Christy Fricks' Health & Medical Journalism Blog

Fresh Air and Sunshine are Good For You!

2008-04-24T09:22:00.001-07:00

Does the mere act of going outside every day confer a health advantage? Researchers have long touted the benefits of exercise for older adults, but what about simply remaining active I daily life? In 1990 researchers at the Haddasah Hebrew Medical Center in Israel decided to answer this question.

They randomly chose 528 ambulatory residents aged 70 or 71 to participate in the study. 348 complete the 12-year data collection. Participants recorded the frequency and length of their outings and intermittently answered questionnaires about their health condition.

The results of the study showed that--yes: participants who go outside daily suffer fewer physical complaints and less of a decline in general health. While women went out day less than men, they still received marked health improvement from the activity.

The study did not trace the reasons the seniors went out, but did suggest that purpose driven activity had further reaching positive repercussions on health. In future studies they plan to research this aspect. Furthermore, the authors suggested that senior living facilities, whether at home or in communal settings, should be modified to encourage daily outings.

Going Outdoors Daily Predicts Long-Term Functional and Health Benefits Among Ambulatory Older People.By: Jacobs, Jeremy M.; Cohen, Aaron; Hammerman-Rozenberg, Robert; Azoulay, Daniel; Maaravi, Yoram; Stessman, Jochanan. Journal of Aging & Health, Apr2008, Vol. 20 Issue 3, p259-272, 14p.

Non-linear data about nursing home staff turnover

2008-04-23T10:39:00.000-07:00

Not surprisingly, high staff turnover in nursing homes is associated with poor quality, according to a study published in the October 2007 issue of Gerontologist.

The more interesting part of the research articled, “Nursing Home Staff Turnover: Impact on Nursing Home Compare Quality Measures,” is that the relationship between turnover and quality might not be linear.

While reducing staff turnover from high to medium resulted in significant improvements, it was not clear that a similar quality change resulted from further reducing it from medium to low rates.

The authors investigated 2840 nursing homes in 2004 using 14 indicators of care quality from the Nursing Home Compare website, a reputable source for nursing home information.

What does this study mean for nursing homes? Nursing homes inherently rely on employees to provide care for their residents, thus staff turnover rates have long been hailed as a hallmark of quality.

The authors suggest that staff turnover should be more closely managed. But because not all staff positions affect nursing homes in the same way, and because the association between turnover and quality is non-linear, how information about turnover rates are presented to the public should be carefully considered.

An Interview with Bill Flatt, D.W. Brooks Distinguished Professor Emeritus

2008-04-23T09:49:00.000-07:00

Bio
Dr. William (Bill) P. Flatt is a D.W. Brooks Distinguished Professor Emeritus in the Foods and Nutrition Department and the Department of Animal and Dairy Science. He taught Human Nutrition and Animal Nutrition, and is currently actively engaged in energy metabolism research, particularly as it relates to obesity. He was the Editor of The Professional Animal Scientist (PAS), a national refereed applied animal sciences journal published by the American Registry of Professional Animal Scientists (ARPAS). He was also the Southeast Regional Associate Editor of the American Society for Nutritional Sciences Nutrition Notes. Bill was named a Senior Teaching Fellow, one of eight University of Georgia faculty appointed for FY 1997.

Interview

Bill Flatt is one of the most interesting and inspiring characters that I met while researching an article on exercise and aging. He has made tremendous improvements in his health over the years and frequently speaks about the process.

Below is an interview I conducted, after attending one of his lectures to an undergraduate fitness class:

In your class lecture you said you started working out at home: What motivated you to attend your first group class?

I was invited by Dr. Sylvia Hutchinson, the LIR Coordinator for Dr.
Cress' Strength Training class in 2003 to take the class. I had already
been working out alone, both at the Ramsey Center and at home, but this
seemed like an ideal opportunity to learn proper techniques for using
equipment and exercising.

What kept you going back? Friendly instructors? good music? quality instruction? social aspects?

All of the above. Dr. Cress is an exceptionally outstanding instructor,
and the KINS students have all been great. They are really interested
in helping us learn about how best to be physically fit. The
instruction is high quality, and the social interactions have been
especially good.

Can you tell me about the social aspects of group fitness?
New friends? interesting people?

The social aspects of group fitness are a major benefit. I have become
well acquainted with a number of older adult retirees as well as with
the undergraduate and graduate students. They are VERY interesting
people from a wide range of backgrounds, experience and interests. It
has been fun!

Why do you think older adult fitness classes, like Dr. Cress's are so popular nowadays?

Because they are so much fun and are exceptionally effective in helping
older adults increase their physical fitness. The class activities are
beneficial, and we receive positive feedback about improvements. Dr.
Cress' class is the most popular LIR class, and is the first to fill to
capacity each time it is offered.

Balance-Use it or Lose it

2008-04-22T15:03:00.000-07:00

Balancing is an art most of us learned so long ago that we take it for granted. I was reminded of this the past couple of weeks while trying to teach my five-year-old son how to ride a bike without training wheels. He fell over and over again--during the many days and hours of trials--hopping back up happily each time.

Watching him, I was amazed at his tenacity and the beauty of the human body to recover and learn.

For me or for many of my elders, even one of the falls he experienced might have lead to a disabling injury; broken ankles, knees, arms or even hips.

But thankfully, we already have good balance, or do we?

As we get older a number of things can knock us off balance, so to speak. We experience a decline in muscle mass, changes in posture and vision. Medical conditions such as stroke, arthritis or even the medication that we take can affect our ability to remain upright. Many of these things can happen so gradually that we may not even notice ourselves becoming unsteady.

This is not an inevitable process. Regular exercise is required for older adults wanting to maintain their equilibrium exercise, but not necessarily riding bikes.

Tai chi is one workout proven to be particularly safe and helpful. Tai chi is a form of Chinese martial arts that involves a series of slow gently movements designed to improve strength, balance, and coordination.

A study published in the February 2005 edition of Geriatrics showed that regular Tai chi practice reduces fall in older adults by improving functional balance. The dance-like movements are coordinated with breath-work and mediation: a much more serene way to practice balancing that we did when we were kids.

Geting Quotes and FOIA Fridays

2008-04-03T11:42:00.000-07:00

I've never had any trouble getting people to talk. I have that kind of face or something. People like telling me their stories and I usually like hearing them.

But last semester I tried to write several stories about the local Veterans Administration health care system. I say tried, because I had a hell of a time getting access to information, and to people.

I learned a lot, the hard way. So I was hoping that the AHCJ panel on Getting Quotes would give me some new information.

There were a lot of fun war stories going around about 'the quote that got away' etc...

But the best thing about the workshop: learning about FOIA Fridays. Seth Borenstein of the AP is responsible for instigating this little fad. The idea is that every Friday journalists should try to submit at least one Freedom of Information Act request to a government agency on a subject they think will make a good news story. By exercising our rights maybe they’ll actually get used to responding.
(Seth will even provide you with a generic FOIA letter if you email him at sborenstein@ap.org)

Seth began by reminding us that, “no matter what the history, I always start out assuming the agency will be helpful and cooperate.” This is advice that several panelists reiterated.

Many of them recommended that reporters should be open and honest about what you are doing and why you are asking questions. Other advice was to build a relationship with your local officials. Let them know that you are serious and most of all, understand that some non-response is just miscommunication or individual problems.

That being said, persistence is key!

p.s. Seth also has a list of Escalation tools and Colombo tricks that he promises to email anyone who asks.

Show Me the Money!

2008-04-03T11:41:00.001-07:00

A good journalist can dig up just about any information. I love that about my colleagues.

At the, “How to Track Lobbying Money,” panel at AHCJ Paul Singer started Googling websites as fast as we could jot down the addresses. He showed us several databases where the money, “hides,” like FEC.gov or, lobbyingdisclosure.house.gov. The majority of them he found by simply typing in Lobby Disclosure Act of Secretary of Defense.

There is so much information out there that he gave us interesting tips on using Excel spreadsheets to compile, track and look for trends in things like, earmarks.

Here is an earmark database: http://earmarks.omb.gov/

What is an earmark you ask?
The U.S. Office of Budget and Management defines them as this: “funds provided by the Congress for projects or programs where the congressional direction (in bill or report language) circumvents the merit-based or competitive allocation process, or specifies the location or recipient, or otherwise curtails the ability of the Executive Branch to properly manage funds. Congress includes earmarks in appropriation bills - the annual spending bills that Congress enacts to allocate discretionary spending - and also in authorization bills.”

Yeah, so earmarks are what the lobbyists are lobbying for. At the bottom of every bill that is passed there is a list of earmarks. There can be thousands of earmarks on a bill. The earmarks determine how much money is spent, where and on what.

And, did you know that pharmaceutical companies have spent more money on lobbying than any other Industry?
http://www.pharmalot.com/2008/02/the-big-spenders-tracking-the-lobbying-dollars/
http://www.lobbywatch.com/

Armed with all this useful information, I was pretty excited to go home and start digging around on the Internet. Until the last member of the panel Dan Boston, an actual lobbyists, began speaking. “Earmarks are kind of baby dollars,” he said. He used the analogy of an Onion, and pointed out that this is just the 1st layer of information when you are tracking lobbying money. He cautioned us to “keep money in perspective,” and told us that there are, “things that won’t ever be reported,” such as: crisis communications firms, public relations, grasstop firms, etc.

How can you track the money that isn’t reported? You have to get someone to talk.

Speed Dating for Freelancers

2008-04-02T18:37:00.000-07:00

This year, for the first time ever the Association of Health Care Journalists offered a pitchfest at their annual conference. Attendees had 7 minutes to pitch story ideas to editors of Health, WebMD, USAToday, Shape, Prevention, New York Times, Los Angeles Times, Scientific America, MSNBC, and the Washington Post.

Sign-up was first come first served via the AHCJ website prior to the conference, with a few places reserved for onsite registration the morning of the event.

I decided to try it. I signed up to speak with WebMD, Health and USAToday. (Mainly because those were some of the only time slots available by the time I decided to do it.)

About a month before the event I began preparing: brainstorming ideas, researching the places I’d chosen to pitch to, freshening up my resume and copying some of my favorite clips.

For each editor I prepared 3-5 ideas, with a paragraph describing each, thinking they would want a written copy of them. So Friday afternoon of the conference, a half hour before my appointment with WebMD, I took one last look at my pitches and tried to print them out.

It was futile. I ran out of time fighting with the hotel printers. So I arrived 2 minutes late, out of breathe for my first interview, with no “cheat sheet” to pitch my ideas from.

Imagine me sitting in my new business suit, sweating, stuttering, dropping my papers on the floor, spitting out my ideas in a rush, shaking nervously...yeah, it was an awesome moment for me.

The editor was polite enough. He liked a couple of my ideas, the ones I actually managed to tell him about, gave me some hints and filed away my card before the minder rang the timer at 7 minutes.

I left discouraged and a little defeated, dreading the next interviews. During the hour and a half before my next interviews I managed to rally.

Chatting in the hallway with the other journalists that were pitching helped a lot. Many of them had signed up for all 6 organizations and there was a wide range of experience among us. But, very few had ever been to a pitchfest. We were all excited at the prospect of selling a story idea, and many of us were nervous.

The second and third interviews went much smoother. I was relaxed and actually spent some time talking with the editors. At first I was a little baffled by how quickly they decided whether an idea would work or not. But later I realized that they simply knew their publications quite well.

The editors all gave good feedback on how to frame my stories, so that the next time I pitch to their publication, Ill have a better idea what the want.

Overall it was a good experience and I’m hoping to do it again next year. Of course, the best part was that I actually sold a story!

Blogging from Health Journalism 2008 Conference--Panel: How to Cover Nursing Homes and Other Long-Term Care

2008-03-29T11:58:00.000-07:00

“Only 5% of nursing homes in the U.S. have adequate staffing.”—Charlene Harrington, Ph.D., R.N.

The statistic Harrington gave us was staggering. I walked away from the panel on, “How to Cover Local Nursing Homes and Other Long-Term Care,” with a profound disgust with the nursing home industry, a renewed respect for the work of my journalist colleagues, and a new set of tools with which to pursue my own investigative articles.

Harrington, who began investigating nursing homes in 1975, said that since that time, “very little has changed.” The things that haven’t changed, are the abysmal conditions found in long-term care facilities.

She cited weak regulatory oversight and lack of enforcement as the main reasons that nursing homes continue to operate under substandard conditions. Quite often a nursing home will be cited and fined repeatedly for such offenses as letting a patient die of dehydration. Shockingly, after being penalized they are still allowed to operate, almost always without making any corrective changes.

Staffing is the most urgent change that is needed. In nursing homes, “there has been a 25% drop in RN’s since 2000,” said Harrington.

On the practical side, panelists Lisa Chedekel, Charles Bell, and Charles Duhigg supplied the attendees with several tools to begin researching our own local nursing homes.

Items such as the Nursing Home Quality Monitor, issued by consumer reports, provide a basic place to begin. It lists better and worse nursing homes by state.

There is also an item called a CMS-2567 Inspection Report that should be posted and accessible in the lobby of all nursing homes.

All of the panelists have been involved with inspiring work to help communicate the largely ignored issue of long-term care facilities. Obviously, much more publicity of the problem is needed. But, ultimately, Harrington said that her hope lies with the next generation, “the baby boomers are coming and they are not going to put up with what we allowed for our parents.”

Silver Sneakers-A New Fitness Niche

2008-03-23T19:33:00.000-07:00

Researchers have long touted the benefits of exercise for aging adults. But, they remained baffled as to how to encourage more of them to get moving. Now insurance companies, looking for ways to reduce healthcare costs, are offering incentives to seniors who attend certified fitness programs at local gyms. Apparently the gamble may be paying off.

A recent study published in January of 2008 in the Journal of Preventing Chronic Disease, showed that regular participation in an insurance sponsored health club benefit program called Silver Sneakers was associated with slower growth in total health care costs in the long term, but not in the short term.

Healthways, the company that founded Silver Sneakers partners with local gyms to offer their brand of older adult fitness programs.

Insurance companies participating in the SS health plan, then offer their insured incentives to participate: including free access to local fitness centers and classes that are part of the program.

Here in Athens SS classes are offered through both the local Senior Center and the YWCO.

The University of Washington study, “Managed-Medicare Health Club Benefit and Reduced Health Care Costs Among Older Adults,” included approximately 5000 older adults over a two-year period participating in the program. Their healthcare costs were compared to a group of people of the same age, gender and geographical location who were not in the program. Funded by the Centers for Disease Control and Prevention, the positive results of the research are certain to increase the popularity of the SS fitness program, at least among insurers.

How hard is it for you to get to the grocery store?

2008-03-07T09:22:00.000-08:00

Eat better, live well. Even for people that have the proper nutritional information it can be hard to do. But what if just getting to the grocery store is a challenge?

For many older adults, access is the greater part of the battle to eat well. That is the topic of several articles I've read recently which looked at the availability of healthful foods to older adults living in rural areas.

Most of us know that many elders lack personal transportation; they can't drive, they don't own a car or the one they do have has become too expensive to maintain. And of course, in rural areas, public transportation is limited or non-existant. Without transportation the closest store will be the one that you are forced to shop at.

These studies have proven, what we all know. Convenience stores are more expensive and have fewer healthy options like fresh fruits and vegetables. Some grocery stores are more expensive than others. If you had $50 to spend on your food for a week. would you rather shop at Earth Fare, Kroger or Wal-Mart? The cheapest grocery stores don't have the most healthy options.

One of the new and interesting things that these studies have explored is the distance and frequency of different types of grocery stores. They've found that there are more convenience stores than grocery stores in rural areas. And that the distance to the grocery stores is often much greater for rural adults.

Availability of Healthful Foods in Rural Areas: A Challenge to Older Adults. By: Bustillos, Brenda; Sharkey, Joseph R.; Anding, Jenna; McIntosh, Alex. FASEB Journal, Apr2007, Vol. 21 Issue 6

Community Food Resources and Chronic Disease: Objective Measures and the Perceptions of Older Adults in Rural Areas. By: Sharkey, Joseph R.; Horel, Scott A.; Li Zhu; Burdine, James N.. FASEB Journal, Apr2007, Vol. 21 Issue 5,

Eat Well Live Well: Mary Ann Johnson, PhD., Prof. Foods and Nutrition

2008-03-07T08:23:00.001-08:00

The old Food Pyramid and the new.

Mary Ann Johnson laughs when she talks about the latest version of the U.S.D.A. food pyramid. Johnson is a professor of Foods and Nutrition at the University of Georgia. But what she is best known for, is translating complex nutritional information into easy to understand meal plans.

In addition to teaching classes, Johnson works primarily with older adults aged 70 and above. She partners with federal and local government agencies and other nutritionists at the University of Georgia, to create and implement nutrition plans through senior centers.

So it’s understandable that she would laugh about the food pyramid. The latest version from 2005 does presents a better nutritional balance, but it is confusing and hard to read, and that’s putting it lightly.

Here are some excerpts from our recent interview in February:

Q: So how do you choose what to eat?

“It’s very very challenging. And we don’t think that now people are going to be perfect about their diet. Nobody knows how they are supposed to eat. And so people with diabetes, especially with what you have to give up--a lot of stuff-- it’s the balance of the meal. We are just trying, not matter what their age group, we just want to move people closer to better meals.”

Q: How are you doing that?

“Ill show you!” *Johnson pulls out a binder with lessons plans* “ So we have this graphic with color called “plan your plate” with your protein foods your non-starch vegetables, your starchy vegetables, it’s not complicated. This is fabulous for children for adults for anyone!”

Q: Who do you develop these plans for?

“We are a non-medical model; so, most of our programs are developed for people at senior centers. But we develop them in such a way that the materials could be used by a wide range of educators and appeal to a wide range of older people.”

Q: What are the differences in nutritional requirements for older adults, young adults and children?

Actually, there are many many more similarities than differences. Everybody should be eating some vegetables, everybody should be eating protein, and you should have milk or dairy foods, whole grains… It is just a little different in the details. An in-active older person would need way less calories than an active teenager
And there are a few unique nutritional needs of older people; Calcium and Vitamin B-12 are a little harder for adults to get for some reason.
Most nutrient recommendations are pretty much the same. It’s really more about the quality of food, meeting their energy needs and not exceeding them. That is important at any age.

Q: Why nutrition and aging? What do you like about this field?

Where I work in nutrition, you can see the results of your work very quickly. I’m involved with developing the programs, to going across the state. And I like the partnership that we have. I’m connected into a pool of minds and young workers. We have a great workforce. At the state and federal level they see what the needs are and they have a broader vision of what we should work on. We take big ideas from the federal and state government and work it out into real programs!

Live Well Age Well
Mary Ann Johnson co-created this website

Good news for Snackers!

2008-02-24T16:52:00.000-08:00

The older you get, the more you should snack. At least according to one article published last Spring in the Journal of the American Dietetic Association.

Adults aged 65 and older often have trouble consuming enough calories in a day. Eventually, not eating enough begins to contribute to an overall lack of energy. It creates a cycle; the more tired they get, the less they want to prepare meals.

Looking for an answer to this problem, researchers examined information from the U.S. governments 2002 National Health and Nutritional Examination Survey.

They found that older adults were more likely to snack at least two or more times during a day. At first glance that might seem like a bad thing, given all the current headlines and fears about obesity..

But, for older adults, snacking is good. 84% of older adults in this survey snacked. The snackers had significantly higher daily intakes of energy, protein, carbohydrate, and total fat compared to the non-snackers.

Citation: Benefits of Snacking in Older Adults. Journal of the American Dietetic Association, Volume 107, Issue 5, May 2007, Pages 800-806
Claire A. Zizza, Francis A. Tayie and Mark Lino

Disparities in Ownership of Preventive Health Equipment

2008-02-17T14:03:00.000-08:00

Diabetic older adults, living in rural areas tend to lack the equipment to self-manage their diabetes, confirmed an article published in Fall of 2007 in the Journal of Rural Health titled, “Ethnic and sex differences in ownership of preventive health equipment among rural older adults with diabetes,” by Ronny Bell, PhD.

Diabetes is a disease that is managed, not cured, and the bulk of responsibility for treating the disease lies in self-management. While doctors diagnose the disease and prescribe medication, diabetics must still work to maintain consistent, proper, levels of sugar in their blood through a combined regimen of diet, exercise and often medication.

So, not having the right tools, puts rural older adults at greater risk for complications such as: blindness, kidney failures, and foot ulcers.

The blood glucose monitor is the most basic self-management tool of the diabetic, enabling them to test their own sugar levels throughout the day to determine whether they need to alter their diet, medication or activity levels. Other tools include pillboxes, home exercise equipment, kitchen aids, special socks and even hand-held mirrors for examining their feet.

While many studies have looked at the degree of self-management in older adults with diabetes, this is one of the first to look at the availability of the equipment to perform these tasks.

The study found that 85% of older adults had access to blood glucose monitors, an item that is covered by Medicaid, but that the rate of ownership of the other items for self-care varied widely.

As the study expected, there was some correlation between equipment ownership and ethnicity, living arrangements, mobility, poverty status, and formal education. Overall the study showed a need for health care providers to be aware of barriers to self-management such as a lack of access to equipment.

A full text version of the article can be found here.

Chatting with M.Elaine Cress Ph.D, Associate Professor Department of Kinesiology and Institute of Gerontology

2008-02-06T09:30:00.000-08:00

After interviewing Anne Glass at the Institute of Gerontology, I headed to the Ramsey Center to talk with Dr. Elaine Cress.

Cress is a professor in UGA’s department of Kinesiology with a half-time appointment at the Institute of Gerontology. Her expertise is in Exercise Physiology, Aging and Physical Performance and her research utilizes the "Continuous-Scale Physical Function Performance Test" which she developed and which is currently used in 10 countries, according to Cress’.

I arrived early, expecting a quiet office interview, and soon found myself a guest in Cress’ afternoon class.

Her bi-weekly Exercise and Aging practicum is an intergenerational class. It pairs 15 undergraduate seniors and juniors in exercise physiology with older adults from the Learning in Retirement program. Under the watchful eye of Dr. Cress, the students work one-on-one assisting the older adults with strength training exercises.

“I couldn’t watch 15 students all the time, but they (the younger students) can work with them and watch them one-one-one and at the end of the semester I have a big ol’ potluck and invite all the students” said Cress. The class just has a whole intergenerational component that is really really cool.“

In fact, as I watched the class get into a circle for their warm-up before lifting weights, there was a definite happy buzz. The undergraduates were talking and laughing with the older adults while they went through a series of gentle stretches, arm circles and danced the grapevine together.

As a dance teacher who has worked with a variety of age groups myself, watching Cress’ class was an inspiring experience for me. Here are some excerpts from my visit:

Can you tell me a little bit about the importance of strength training for older adults?

“We lose muscle mass as a part of the aging process, and that’s exacerbated by the fact that most of us become more and more sedentary, have skeletal problems or other diseases. And if we are physically active, it is not necessarily working systematically all the muscles.”

When you say we lose muscle mass what does that actually mean? Does that mean your muscles are shrinking or that they become weaker?

“We actually lose muscle, the mass, so our weight that is attributable to muscle goes down. So For people who’s weight is staying the same, they are losing muscle. So if their weight is staying the same what they are weighing is fat.
“Its not like muscle converts to fat, I wouldn’t want to say that. But as you age even if your weight is staying the same you have less muscle mass.
“When we have less muscle mass we have less strength. And people as they get older they have more and more trouble doing things that we do in everyday life like climbing stairs, carrying groceries, and carrying grandchildren. Without a systematic effort to work all the muscles on a regular basis and progressively overloading the muscles, then what we do in every day life becomes closer and closer to what is our top possible thing to do.”

Would it be correct to say that your capacity is shrinking?

“Yes your capacity is shrinking but what you do in every day life stays the same, but as those get closer and closer together your physical reserve dwindles and then what your having to do on a day to day basis gets more and more hard, So everyday life becomes harder. “So by doing strength training what you have to do everyday becomes easier you have to do is set aside some time to do something that is hard.

But obviously, strength training is not available to everyone?

That’s part of our problem.

Talking with Anne Glass, Ph.D. Assistant Director, Institute of Gerontology & Associate Director, Georgia Geriatric Ed. Center

2008-02-04T14:00:00.000-08:00

Anne P. Glass, Ph.D.
Assistant Director, UGA's Institute of Gerontology

“There are roughly 70000 people over the age of 100 and by the year 2050 there could be as many as 850 000 to a million, So that’s huge and we as a country are not prepared for that.”—Anne P. Glass, Ph.D.

Last fall, Dr. Glass, visited our Health and Medical Journalism class and presented information about UGA’s Institute of Gerontology and the health disparities faced by older Georgians. She also discussed the aging of Georgia's population and the health challenges it will present.

Looking at some of the statistics that she brought to class such as:

-38% of older Georgians live below of within 200% of the poverty level
-The number of older Georgians is increasing at nearly twice the national rate
-Georgia has the 5th highest percent of African American Medicare beneficiaries
-Increase in 65+ population is projected to be the 5th highest in the nation between now and 2020

The information was striking enough that she was first on my list of people to interview this semester.

Dr. Glass is one of three full faculty members at the Institute. She received her certificate in Gerontology from UGA and later returned to work there as assistant director and graduate coordinator.

Her research interests include end-of-life care, long-term care, housing and community/non-kin care giving and cross-cultural comparisons. In addition to her research she teaches several classes including a Seminar on Aging. And she is currently organizing a March 16^th conference here at the University on “Improving End of Life Care for Frail Elders.”

Recently the Institute of Gerontology received a three year grant from the federal government to found the first Georgia Geriatric Education Center. Through the GGEC, Glass is working with other Gerontologists to develop training modules for health care professionals across the state with the hopes of improving care for our elders.

Here are some excerpts from my recent interview with Glass:

So, how are you helping to prepare us here at the Institute for the aging of the population? What are some of the projects that the Gerontology Institute is working on?

“There’s a lot going on actually! The ways that we would be helping through here is by educating UGA students. I actually got my certificate in Gerontology here and ended up coming back here.

“And that’s a great program and we can take students who are working on a graduate program and we can also take students just for a certificate.”

“One of the things we do in the first course, which is a seminar on aging, and that, is an overview.”

“We do things like the aging simulation. That involves goggles with Vaseline, earplugs all kind of stuff to capture what it’s like give you an idea of what …experience and they have to try using a walker to get into a bathroom.”

“We also have a dementia simulation too. Part of it is also taking them to different parts of the building here and In the way that is sometimes done in a nursing home where they say “just sit there honey and Ill be right back, rest there” and then they leave them in the hallway to sit and then walk by as if they don’t see them.”

“So it really gives them some insight into what it is like for people in nursing homes.

“But a second major thrust for us now is the government has funded us as a Geriatric education center.”

What does that mean to be a geriatric education center?

“They’ve been around for several years but Georgia has never had one before. The goal of the Georgia Geriatric Education center is to provide training in Geriatrics and Gerontology to health care professionals, physicians in particular but really all types of health care workers including nurses and social workers.”

As part of the GGEC the Institute has been developing online training modules; how will these be available?

“Some of the training will be available online, some of it will be done through conferences and doing sessions with physicians offered services, the training modules will be used by faculty and we want them to be widely available, we are targeting medically underserved and rural areas…”

And since the Institute is small who is actually developing them?

“In the GGEC we are currently are partnering with Mercer University, and they have a very outstanding geriatric program there, as well as a palliative care program.”

Palliative Care?

“That’s a whole another story! I’m organizing a conference on improving end of life care for frail elders and that is one of the things I want to press there.

“There is hospice, and then there is palliative care which is broader and it’s becoming more and more used, that term, and it sort of means “make people comfortable.”

“Hospice is structured right now, the way reimbursement is set up is so that you kind of have to give up on curative care to get hospice and the idea would be that over time you would be able to do some of the palliative care, comfort things without giving up your curative care.

“So what a few hospitals in the country have started doing is to have a palliative care consult in the hospital. So that’s one of the things I hope to showcase this at these conferences.

You are also interested in the idea of co-housing. Can you tell me a little bit about that?

“What that’s about is taking the idea of co-housing and applying it to elders. It’s designed to facilitate community. The whole co-housing thing started in Denmark and in Europe and was bought over here probably in the 1970’s and intergenerational co-housing spread around the country

“I’m interested in that, because when you look at who is going to take care of all these centenarians and the people in their 90’s and 80’s, the typical caregiver is the middle aged, 25-39, and that age group’s population growth is going to be very flat for the next few decades whereas the older population is going to be going up.

Conversations with UGA's Institute of Gerontology

2008-02-04T09:23:00.000-08:00

Every so often I am fortunate enough to meet someone personally inspiring in an interview, or I come across a story that is just waiting to be told. I was fortunate enough to walk away from the two such interviews last week, excited and eager to sit down and write.

Anne Glass and Elaine Cress both work for UGA's Institue of Gerontology, their teaching and research deals with aging: the aging of the population, the aging of our workforce, how to take care of our elders, who will take care of our elders, disparities in health care for the aging, and how to maintain and improve physical health as we age.

Of course most of us don’t thing of aging as an exciting topic--most of us don’t like to think of aging at all. But, if Glass and Cress have any influence, then aging will be a much more pleasant experience for us all.

Senior Citizens & Drug Addiction

2008-01-22T13:14:00.000-08:00

Senior citizens and chemical dependency; these are two phrases you probably haven’t seen together. Drug addiction is usually portrayed as a malady of youth. However the increased potential of two formerly not-on-the-radar senior health issues--chemical dependency and sleep disorders--to further challenge rural senior’s health care was the topic of a recent article, “Chemical Dependency and Sleep Disorders,” in the December 2007 issue of Rural Roads, a journal of the National Rural Health Association.

As the article points out, the goal of most rural hospitals is to provide a wide range of community services, the majority of which contribute to the financial health of the facility.

This broad approach to rural health means that screening for behavioral health problems such as sleep disorders or chemical dependency are considered, “specialty services” for older patients.

On average, seniors tend to sleep less than younger adults. They also have problems with early morning wakening rather than problems falling asleep. So it is not surprising that there is a misconception that disturbed sleep is a normal part of aging. As a consequence, insomnia and sleeplessness due to depression are often overlooked in primary health exams.

Chemical dependency is also overlooked. Up until now alcohol and drug addiction tended to decrease with age. But studies predict this will change. There will be as much as a “29% increase in the risk of development of substance abuse disorders in the boomer generation compared to the current generation of seniors,” according to the article. Reasons for this include both the general aging of the U.S. population and what the article details as baby boomers “unprecedented early exposure to alcohol and drugs.”

Increased screening and improved treatment options may soon be available. The American Medical Association’s released new Current Procedural Terminology (CPT) codes for the screening and intervention of substance abuse this January.

These new codes will not only raise awareness of the need for screening for these issues, but will potentially make reimbursement available to primary care physicians who provide these services, according to the author, Robert Cuyler, PhD., the vice-president of Diamond health care. Ultimately the importance of all this is that it increases the range of senior health available in rural medical settings.

http://www.nrharural.org/