Better Health - November 2024 by repubnews

Can Medicare Advantage Improve My Health? Better Health

PROFILES: Sisters Mary and Eleanor Dooley of Elms College, D9

DAKIN: Compassionate care for community pets, D9

LIFESTYLE: The world of high-priced pens, D9

Every year, from October 15 to December 7, seniors and other Medicare-eligible individuals can choose their Medicare health plans for the coming year.

Additional Benefits

Beyond what Original Medicare covers, most Medicare Advantage plans offer additional benefits such as:

Fewer Hospital Visits and Complications

There are many studies that show Medicare Advantage can help people be healthier.

Dental, hearing and vision: Health plans know these services are important to overall health and many include coverage or allowances for these services.

Fitness allowances or reimbursement programs: Many plans offer allowances or reimbursements for memberships to gyms, fitness programs, or weight loss programs, encouraging regular physical activity and healthy eating—both cornerstones of good health. Health New England’s Medicare Advantage plans offer $150 toward fitness and nutrition programs, and many other healthy choices.

that address these needs, such as meal delivery services, and wellness programs focused on nutrition and mental health support. Health New England’s Healthy Directions program offers a one-stop shop for health and wellness information, tools, and resources that members can access from anywhere. These services make health care more accessible and help remove barriers that can negatively affect health outcomes. For individuals who may struggle to get to appointments or maintain a balanced diet, these added supports can significantly influence their overall health trajectory.

Telehealth services:

Is Medicare Advantage Right for You?

A 2018 study found that those with Medicare Advantage coverage had 23 percent fewer inpatient stays and 33 percent fewer emergency room visits than traditional Medicare members. It also found that people with clinically complex diabetes who were covered by Medicare Advantage had lower rates of complications.

Preventive Care

One reason for those results may be that Medicare Advantage plans offer fully cover preventive health visits, screenings, vaccinations, and lab tests. These can help indi-

Convenient access to medical professionals via telehealth has become a lifeline, especially for those managing chronic conditions or limited by mobility.

Addressing Social Determinants of Health

Improving health isn’t just about doctor visits and medications. Medicare Advantage plans are increasingly recognizing the importance of social determinants of health—factors like housing or nutrition—which influence a person’s overall well-being. Some plans now offer benefits

Ultimately, whether a Medicare Advantage plan can improve your health depends on your individual needs and priorities. For those who prefer a comprehensive approach that includes preventive care and benefits beyond basic medical coverage, Medicare Advantage plans offer a compelling option. With their focus on keeping you healthy, not just treating you when you’re sick, Medicare Advantage can be a powerful tool in improving both your health and overall quality of life.

Sarah Fernandes, the Manager of Medicare Sales and Retention at Health New England, resides in Belchertown and is dedicated to assisting people in acquiring appropriate Medicare coverage for their health care needs.

Families can share caregiving responsibilities

Family caregivers are unsung heroes. Such individuals typically provide vital services to their loved ones who cannot fully care for themselves, and they often do so without compensation.

Data from the U.S. Bureau of Labor Statistics indicates the prevalence of family caregivers across the country. According to the BLS, 14 percent of the population, which equates to roughly 37 million people, provide unpaid eldercare across the nation. Unpaid caregivers also provide vital services in Canada, where the Canadian Institute for Health Information reports such individuals provide an average of 17 hours of unpaid care each week (26 hours for those who care for seniors with dementia). Caregiving for a family member can take a toll that affects caregivers’ physical and mental health. According to the Centers for Disease Control and Prevention, caregivers are at increased risk for developing multiple chronic diseases since many neglect their own health needs while caring for others. In addition, roughly 15 percent of caregivers who participated in a CDC survey reported experiencing 14 or more mentally unhealthy days in the past month.

The physical and mental toll of caregiving underscores how important it can be for families to find ways to share caregiving duties. Though each situation is unique, the National Institute on Aging offers the following advice

to families as they seek to share the responsibility of caring for a loved one in need.

Identify the care required

The NIA recommends families discuss caregiving needs as early as possible and ideally before an emergency situation arises. If possible, the person in need can participate in this conversation and help to calmly discuss which services are wanted and needed. If a loved one is diagnosed with a condition in early stages, such as dementia, families can then work together to identify the level of care required in the immediate future and potentially down the road should the condition worsen.

Choose a primary caregiver

The primary caregiver will be the individual who accepts the bulk of the daily responsibilities of caregiving. Identifying this person early, ideally before a primary caregiver is even needed, can limit confusion should the day come when the individual needs daily care.

Determine each caregiver’s contribution

The caregiving team can discuss each person’s skills

and how they can be used to take care of the individual in need. This can be particularly useful when assigning specific tasks. For example, a caregiver who works in the medical field may be most qualified to speak to medical staff about their loved one’s condition, while another who works in the financial sector may be tasked with managing a loved one’s bank accounts and ensuring bills are paid on time.

Recognize

everyone has limits

A caregiving team is just that: a team. As noted, caregiving can take both a physical and emotional toll, so it’s important that everyone, and particularly the individual chosen as the primary caregiver, receive routine breaks to ensure everyone can take care of themselves. It’s important that a caregiving team maintain a degree of flexibility to account for the physical and mental challenges caregivers may encounter as they tend to a loved one in need.

Time to Choose a Medicare Plan?

We’re here to make sure you’re prepared. Connect with your local Medicare team! We can help you understand your options so you can make the best decision for your health care needs.

Sharing the responsibility of caregiving can ensure caregivers and their loved ones in need are not overwhelmed by the challenges they might confront each day. More information about caregiving can be found at nia.nih.gov. (855) 460-0567, TTY

What is Parkinson’s disease?

Who hasn’t tapped fingers on a desk with anxiety or shook a leg under a table awaiting some sort of news?

These motor impulses may seem involuntary, but they largely are under the control of the individual. For a portion of the population, fidgeting and tremors are out of their control, and are hallmarks of a movement disorder called Parkinson’s disease.

The Parkinson’s Foundation says Parkinson’s disease (PD) affects 10 million people worldwide. PD is a progressive neurodegenerative disorder that predominantly affects the dopamine-producing neurons in an area of the brain called the substantial nigra.

Since PD affects the ner-

vous system, various parts of the body controlled by nerves can be impacted by the disease. Symptoms often start slowly and may be virtually undetectable to the average person. The Mayo Clinic says the first symptoms may be a barely noticeable tremor in just one hand. Stiffness or slowing of movement also can be an early marker of the disease. Some people with PD may begin to have expressionless faces and speech may become soft or slurred. Symptoms worsen as the condition progresses.

The National Institute of Neurological Disorders and Stroke identify these four primary symptoms of PD, though it should be noted that everyone experiences symptoms differently.

Tremor:

Shaking often begins in a hand, although a foot or the jaw may be first affected. One tremor characteristic of PD is a rhythmic back-and-forth motion that may involve the thumb and forefinger and appear as ‘pill rolling.’ It is most obvious when the hand is at rest.

Rigidity:

Muscle stiffness and resistance to movement affects many people with PD. The muscles remain constantly tense and contracted so that a person aches or feels stiff. This rigidity can become obvious when another person tries to move the individual’s arm, which will only move in short, jerky movements known as ‘cogwheel.’

Bradykinesia:

This is a slowing down of spontaneous and automatic movement. Activities that were once easily performed now take much longer. There often is a decrease in facial expression, called ‘masked face.’ A person with PD may not move his or her arms while walking.

Postural instability:

This impaired balance and change in posture can increase the risk of falls. Postural instability also may affect walking gait. Someone with PD may appear to be shuffling. The cause of PD remains unknown. Scientists believe a combination of genetic and environmental factors are at the root of the disease. There is no cure for PD, although there are treatment options that may help alleviate some symptoms. Currently there is no treatment to slow the progression of PD. The Mayo Clinic says changes occur in the brains of people with PD. Notably there is the presence of clumps of substances called Lewy bodies. These Lewy bodies often show a widespread protein called alpha-synuclein, which cells can’t break down. Researchers have found alpha-synuclein in the spinal fluid of people who later develop PD.

The Parkinson’s Foundation says people with PD take domaminergic medications to replace missing dopamine in the brain. This helps to treat various symptoms. Ongoing research into PD has led researchers to find ways to identify biomarkers for PD that can lead to earlier diagnoses and more tailored treatments.

Various conditions can produce symptoms similar to PD. It is best to discuss any concerns with a doctor. A consultation with a neurologist likely will be recommended. With the right treatment and support, someone with PD can still live a quality life for years after diagnosis.

Facts about

A good night’s rest can be just what the body needs to feel revitalized and ready to tackle a new day.

Indeed, rest is important for people of all ages, including seniors.

The link between Sleep and Healthy Aging Alzheimer’s Disease

The National Institutes of Health reports that incidences of Alzheimer’s disease and other dementia increased by roughly 148 percent between 1990 and 2019. By 2020, more than 55 million people across the globe were living with dementia, according to Alzheimer’s Disease International (ADI). ADI adds that Alzheimer’s disease is the most common cause of dementia, accounting for as many as 75 percent of all cases worldwide.

Alzheimer’s disease (AD) is perhaps the most widely recognized form of dementia. But even those who are familiar with AD may not know the answers to common questions about it. Are Alzheimer’s and dementia one and the same?

No. Dementia is an umbrella term that refers to various conditions that the National Institute on Aging notes affect a person’s ability to think, reason and remember. AD is merely one type of dementia, and additional forms of the condition include Lewy body dementia and vascular dementia.

What distinguishes Alzheimer’s disease from other forms of dementia?

The David Geffen School of Medicine at the University

of California, Los Angeles reports that Alzheimer’s is characterized by progressive memory loss and cognitive decline. In addition, the Alzheimer’s Association notes AD affects the part of the brain associated with learning first, so individuals with the condition often exhibit difficulty remembering in the early stages of the disease. Are there other early signs of AD?

The NIA notes there are some additional early signs of AD, but also points out that different people exhibit different early signs of the disease. Some early signs may include:

• Decline in ability to find the right words

• Vision/spatial issues

Mild cognitive impairment (MCI)

The NIA notes that signs of MCI include losing things often, forgetting to go to appointments or other events, and struggling to come up with words compared to people in the same age group. The presence of MCI does not necessarily mean a person will develop Alzheimer’s, and certain conditions, including stroke, can increase risk for MCI.

What causes Alzheimer’s disease?

The causes of Alzheimer’s remain a mystery, though research is ongoing and medical professionals have connected some dots. For example, the NIA notes that the presence of the genetic condition Down syndrome increases a person’s risk of developing AD. That supports the notion that some cases of AD are caused by a genetic component, which scientists believe may also explain cases of early-onset dementia.

The NIA notes that research also indicates late-onset Alzheimer’s, which is typically diagnosed in individuals in their mid-60s, is linked to age-related changes in the brain that occur over several decades.

Is there a cure for Alzheimer’s disease?

No. There is no cure for Alzheimer’s disease, and the NIA notes that no scientific evidence exists to support claims that various supplements or products like coconut oil can cure or delay the onset of AD.

Tens of millions of people across the globe are living with Alzheimer’s disease. Finding answers to common questions about the disease can help individuals and their families manage AD more effectively.

The National Council on Aging notes the brain needs sleep to regulate the body, restore energy and repair damage. Recognition of that is vital for aging men and women, some of whom may be more vulnerable to sleeping problems than they realize. In addition to being more vulnerable to age-related health problems that can interrupt their sleep, thus affecting its quality, aging men and women may find their sleep routines change over time. For example, a 2019 study published in the journal BMC Geriatrics found that active elderly people reported it took them longer to fall asleep as they got older.

The NCOA says it’s a misconception that older adults need more sleep than younger people, noting adults of all ages require the same amount of nightly rest. However, things may change for seniors in regard to how much time they need to spend in bed. The NCOA notes this is because adults

may be more likely to experience poor sleep quality and continuity. When that occurs, adults still need the recommended minimum of seven hours of nightly sleep, but they may need to spend more time in bed since it’s taking them longer to fall asleep.

It’s important that aging adults recognize that they can spend too much time sleeping as well. A 2019 study published in the Journal of the American Geriatrics Society found that too much sleep is linked to the same health problems as too little sleep, issues that include an elevated risk for heart disease and falls.

Sleep issues affecting older adults also may be a byproduct of various contributing factors. The NCOA notes that frequent contributors to sleep concerns include:

Pain that affects the back, neck, or joints

Mental health issues, including anxiety and depression

Neurodegenerative disorders that are more frequent among aging populations, such as dementia and Alzheimer’s

Sleep apnea or disordered breathing at night

Restless leg syndrome, a condition that tends to worsen with age and is characterized by an urge to move limbs often

• Nocturia, a condition marked by a need to urinate at night

• Stimulating medications or medication interactions

• Decreased exposure to sunlight

• Sedentary lifestyle

Aging men and women who are experiencing difficulty sleeping should know that such issues are treatable and not something that needs to be accepted as a normal part of growing older. For example, individuals whose sleep is routinely interrupted by a need to urinate can avoid certain beverages, including alcohol and caffeinated drinks.

Sleep and healthy aging go hand in hand. Aging adults experiencing difficulty sleeping can consult their physicians and visit ncoa.org to learn more about overcoming sleep-related issues.

By T risha Pasricha M D

Washington Post

As I grow older, I feel like I’m more often tired and needing more naps.

How can I keep my energy up?

Feeling constantly exhausted is not normal, regardless of your age. It’s a myth that as we age, fatigue becomes par for the course, though it is a common symptom: One

study found that 29 percent of 70-year-olds and 68 percent of 85-year-olds experienced fatigue. In one study, among older adults, low energy was more often cited as the reason it’s hard to get out of bed than even chronic joint or back pain.

Fatigue may not bode well.

A study of almost 1,000 adults, age 75, living in Norway and Finland, found that those who reported feeling tired in their daily activities had more than twice the odds of becoming disabled within the next five years than those who did not. People who experience fatigue are also more likely to experience loneliness and have higher mortality rates.

Talk through your symptoms of low energy with your physician, who can help tease out the nuances, which may lead to a specific diagnosis. For example, are you feeling more physically depleted, inert or sleepy? What baseline are you comparing your current symptoms to? Such questions are an important part of the initial evaluation with someone who knows your full medical history.

Ways to boost energy for older adults

Our energy level is determined by many factors, and we can increase it in different ways.

Add more protein to your diet and cut down on ultraprocessed foods and snacks. Issues with nutrition can be a big part of why we feel fatigued. Some of it is directly related to the foods we’re eating. A balanced diet for older adults should include about 0.6 g of protein per pound of body weight (a 150-pound person should aim for 90 grams of protein daily). Foods that drag us down include refined carbs and ultra-processed foods that may offer short bursts of energy but leave us feeling sluggish and unfulfilled. But there can also be problems with appetite and swallowing, commonly related to diminished saliva production (which affects one-third of older adults) or dental issues.

Take care of your oral health.

Would it surprise you to learn that having fewer teeth predicts fatigue in older age? Tooth loss often results from oral infections related to poor oral health. Studies have found unhealthy dietary choices, such as eating fewer fruits and vegetables that are harder to chew, go handin-hand with tooth loss and increasing age.

Decreased muscle mass contributes significantly to why older adults feel fatigued. As early as in our 40s, we lose muscle mass, also known as sarcopenia, which can diminish our stamina. I advise patients to check their grip strength as an indicator of overall muscle quality and work on weightlifting.

We don’t have to bulk up like Arnold Schwarzenegger, but we can build muscle well into our 80s and 90s. It’s never too early or too late to start incorporating weights into our exercise routines. Studies have found that resistance training can improve older adults’ independence in daily activities and enhance energy. One old but good randomized controlled trial published in the New England Journal of Medicine in 1994 found that high-intensity resistance training was “feasible and effective” in reducing physical frailty among nursing home residents whose average age was 87.

Check for underlying diseases such as anemia. A randomized controlled trial published last year on the effect of low-dose aspirin and anemia among older adults had an unexpected finding: About 1 in 5 older adults who didn’t get aspirin and were just on a placebo developed anemia within five years of enrolling in the study. This means many older adults are at risk of experiencing low red blood cell counts over time, which can cause significant fatigue unless addressed. Besides anemia, hypothyroidism can make people feel constantly tired. As we age, hypothyroidism steadily becomes more common, especially among women. It affects less than 2 percent of people in their 20s but more than 10 percent of people in their 70s and 80s.

Other diseases associated with fatigue and older age include Parkinson’s disease, heart failure, kidney disease and cancer. Chat with your physician about your symptoms in depth and decide if you should pursue more testing.

Change your sleep patterns and bedroom temperature. As many as 50 percent of older Americans experience insomnia and other sleep disorders. Our circadian rhythm

tends to shift with age, telling us to sleep and rise earlier in the day. While older adults still need to aim for 7 to 8 hours a night, according to the National Sleep Foundation, give yourself permission to nap. A systematic review from 2022 found that indulging in a little daytime siesta didn’t compromise how long older adults slept at night but did improve daytime fatigue. The American Geriatrics Society does not recommend many sleep aids, especially for older adults, who are more sensitive to medications such as Ambien or Lunesta, because they may increase drowsiness to the point of raising the risk of car accidents, falls and other dangers.

How do you set your thermostat or room fans? Some evidence suggests that older Americans sleep best between 70 and 74 degrees Fahrenheit, which is especially important during the summer months. There are also several disorders such as sleep apnea that can contribute to fatigue symptoms and are worth exploring with your physician.

Rethink your medications. At your next primary-care visit, talk about your medications and whether they are all necessary in the doses you’re taking them. Many common prescriptions - from blood pressure medications to anti-depressants - can zap our energy levels. Furthermore, too many medications in general interacting with each other is also correlated with fatigue.

What I want my patients to know There are so many voices telling us that aging means slowing down. If we internalize those messages, we can mistakenly normalize the idea that feeling constantly fatigued is a part of that process. One important masquerader of fatigue that often gets discussed, and for good reason, is depression. Depression can lead to feelings of boredom, difficulty sleeping and exhaustion. If you’re experiencing these symptoms, talk to someone you trust, such as a health-care provider or family member, about how to get the help you need.

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