Category Archives: Geriatrics

Improving Home and Community-Based Services for People with Dementia

Over the past 25 years, significant strides have been made in shifting services for people with dementia and Alzheimer’s disease to home and community settings. Home and community-based services (HCBS) enable people with various forms of dementia to receive care in a familiar setting while promoting their independence, well-being, and overall quality of life. As… Read More »

Pandemic Aging in Place Services: A Silver Lining for the Silver Economy

By | March 16, 2022

When COVID-19 forced sudden lockdowns in 2020, Americans realized quickly that the supply of services available at home did not match growing quarantine demands. Both the public and private sectors responded with shifts to delivering contact-free services. That pandemic shift may have long-term benefits for older adults seeking services to support aging in place. Pandemic… Read More »

Nursing Home Characteristics and COVID-19 Outcomes: The Evidence is Mixed

By | December 17, 2021

COVID-19 has severely affected nursing homes. As of now, over 139,270 residents and 2,155 nursing home staff have died from COVID-19. This post provides insight on the questions researchers are asking to understand the impact of nursing facility factors on COVID-19. A Perfect Storm The combination of a frail, aging population, close living quarters, and… Read More »

Blood-Based Biomarker Tests Address Unmet Need in Alzheimer’s Disease Care

By | September 1, 2022

The Alzheimer’s Association’s 2021 Alzheimer’s Disease Facts and Figures report [PDF] shares that currently, six million Americans are living with Alzheimer’s disease, a number that has increased 145% since the turn of the century.  Around the world, there are 50 million people living with Alzheimer’s disease or related dementia. Only a quarter of would-be patients… Read More »

How to Reduce Medicaid HCBS Disparities Using an Assets Framework

Long-term services and supports (LTSS) for older adults and persons with disabilities have become a policy priority. The American Rescue Plan and the proposed American Jobs Act aim to increase LTSS spending through the Medicaid program, particularly for Home- and Community-Based Services (HCBS). These measures would address the need for wider service availability, while presenting… Read More »

Becoming dementia friendly: Less stigma, more inclusion, better care

By | November 11, 2020

With a growing recognition of the toll that dementia takes on individuals, families, and communities, there is a movement to prepare our society to better meet the needs of people living with dementia. This movement is referred to as becoming “dementia friendly,” and it can reduce stigma, increase inclusiveness, and improve care. A family example… Read More »

There is still much we don’t know about dementia and wandering

By | November 4, 2020

John bowled in a Friday night league for 20 years. It was often the highlight of his week – a chance to spend time with friends, blow off some steam, and enjoy some friendly competition. Now 75 and living with dementia, John has tried more than once to walk to a bowling alley that no… Read More »

Potential effects of COVID-19 on health care utilization and quality measures

What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is… Read More »

Timing is Everything: Defining the Serious Illness Population for Palliative Care

The current healthcare system is not built for individuals with serious illnesses. These individuals can benefit from palliative care, which focuses on quality of life and symptom relief. Alternative payment models that incorporate palliative care are in development. Yet, the challenges of expanding these models of care are substantial. Betsy recently died after a sixteen-year… Read More »

What contributes to inappropriate antipsychotic medication use?

By | October 18, 2019

Inappropriate antipsychotic medication use among older adults with dementia is associated with increased risk [pdf] of hospitalization and death. In 2017, the rate of potentially inappropriate use was 16%, having fallen from 24% in 2011. While this decline has been substantial, further decreasing the rate is an important goal to protect the health and wellbeing… Read More »

Medication Overload: The drug epidemic that no one is talking about

The opioid crisis has captured America’s attention, becoming an official “national emergency” and prompting swift action from government agencies, patient advocates, and health care providers. This is as it should be. Over the past decade, opioid overdoses have led to millions of hospitalizations, more than 100,000 deaths, and caused great harm in communities all across… Read More »

Finding Happiness As We Age

How happy are you? That’s a tricky question and there’s a lot that can impact your answer.  According to a 2016 article in The Economist, these include factors like your financial status, health, relationships and education.  One factor that might also have a big influence on your answer is your age.  As a society, we… Read More »

End-of-Life Care and the Opioid Crisis: Potential Implications and Unintended Consequences

Reactions to the opioid crisis are affecting patients in need of hospice and end-of-life care in the United States. Hospice providers have been largely exempt from the increasing regulation of opioid and narcotic prescriptions, as most recent laws and regulations affecting opioid prescribing specifically exempt individuals receiving cancer treatment, palliative care, or those nearing their end-of-life. However,… Read More »

BRIEF: Out-of-pocket costs for Alzheimer’s disease

By | July 26, 2018

Alzheimer’s disease and related dementias (ADRD) affect about 5.7 million people in the US. Although most of those affected are covered by Medicare, many of the medical costs are not covered by insurance and must be borne by patients and their families. Total costs of care for ADRD have been estimated at more than $277… Read More »

Risk Selection and Health Outcomes in Private Medicare Plans

By | December 18, 2017

A new study in the January 2018 issue of Medical Care, “Changes in Case-Mix and Health Outcomes of Medicare Fee-for-Service Beneficiaries and Managed Care Enrollees During the Years 1992-2011” by Dr. Siran Koroukian, et al., finds that while Medicare Advantage private plans continue to benefit from favorable risk selection, Medicare Advantage (MA) enrollees do not have better… Read More »

Falls and the rise of wearable sensors

By | July 27, 2017

“I’ve fallen, and I can’t get up!” Remember that catchphrase of the late 1980s and early 1990s, based on the television commercial for LifeCall? Well, the Mrs. Fletcher of yesterday would be amazed by the wearable devices of today – they might even be able to prevent her fall in the first place! According to… Read More »

Problems with Epilepsy Drug Treatment for Older Adults

By | June 3, 2017

Expensive brand-name drugs are prescribed over older, less costly generics whose efficacy and risk profiles aren’t much different. Sometimes the financial issues involved are painfully obvious, such as when a drug company introduces a new, “improved” version of a medication that is merely a longer-acting version of the same chemical entity shortly before the patent expires on the original… Read More »