If I asked you to explain the word “health” to me, you’d probably give me a pretty great definition. After all, we all know what it means to be healthy, right? Spoiler alert: Good health doesn’t just mean you eat right, exercise, are a great weight, and don’t have any ailments. According to the World Health Organization, health is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” As you can imagine, as you age “health” gets a bit trickier.

The America’s Health Rankings United Health Foundation recently released its Senior Report 2017. In it, there’s good news and bad news. I encourage you to take a look at it when you get a chance, as whether you know it or not, at some point (if not already), you’ll be part of these statistics.

To sum it up, since 2013, there’s been a:

• 30 percent decrease in hospital deaths among Medicare beneficiaries aged 65+
• 25 percent reduction in preventable hospitalizations among Medicare beneficiaries aged 65+
• 21 percent decrease in hip fracture hospitalization rates among Medicare beneficiaries aged 65+
• 9 percent reduction in visits to the Intensive Care Unit (ICU) in the last six months of life among Medicare patients aged 65+
• 7 percent decrease in hospital admissions among Medicare patients aged 65+

That’s the good news. So what’s the bad news? As a nation, obesity, nutrition, and access to healthy food remain challenges for seniors. Since 2013:

• Obesity has increased 9 percent for adults aged 65+. Obesity prevalence is higher among those with lower education and income. The causes of obesity are complex and include lifestyle, social and physical environment, genetics, and medical history.
• Food insecurity — meaning reduced food intake and/or disrupted eating patterns due to lack of resources for food — has increased 16 percent for adults aged 60+. Compared with younger adults, seniors living at home are at an increased risk of hunger due to health conditions, disability, and functional limitations that impact their ability to obtain or prepare food.

The report also identifies the most and least healthy states for seniors. The healthiest states for seniors are spread throughout the U.S., with Minnesota leading the pack. The least healthy states are clustered in the southern region. Mississippi rounds out the pack with the lowest ranking.

Some Issues

After all of that, I can’t help but bring up a few problems we have on our hands.

• Cost — Millions of dollars are spent yearly for medical treatments and hospitalizations for nursing home resident falls, pressure ulcers, urinary incontinence, malnutrition, dehydration, and ambulatory care sensitive diagnoses.
• Services — While aging services providers nationwide are making efforts toward systematic quality improvement, inadequate staffing (due to caregiver shortages) and staff training contribute to poor and/or adverse resident health outcomes. The lack of availability of quality caregivers tends to increase elder abuse and exploitation, which has an enormous impact on the health and finances of the elderly.
• Cognitive difficulty — More than four million U.S. adults aged 65 years and older have cognitive difficulty. The number of people living with cognitive impairment (CI) is projected to double in the next two decades as the baby boomer population ages. Age is the greatest risk factor for CI. Seniors with CI experience more hospitalizations and higher-than-average annual healthcare costs compared with those without CI. Alzheimer’s disease is the most expensive disease, costing more than heart disease and cancer in the last five years of life. Evidence suggests that keeping intellectually engaged and physically active promote healthy cognitive aging.

The Solution

What’s the fix? Sadly, there’s no easy fix. What I can give you are a couple of tips that will send you in the right direction.

• Transition planning — When it comes to transitioning an elderly individual to a higher level of care, one must remember many patients (and their families) unrealistically believe they don’t need the additional assistance or the current level of care is “sufficient.” While there’s no perfect answer and no solution will please everyone, it’s imperative to understand safety may not always be the top priority; there are numerous other variables that need to be considered. Most individuals (and their families) will opt for quality of life over quantity of life. The key is to develop a transition plan before a crisis situation develops.
• Train caregivers — As caregivers work with more residents who are obese or cognitively impaired, it’s critical they’re properly trained and aren’t subjected to potential injuries from moving larger residents or dealing with combative residents.
• Develop risk management processes — This is key. While some hospital readmissions are necessary when unexpected problems occur, many are preventable through discharge planning, care coordination, and effective communication with patients and their families. Establishing risk management processes to address potential confusion about prescribed medications after discharge, miscommunication between care teams on such information as new test results, and improper follow-up care after release is important, as these are among the top reasons patients are readmitted to a hospital.

The good news is Holmes Murphy can help with all of this! We specialize in the aging services industry and have individuals who can assist with identifying potential issues and help develop a risk management plan that includes avoiding potential injuries to patients and/or staff. I encourage you to reach out to us at any time. We’d be happy to evaluate the processes you have in place, identify potential issues, and get you on the right track to success!