RI ARA October 28, 2018 E-Nwsletter by RI ARA

RI ARA

Publication 2018 Issue 43 Published in house by the RI ARA

October 28, 2018 E-Newsletter Senate passes bipartisan bill to curb opioid crisis

The Senate on Monday passed a bipartisan, multipronged package of 70 bills aimed at curbing the opioid epidemic, but Congress still has work to do to reach the finish line. The package, which passed 99-1 and focuses on prevention and treatment, includes a provision President Trump endorsed on Twitter last month. It marks the most comprehensive action the Senate has taken on the crisis in more than two years. The Senate will now have to reconcile its bill with the House's, which passed earlier this summer.

"I think this bill represents Congress at its best," Sen. Orrin Hatch (R-Utah), chairman of the Senate Finance Committee, said from the floor Monday. "There has been no shortage of effort or genuine concern from both sides of the aisle to address this painful issue that has hurt so many American families." A key part of the package is the STOP Act, which would crack down on the shipment of deadly, synthetic opioids into the U.S. from other countries.

While private shippers like FedEx and UPS are required to gather data in advance on incoming, international shipments, the United States Postal Service (USPS) is not, making the agency the delivery system of choice for drug traffickers trying to ship drugs into the country, according to a congressional report released earlier this year. The STOP Act, authored by Sen. Rob Portman (R), whose home state of Ohio is among the most hard-hit by the crisis,

would require that USPS screen packages coming from overseas. Of the 72,000 drug overdose deaths in 2017, about 30,000 were attributed to the use of synthetic opioids, according to preliminary data released earlier this year by the Centers for Disease Control and Prevention. The package would also make a number of regulatory changes aimed at improving access to treatment for opioid use disorder and authorize federal agencies to award grants to local and state groups and municipalities fighting the epidemic….Read More

McConnell defends Trump-backed lawsuit against ObamaCare Senate Majority Leader Mitch McConnell (R-Ky.) defended the Trump administration’s decision to join a lawsuit that seeks to overturn ObamaCare and its protections for people with pre-existing conditions. “It’s no secret that we preferred to start over" to repeal and replace Obamacare, McConnell said in a newly published interview with Bloomberg. “So no, I don’t fault the administration for trying to give us an opportunity to do this differently and to go in a different direction.” The lawsuit was filed by leaders in Texas, along with 19 other Republican state attorneys general, and calls for all of ObamaCare to be overturned as unconstitutional. The Trump administration is supporting the states in court, arguing specifically that the sections of

the law protecting people with preexisting conditions from being denied coverage or charged more should be overturned. Democrats have made the case a signature issue in the midterm elections, especially vulnerable red-state candidates like Sens. Joe Manchin (WVa.) and Claire McCaskill (Mo.). They’ve been blasting Republicans over the lawsuit, and warning that their GOP opponents want to abolish popular protections for preexisting conditions. Republicans in tight races recognize their vulnerability on pre-existing conditions and have sought to alter their positions on the issue. Multiple Republicans, including most recently Sen. Ted

Cruz(Texas), have softened their stance. But the argument they are making has been complicated by their party’s repeated efforts to repeal ObamaCare, including pre-existing conditions protections. McConnell said he sees no problem in Republicans trying to use the courts to accomplish their goal of repealing ObamaCare. “Nothing wrong with going to court. Americans do it all the time; we can do it, too," he said. The Kentucky Republican also said he was not concerned about the lawsuit being a liability on the campaign trail. “Our candidates are able to deal with it,” McConnell said in the interview. "There’s nobody in the Senate that I’m familiar with who is not in favor of

coverage of pre-existing conditions." Republicans have introduced some bills in Congress that they argue would be able to protect people with pre-existing conditions if the law is struck down. Critics say none of the bills go far enough, and they still allow insurers to charge unaffordable rates for people with pre-existing conditions. ~~~~~~~~~~~~~~~~~~~~~

Trump: All Republicans will support people with pre-existing conditions 'after I speak to them' However, Trump’s administration is currently arguing in court that ObamaCare’s pre-existing condition protections should be struck down, a point Democrats were quick to make in response.

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/

CMS announces 2019 Medicare Parts A & B premiums and deductibles

Today, the Centers for Medicare & Medicaid Services (CMS) announced the 2019 premiums, deductibles, and coinsurance amounts for Medicare Parts A and B. “CMS is committed to empowering beneficiaries with the information they need to make informed decisions about their healthcare,” said CMS Administrator Seema Verma. “In addition to the information we recently released for Medicare Advantage, the program through which private plans provide Medicare benefits, today we are releasing information for fee-for-service Medicare, so enrollees understand their options for receiving Medicare benefits.” As announced earlier this month, CMS launched the eMedicare Initiative that aims to modernize the way beneficiaries get information about Medicare and create new ways to help them make the best decisions for themselves and their families. Ahead of Medicare Open Enrollment – which begins on October 15, 2018 and ends December 7, 2018 – CMS is making improvements the Medicare.gov website to help beneficiaries compare options and decide if Original Medicare or Medicare Advantage is right for them. Among the tools released as part of the eMedicare Initiative is a stand-alone, mobile optimized out of pocket cost calculator that will provide information on both overall costs and prescription drug costs.

Medicare Part B Premiums/Deductibles Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. The standard monthly premium for Medicare Part B enrollees will be $135.50 for 2019, a slight increase from $134 in 2018. An estimated 2 million Medicare beneficiaries (about 3.5 percent) will pay less than the full Part B standard monthly premium amount in 2019 due to the statutory hold harmless provision, which limits certain beneficiaries’ increase in their Part B premium to be no greater than the increase in their Social Security benefits. CMS also announced that the annual deductible for Medicare Part B beneficiaries is $185 in 2019, an increase from $183 in 2018.

Medicare Part A Premiums/Deductibles Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicarecovered employment. The Medicare Part A inpatient deductible that beneficiaries will pay when admitted to the hospital is $1,364 in 2019, an increase of $24 from $1,340 in 2018.

Medicare Advantage Premiums Medicare beneficiaries can choose to enroll in fee-for-service Medicare (Parts A and B) or can select a private Medicare Advantage plan to receive their Medicare benefits. Premiums and deductibles for Medicare Advantage and Medicare Prescription Drug plans are already finalized and are unaffected by this announcement. Last month, CMS released the benefit, premium, and cost sharing information for Medicare Advantage plans in 2019. On average, Medicare Advantage premiums will decline while plan choices and new benefits increase. On average, Medicare Advantage premiums in 2019 are estimated to decrease by six percent to $28, from an average of $29.81 in 2018. For a fact sheet on the 2019 Medicare Parts A & B premiums and deductibles, please visit: https://www.cms.gov/newsroom/fact-sheets/2019-medicare-parts-b-premiums-and-deductibles. For more information on the 2019 Medicare Parts A and B premiums and deductibles (CMS-8068-N, CMS-8069-N, CMS-8070-N), please visit https://www.federalregister.gov/public-inspection Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/

6 Things to Know About Medicare Fall Open Enrollment

Fall Open Enrollment is the time of year from October 15 through December 7 when you can change your Medicare coverage. You can join a new Medicare Advantage Plan or stand-alone prescription drug plan (Part D) plan. You can also switch between Original Medicare with or without a Part D plan and Medicare Advantage Here are six things to keep in mind while you are choosing your Medicare coverage: 1) Fall Open Enrollment occurs each year from October 15 through December 7. Any change you make during Fall Open Enrollment will take effect January 1. In most cases, Fall Open Enrollment is the only time you can pick a new Medicare Advantage or Part D plan. If you have Medicare Advantage, you can also switch to Original Medicare. To get drug coverage, you should also join a Part D plan. Depending on where you live, you may be able to buy a Medigap policy, which helps pay Original Medicare costs. Limitations apply as to who can buy a Medigap and when. 2) Review your current Medicare health and drug coverage. If you are dissatisfied with your coverage for next year, make changes during

Fall Open Enrollment. If you have Original Medicare, take a look at next year’s Medicare & You handbook to know your Medicare costs and benefits for the upcoming year. If you have a Medicare Advantage Plan or a Part D plan, you should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from your plan. Review these notices for any changes in the plan’s costs, benefits, and/or rules for the upcoming year. Even if you are satisfied with your current Medicare coverage, look at other Medicare options in your area that may better suit your individual needs in the upcoming year. For example, check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Part D could lower their costs by shopping among plans each year. There could be another Part D plan in your area that covers the drugs you take with fewer restrictions and/or lower prices. 3) Help is out there. Use Medicare’s Plan Finder tool if you need help finding Part D plans. The Plan Finder tool compares plans based on the drugs you need, the pharmacy you visit, and your drug costs. If you want to join a Medicare

Advantage Plan, call 1-800-MEDICARE to find out which plans are in your area. When you receive the list of plans, check the plans’ websites or call them to see which best fits your needs. If you research a plan online, also call the plan itself to confirm what you have learned. Make sure the plan includes your doctors and hospitals in its network. Confirm that the plan covers all your drugs, and that your pharmacies are in the preferred network. Write down everything about your conversation, including the date, the representative you spoke to, and any outcomes or next steps. This information may help protect you in case a plan representative gives you misinformation. Call or visit the website of your State Health Insurance Assistance Program (SHIP). Your local SHIP can help you understand your Medicare coverage options and navigate any changes. 4) The best way to enroll in a new plan is to call 1-800MEDICARE. Enrolling in a new plan directly through Medicare is the best way to protect yourself if there are problems with enrollment. Write down everything about the conversation when you enroll through Medicare, including the date, the representative you spoke to, and any outcomes or

next steps. Before you enroll in a new plan, remember to confirm all the details about your new plan with the plan itself. 5) If you are dissatisfied with a Medicare Advantage Plan you choose during Fall Open Enrollment, you can change your plan during the Medicare Advantage Open Enrollment Period (MA OEP). The MA OEP occurs each year from January 1 through March 31, with changes taking effect on the first of the month following the month you enroll. During this time, you can switch from one Medicare Advantage Plan to another, or switch from a Medicare Advantage Plan to Original Medicare with or without a Part D prescription drug plan. 6) Understand the difference between Fall Open Enrollment and Open Enrollment for the state or federal Marketplaces. The federal Marketplaces (also known as Exchanges) offer annual open enrollment periods for uninsured and underinsured Americans. This enrollment period may overlap with Fall Open Enrollment. The Marketplaces are typically not meant for people with or eligible for Medicare. If you have or are eligible for Medicare, you should only use the Fall Open Enrollment Period (October 15 through December 7) to make changes to your Medicare coverage.

Repeal the GPO and WEP The House bill to repeal the GPO/WEP is H.R. 1205 by Rodney Davis (R-IL). Make sure your Rep. has signed. Check the list here . S. 915 by Sherrod Brown is the current bill in the Senate. Have both your Senators signed on? Check the list here.

The Committee for Social Security Fairness  A Grassroots movement of You can get your state Thurmond put a resolution active and retired public legislature to tell the US through the CA Legislature servants of all professions, Congress to repeal the GPO and telling Congress to REPEAL working to repeal the GPO WEP! You can adapt this THE GPO/WEP. Let us know if WEP. resolution from CA for your we can support you when you  Join us as an individual and state! (See Action Alert #101 do this in your state. Write to ask your professional group to for wording) Assemblyman ssfairness@gmail.com. join us too. Social Security Fairness Repeal the Government Pension Offset and the Windfall Elimination Provision

As Billions In Tax Dollars Flow To Private Medicaid Plans, Who’s Minding The Store? With no insurance through his job, Jose Nuñez relied on Medicaid, the nation’s public insurance program that assists 75 million low-income Americans. Like most people on Medicaid, the Los Angeles trucker was assigned to a private insurance company that coordinated his medical visits and treatment in exchange for receiving a set fee per month — an arrangement known as managed care. But in 2016, when Nuñez’s retina became damaged from diabetes, the country’s largest Medicaid insurer, Centene, let him down, he said. After months of denials, delays and erroneous referrals, he claimed in a lawsuit, the 62-year-old was left nearly blind in one eye. As a

result, he lost his driver’s license and his livelihood. “They betrayed my trust,” Nuñez said, sitting at his kitchen table with his thick forearms folded across his chest. The current political debate over Medicaid centers on putting patients to work so they can earn their government benefits. Yet some experts say the country would be better served by asking this question instead: Are insurance companies — now receiving hundreds of billions in public money — earning their Medicaid checks? More than two-thirds of Medicaid recipients are enrolled in such programs, a type of

public-private arrangement that has grown rapidly since 2014, boosted by the influx of new beneficiaries under the Affordable Care Act. States have eagerly tapped into the services of insurers as one way to cope with the expansion of Medicaid under the ACA, which has added 12 million people to the rolls. This fall, voters in three more states may pass ballot measures backing expansion. Outsourcing this public program to insurers has become the preferred method for running Medicaid in 38 states. Yet the evidence is thin that these contractors improve patient care or save government money. When auditors,

lawmakers and regulators bother to look, many conclude that Medicaid insurers fail to account for the dollars spent, deliver necessary care or provide access to a sufficient number of doctors. Oversight is sorely lacking and lawmakers in a number of states have raised alarms even as they continue to shell out money. “We haven’t been holding plans to the level of scrutiny they need,” said Dr. Andrew Bindman, former director of the federal Agency for Healthcare Research and Quality and now a professor at the University of California-San Francisco. “This system is ripe for profit taking, and there is virtually no penalty for performing badly.” ...Read More

In this Halloween Season, Zombie Threats to Health Care Put Us at Risk

Certain threats to health care seem to arise from the dead regularly, and this Halloween season features an assortment of such zombie threats to Medicare, Medicaid, and the Affordable Care Act (ACA). As 2018 winds down, we must remain vigilant about attempts to cut or eliminate these vital programs that help older adults, people with disabilities, and their families and caregivers. Last year, Congress failed multiple times in wide-ranging attempts to repeal the ACA, which would have put an end to important protections, including protections that:  keep individuals from being charged more for insurance because of their age or health condition;  allow people with preexisting conditions to buy the same plans with the same

coverage as everyone else; and  require plans to cover an array of needed benefits, including prescription drugs and hospital care. In addition to attempts to eliminate the ACA, Congress tried and failed to end Medicaid as we know it with attempts to cut and cap the program. These changes would have harmed everyone with Medicaid including older adults who rely on Medicaid to stay in their homes or for nursing facility care. Facing election year pressures, Congress put those ideas on the back burner in 2018, but Congressional leaders are openly saying that ACA repeal may be back on the table in 2019. This week has also seen Medicare, Medicaid, and Social Security cuts brought to the forefront as some in Congress search for ways to pay

for last year’s tax plan that has ballooned deficits. We predicted the tax bill would put these programs at risk as the legislation was expected to add $1.5 trillion to the debt over 10 years, creating financing challenges for the federal government. Congressional leaders claimed the tax plan would “pay for itself,” but the results indicate the opposite, with revenues dropping sharply. While Congressional attention has been elsewhere in recent months, these programs have remained under threat, due to legal challenges and administrative actions. Some states and the Trump Administration are attacking the ACA in court in an attempt to eliminate the law’s protections for people with pre-existing conditions. A decision from this case could happen any day, and if the court

finds for the plaintiffs, chaos may reign for people who desperately need health care coverage to treat significant conditions. At the same time, the Administration is advancing state efforts to restrict Medicaid eligibility, making changes that may make it harder for people with Medicare to make optimal coverage choices, and undermining the ACA. As Medicare, Medicaid, and the ACA continue to face significant opposition at the state and federal levels, Medicare Rights will keep fighting to protect these vital programs, which help maintain economic security and build well-being for millions. As always, our goal is to work together with Congress and the Administration to create lasting solutions to provide health care for all.

FRAUD ADVISORY WARNING!!!!! FRAUD ADVISORY: Inspector General Warns Public About Caller-ID "Spoofing" Scheme Misusing SSA Customer Service Number The Acting Inspector General of Social Security, Gale Stallworth Stone, is warning citizens about an ongoing callerID “spoofing” scheme misusing the Social Security Administration’s (SSA) national customer service phone number. SSA has received numerous reports of questionable phone calls displaying SSA’s 1-800 number on a caller-ID screen. This is a scam; citizens should not engage with these calls or provide any personal information.

The reports indicate the calls display 1-800 -772-1213, SSA’s national customer service number, as the incoming number on caller ID. People who have accepted the calls said the caller identifies as an SSA employee. In some cases, the caller states that SSA does not have all of the person’s personal information, such as their Social Security number (SSN), on file. Other callers claim SSA needs additional information so the agency can increase the person’s benefit payment, or that SSA will terminate the person’s benefits if they do not confirm their information. This appears to be a widespread issue, as reports have come from citizens across the country.

SSA employees do contact citizens by telephone for customer -service purposes, and in some situations, an SSA employee may request the citizen confirm personal information over the phone. However, SSA employees will never threaten you for information or promise a Social Security benefit approval or increase in exchange for information. In those cases, the call is fraudulent, and you should just hang up. “This caller-ID spoofing scheme exploits SSA’s trusted reputation, and it shows that scammers will try anything to mislead and harm innocent people,” Stone said. “I encourage everyone to remain

watchful of these schemes and to alert family members and friends of their prevalence. We will continue to track these scams and warn citizens, so that they can stay several steps ahead of these thieves.” The Acting Inspector General urges citizens to be extremely cautious, and to avoid providing information such as your SSN or bank account numbers to unknown persons over the phone or internet unless you are certain of who is receiving it. If you receive a suspicious call from someone alleging to be from SSA, you should report that information to the OIG at 1800-269-0271 or online at https://oig.ssa.gov/report.

Medicare as we know it is under attack .Current efforts and proposals will privatize Medicare and increase costs. Against the wishes of most Americans, some lawmakers want to cut Medicare benefits, driving up costs to you, and making health care and prescription drugs even less affordable. They ignore simple fixes that would strengthen the program. Many are working to divide up Medicare into limited private insurance plans. Some want to raise the age of eligibility, which would lead to higher costs for those who are eligible. Some even want to completely transform Medicare from a program with clearly defined benefits to a "voucher" program with set contributions which would not be enough to pay for most people's care. This would end the Medicare program as we know it. Today, 59 million older people and people with disabilities have health care

because of Medicare. Most Americans say Medicare works well. If Medicare is in jeopardy, these people's lives are in jeopardy. In 1995 Newt Gingrich predicted that privatization efforts would lead Medicare to "wither on the vine." He said it was unwise to get rid of Medicare right away, but envisioned a time when it would no longer exist because beneficiaries would move to

private insurance plans. That's what's happening right now in Congress, and it is not just by chance. Recent tax cuts for the highest earners have created a federal budget deficit of over 1.5 trillion dollars. Having just created this extraordinary deficit, some lawmakers are now calling for cuts to Medicare, Social Security, and other valuable programs, to solve this unnecessary, manufactured

financial "crisis." Medicare has met the needs of individual families for over 50 years while also helping to unite our national family. Medicare has helped pull families out of poverty, kept them well, and advanced health care innovations that benefit all Americans. Don’t let this national treasure unravel. We need to improve Medicare, not cut it. Let's renew it and strengthen it for generations to come. Protect Medicare. Don’t make America sick again.

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Are Older Adults Taking Benzodiazepines Safely? IF YOU'RE FEELING anxious or sleeping poorly, it's tempting to turn to pills to solve the problem. However, prescription sedative drugs known as benzodiazepines carry significant risks, particularly for older adults. Many people in their 60s, 70s and 80s take antianxiety medications – such as Xanax, Valium and Ativan – sometimes indefinitely. Sleeping pills – such as Halcion and Restoril – meant for short-term use can turn into long-term habits. Sedation, dizziness and weakness are among the most common benzodiazepine side effects. Depressed mood, headaches, memory problems

and irritability can also occur. Disorientation, balance problems, daytime drowsiness and increased risk of injuries – like falls – are also benzodiazepine side effects. The very problems older adults hope to avoid, such as mental confusion or hip fractures, become more likely. Even so, physicians keep writing and refilling these prescriptions for their older patients. A new study finds that many patients take benzodiazepine drugs for months on end. Common Benzodiazepines When the generic name of a

drug ends with "pam" or "lam," that indicates it's a benzodiazepine. Valium (diazepam), Ativan (lorazepam) and Xanax (alprazolam) are common medications for treating anxiety disorders. Klonopin (clonazepam), used to control and prevent seizures, is also prescribed for panic attacks. For sleep problems, benzodiazepines approved by the Food and Drug Administration are flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril), triazolam (Halcion) and Estazolam (estazolam). Benzodiazepines are thought to work by affecting chemicals

in the brain called neurotransmitters, which communicate with nerves in the body. These drugs appear to enhance the calming effects on the nerves. Overprescribing to Older Adults A new review published in the September/October 2018 Harvard Review of Psychiatry looked at evidence of effectiveness and tolerability among older adults with three conditions for which benzodiazepines are commonly prescribed: insomnia, anxiety disorders and dementia symptoms…..Read More

Seafood rich in omega-3 may promote healthy aging In our increasingly aging society, it is worth asking: what can we do to ensure that we don't just live longer lives, but also healthier ones? New research suggests one possible answer — eat more seafood! A new study, led by Heidi Lai from the Friedman School of Nutrition Science and Policy at Tufts University in Boston, MA, investigates the link between high consumption of omega-3rich seafood and healthy aging. Lai and colleagues define "healthy aging" as "meaningful

lifespan without chronic diseases and with intact physical and mental function." As the researchers explain in their paper, the problem of healthy aging is increasingly important. Populations are aging rapidly across the globe and the rates of chronic disease along with them. So, more and more research is looking into what constitutes healthy aging and what we can do to achieve it. In this regard, the studies on the link

between omega3 fatty acids and agerelated chronic disease have been somewhat inconsistent. For instance, some studies referenced by Lai and colleagues have found an inverse relation between omega3 consumption and cardiovascular disease. However, others have found that omega-3 intake correlates with a higher incidence of prostate cancer.

Other studies have yielded "mixed or inconclusive" results when it comes to omega-3s and "cancer, diabetes, lung disease, severe chronic kidney disease, and cognitive and physical dysfunction." So, the researchers set out to clarify this potentially significant role that dietary omega-3 fatty acids play in the aging process. The scientists published their findings in the journal The BMJ…..Read More

FDA Could Approve Opioid 10 Times Stronger Than Fentanyl This week, an FDA panel voted 10-3 to recommend approval for a new fast-acting form of an opioid drug that’s 10 times more potent than fentanyl. Opioid overdose is the leading cause of death for Americans under the age of 50, with the sharpest increase in overdose deaths in 2017 connected to fentanyl and other synthetic opioids. Fentanyl — a highly regulated prescription

drug that has been extensively counterfeited in recent years — is extremely dangerous because it’s much stronger than heroin, so drug users who either don’t realize the substance they’re using is cut with fentanyl, or don’t anticipate such a strong effect, can easily overdose.

The new drug, which would be marketed as Dsuvia, is a sublingual pill form of sufentanil, a synthetic opioid that is used for IV and epidural anesthesia. This new form of the drug is designed for fast relief from acute pain, and can start working in as little as 15 minutes. It’s meant to be used in medically supervised settings only, administered by

health care professionals. This form of a strong painkiller that doesn’t require swallowing could be potentially valuable for patients who can’t swallow pills, and the single-dose form can help avoid dosage errors. Of course, there is also the obvious concern about introducing yet another highlypotent opioid drug into the world that could be deadly if used incorrectly….Read More

Early-Onset Alzheimer's: When Symptoms Begin Before Age 65 What is early-onset Alzheimer's? Early-onset Alzheimer's is an uncommon form of dementia that strikes people younger than age 65. Of all the people who have Alzheimer's disease, about 5 percent develop symptoms before age 65. So if 4 million Americans have Alzheimer's, at least 200,000 people have the early-onset form of the disease. Most people with early-onset Alzheimer's develop symptoms of the disease in their 40s and 50s. Causes Some people with early-onset Alzheimer's have the most common form of the disease. Experts don't know why these people get the disease at a younger age than others do. But others with early-onset Alzheimer's have a type of the disease called "familial

Alzheimer's disease." They're likely to have a parent or grandparent who also developed Alzheimer's at a younger age. Early-onset Alzheimer's that runs in families is linked to three genes—the APP, PSEN 1, and PSEN 2—that differ from the APOE gene that can increase your risk of Alzheimer's in general. Together, these three genes account for less than 1 percent of all Alzheimer's disease cases but about 60 to 70 percent of early-onset Alzheimer's cases. If you have a genetic mutation in one of those three genes, you may develop Alzheimer's before age 65. Genetic testing for these mutations is available, but anyone who's considering it

should pursue genetic counseling—to examine the pros and cons beforehand. For example, it may be helpful to consider how a positive test may affect your eligibility for long-term care, disability, and life insurance. On the other hand, if you know you carry a form of the early-onset genes, you may be able to take steps to make it easier for you and your loved ones to cope with the effects of the disease. If you have early-onset Alzheimer's linked to one of the three genes or carry a form of these genes without symptoms, talk to your doctor about participating in a research study. By studying the early-onset form of Alzheimer's, researchers hope to learn more about the

causes and progression of the disease and develop new treatments. Accurate diagnosis critical An accurate diagnosis of early-onset Alzheimer's is crucial for medical reasons to rule out other potential issues and get the most appropriate treatment as well as for personal and professional reasons. For you and your family, the diagnosis is fundamental in helping the family respond with appropriate understanding and compassion. It can also give you and your family more time to make important decisions about financial and legal issues. At work, it can allow you to explain your condition to your employer and perhaps arrange a lighter workload or more convenient schedule….Read More

Health Tip: Suggestions For Healthier Aging Many factors influence how we age, ranging from dietary choices and physical activity to health screenings and managing risk factors for disease. The U.S. National Institute on Aging suggests these steps to promote healthier aging:

and shape. Both Get regular your body mass exercise. Studies index and the shape have shown that of your body (where people who you carry weight) exercise often live make a difference. longer, healthier Eat a varied and and happier lives. Pay close attention to weight balanced diet.

Identify and participate in activities that you enjoy, such as volunteering, hobbies and social actives.  Health Tip: Find Activities You Enjoy  Health Tip: Treating HeatRelated Illness

Poorer Care at For-Profit Nursing Homes, Study Claims Older adults who live in forprofit nursing homes are nearly twice as likely to have health problems linked to poor care than those in nonprofit nursing homes and those who live in private homes, a new study finds. "We saw more -- and more serious -- diagnoses among residents of for-profit facilities that were consistent with severe clinical signs of neglect, including severe dehydration in clients with feeding tubes which should have been managed, clients with stage 3 and 4 bed sores, broken catheters and

feeding tubes, and clients whose medication for chronic conditions was not being managed properly," said study leader Lee Friedman. Friedman, an associate professor of environmental and occupational health sciences at the University of Illinois at Chicago, added that substandard care falls within the definition of elder abuse. The study included more than 1,100 people, aged 60 and older, who were seen in five Chicagoarea hospitals between 2007 and

2011 for health problems that could be related to poor care. Along with finding that neglect-related health problems were more common in for-profit nursing homes than in nonprofits, the researchers also found that community-dwelling patients had fewer of these problems than those in any type of nursing home. Community-dwelling patients need help with daily living but live in private homes, often with family members or friends. "For-profit nursing facilities pay their high-level

administrators more, and so the people actually providing the care are paid less than those working at nonprofit places," Friedman said in a news release from the University of Illinois. "So staff at for-profit facilities are underpaid and need to take care of more residents, which leads to low morale for staff, and it's the residents who suffer." He said more oversight of nursing homes is needed, along with improved screening and reporting of suspected neglect. The study was published recently in the journal Gerontology.

The New Face of Grandparenting GRANDPARENTS ARE IN THE news more than ever today. Some are caregivers, raising their grandkids, while others are separated or estranged from them. What's going on? Has the role of grandparents diminished, or is it needed now more than ever? Separated or Estranged In a recent survey by the National Association for Grandparenting, many adults – 23 percent – had no memories of their grandparents. They were either deceased before they were born, lived far away or made no effort to connect. We can't do much about the first, and distance is no excuse for not connecting, not when you can use tools like Skype, Zoom and FaceTime. Even grandparents in the same geographic vicinity may not have a close relationship. Psychologists have noticed two life-stage barriers that are holding back people. Some people have a limited view of the years they have left. They may think their best years are in the past. They may think taking it easy, keeping to themselves and not being engaged is something they earned the right to do. They don't ask a fundamental question: What's next? Part of the "what's next" could be a purposeful relationship with their grandchildren.

The second barrier is easier to understand: relationships with children. They are the gatekeepers to the grandchildren. Tension or unresolved pain in that relationship can cause hindrances, and healing those wounds is an important part of being a grandparent. Be open to a child's perspective, and seek or give forgiveness as needed. Pride often stands in the way. Grandparents Raising Grandchildren The opioid crisis, among other things, is a contributing factor for why nearly 3 million grandparents in the U.S. are taking care of more than 8 million children. There is a burden that comes with this responsibility, as many of these grandparents live at or below poverty and are working hard just to keep their household running. They may suffer poorer health, too. Yet, raising grandchildren in most cases is better than putting them into foster care or temporary placement. Many communities have created grandparent support groups and navigator programs that help identify and access much-needed public and private resources. Project Healthy Grandparents at Georgia State University offers support. Grandhousing, which provides

apartments specifically for grandparent-headed families, is rising. Presbyterian Senior Services has one such initiative running in New York City. The Supporting Grandparents Raising Grandchildren Act was recently signed into law. It establishes a Federal Advisory Council to support grandparents and other relatives raising children. Its charge is to "identify, promote, coordinate and disseminate information about resources and best practices to help relative caregivers meet the health, educational, nutritional and other needs of the children in their care as well as maintain their own physical and mental health and emotional wellbeing." What's the Balance? There is no playbook for being a grandparent. There are some 70 million grandparents in the U.S., most of whom do not live on these fringes. So, it's important to reconsider and reflect on the great joy and opportunity grandparenting brings:  As parents, you probably didn't get to spend hours and maybe days of uninterrupted time with your children. When my wife and I visit our young granddaughters, it's an immersion.

 Grandparents tend to become much more patient and attentive then they've ever been.  Your stress and anxiety lessen while your quirky sides emerge. People actually uncover what it's like to be silly.  Senior isolation is a real phenomenon. Yet, grandparents who are involved live longer. It's all about human contact.  You get to share stories, family history, and legacy. Research shows that children who have a strong "family narrative" enjoy better emotional health. The more children know, the stronger their sense of control over their lives, the higher their self-esteem and the more successfully they believed their families functioned. Oh yeah, you get to give them back! We need to support grandparents raising grandchildren and encourage those who do not have relationships with their grandchildren to break the barriers stopping them. For the rest of us, we truly need to smell the roses and appreciate the joys and blessings we have because our grandchildren are in our lives.

5 Steps for Choosing the Right Assisted Living Community Consumer Reports has no financial relationship with advertisers on this site. For many frail older Americans, assisted living has become an increasingly popular alternative to remaining in their homes. You can live in a comfortable residence and receive the services that you need, such as help with bathing and dressing, as well as avoid the institutionalized setting of a

nursing home. But finding the right residence can be a daunting challenge. For one thing, the cost is high— in 2018 the median fee for a private one-bedroom jumped to $48,000 per year, up 6.7 percent from 2017, according to Genworth, a long-term-care insurer. Most residents pay out of pocket, though some qualify for Medicaid. (Medicare

generally does not cover long-term-care services.) “The assisted living industry originally targeted healthier older adults with hotellike services,” Grabowski says. “But given the level of chronic illness and medical complexity they’re now seeing in their residents, some in the industry are moving to a new paradigm that recognizes you have to

deliver both health care and hospitality services.” Smart Questions to Ask  What kind of help do you need?  What is the quality of care?  What are the real costs of care?  Can your loved one age in place?  Will your family member have an advocate? Read More