Prime Time - Jane Fonda [127]
Meaningful community connections promote good health. A prime example of an effective community-focused program is the AARP’s Blue Zones Vitality Project. Inspired by Dan Buettner’s The Blue Zone: Lessons for Living Longer from the People Who’ve Lived the Longest, an initiative was carried out by the United Health Foundation in the city of Albert Lea, Minnesota. Older citizens participating in the program joined walking groups, volunteered with youths, attended neighborhood picnics, ate nutritious foods, increased their social networking, and attended “purpose workshops.” The initiative included before and after measurements of respondents’ overall wellness. As measured by the “Vitality Compass,” an online tool that offers an estimate of life expectancy based on eating habits, sleeping habits, stress levels, and daily activity, participants in the project raised their life expectancy by three years.20
We deserve social outreach programs that decrease social isolation and increase public health in every community.
We deserve a decrease in waiting time for social service programs.
Medicare Doesn’t Cover Everything
Everyone needs to understand what Medicare covers and what it doesn’t. Medicare benefits are broken up into four categories. Part A includes hospital coverage, encompassing inpatient care, inpatient drugs, and limited home health care stays and stays in a skilled nursing facility. Inpatient stays longer than 150 days are not covered, and stays in a skilled nursing facility longer than 100 days are not covered. Part B includes physician services, some home health services that are not linked to a prior hospitalization, and outpatient services. Part C covers private health plans that contract with Medicare. Part D covers outpatient prescription drugs. Medicare does not pay for long-term nursing home care after 100 days, and sets a 190-day lifetime limit on care in psychiatric hospitals. Surveys indicate that Medicare generally covers 50 percent of health care costs, with 25 percent covered by supplemental plans and 25 percent left uncovered.21
We deserve coverage for long-term nursing home care.
We deserve extensions in coverage for stays at hospitals, including psychiatric hospitals.
Isolation
Isolation is highly detrimental to older citizens with chronic health conditions. Older people frequently have problems communicating with physicians and navigating fragmented health care systems. This is made worse if an individual has difficulty driving to appointments, getting out to pharmacies, or keeping track of medications. Many seniors simply cannot execute their health care directives on their own—they are in need of palliative care.
I wrote about palliative care and its benefits in Chapter 18. Unfortunately, palliative care is not uniformly integrated in states’ Medicare budgets. According to the National Hospice and Palliative Care Organization, A-grade palliative care was available in Vermont, Montana, and New Hampshire. However, F-grade care was observed in Oklahoma, Alabama, and Mississippi.22 It is unsettling that one’s locality can make such a difference in the ability to access appropriate care.
Advocates of palliative care support one-stop-shopping service delivery. Medical “homes” would include offices with multidisciplinary teams serving older patients. Ideally, these teams would allow for collaboration among doctors, nurses, psychiatrists, social workers, physical and occupational therapists, and other professionals. To allow individuals to stay at home, and to reduce the costs associated with long-term care, we need policies mandating that palliative