Exercise for Elders

As HMOs Continue to Drop Coverage for Seniors – Now Over 500,000 Victims – Those Needing Expensive Respiratory Medication, Support and Homecare Services are the Hardest Hit

One Patient Advocate, Geriatric Services of America, is Providing Relief to Victimized Patients Through a Unique, Often No-Cost Program

More than 536,000 US senior citizens are scrambling to find new doctors or new coverage because their health plans terminated their Medicare managed-care services, according to a Nonrenewal Report issued by the Centers for Medicare & Medicaid Services for the year 2002. Among the hardest hit are seniors in California (84,000), Florida (59,000), Pennsylvania (55,000), New Jersey (53,000), Texas (46,000), and Michigan (31,000), who will be losing coverage in the coming year. Even those with continuing coverage face substantial premium hikes and dwindling drug benefits. Particularly hard hit will be those with chronic illnesses such as respiratory disease, who will bear the brunt of high medication and healthcare costs.

Though all seniors 65 and older are covered by Medicare, those enrolled in managed-care programs agree to see doctors within a limited network and receive additional benefits, such as preventative care and prescription-drug coverage. The current coverage crisis stems from rising delivery costs and limited government reimbursement, as doctors and hospitals increasingly balk at seeing Medicare HMO patients, since they aren’t sufficiently reimbursed for their services. Without enough doctors and hospitals providing care, an HMO can’t serve its members. The problem is worst in large urban markets, where more than half of Medicare + Choice beneficiaries live nationwide but where reimbursement rate increases have trailed rising costs since 1997.

To compensate for the funding shortfall, premiums for seniors retaining Medicare HMO coverage are expected to spike while benefits dwindle in the coming year. In California’s Sacramento-area, for example, monthly premiums for Kaiser Permanente’s Senior Advantage Medicare Plan will double from $40 to $80 starting Jan. 1st. Healthnet, following suit, is raising premiums 50 percent, from $40 to $60 per month for its Seniority Plus members in the area. Pacificare and Western Health Advantage, while holding monthly premiums at $50 in their Sacramento-area Medicare plans, will eliminate brand name drug coverage next year.

Across the nation, seniors caught between rising premiums and shrinking coverage will find themselves in a similar bind. Even those with Medigap policies will feel the squeeze. Medigap policies A through J, for instance, have minimum standard benefit packages, and the H, I, and J plans covering prescriptions have annual drug caps ranging from $1,250 to $2,000.

For the 30 million Americans with a Chronic Obstruction Pulmonary Disease (COPD) such as asthma, emphysema or cystic fibrosis – collectively the fourth leading cause of death in the US, however, help is available with Geriatric Services of America (GSA), a national community service organization based in Tempe, Arizona which provides direct help and support to older Americans suffering from chronic respiratory disease. Through its Respiratory Disease Control Program, GSA provides access to a comprehensive range of special medication benefits, as well as support and homecare services, which eliminates out-of-pocket expenses for patients with primary or supplemental insurance coverage.

Through GSA’s patient support center, nebulizers and respiratory medication are provided and paid for with free home delivery, conveniently packaged and ready to use. GSA handles all paperwork, and clinical Patient Care Coordinators work with doctors and insurance companies once a patient has enrolled in the Respiratory Disease Control Program. Patients can enroll themselves in the program; there is nothing to buy, and no enrollment or membership fees.

Currently, Medicare, AARP, Blue Cross, Blue Shield, and over 180 other insurers have special benefits for patients with respiratory disease. GSA provides access to these benefits, and coordinates all elements of care to help patients, doctors, and insurance companies combat respiratory disease.

At a time when US seniors face restricted health care access, rising premiums, and shrinking benefits, GSA stands out as a welcome ally for those needing respiratory medication benefits, support, or homecare services. For more information about GSA, or how someone you know can enroll in this special wellcare program, write to 4812 South Mill Ave., Tempe, AZ 85282; call 800-307-8048; fax 800-345-2425; or email Gary Rheault directly at grheault @ geriatricservices .com.

About The Author

Del Williams is a technical writer based in Torrance, California.

Respiratory Help Is Available For Seniors With COPD

Exercises for older adults- Balance Exercises Balance exercises build leg muscles and help prevent falls. Each year, U.S. hospitals have 300,000 admissions for broken hips, and falling is often the cause of those fractures. Balance exercises can help you stay independent by helping you avoid disabilities that may result from falling.
Safety tips for these excercises:
•    Hold onto a table or chair for balance with only one hand. As you progress, try holding on with only one fingertip.
•    Next, try the following exercises without holding on at all. Ask someone to watch you the first few times in case you lose your balance.
•    If you are very steady on your feet, move on to doing the exercises using no hands, with your eyes closed. Have someone stand close by if you are unsteady.
Side Leg Raises This strengthen muscles at sides of hips and thighs. Strengthening these muscles is important for good balance.
1.    1. Stand straight, directly behind table or chair, feet slightly apart.
2.    2. Hold table or chair for balance.
3.    3. Slowly lift one leg to side, 6 to 12 inches out to the side. Keep your back and both legs straight. Don’t point your toes downward — keep them facing forward. Hold position.
4.    4. Slowly lower leg. Repeat with other leg.
5.    5. Keep back and knees straight throughout exercise.
6.    6. Alternate legs until you repeat exercise 8 to 15 times with each leg.
7.    7. Rest. Do another set of 8 to 15 alternating repetitions.
Hip Flexion
This strengthens thigh and hip muscles. Strengthening these muscles is important for good balance. Use ankle weights if you are ready.
1.    Stand straight; hold onto a table or chair for balance.
2.    Slowly bend one knee toward chest, without bending waist or hips.
3.    Hold position for 1 second.
4.    Slowly lower leg all the way down. Pause.
5.    Repeat with other leg.
6.    Alternate legs until you have done 8 to 15 repetitions with each leg.
7.    Rest; then do another set of 8 to 15 alternating repetitions.
8.    Add modifications as you progress.
Hip Extension
This strengthens buttock and lower-back muscles. Strengthening these muscles is important for good balance. Use ankle weights if you are ready.
1.    Stand 12 to 18 inches from a table or chair, feet slightly apart.
2.    Bend forward at hips at about 45-degree angle; hold onto a table or chair for balance.
3.    Slowly lift one leg straight backwards without bending your knee, pointing your toes, or bending your upper body any farther forward.
4.    Hold position for 1 second.
5.    Slowly lower leg. Pause.
6.    Repeat with other leg.
7.    Alternate legs until you have done 8 to 15 repetitions with each leg.
8.    Rest; then do another set of 8 to 15 alternating repetitions.
9.    Add modifications as you progress.
Anytime-Anywhere exercises to improve balance
These improve your balance. You can do them almost anytime, anywhere, and as often as you like, as long as you have something sturdy nearby to hold onto if you become unsteady.
1.    Walk heel-to-toe. Position your heel just in front of the toes of the opposite foot each time you take a step. Your heel and toes should touch or almost touch.
2.    Stand on one foot (for example, while waiting in line at the grocery store or at the bus stop). Alternate feet.
3.    Stand up and sit down without using your hands.
To check your progress:
1.    Time yourself as you stand on one foot, without support, for as long as possible.
2.    Stand near something sturdy to hold onto in case you lose your balance.
3.    Repeat the test while standing on the other foot.
4.    Test and record your scores each month.
How much, how often?
Don’t do more than your regularly scheduled strength exercise sessions to incorporate these balance modifications – remember, it can do more harm than good to do strength exercises too often. Simply do your strength exercises and incorporate these balance techniques as you progress.
Source : National Institue of Health

Strength exercises build muscle as well as increase your metabolism, which helps keep your weight and blood sugar in check.
Safety tips:

•    Don’t hold your breath during strength exercises. This could affect your blood pressure.
•    Use smooth, steady movements to bring weights into position.
•    Avoid jerking or thrusting movements.
•    Avoid locking the joints of your arms and legs into a strained position. Breathe out as you lift or push a weight and breathe in as you relax.
•    Muscle soreness lasting a few days and slight fatigue are normal after muscle building exercises.
•    Exhaustion, sore joints, and painful muscle pulls are not normal.
An easy excercise routine
1.    Sit in a chair with your back straight.
2.    Keep feet flat on the floor even with your shoulders.
3.    Hold hand weights straight down at your sides with palms facing inward. You can use as little as one or two pound hand weights or you can substitute cans of soup. Some people start without weights. Arm raises.
4.    Raise both arms to side, shoulder height.
5.    Hold the position for 1 second.
6.    Slowly lower arms to the sides. Pause.
7.    Repeat 8 to 15 times.
8.    Rest. Do another set of 8 to 15 repetitions.
Chair Stands strengthen stomach and thigh muscles.
1.    Place pillows against back of chair.
2.    Sit in middle or toward front of chair, knees bent, feet flat on floor.
3.    Lean back on pillows in half-reclining position, keeping your back and shoulders straight.
4.    Raise upper body forward until sitting upright, using hands as little as possible — or not at all, if you can. Your back should no longer lean against the pillows.
5.    Slowly stand up, using hands as little as possible.
6.    Slowly sit back down. Keep back and shoulders straight throughout exercise.
7.    Repeat 8 to 15 times. Rest. Then repeat 8 to 15 times more.
Bicep Curls strengthen upper-arm muscles.
1.    Sit in armless chair. Keep feet flat and even with shoulders.
2.    Hold hand weights at sides, arms straight, palms facing toward your body.
3.    Slowly bend one elbow, lifting weight toward chest. Be sure to rotate palm to face shoulder while lifting weight.
4.    Hold position for 1 second. Slowly lower arm to starting position.
5.    Repeat with other arm. Alternate until you have repeated the exercise 8 to 15 times on each side.
6.    Rest. Then do another set of 8 to 15 alternating repetitions.
Source : National institute of health

Every year we hear stories of seniors falling, ending up in hospitals and never fully recovering. Unfortunately, these falls often result in death. According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury related deaths for seniors age 65 and older. Every year, approximately 35% to 40% of seniors over 65 years of age fall at least one time. The following are five ways to help reduce the risk of you or a loved one from falling:

1. Keep Indoor Pathways Safe- Remove throw rugs or use double sided tape to prevent rugs from becoming loose. Keep telephone and electrical cords out of walkways as well as items such as shoes, blankets and books. Move furniture out of walkways to ensure the path is clear. Always keep stairways free from clutter.

2. Review Medications- Visit with your doctor or pharmacist about the medications you or a loved one is taking. Some prescriptions and over the counter drugs can cause one to become drowsy, dizzy or unsteady. In addition, make sure to get your vision checked once a year to reduce the risk of falling due to poor vision.

3. Exercise Regularly- It is important to improve your muscle flexibility and strength to reduce the risk of falling. Balance and coordination are also important to help prevent falling, and these can be accomplished through regular exercise.

4. Add Safety Features to Bathroom and Bedroom- Install mats or suction cups in the bathtub. Place grab bars near the toilet, shower, and tub area, as well as bench or a stool in the shower. Consider using an elevated toilet seat to help reduce the risk of falling. In the bedroom, keep a lamp or light switch that can be easily reached without getting out of bed. Use night lights in the bedroom, bathroom and hallways.

5. Improve Outdoor Walkways- Paint the edges of outdoor steps, especially steps that are narrow or are higher or lower than other steps. Paint outside stairs with a mixture of sand and paint to help with traction. Keep walkways well lit and clear from debris, snow and ice.

In addition to keeping the home safe from hazards, always try to maintain good health and exercise habits. It is important to wear rubber soled shoes that fully support your feet. Furthermore, limit the consumption of alcohol, and use walking devices such as a cane or a walker if extra support is needed. By reducing the risk of falling, one is increasing the chances of living a happy and safe life.

—————————————————————————You have permission to use this article as long as the author’s full bio is present as well as any hyperlinks to author’s website.

Torey Farnsworth has over 12 years of experience working with seniors. Ms. Farnsworth’s vast expertise encompasses a wide variety of senior issues ranging from adult care to elder law. Her legal experience includes long term care planning, estate planning, ALTCS eligibility and Medicaid planning. Ms. Farnsworth is also a certified caregiver with the State of Arizona as well as a Certified Senior Advisor. Ms. Farnsworth has spent her career in senior care as her family owns and operates assisted living homes.

Ms. Farnsworth owns and operates a senior care placement business in Arizona called Horizon Senior Care Referral. Her placement services are free to seniors and their families. For information on placement services in Arizona, visit http://www.adultcarecentral.com

Senior Living: 5 Ways to Help Reduce the Risk of Falling

Q: I hate Alzheimer’s disease, not only has it robbed me of my husband, but it has taken my life too! I feel like all of my friends have disappeared. I am lonely, and that makes me feel guilty. Help!

A: What you are describing is very typical for caregivers. No one seems to understand! Your world seems to get smaller and smaller as you care for your loved one.

In order for you to continue caring for your husband you need to get some rest and take care of yourself, and more importantly reach out to others. I know, I know easier said than done.

There are many options for you. The key is to pick something and do it.

Do something for yourself. It is very easy to give all of your attention to the person whom you are providing care for and neglect your needs.

1. Get a manicure

2. Go see a movie

3. Go for a walk alone

4. Try to take a nap, when your loved one is sleeping. Even though it takes up time you have to get other things done.

5. Buy yourself a magazine

6. Take a bubble bath

7. Go to a spa

If you are lonely you should avoid isolating yourself. Perhaps your friends have left because they didn’t know what to do to help, simply because you didn’t ask them. If you feel uncomfortable asking for support start with small things and work up to bigger ones.

1. Try inviting a friend to coffee or tea

2. Ask a friend to stay for an hour while you take a bath, read a magazine, or go for a walk alone.

3. Call a local senior daycare program and arrange for your loved one to go there once a week. There are programs available in almost every city.

4. Contact a local Alzheimer’s support group in your area. These people do know what you are going through.

If you are truly burnt out and at the end of your rope, you should check into long term care for your husband. If you cannot continue to give him quality care, or if your health is deteriorating you may need to look at some alternatives.

Renee “Dutchy” Reeves is an Elder Care Consultant with over 10 years of working with the elderly and their families. Her online advice column, “Ask Dutchy” provides practical ideas and advice for assisting the elderly with Alzheimer’s disease, Dementia, Parkinson’s, disability, and those needing long term care.

Feeling Lonely?