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Healthcare

Healthcare (4)

As we get older, particularly into our 50’s and 60’s, cataracts can become a common eye condition experienced by both men and women. Cataracts are a leading cause of vision loss in the United States, so it’s important to know how to protect your eyes to reduce your risk for cataract and to be able to recognize the signs of a developing cataract. 

Cataract Formation

Like the rest of the body, the eyes and the structures that support the visual system undergo significant change as we age. One of the structures that undergoes the most change is the lens in the eye. The lens of the eye is located behind the pupil and the colored iris. The lens helps to focus images onto the retina, which then transmits the images to the brain. Normally the lens is “crystal clear.” 

Aging, and other medical conditions can cause the lens to become cloudy and yellow. This can cause mildly blurry vision, resulting in changes in your eyesight. If the crystalline lens loses significant transparency and clarity, then a cataract has formed. A cataract is the clouding of the eye’s lens, causing blocks or changes in the passage of light into the eye. 

Vision Changes Due to Development of Cataracts

If you have cataracts, you may notice changes in your vision, such as:

  • Difficulty seeing in dim illumination
  • Difficulty with night driving
  • Colors appear faded or dull
  • Experiencing glare, haloes, or light sensitivity 
  • Diminished vision

The only way to treat cataracts is to remove them surgically. The longer cataracts are left untreated, the more difficult it can be to successfully remove the cataract and restore vision.  

Cataracts can affect you even if you’ve had normal vision and relatively healthy eyes throughout your life. This is because, for most people, cataract development is a part of the normal aging process. 

Risk Factors for Developing Cataracts

Certain health and lifestyle conditions and use of certain medications can increase your risk for developing cataracts, such as:

  • diabetes 
  • trauma to the eye
  • chronic inflammation of the eye
  • other eye disease
  • repeated sun exposure without using UV protective eyewear (on cloudy days also)
  • long-term use of steroids, cortisone (including for asthma)
  • other chronic inflammatory medical conditions
  • smoking
  • genetics, family history

This month in Gym Talk we will be focusing on brain health. When most people think of exercise and physical activity they think of building strength, improving balance and flexibility, or going for a walk. However, exercising the mind is just as important as exercising the body. The mind needs to be challenged daily in order to keep the brain working to the best of its ability for as long as possible. 

As we age, maintaining a sharp mind is a top priority. Activities you do to improve your body also benefit your brain. Exercise can increase the blood flow and oxygen to your brain as well as help your brain grow new neuronal connections. Mentally stimulating activities for your brain are just as important. Brain games help individuals to stay focused on the task at hand, remember instructions and improve our working memory so we have the skill to remember and use relevant information while performing an activity. Try participating in arts and crafts, do word puzzles and logic games, work on a jigsaw puzzle, attempt a sudoku puzzle or trivia game to help exercise your mind. 

Try a few tasks that target memory and attention:

  1. Name two objects for every letter in your first name
  2. Say the months of the year in alphabetical order
  3. Name six or more things you wear on your feet that start with an “S”

There are many ways to exercise the mind through brain games and activities. Try the game below for fun! Say aloud what color you see in every word, NOT the word you read as quick as possible. Go from left to right, from top to bottom.

Ready. Set. Go!

word game

Fears of being placed in a nursing home preoccupy a supermajority of older adults as in surveys about their course of aging they consistently ranked memory loss, financial insecurity and losing independence as their top three concerns.1 Yet, after age 80, the risk of being placed in a nursing home increases significantly. Seniors of advanced age experience what is termed “functional aging”, that is an inevitable, progressively declining continuum in functional ability from having a stable capacity to perform daily activities through a state of physical vulnerability (influenced by cognitive loss) in which the person is losing independence.2 At advanced ages, some caregiver support becomes necessary for many, and for some, a nursing home admission. 

Although most seniors accept that the aging process accelerates physical and cognitive decline after age 80, they want to know whether they have any means to control the degree or pace of their functional losses. This article discusses the evidence-base showing that changes in lifestyle, particularly engaging in exercise targeted to improving functional fitness even in seniors who were mostly sedentary, can slow and in some cases reverse functional impairment, which in turn reduces the risk of being placed in a nursing home. In fact, there is strong evidence that long-term habitual exercise is linked to a slowing of the biological aging process, which certainly enhances independence.3: but, studies also show that even sedentary older adults who begin to exercise in later life can see significant improvements in physical and cognitive health.4

Functional impairment is caused by not only age, cognitive decline, multiple chronic medical conditions or following an acute medical event, but also from lifestyle choices- a sedentary lifestyle is shown to decrease functional fitness levels which in turn increases functional impairment while engaging in a physically active lifestyle appears to derive a polar opposite effect.5 Functional impairment reduces ability to perform activities of daily living, “ADL’s”:6 and, consequently, the most common reason that very old adults are placed in a nursing home is loss of ability to perform ADL’s.7 (Over 80% of nursing home residents need assistance with 3 or more ADL’s). Thus, when functional fitness is improved through exercise, that is, when an older adult experiences an enhanced ability to the summon strength, energy and executive function needed to carry out basic ADL’s, independence is retained for longer which reduces the risk of being placed in a nursing home.8

Posted in the Senior Care Topics Series by Everbrook Senior Living

Seniors reading or watching the news are informed that Medicare, through its parent agency, Centers for Medicare and Medicaid, CMS, is now covering some essential non-medical services such as in-home care, transportation, and soon phone consultations with the doctor. In brief, Medicare following passage of the CHRONIC Care Act of 2017 and through reinterpretation of its own rules, has empowered only Medicare Advantage Plans, “MA”, to offer a broader array of supplemental benefits including vision/hearing screens to name a few and now non-skilled home-health to beneficiaries who demonstrate a medical need for such services. A supplemental benefit under Medicare is defined as: 

  • A service or benefit not covered by traditional Medicare 
  • A service or benefit that is primarily health-related, and
  • A service or benefit in which the MA plan incurs a non-zero direct-medical cost.

Although seen universally as a positive step toward the continuing trend to reform coverage rules so medical providers can be paid to treat longer term chronic illness, in reality, seniors in need of home-health aides to support disabilities or who hope to talk to their doctor over the phone instead of having to travel their office will likely have to wait several years to receive those benefits in manners which make real improvements to their quality of health and life. Yet, for seniors with complex chronic illness which includes many senior living residents, MA plans appear to be the best option to get the most comprehensive coverage including essential supplemental benefits not available in traditional Medicare like in-home care or telehealth benefits, although with some uncertainties to work through. Medicare Part D amendments and other payment models being tried at CMS are not discussed here.

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