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The issue of seniors and social isolation came into sharper focus during the pandemic, with nursing homes locked down and those 65 and older too often left to fend for themselves, without the crucial support of loved ones. Immediately there were reminders that isolation is on par with smoking as a risk factor for mortality, and that it has been shown to cause or exacerbate such conditions as Alzheimer’s disease, obesity, diabetes, high blood pressure, heart disease, neurodegenerative disorders and even cancer.
This will continue to be a concern going forward, given the aging U.S. population. The Census Bureau estimates that by 2030, 70 million Americans (or roughly two in 10) will be over the age of 65. Keeping them connected is a question of the personal and the technological, of maintaining one’s physical and mental health.
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Two of the loftier healthcare aims of President Joe Biden – one dating back to his days as vice president, the other stressed in his first State of the Union Address, in March 2022 – are, respectively, curtailing the cancer rate and addressing the mental health crisis in the U.S.
Both are part of The Calendar Year 2023 Physician Fee Schedule (PFS) Final Rule, which was announced on Nov. 1 by the U.S. Department of Health and Human Services, through its Center for Medicare & Medicaid Services (CMS). The rule, which goes into effect Jan. 1, 2023, will expand access to not only behavioral healthcare and cancer screening coverage but also dental care, while promoting innovation and coordinated care.
Medicare payments have been made under the PFS since 1992, and cover services rendered in various settings, including hospitals and skilled nursing facilities.
HHS Secretary Xavier Becerra reiterated in a news release the Biden-Harris Administration’s commitment to “expanding vital prevention and treatment services.”
“Providing whole-person support and services through Medicare,” he added, will improve health and well-being for millions of Americans and even save lives.”
While beginning the first of his two terms as vice president under Barack Obama in 2016, Biden launched the Cancer Moonshot, the aim of which was to “accelerate the rate of progress against cancer.” That announcement came the year after Biden’s son Beau died of brain cancer at the age of 46.
Since becoming president in January 2021 Biden has set a new goal of cutting the cancer rate by at least half over the next 25 years.
“The experience of cancer – of getting a cancer diagnosis, surviving cancer, losing someone to cancer – has touched virtually every American family,” reads the copy on the White House page summarizing the Moonshot. “This is personal for the President and First Lady, like it is for so many of you.”
In his first State of the Union Address, he stressed that mental-health services should be accessible to all Americans, and his fiscal year budget for 2023 contained a provision doubling the funding for programs integrating physical and mental health.
The PFS final rule builds upon that, as it “ensures that the people we serve will experience coordinated care and that they have access to prevention and treatment services for substance use, mental health services, crisis intervention and pain care,” as CMS Administrator Chiquita Brooks-LaSure said in the aforementioned news release.
Preparing for Winter
Winter preparedness is especially important for seniors, so healthcare providers would do well to encourage those age 65 and over to take the necessary steps to keep themselves safe over the coming months.
Those steps include the following:
While the pandemic has abated to some degree, it is still lingering. In early November 2022, for example, an average of 334 Americans were dying every day from COVID-19, and Dr. Ashish Jha, head of the White House Covid task force, has said that 70 percent of the deaths are among those 75 and older.
Small wonder that Jha told Yahoo Finance in October that getting the vaccine could be “the difference between life and death.”
Getting a flu shot is no less important. Dr. Leslie Kernisan, a geriatrician, cited CDC statistics showing that in an average year before the pandemic, influenza impacted between nine million and 45 million Americans, led to as many as 810,100 hospitalizations and resulted in between 12,000 and 61,000 deaths.
The bottom line: Seniors need their shots.
Falls are the leading cause of accidental death among seniors, and the danger obviously ramps up in the winter time, when outdoor areas can be snow-covered and/or icy and even indoor floors can wind up slippery, should someone walk in with wet footwear.
Caregivers and healthcare providers would do well to heed the advice offered on the website HealthinAging.org, which urges that the outdoor steps and walkways around seniors’ dwellings be cleared of snow and ice. Also, seniors should be made aware of the necessity of wearing footwear with non-skid soles, and replacing the tips of canes that might have been worn smooth.
The National Institutes of Health reports that we lose body heat faster as we age, and that that can lead to hypothermia, which in turn can result in issues impacting the heart, liver and kidneys.
It goes without saying, then, that it is best to urge seniors to stay indoors, but that doesn’t go quite far enough. They also need to make sure they are dressed warmly – in layers, preferably – and that they set the heat at 65 degrees or higher. The NIH took note of a Vermont man who had his thermostat at 62 and was saved only by the timely arrival of his son.
If seniors must venture out – and sometimes it’s just unavoidable, should they have an appointment, etc. – they should be urged to wear not only a hat, gloves and coat, but also a scarf to cover their nose and mouth.
There is nothing like cozying up to a fireplace in the wintertime, but the dangers of fire or carbon monoxide poisoning are very real.
As a result, seniors should be urged to make sure their smoke detectors and carbon monoxide detectors have up-to-date batteries, and that their chimneys and flues are inspected each year. Also, a word about space heaters – they need to be at least three feet away from curtains, bedding and furniture, according to HealthinAging.org.