Peach Tree Times
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The maze of Medicare has a lot going on. With government and private companies offering different kinds of healthcare coverage, how are you supposed to know what to do? According to CNBC, 70 percent of soon-to-be retirees wish they had a better grasp of Medicare. Sadly, there is a lot of misunderstanding about what is covered by Medicare, what the program costs, and what other options are available to seniors. Hopefully, this quick guide can clear things up.
All of Medicare’s Parts
First, it's important to understand the difference between Medicare Parts A, B, C, and D. In general, Part A covers medically necessary hospital expenses, including lab tests and surgeries. Part B covers outpatient care, such as doctor’s visits and physical therapy. Part C, known as Medicare Advantage, is additional coverage offered by private companies. Finally, Part D covers prescription drugs and is also available through private insurance. For a more detailed explanation, check out this article from the Balance.
Your Additional Coverage Options
Due to all the confusion surrounding Medicare, many seniors don't look into their extra coverage options. Only one-third of eligible seniors are enrolled in a Medicare Advantage plan, but most people can benefit from the additional coverage. Though Medicare Advantage plans are offered by private companies, they are still regulated by the government and must provide the same coverage as the federal plans. However, they often include an array of additional coverage benefits. For example, Humana Medicare Advantage plans provide vision, dental, and prescription drug coverage, as well as free gym memberships through Silver Sneakers.
What You Have to Pay
Cost is another aspect of Medicare that is misunderstood. Many people are under the impression that the federal Medicare program (Part A and B) is free to seniors over the age of 65. While Part A is free for most Americans, everyone must pay a monthly premium for Part B. You will also have to pay out-of-pocket for about 20 percent of your medical expenses.
Where Medigap Comes In
Medigap, like Medicare Advantage, is a private insurance option for seniors who are eligible for Medicare. Medigap insurance covers the out-of-pocket expenses that come with Original Medicare, essentially filling the gaps in coverage. Many Medigap plans also pay for services that are not covered by Original Medicare, such as foreign travel insurance. However, Medicare Advantage usually eliminates the need for Medigap.
Choosing the Right Plan for Your Needs
You can’t have both Medicare Advantage and Medigap at the same time, so choosing a plan for your additional coverage can be tricky. Forbes recommends thinking of Medicare Advantage as an alternative form of Medicare that offers additional benefits on top of regular Medicare. Medigap is more like a coverage supplement, helping you pay your out-of-pocket expenses. Medicare Advantage plans replace Medicare, while Medigap plans are combined with Medicare.
Put careful thought into your Medicare decision because you can only switch your plan during the Medicare Open Enrollment Period near the end of each year. Consider what kinds of medical services you use. For example, if you require vision care, hearing aids, or prescription drugs, a Medicare Advantage plan might be your best option. Medicare Advantage plans tend to have lower premiums than Medigap plans, but you may be left paying more out-of-pocket for your services. Just make sure the plan you choose covers the doctors, clinics, pharmacies, and hospitals that you prefer. If you like to travel, you may also want to check that your plan will cover your medical costs in different states.
It will take some time to learn everything you need to know about Medicare. Don't rush the process. Consider your options carefully so you can take full advantage of this beneficial healthcare coverage. When you're covered properly, you'll be able to use all the health services you need to stay happy and healthy in retirement while minimizing your financial concerns.
*Written by Sharon Wagner
Most people see their sleep habits shift as they age, but a new review suggests that some seniors lose the ability to get deep, restorative rest.
And that can come with health consequences, said review author Bryce Mander, a sleep researcher at the University of California, Berkeley.
Sleep "fragmentation" has been linked to a number of medical conditions, including depression and dementia, Mander said. People with fragmented sleep wake up multiple times during the night and miss out on the deep stages of sleep.
It is true that medical conditions, or the treatments for them, can cause sleep problems, according to Mander.
Take dementia, for example. Research suggests there is a "bi-directional" link between sleep disruptions and the dementia process, said Joe Winer, another Berkeley researcher who worked on the review.
Dementia often causes sleep problems. Poor sleep, in turn, may speed declines in memory and other mental skills. According to Winer, animal research suggests that deep sleep helps "clear" the brain of the amyloid-beta proteins that build up in people with dementia.
So there may be a "vicious cycle," Winer said, where dementia and poor sleep feed each other.
Similar vicious cycles may be at work with other diseases, too, Mander said. He also stressed, though, that some shifts in sleep habits may be perfectly normal.
Older people are famously prone to being "early to bed, early to rise." They may also sleep a little less than they used to in their younger days. And that may be fine, the researchers said.
"We don't want to create a panic that if you're sleeping a little less than you used to, you're going to develop dementia," Mander said.
But, he added, it is important to recognize sleep as one of the lifestyle factors critical to good health -- right along with exercise and a healthy diet.
In fact, Mander noted, one reason that regular exercise keeps us healthy is that it can support better-quality sleep.
"Why do some people age more 'successfully' than others?" he said. "We think sleep is one of the factors."
Dr. Sanjeev Kothare, a sleep specialist who was not involved in the study, said poor sleep "clearly" has health consequences.
Sleep apnea is a good example, said Kothare, of the NYU Langone Comprehensive Epilepsy-Sleep Center, in New York City.
Obstructive sleep apnea causes repeated stops and starts in breathing during the night, and it's linked to major diseases, such as heart disease and diabetes. Research al stern University in Chicago. She said sleep quality is more important than "duration."
So if older people are sleeping a little less than they used to -- or wake up once at night then quickly fall back asleep -- that's probably not a red flag, according to Zee.
But, she said, older adults should talk to their doctor if they routinely sleep less than six hours a night, or lack long "consolidated" blocks of sleep.
In some cases, Zee said, sleep apnea may be to blame. In other cases, people may need lifestyle adjustments that can improve their sleep. The good news, Zee said, is that "behavioral and environmental changes are powerful."
Older people can improve their sleep by fitting physical and social activity into their daily routine, Zee said. At night, she suggested they make sure the bedroom temperature is comfortable and limit exposure to artificial light -- especially the blue glow of computer and TV screens.
Zee also stressed the importance of getting enough daylight, in the morning and afternoon: That helps keep the body's circadian rhythms (the sleep-wake cycle) on track.
But people should not wait until old age to care about sleep. According to Mander's team, people often start losing the capacity for deep sleep in middle age, and that decline continues over the years.
What's not clear yet, Mander said, is whether good sleep habits earlier in life help protect people from sleep problems in old age.
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When a typical person gets up in the morning, they sit up and throw their feet over the edge of the bed. Then they stand and walk to the bathroom. They take care of toileting, then shower, brush their teeth and many other activities to prepare themselves for the day.
When it comes time to think about food, they plan a menu, shop for the foods they want to eat and prepare their meals. Next, they sit down to eat. After the meal, they clean up the kitchen and wash the dishes.
All these activities, and many others, are referred to as Activities of Daily Living.
What are Activities of Daily Living (ADLs)?
Activities of Daily Living or ADLs is a term used by healthcare professionals to refer to the basic self-care tasks an individual does on a day-to-day basis.
These activities are fundamental in caring for oneself and maintaining independence. An individual's ability or inability to perform ADLs is often used by health professionals as a way of measuring an individual’s functional status, especially that of older adults or those with disabilities.
Basic ADLs, sometimes referred to as BADLs, are self-care activities routinely performed which include, but are not limited to:
As a person ages, ADLs slowly become more difficult to accomplish independently and gradually take more time to complete. Certain health issues, such as a stroke, or accidents, such as a fall, also affect a person’s ability to accomplish ADLs, sometimes dramatically.
Instrumental Activities of Daily Living
Instrumental Activities of Daily Living or IADLs are not essential for basic functioning; however, they enable a person to live independently within a community. They’re generally more complex than basic ADLs.
IADLs are made up of activities which include, but are not limited to:
Being able to perform both ADLs and IADLs is important for seniors to be able to successfully and safely live independently.
How are the ADLs Used in Senior Care?
Together, ADLs and IADLs make up the skills a person generally needs to successfully and safely live independently.
Therefore, a person’s ability or inability to perform ADLs and IADLs is used to gauge their need for care and/or occupational or physical therapy. Most healthcare service models use evaluations such as the Katz ADL Index to determine and evaluate their patient’s proficiencies and to then develop appropriate care plans to ensure all care needs are met.
Physical therapists prescribe exercise to help patients gain and/or maintain their independence based on ADL proficiencies. Prescribed exercises are based on an individual’s problematic ADLs. For example, slow walking speed is associated with an increased risk for falls; therefore, exercises are prescribed to impact and improve ambulation (an ADL proficiency) to reduce fall risk.
When completing patient assessments, occupational therapists often assess a patient's proficiency of IADLs. There are twelve types of IADLs that the American Occupational Therapy Association recognizes as necessary to live in co-occupation with others:
Physicians, geriatric social workers, rehabilitation specialists and others in senior care often evaluate a person’s ability to perform ADLs and IADLs as part of a functional assessment. Difficulties performing IADLs may signal early dementia and Alzheimer's. Evaluations of IADLs are used to make a diagnostic evaluation and influence decisions on the type of care an older adult may require.