HEALTHY AGING

AVOIDING HOSPITALIZATION AND RE-HOSPITALIZATION

HOSTED BY: DR. SHARON B. MCLEOD

BMS HOME CARE PLUS:

"PREVENTION IS OUR PRIORITY"

NYC SENIORS• In 2010, the elderly population 60 years and older living in New York City numbered 1,407,635,

representing 17.2% of the City’s population. Approximately 30% of persons 60 and over are between ages 60 and 64, one-in-three are 75 and over, and one-in-ten are 85 and over.• • The City’s elderly population 60 and over comprises 580,355 (41.2%) males and 827,280 (58.8%)

females. At age 85, the number of women is about double that of men.• • Brooklyn and Queens are the boroughs with the largest number of residents 60 and over, each

accounting for about 30% of the City’s 60 plus population. This is followed by Manhattan (21.3%), the Bronx (14.7%), and Staten Island (6.2%). • • In New York State, 38.2% of the elderly population 60 plus resided in New York City. • Changes in

Chronic illnesses Among Seniors • Approximately 80 percent of the U.S. senior population suffers from at

least one chronic illness • 50 percent of this population has been diagnosed with at least two

chronic illnesses• As this population continues to grow and age, the prevalence of chronic

illness is likely to increase. For older adults, chronic disease is often linked to a higher rate of injuries, functional limitations, and cognitive impairments. In 1998, 31 percent of New York State adults age 65 to 69, and 38 percent of adults age 70 or over reported the prevalence of a functional limitation, such as a physical impairment or health condition, that affected their ability to perform activities

CHRONIC CONDITIONS CONTD.• Once you make it to 65, the data suggest that you can live another 19.2 years, on average. For many, then,

senior living includes carefully managing chronic conditions to stay healthy.

• Arthritis is probably the number one condition that people 65 or older contend with,” said

• Heart Disease: to the U.S. Centers for Disease Control and Prevention (CDC), heart disease remains the leading killer of adults over age 65, accounting for 1,156 deaths per 100,000 people in 2009, the most recent statistics. As a chronic condition, heart disease affects 37 percent of men and 26 percent of women 65 and older.

• Cancer: Cancer is the second leading cause of death among people over age 65, with 982 deaths a year per 100,000 people. According to the CDC, 28 percent of men and 21 percent of women over age 65 are living with cancer.

• Respiratory Diseases: Chronic lower respiratory diseases, such as COPD, are the third most common cause of death among people 65 and older, annually taking 291 lives per 100,000 people. About 10 percent of men and 13 percent of women are living with asthma, and another 10 percent of men and 11 percent of women are living with chronic bronchitis or emphysema.

CHRONIC CONDITIONS CONTD.• Alzheimer’s disease accounts for about 184 deaths per 100,000 people over age 65

each year. The Alzheimer’s Association reports that as many as 5 million adults over 65 live with Alzheimer’s disease,

• The National Osteoporosis Foundation estimates that 52 million Americans are affected by low bone mass or osteoporosis, putting them at risk for a fracture or break that could lead to poor senior health and reduced quality of life.

• Diabetes• About 24 percent of men and 18 percent of women

older than 65 are living with diabetes, a significant senior health risk. According to CDC data, diabetes causes 121 deaths annually among 100,000 adults over age 65.

CHRONIC CONDITIONS CONTD.• Influenza and Pneumonia• Although the flu and pneumonia are not chronic conditions, these

infections are among the top seven causes of death in people over age 65, at 104 per 100,000 adults a year.

• Falls and Other Injuries• The number of physical injuries from falls, accidents, and violence is

hard to track, but data from the CDC suggest that 29.1 percent of emergency room visits by seniors are related to injury and 13.5 percent are due to unintentional falls.

CHRONIC CONDITIONS CONTD.• An analysis of data from the National Epidemiologic Survey of Alcohol and Related Conditions suggests that

one in five people over 65 have had a substance or alcohol abuse problem at some point in their lives.

• Obesity About 40 percent of adults 65 to 74 years old are obese

• Obesity is an important senior health risk factor for heart disease, diabetes, and cancer -- chronic conditions that impact quality of life. It can also be a signal that an older adult isn’t as active or mobile as he or she once was.

• Oral HealthHealthy teeth and gums are important not just for a pretty smile and easy eating, but also for overall senior health. According to the CDC, 25 percent of women and 24 percent of men over 65 have no natural teeth. As you age, your mouth tends to become dryer and cavities are more difficult to prevent, so proper oral health care, including regular dental checkups, should be a senior health care priority, Dr. Wei said.

CHRONIC CONDITIONS CONTD.• Poverty

About 9 percent of adults over 65 are living in poverty. Older women are slightly more likely than men to be living in poverty, and single older adults are also significantly more likely to live alone with fewer resources. Poverty affects senior health if you're unable to afford doctor visits, medication for chronic conditions, and other essential senior health care needs.

MENTAL ILLNESS AMONG SENIORS• More than 6.5 million of the 35 million Americans aged 65 or older are affected by

• Depression in the elderly often go untreated because may believe it is a normal part of aging. This certainly is not true

• HOW SERIOUS IS THIS PROBLEM???• More than 6.5 million of the 35 million Americans aged 65 or older are affected by depression. • Depression in the elderly often go untreated because may believe it is a normal part of aging. This certainly is not

true. The elderly faced devastating consequences of depression without treatment due to loss of connections and sometimes multiple chronic medical conditions. The manifestations of depression are different in the elderly and pride, cultural and lack of knowledge may be a hindrance in obtaining treatment.

• • Approximately 90 % of the elderly do not receive adequate care for depression and a staggering 78% is not treated at all.

• • 20% of the elderly who experience the loss a spouse will suffer from depression within the first year.• Older Adult Attitudes toward Depression: (courtesy of MHA: Mental Health of America)• According to a Mental Health America survey on attitudes and beliefs about clinical depression:

MOST COMMON COST OF HOSPITALIZATION• Today there are over 43.1 million adults aged 65 and older in the United States; by

2040, that number will rise to 79.7 million.• Seniors represent 13.7% of the United States population, about 1 in 7 Americans.• Nearly 92% of older adults have at least one chronic condition, and 77% have at

least two.• Some type of disability (e.g. difficulty in hearing, vision, cognition, ambulation,

self-care, or independent living) was reported by 36% of adults aged 65 and over in 2012.• Source: Administration on Aging, 2012; Center for Disease Control

and Prevention, 2012; National Council on Aging, 2014

POSSIBLE REASONS FOR RECURRENT HOSPITALIZATIONS

• As many as one in five patients is readmitted within 30 days of his or her discharge, reports the federal Agency for Healthcare Research and Quality. And nearly one in seven patients undergoing certain major surgeries have to be readmitted within 30 days, according to a study in the New England Journal of Medicine in 2013.

• 1. NEW HEALTH PROBLEMS• 2.COMPLICATIONS SUCH AS: INFECTION, PNUEMONIA• 3. EARLY DISCHARGE

PREVENTING RE-HOSPITALIZATION• RISK FACTOR FOR RE-HOSPITALIZATION• Age

• Male gender• Poor self-rated general health• Availability of an informal caregiver• Having ever had coronary artery disease• Having had diabetes during the previous year• A hospital admission during the previous year• More than six doctor visits during the previous year

CONSEQUENCES OF RE-ADMISSION

• 17.7 BILLION PER YEAR PAID BY MEDICARE• RISK TO PATIENT: • IT’S A TRAUMATIC EVENT, • RISK OF MULTIPLE COMPLICATIONS, • DRUG RESISTANT INFECTIONS, • MEDICATION ERROR, SLEEP DISTURBANCES, BED SORES, COGNITIVE PROBLEMS

STRATEGIES THAT CAN REDUCE RE-HOSPITALIZATION: • GOOD DISCHARGE PLANNING IS OF UTMOST IMPORTANCE

• THINGS YOU CAN DO TO HELP:• 1. ACTIVELY PARTICIPATE IN YOUR DISCHARGE PLAN. IF YOU ARE UNABLE TO DO SO,

ENSURE YOU HAVE AN ADVOCATE • 2. SPEAK UP IF YOU ARE NOT READY TO GO HOME• 3. ENSURE YOU GET YOUR DISCHARGE SUMMARY AND LIST OF MEDICATION• 4. GET PERTINENT TEST RESULT • 5. SCHEDULE AN APPOINTMENT TO FOLLOW-UP WITH YOUR PRIMARY CARE DOCTOR

WITHIN A WEEK NO LATER• 6. GET TO KNOW HOSPITAL RATINGS YOUR PRIMARY DOCTORS ARE AFFLIATED WITH

PREVENTIVE CARE

STAYING HEALTHY: THE BODY, SMIND SPIRIT CONNETCION :MIND

AREAS OF THE BRAIN INVOLVED IN MEMORY

MEMORY ???WHAT IS Memory :Memory is our ability to:Encode, Store, Retain and subsequently Recall information and past experiences.

IS MEMORY LOSS A NORMAL PART OF AGING??•Normal aging is not responsible for causing memory disorders

.

• However, aging is associated with a general decline in cognitive and neural systems, including memory.

• Alzheimer's is not a normal part of aging,

although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s.

When should I be concerned?• While mild forgetfulness can be a normal part of aging, it can also be a

sign of more serious memory problems:

•Mild cognitive impairment, •dementia, or even •Alzheimer's disease.

• Memory disorders can range from mild to severe, which may result from some kind of damage to the structures of the brain, hindering the storage, retention and recollection of memories.

WHAT IS DEMENTIA•DEMENTIA : • Is a general term for loss of memory and other mental function that is severe enough to interfere with daily life.

•Alzheimer’s is one type of dementia

THE ALZHEIMER’S BRAIN• Alzheimer's disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all its functions.

WHAT CAN YOU DO TO KEEP YOUR BRIAN HEALTHY??• Visit your doctor regularly. • Get your “numbers” checked, including weight, blood sugar, blood pressure and

cholesterol. • If you have diabetes, manage it properly. • Stop smoking. If you don’t smoke, don’t start.• Take action to minimize stress. Studies have found that regular physical activity

decreases stress, increases your ability to manage stress and leads to better mood overall. • Get enough sleep. Inadequate sleep due to conditions like insomnia or sleep apnea can

result in problems with memory and thinking.• Avoid excess alcohol. Seek professional assistance to address anxiety, depression or

other mental health concerns.

THE MEDITERRANEAN DIET

HEALTHY AGING

YOU ARE AS YOUNG AS YOU THINK•Joan Collins, June 1999•“I never think about age. I believe your age is totally how you feel. I’ve seen women of thirty-five who are old and people of seventy-five who are young. As long as I look after myself physically, mentally and emotionally, I’ll stay young.”