily incontinence. Incontinence may happen when you are laughing, coughing, sneezing or participating in physical activity. It occurs when the muscle that controls the output of urine from the bladder (urethral sphincter) is not able to hold urine. Prior trauma to the urethral area, neurological injury and some medications may weaken the muscle. Weakness also may occur in women after pelvic surgery,

women who have had multiple pregnancies, women with pelvic prolapse (when the bladder or urethra pushes into the vaginal space), and women with low estrogen levels. The risk of incontinence increases with advancing age, obesity, chronic bronchitis, asthma and childbearing. An effective treatment option for incontinence is to practice Kegel (or pelvic floor muscle) exercises, which can strengthen the muscles that support the urethra, bladder, uterus and rectum. If women do the exercises for five minutes, twice a day, they should notice a decrease in urine loss within 12 weeks. Remember, if Kegels are performed regularly, surgery can be avoided. For more information, consult your physician.

PROSTATE ALERT A

s men age, the chances of prostate gland problems increase. A prostate gland is an essential part of the male reproductive system. By age 50, more than half of all men (or 10 million Americans) have a condition called benign prostatic hypertrophy (BPH). BPH is not life-threatening, but it causes uncomfortable symptoms including: difficulty starting the urine stream, a need to urinate frequently and a feeling of incomplete bladder-emptying. Treatment options for BPH include: simple waiting, drug therapy, surgery, electrovaporization, needle ablation, laser therapy, balloon dilation and stents. Prostate cancer, which is not related to BPH, is a

more serious health problem than BPH. Sometimes there are no symptoms of prostate cancer; however, some men may experience a weakening of the urinary stream or the need to urinate more often. Symptoms of advanced prostate cancer may include blood in the urine, impotence and pain in the pelvis, spine, hip or ribs. If prostate cancer is detected, treatment options include: surgery (removal of the prostate), radiation therapy, seed implantation or prostate cancer brachytherapy, or cryosurgery. Contact your physician if you are experiencing prostate problems.

MAKE YOUR VOICE HEARD A

“ dvance directives” is a term referring to two types of legal documents — the living will and the durable power of attorney for health care. No matter what your age, gender or lifestyle — making plans for your future, should you be incapacitated, is a wise decision. A living will is a document in which you — while still mentally competent — can direct your physician to withhold, or to withdraw, life-sustaining treatment. Living wills usually become effective when you are no longer capable of expressing your wishes, and you have been diagnosed as irreversibly unconscious, in a vegetative state or terminally ill. With the health care power of attorney, you may

appoint someone to make medical decisions for you should you become unable to communicate your wishes. The person you appoint should understand the terms and be willing to make life and death decisions on your behalf. Remember, you do not have to have an advance directive to be admitted to a hospital or nursing home. Most states recognize advance directives written in other states. You can change your advance directive any time you choose. For more information, speak with your attorney or your physician.

Coping with

Alzheimer’s Disease L

ike former President Ronald Reagan, approximately 4 million Americans currently have the degenerative brain disease known as Alzheimer’s Disease. It’s the fourth leading cause of death in adults in the United States, and it is estimated that unless effective methods for prevention and treatment are found, it will reach epidemic proportions by the middle of this century. Alzheimer’s Disease is a degenerative disease of the brain from which there is no recovery, and it is one of the most common causes of the loss of mental function known broadly as dementia. Slowly, Alzheimer’s Disease attacks the nerve cells in the cortex of the brain as well as surrounding structures, impairing a person’s abilities to govern emotions, recognize errors and patterns, coordinate movement, and, simply, remember. In the end, an afflicted person loses all memory and mental functioning. Although there is no definitive cause of Alzheimer’s Disease, known risk factors are age (the risk rises with age, doubling each decade after age 65) and a family history of the disease. Possible risk factors include a previous traumatic head injury earlier in life, gender (women may have a higher risk of getting the disease) and mental acuity (studies suggest a lower risk for developing the disease for those who keep mentally fit). Symptoms of Alzheimer’s include forgetfulness, loss of concentration, unexplained weight loss, problems with motor skills including mild difficulties in walking. Some symptoms are similar to signs of natural aging, but differences between normal aging and Alzheimer’s may be the patient’s inability to understand the meaning of words. Even today, with all the medical technology available, a definite diagnosis of Alzheimer’s still is only possible when an autopsy reveals the hallmarks of the disease.

With Alzheimer’s, the brain develops dense deposits called neuritic plaques, outside and around the nerve cells in the brain. Inside the cells, twisted strands of fiber or neurofibrillary tangles develop. As the disease spreads through the brain, those with Alzheimer’s began to lose short-term memory. Eventually, routine tasks become difficult. Then, the disease takes away language skills. Disturbing behaviors such as wandering and agitation also are signs of the progression of the disease. The duration of Alzheimer’s Disease, from the time of diagnosis to death, may be 20 years or more. The average length is thought to be four to eight years. Diagnostic tools that physicians use to determine if a patient has Alzheimer’s include taking a patient history, physical examination and laboratory tests, brains scans and neuropsychological testing. Alzheimer’s Disease has been estimated to cost the nation $80 to $90 billion per year. Caring for a patient with Alzheimer’s costs more than $47,000 per year whether the person is at home or in a nursing home, according to a recent study in northern California. Treatment for Alzheimer’s patients depends on the patient and physician. If you suspect that someone in your family has this disease or has already been diagnosed with Alzheimer’s Disease, please work with your physician for proper treatment. — Sources: The National Institute on Aging, the National Institute on Health and WebMD.

14 W

The Job of Caregiving … When the Caregiver Needs Help

atching parents, grandparents or any loved one gradually lose their independence as their bodies and/or minds surrender to the aging process, can be one of the most difficult and frightening experiences you might face in life. Suddenly a loved one on whom you have depended and admired all of your life needs you. They need your help in order to remain at home for as long as possible. You want to be there for them the way they have always been there for you. But what happens when you also have others who depend on you —perhaps a spouse, small children, other elderly family members — or you work outside the home? Did you know that 75 percent of caregivers are women and, of those, 25 percent care for both older parents and children, and 50 percent work outside the home? So it’s not difficult to understand why the demands and responsibilities of caregivers can cause them to become overwhelmed. Many are overcome with stress, frustration, isolation, grief, exhaustion and even resentment. Often caregivers become so busy caring for someone else that they neglect themselves. The stress of caring for someone else often leads to illness which can result in even a more stressful situation for the caregiver and their family. So, if you are a caregiver, first take care of yourself through regular checkups, eating a balanced diet and exercising. One of the most important things for all caregivers to realize is that they do not have to bear the responsibility alone. Help is available. One of the first places you need to contact is your nearest Area Agency on Aging (AAA). According to Elaine Eubank, president of CareLink, the Central Arkansas Area on

Aging, “We hear questions from worried caregivers every day. Care coordinators are on call to answer eligibility questions and to match needs with all available programs, assistance and opportunities. Area Agencies on Aging serve as clearinghouses of information on aging services. That’s why caregivers are wise to call their Area Agency first.” Phone numbers for Area Agencies in Arkansas are listed on the facing page. Your nearest AAA can help evaluate your older relative’s situation and determine the level of care needed. Your family member might be eligible for some of the services offered by this agency to older individuals with limited incomes, including home health aides, transportation, home-delivered meals and household chores. For older individuals with higher incomes, the AAA can help you find private pay services. Respite care is another option available to caregivers. Respite care gives the primary caregiver a temporary break, ranging from a few hours, to days or weeks. This service is provided by adult day care centers, home health agencies, senior centers and some nursing homes. Respite care also may be arranged through the AAA. Other good sources of information for referrals to home care workers and agencies are hospital or nursing home discharge planners or social workers, if your older family member has been hospitalized. If you decide to advertise in a newspaper for a home care worker, it’s important to screen the applicants carefully. Be sure to ask for proper identification and check references thoroughly. Stealing and fraud are occurring more and more frequently among caregivers for the elderly. Also, be sure the home care worker has the qualifications and/or training necessary to provide the proper level of care for your family member, particularly if they have special medical needs, such as insulin injections, or will need to be transferred from a wheelchair. Private geriatric case managers also may be hired to

evaluate your older relative’s situation to assess their needs, help locate and arrange for the appropriate home health care services, and keep family members informed. Again, a thorough investigation of the agency or individual is recommended before hiring. Other things you might do to help you manage your responsibilities as a primary caregiver: • If you work and your job and caregiving responsibilities conflict, talk to your boss about flextime or rearranging your schedule. • If you have siblings who live nearby, don’t hesitate to ask them to share in the responsibilities. They have as much reason as you do to assist with your aging family member. • Encourage your older children to become involved in the care of your family member. If not overburdening, it can help them become more empathetic and responsible. • Ask other family members, neighbors and friends if they would be willing to assist with transportation, shopping, respite care and household chores. Although caregiving can be a very difficult and stressful job, it can also be very rewarding. As a caregiver, you have an opportunity to “give care” to loved ones who have cared for you for most of their lives. A great deal of pleasure can come from knowing that because of you, your aging family member is able to live as independently as possible at home with their family. — Sources: U.S. Administration on Aging; AARP Webplace; CareLink, Central Arkansas Area Agency on Aging, Inc. If you are a caregiver and need assistance caring for your elderly relative, you might find the following list of phone numbers for regional Area Agency on Aging offices in Arkansas and other phone numbers and Web site addresses helpful: AAA of Northwest Arkansas Area Connection Harrison (Serving Baxter, Benton, Boone, Carroll, Madison, Marion, Newton, Searcy and Washington counties) (870) 741-1144 Toll-free 1-800-432-9721 White River AAA Batesville (Serving Cleburne, Fulton, Independence, Izard, Jackson, Sharp, Stone, Van Buren, White and Woodruff counties) (870) 793-4431 Toll-free 1-800-382-3205

15 East Arkansas AAA Jonesboro (Serving Clay, Craighead, Crittenden, Cross, Greene, Lawrence, Lee, Mississippi, Phillips, Poinsett, Randolph and St. Francis counties) (870) 972-5980 Toll-free 1-800-467-3278 AAA of Southeast Arkansas Pine Bluff (Serving Arkansas, Ashley, Bradley, Chicot, Cleveland, Desha, Drew, Grant, Jefferson and Lincoln counties) (870) 543-6300 Toll-free 1-800-264-3260 Central Arkansas AAA CareLink North Little Rock (Serving Faulkner, Lonoke, Monroe, Prairie, Pulaski and Saline counties) (501) 372-5300 Toll-free 1-800-482-6359 AAA of West Central Arkansas Hot Springs (Serving Conway, Clark, Garland, Hot Spring, Johnson, Montgomery, Perry, Pike, Pope and Yell counties) (501-321-2811 Toll-free 1-800-467-2170 Southwest Arkansas AAA Magnolia (Serving Calhoun, Columbia, Dallas, Hempstead, Howard, Lafayette, Little River, Miller, Nevada, Ouachita, Sevier and Union counties) (870) 234-7410 Toll-free 1-800-272-2127 Western Arkansas AAA Fort Smith (Serving Crawford, Franklin, Logan, Polk, Scott and Sebastian counties) (501) 783-4500 Toll-free 1-800-737-1827 Division of Aging and Adult Services Arkansas Department of Human Services Little Rock (501) 682-2441 Eldercare Locator: 1-800-677-1116 Web sites: U.S. Administration on Aging National Association of Family Caregivers CareLink White River Area Agency on Aging (Batesville)

aoa.dhhs.gov nfca.org care-link.org wraaa. com

To grandma’s

house we go …

ou thought you could never love another child they way you had loved your own, but then your grandchildren were born. More than 3.9 million children in the United States are now being raised by their grandparents. The American Association of Retired Persons (AARP) reports that parental substance abuse, divorce and teenage pregnancy are the primary reasons that grandparents become the parents to their grandchildren. Grandparenting can be rewarding no matter whether you are the primary caregiver or just visit them occasionally. Whatever role you play in your grandchild’s life, there are ways to be a better grandparent. • Nurture the relationship with your child and his/her spouse before grandchildren are born. Be there when your grandchild is born. Bonding with the baby from the beginning is a great way to build a strong family. • Spend time one-on-one with your grandchildren. • Be part of your grandchild’s life. This means keeping up with his or her day-to-day activities. Call, write,

Pain and stiffness could equal arthritis I

f you are feeling a little pain or stiffness in your joints, you may be one of 43 million Americans who have arthritis. Arthritis is one of the most common chronic health conditions and the number one cause of limitation in movement in the United States. Arthritis is the umbrella term for more than 100 different diseases that cause pain, swelling and limited movement in joints and connective tissue throughout the body. It is usually chronic, which means it lasts a lifetime. Anyone at any age may be diagnosed with arthritis. The three most prevalent types of arthritis are osteoarthritis, fybromyalgia and rheumatoid arthritis. Osteoarthritis is a degenerative joint disease in which the cartilage that covers the ends of the bones in the joint deteriorates, causing pain and loss of movement as bone begins to rub against bone. In

e-mail or fax cards and letters to your grandchild if you live far away. If you live near your grandchild, attend school functions or sporting events. Remember that whether you are an occasional sitter or the primary caregiver for your grandchild, the child’s safety is your concern. If you are driving somewhere with your grandchild in tow, remember: • Buckle-up. (Children under age 12 should ride in the back seat.) • Turn off your radio so you can pay close attention to what is going on around you. Drive with a large “anticipation zone.” Look down the road far enough to get a picture of what is ahead. • Avoid driving in bad weather, heavy traffic or highspeed areas. Remember that nothing can replace the attentive supervision of a loving grandparent. Enjoy your time with your grandchildren — they will remember and appreciate it for years to come.

fibromyalgia, widespread pain affects the muscles and attachments to the bone. Rheumatoid arthritis is an autoimmune disease in which the joint lining becomes inflamed as part of the body’s immune system activity. Symptoms of arthritis are pain, stiffness, swelling (sometimes) and difficulty moving a joint. If you notice one or more of these symptoms for more than two weeks, you should see your physician. Physicians can diagnose arthritis based on an overall pattern of symptoms, medical history, physican examination, X-rays and laboratory tests. Most treatment programs include a combination of medication, exercise, maintaining an appropriate weight, rest, use of heat and cold, joint protection techniques and, sometimes, surgery. If you are experiencing symptoms of arthritis (or you know someone who is), please seek a diagnosis and treatment from your physician. — Source: The Arthritis Foundation®.

S E N I O R S’

Coping with “the change of life” Menopause is a change, but it is a natural one. It is the transition period in a woman’s life when the ovaries stop producing eggs, menstruation decreases and eventually ends, and when the body decreases production of the female hormones — estrogen and progesterone. Menopause normally occurs between the ages of 40 and 55. Symptoms may include hot flashes and skin flushing, mood changes, decreased sex drive, irregular menstrual periods and vaginal dryness. Natural menopause usually requires no treatment. Surgical menopause that occurs prior to natural menopause may require estrogen replacement therapy (ERT). Physicians may recommend ERT to: reduce the undesirable symptoms of menopause, help decrease vaginal drying and prevent osteoporosis (see article on right) after menopause. If you have questions or concerns about menopause, please contact your primary care physician.

Are you experiencing hearing loss? Signs of hearing loss include: 1) Listening difficulty at a restaurant with family and friends. 2) Your hearing condition causes arguments with members of your family. 3) You hear frequent jokes about your hearing ability. 4) Your spouse, children or friends say they often have to repeat things for you. 5) You attend fewer church events or social functions because of your hearing condition. 6) You turn up the volume on your television or radio beyond a normal level. 7) You experience frustration when having conversations with family or friends because you can’t hear what they are saying. Hearing problems are common. Approximately one in 10 people experience some degree of hearing impairment. If you think you have a hearing impairment or hearing loss, please contact your physician.

17 The most common type of bone disease: Osteoporosis

Researchers estimate that 23 percent of American women over the age of 50 have osteoporosis. It is a major public health threat for more than 28 million Americans, 80 percent of whom are women. Osteoporosis is the progressive loss of bone density and thinning of bone tissue. The leading cause of osteoporosis is hormone deficiencies, so women who are menopausal may be at risk. Significant risk of osteoporosis has been reported in people of all ethnic backgrounds. Although it is often reported as an older person’s disease, it can strike at any age. There are no symptoms of osteoporosis in its earliest stages. However, symptoms occurring late in the disease include: fractures of the vertebrae, wrists or hips; lower back pain; neck pain; bone pain or tenderness; loss of height over time; and stooped posture. Treatment options should be discussed with your primary care physician. They may include medications (such as estrogen replacement therapy), lifestyle changes such as regular exercise and a diet that includes calcium, vitamin D and protein. Prevention of this disease is a lifelong commitment. It should start with a proper diet and regular exercise. — Source: National Osteoporosis Foundation.

Leading T

his issue of Blue & You continues our mission to introduce our state senators and representatives of the Arkansas General Assembly to our customers.

Rep. Paul Bookout (D) (Dist. 87) Jonesboro Education; Energy; Insurance & Commerce; Joint Budget (O) 870-932-6662 (H) 870-935-8030

Rep. Billy Gipson (D) (Dist. 92) Monette City, County & Local Affairs; Judiciary (H) 870-486-2592

Rep. Geoff Buchannan (R) (Dist. 4) Bentonville Education; State Agencies & Governmental Affairs (O) 501-855-6314 (H) 501-855-9363

Rep. Mary Beth Green (R) (Dist. 11) Van Buren City, County & Local Affairs; Joint Performance Review; Public Transportation (O) 501-996-5584 (H) 501-471-9598

Rep. Olin Cook (D) (Dist. 30) Russellville Chair, Education; Aging, Children & Youth, Legislative & Military Affairs; Joint Budget (O) 501-968-4203

Rep. Calvin Johnson (D) (Dist. 72) Pine Bluff City, County & Local Affairs; Public Transportation (O) 870-543-8256 (H) 870-535-1075

Rep. Jim Duggar (R) (Dist. 6) Springdale City, County & Local Affairs; Judiciary (O) 501-751-7500 (H) 501-751-7575

Rep. Barbara King (D) (Dist. 98) Helena Joint Performance Review; Revenue & Taxation; State Agencies & Governmental Affairs (H/O) 870-338-7983

Rep. Jake Files (R) (Dist. 12) Fort Smith Revenue & Taxation; State Agencies & Governmental Affairs (O) 501-782-7222 (H) 501-646-0191

Rep. Steve Napper (D) (Dist. 54) Little Rock Aging, Children & Youth Legislative & Military Affairs; Judiciary (O) 501-378-7755 (H) 501- 663-1491

the Way These elected officials spend numerous hours working on health care issues that affect you. (Upcoming issues of Blue & You will feature additional profiles of our legislators.) Rep. Steve Oglesby (D) (Dist. 17) Hatfield Aging, Children & Youth, Legislative & Military Affairs; Joint Performance Review; Public Transportation (O) 501-394-6740 (H) 870-389-6682 Rep. Marvin Parks (R) (Dist. 44) Greenbrier Judiciary; State Agencies & Governmental Affairs (O) 501- 327-4828 (H) 501-679- 5306

Rep. Mary Ann Salmon (D) (Dist. 61) North Little Rock City, County & Local Affairs; Education; Rules (O) 501-372-5500 (H) 501-753-4521

Rep. Bill Scrimshire (D) (Dist. 35) Malvern Joint Performance Review; Public Transportation; State Agencies & Governmental Affairs (O) 501-332-3638 (H) 501-337-1137 Sen. Jim Argue (D) (Dist. 15) Little Rock Chairman, Committee on Committees; City, County & Local Affairs; Education (O) 501-664-8632 (H) 501-224-8181

19 Sen. Jack Critcher (D) (Dist. 24) Grubbs Agriculture, Economic & Industrial Development; Committee on Committees; Joint Advanced Communications & Information Technology; Revenue & Taxation (O/H) 870-252-3592 Sen. Jim Hill (D) (Dist. 5) Nashville Vice-Chair, Revenue & Taxation; Agriculture, Economic & Industrial Development; Rules, Resolutions & Memorials (O/H) 870-845-3273

Sen. David Malone (D) (Dist. 35) Fayetteville Chair, Education; Efficiency; Joint Advanced Communications & Information Technology; Joint Budget; State Agencies & Governmental Affairs (O) 501-575-5581 (H) 501-442-0633

PROMOTING IMMUNIZATIONS THROUGH OPERATION KIDCARE

ew Arkansans today see the painful effects of people stricken with polio, whooping cough or diphtheria, thanks to the commitment of parents and caregivers in our state and nation who have had their children immunized throughout several decades. Arkansas Blue Cross and Blue Shield supports childhood immunizations and well-child check-ups as important aspects of ensuring children get off to a healthy start early in life and are protected from diseases later in life. Supporting Operation KidCare is one way in which Arkansas Blue Cross seeks to keep these elements of children’s health in the public’s mind. Operation KidCare is a cooperative effort between the Arkansas Department of Health (ADH), the Department of Human Services, Arkansas Blue Cross and Blue Shield and six hospitals throughout the state. Through a public awareness program, the goal of the coalition is to develop a network dedicated to promoting child health and welfare through: • Immunizations To increase age-appropriately immunized levels for Arkansas’ two-year-olds to 90 percent by the end of the year 2000. As part of the Operation KidCare program, parents can pick up, from their immunization provider, a KidCare Pak — an “important papers” folder made especially for children’s records, such as birth certificates or immunization records. To encourage the completion of all immunizations, inside the KidCare Pak parents also will find a bright yellow card that is validated by their immunization provider each time their child receives a round of shots. Upon completion of the 12- to 15-month round of shots, parents can register for a chance to win a $500 grocery shopping spree. “Children have plenty of tough situations to face

throughout their life,” said Robert L. Shoptaw, president and CEO of Arkansas Blue Cross. “Dealing with the effects of chronic or fatal diseases which can be avoided through immunizations should not be one that Arkansas children or their parents should have to endure. The goals of the Operation KidCare program are consistent with our organization’s mission to keep people healthy.” Look for Arkansas Blue Cross to take a more visible role in television commercials supporting Operation KidCare’s promotion of immunizations and well-child check-ups. Operation KidCare also is featured in a segment of Arkansas Blue Cross’ newest television spot. Immunizations are convenient to get through physician offices, many hospital pediatric clinics, and any Arkansas Department of Health Clinic. Immunizations are free through ADH clinics, most health maintenance organizations like Health Advantage and many hospital clinics. If you need more information about where you can get your child immunized, call the ADH at 1-800-235-0002. Other members of the Operation KidCare Coalition include: Arkansas Children’s Hospital; CHRISTUS St. Michael Health System (Texarkana); Northwest Medical Center (Springdale); St. Bernards Health Care (Jonesboro); St. Mary’s Hospital (Rogers); and Washington Regional Medical Center (Fayetteville).

l l l l

BlueAnn “rocks”¯ lueAnn Ewe will “rock” the tube again in 2000! Two new animated television commercials will premiere during family programming in July and run throughout the fall. The TV spots are designed to teach children about health and safety through fun, memorable music and images. The new spots focus on the importance of exercise (“Exercise Beat”) and safety (“Sing the Safety Song”) in overall wellness. Affectionately referred to as “BlueAnn Rocks,” the spots feature BlueAnn Ewe, Arkansas Blue Cross and Blue Shield’s ambassador of health and wellness who is the central figure of its Blue & Youth Health Program. In 1999, the first two animated television spots focused on nutrition (the “Food Pyramid”) and peer pressure (“Backbone”) and made an estimated two million impressions with kids and more than two million additional impressions with adults.

The Blue & Youth Health Program, an effort to improve the health status of young people in our state, consists of five components — the BlueAnn Elementary School Education Program, High School Heroes antismoking program, the Wildwood Tour traveling theater program, and the new BlueAnn Health and Class Clubs. The “BlueAnn Rocks” musical health messages support topics taught in the Blue & Youth Health Program and offer a new medium for kids to learn about health and wellness. The plan is to develop two new spots each year focused on a different health topic in an effort to create a library of “music videos.”

Measuring up in the new millennium Arkansas Blue Cross and Blue Shield and its family of companies will begin a new way of measuring operational and service performance this year ... all to the benefit of our members. The new Member Touchpoints Measures (MTM) program will be a way of measuring standards that shape member satisfaction. Beginning July 1, Arkansas Blue Cross, Health Advantage and USAble Administrators will begin collecting new MTM direct measures data, which will measure how timely and accurately we perform tasks that meet members’ needs. A new MTM survey will begin in the second half of 2001 to ask members how well the companies are serving their insurance needs. “With the Member Touchpoints Measures program, in addition to measuring timeliness of processes, we will be measuring how truly effective we are with our customers during these transactions,” said Reggie Favors, vice president of

Customer Services. “Quality takes on a whole new meaning for our companies in relation to taking care of our customers.” The MTM program will assess a member application from the time it is taken until the ID card is delivered, not only on a timeline, but also according to how well the customer is pleased with all aspects of service during the process. MTM Direct Measures will capture accuracy and timeliness of the process; then the MTM Survey will capture the members’ perceptions of the process or how satisfied they were with the process. “Absolutely everyone who touches the health care services of our members from the board room to the bedside and all points in between — both inside the companies and outside of them, such as physicians and hospital staff, agents and brokers — will impact our new MTM performance standards,” said Favors. “Ultimately, we hope MTM will help us to have very satisfied customers.”

ge Health Advanta members —

take note!

GET TO KNOW HEALTH ADVANTAGE

Health Advantage, a health maintenance organization (HMO), is jointly owned by USAble Corporation, a wholly owned subsidiary of Arkansas Blue Cross and Blue Shield, and Baptist Health HMO, Inc. Health Advantage is the first HMO to have a statewide network in all 75 counties and is the only federally qualified statewide HMO. Health Advantage, the oldest HMO in Arkansas, serves more than 175,000 members with a network of more than 3,500 providers and 92 hospitals. When you receive printed information from Health Advantage, you may wonder what some of the terms or phrases mean. Keep reading for important information to help you better understand your HMO. PCP – Primary Care Physician A PCP is primarily responsible for providing, arranging and coordinating all aspects of the member’s health care. PCPs are general practitioners, family practitioners, internists and pediatricians. HMO – Health Maintenance Organization For specialty care in an HMO plan, a referral from the PCP to a plan provider is necessary for benefits to be applied, except for gynecological and obstetrical services provided by plan gynecologists and obstetricians for female members. NOTE: Services from any out-ofnetwork provider must be prior approved by Health Advantage.

POS – Point-of-Service Plan 1. Members on a POS plan have the option of utilizing higher in-network benefits when there is a referral from the PCP to a plan provider. 2. Members on a POS plan also have the option of using participating providers or non-participating providers without a referral from their PCP, and benefits will be applied according to the lower out-of-network benefit level, which includes a deductible and higher member coinsurance. The member is financially responsible for the difference in the amount billed by non-participating providers and Health Advantage allowed charges as well as applicable deductibles and co-insurance. Co-payment – Amount required to be paid to a plan provider by the member for a service provided as described in the member’s schedule of benefits.

that the member is responsible for — sometimes in addition to the co-payment. A referral is not a guarantee of payment. It is always the member’s responsibility to ensure that all providers are participating with Health Advantage before seeking treatment to ensure benefits can and will be applied. All services rendered will be paid in accordance to the terms of each member’s evidence of coverage. The Health Advantage Customer Service Department may be contacted Monday through Friday 8 a.m. to 5 p.m. toll-free at 1-800-843-1329 to answer questions regarding benefits and to verify that providers are participating with Health Advantage.

REMINDER Coordination of Benefits (COB): Please let Health Advantage know immediately if you or any member of your family is covered by any other health plan. Call our customer service department at (501) 221-3733 or 1-800-843-1329, and we will update your eligibility information. Current information allows claims to process efficiently and saves health care dollars.

Co-insurance – A percentage of the amount allowed by Health Advantage for services rendered

Special thanks A special thanks to Steven L. Thomason, M.D., FAAFP, and Thomas Braswell, M.D., for their commitment to this issue of Blue & You focusing on healthy living for older adults. Dr. Thomason is with the Baptist Health Family Clinic in Little Rock and Dr. Braswell is with the Baptist Health Family Clinic in England.

23 rkansas Blue Cross and Blue Shield strives to be a A good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans. Meals on Wheels Arkansas Blue Cross and Blue Shield is going mobile. For Meals-on-Wheels, that is. Administered by CareLink, the Central Arkansas Area Agency on Aging, Meals-on-Wheels is a program in which volunteers deliver meals to the homebound elderly and disabled. Arkansas Blue Cross’ Enterprise Employees’ Committee has taken on a Meals-on-Wheels route, and once a week its members and other employees deliver lunchtime meals to homebound and disabled residents of Parris Towers in downtown Little Rock. Meals-on-Wheels is one way in which CareLink and its volunteers — like the employees of Arkansas Blue Cross — help older and disabled Arkansans live a better quality of life, more independently, and in the environment of their choosing. High School Heroes stomp in Pine Bluff Kids are “stompin’” in Southeast Arkansas with the launch of the High School Heroes program in the Pine Bluff School District. About 15 High School Heroes and BlueAnn Ewe took their message of not giving in to peer pressure to smoke to about 150 fifth-graders at Belair Primary School in Pine Bluff. Junior and senior students from Pine Bluff High School taught the younger set about the deceptive appeals of tobacco advertising and how to resist those people who will try to entice them into smoking. The High School Heroes also taught the fifth-graders how to do the BlueAnn “Stomp” to encourage them to “stomp those cigarettes to the ground.” Leann Rogers of Arkansas Blue Cross and BlueAnn Ewe helps launch Blue Shield’s Southeast the High School Heroes Regional Office “pumped program in Pine Bluff.

up” the fifth-graders before the Heroes’ presentation and shared her take on why cigarette smoking is not “cool.” High School Heroes was developed by the American Lung Association, and Arkansas Blue Cross serves as the statewide title sponsor of the student-to-student teaching program which carries an anti-smoking message to fifth-graders. “Brownies” get health tips BlueAnn Ewe lent a helping hoof to members of Brownie Troop 299 to support them in earning points toward a merit badge. At their regularly scheduled troop meeting, these Brownies BlueAnn Ewe leads the ropeparticipated in BlueAnn’s jumping exercise with an airhealth lesson and got all borne member of Troop 299. kinds of “Wild and Woolly Health Tips for Kids” which can be applied toward their Food and Nutrition badge. These troopers eagerly jumped rope with BlueAnn, listened to her heart, brushed her teeth, and answered questions about overall health and wellness. At the end of the lesson, each Brownie got to take home a copy of BlueAnn’s coloring book and “pledged” to be their healthy best. BlueAnn goes to School Reading, writing, arithmetic ... and rockin’ good health, too! BlueAnn has been busy in elementary schools around the state teaching first-graders about the importance of developing good health behaviors that last a lifetime. At a recent visit to St. Patrick’s School in North Little Rock, BlueAnn taught health to four classes, two of which were members of the BlueAnn Class Club. The students had completed and returned their Healthy Habits Activity Calendars and were excited to see their health hero in person and get to share with her what healthy habits they had been practicing every day at school and at home. They also were thrilled to receive a BlueAnn doll for their classrooms, so they could have their own health-and-wellness mascot around to remind them to “have fun ... stay healthy.”

— a guide to health insurance terminology

f health care terminology (including abbreviations and acronyms) leaves your head spinning … Arkansas Blue Cross and Blue Shield would like to help you make sense out of all the jargon. We want you to be an informed customer, so in each issue of Blue & You we will explain the meaning behind those health insurance words, acronyms and abbreviations that you may encounter when reading health care-related materials. Hospice — An agency which provides palliative, supportive and medically necessary care for terminally ill patients. Skilled Nursing Facility (SNF) — A facility that is primarily engaged in providing inpatients: 1) skilled nursing care and related services for patients who require medical or nursing care of less intensity than that rendered by a hospital, or; 2) rehabilitation services for the rehabilitation of injured, disabled or ill persons. Medicaid — A federally assisted state operated and administered program providing medical benefits for certain low-income persons in need of health care. Authorized by Title XIX of the Social Security Act, it does not cover all the poor or needy, but only persons who are members of one of the categories covered under welfare. Although subject to federal guidelines, the state determines the benefits covered, program eligibility, the rates to be paid, any providers, and methods of administered the program. Medicare — The federal program of health insurance for people 65 and over, for individuals eligible for Social Security disability payments, and for individuals with end-state renal disease. Enacted, along with Medicaid, in 1965, it consists of two separate but coordinated programs: “Part A” hospital insurance that is automatic and the largest single third-party payer of hospital services; “Part B” supplementary medical insurance that is voluntary, the subscriber paying a monthly premium, and covering the services of health professionals.

Medicare supplement — A private medical expense insurance plan that supplements Medicare coverage. Medi-Pak is an example of a Medicare supplement. Palliative Care — A form of treatment directed toward relief or control of distressing symptoms or pain without attempting to be curative. Hospice care usually includes palliative care. Pharmaceutical Cards — Identification cards issued by a pharmacy benefit management plan to plan members. These cards assist pharmacy benefit management plans in processing and tracking pharmaceutical claims. These cards also are known as prescription cards or drug cards. Senior Market — A market segment or age group that is comprised largely of persons age 65 or older who are eligible for Medicare benefits.

Northeast Regional Office Move Arkansas Blue Cross and Blue Shield’s Northeast Regional office, headquartered in Jonesboro, is moving. On July 14, the office will move to its new location at 707 East Matthews, Jonesboro, AR 72401. All telephone numbers for the office will remain the same. The office staff will continue to provide full service to our Northeast Arkansas members.

Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181

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