What is Ulcerative Colitis?

Ulcerative colitis (UC) is a chronic inflammatory disease that affects the colon, also known as the large intestine. Ulcerative colitis and Crohn’s disease are collectively known as Inflammatory Bowel Disease (IBD). Though most people first develop symptoms of ulcerative colitis in their 20s, the next most common time to be diagnosed is between the ages of 50 and 80.

Although treatment of ulcerative colitis is the same regardless of age, it has recently been suggested that treatment as usual may not be the best thing for seniors. Care for ulcerative colitis is often based on data from clinical trials that excludes older people because of their multiple chronic conditions, and their need to take multiple medications.

Age does make a difference. Although ulcerative colitis is not generally associated with an increased risk of colorectal cancers, they are strongly associated in the elderly population. Screening for colorectal cancers, however, usually involve having a colonoscopy, a more risky procedure in the elderly.

In addition, ulcerative colitis is often treated with corticosteroids. These increase the risk of infectious diseases, such as the flu, hepatitis B, and pneumococcal disease, since steroids suppress the immune system. Older people are at greater risk of complications from these diseases, and should make sure to be immunized if they need a steroid regimen.

Older people with ulcerative colitis are also a greater risk of the following life-threatening complications: blood clots (thrombosis), including deep vein thrombosis (DVT); perforation of the colon; primary sclerosing cholangitis; and toxic megacolon.

Early recognition of ulcerative colitis can help UC sufferers decrease their risk of complication, and have a similar survival rate as the general population.

At the Regency Nursing and Rehabilitation Centers, we offer the very best of care in a patient-centered environment. This means always listening to our residents and patients and respecting their capabilities, while helping them to achieve maximum functionality and independence. And always maintaining the highest professional and quality standards in our staff and our facilities. Our 25 years of excellent care have led to us being awarded a Best Nursing Homes award by US News & World Today, a 5-Star rating by USA Today, and an A+ rating by the Better Business Bureau, among many other awards.

Contact us by clicking here to see which of our three facilities will best meet your needs or the needs of your loved one.

Malnutrition in Seniors—Know the Signs

A growing concern in the senior population is the problem of malnutrition. Malnutrition occurs when an individual’s diet fails to provide proper nutrition for the human body to maintain good health. This doesn’t always mean that there is a lack of food; many times malnutrition can result from consistently poor food choices.

Signs and Dangers of Malnutrition

Malnutrition in seniors can result in many health problems. Take notice this holiday season and look out for these common symptoms and results of malnutrition:

  • Weight loss
  • Unusual bruising or injuries that don’t seem to heal on their own
  • Muscle weakness, making the senior more susceptible to dangerous falls
  • Memory loss or cognitive decline
  • A weakened immune system, which can lead to getting sick more often, and cause minor illnesses to develop into more serious problems.

Malnutrition in seniors can stem from a number of causes. These include:

  • Oral, digestive, or general health problems. Many seniors may suffer from health issues that require restricted diets, and the foods they are allowed may be unappetizing or bland. They may have oral or dental problems that make chewing and swallowing difficult.
  • Decreased mobility. A senior with decreased mobility or declining fine motor skills may find it difficult to navigate the kitchen to prepare meals, and may resort to low-nutrition packaged snacks. Additionally, an individual suffering from dementia may forget to prepare meals, or may even lack the ability to venture out to a grocery to buy healthful foods.
  • Loss of appetite due to social isolation, depression, or medication. If an individual fails to take an interest in food, he or she will tend to choose easily accessible foods that don’t need to be prepared, which are often over-processed and lacking in proper nutrition. For example, he or she may choose to eat cookies or packaged snacks rather than taking the time to cook a proper chicken dinner, because it requires less effort. A senior living on his own may feel that preparing meals to eat alone requires too much effort. Additionally, some medications can lead to decreased appetite.
  • Financial constraints. Many seniors who are no longer working may no longer have the funds to purchase healthy foods, and may opt instead for cheaper, less nutritious choices.

How to Prevent Malnutrition

Help combat malnutrition in your senior by taking these steps:

  • Make mealtimes an enjoyable time. For a senior who has lost interest in preparing meals due to social isolation, try to arrange for friends or relatives to visit at mealtimes, or to have their meals at senior centers. If your loved one is restricted to unappealing foods, experiment with new spices, colors, and variety, and choose snacks that are nutrient-rich, such as nuts and cheeses.
  • Exercise and the outdoors can help increase appetite. Encourage your senior to engage in light activities such as walking. This can help with feelings of social isolation as well.
  • Ask your loved one about his/her eating habits, and try to ensure that there are always nutritious options at hand.
  • Always discuss medications with a doctor or pharmacist, and be aware if they may lead to loss of appetite or digestive problems.
  • Many communities have resources and programs for seniors, such as Meals on Wheels, which can help your senior with providing proper meals.

If you think you see symptoms of malnutrition in your loved one, always discuss your concerns with a healthcare provider.  Malnutrition can be difficult to detect, but can lead to a myriad of health problems over time. A doctor can identify underlying causes and can provide you with individual guidance and strategies to care for your loved one in the best way possible.

Manage the Holidays While Caring for Your Loved One with Dementia

We’re well into holiday season, and your to-do list probably feels like a mile long. You have gifts to buy (don’t forget your loved one’s incredible nurses and aides at Regency!), family dinners to plan, cards to send, and so much more.

The holiday season can sometimes feel frantic, but it’s also lots of fun. Is it as enjoyable for your loved one with dementia?

Whether or not your loved one lives with you, the hustle and bustle of this jolly season can be stressful. People with dementia need stability and routine, and any slight change can be very disorienting to them.

Here’s how you can help them weather the holiday season calmly—while keeping yourself sane:

Keep to routine

Staying on schedule is the best possible gift you can give your loved one with dementia during the holidays. If your loved one is an LTC resident, visit them at the same time you always do. This may be hard with all the extra errands you have to do, but try to keep to it as much as possible.

Include them in your preparations

Ask your loved one to help you decorate the table, bake cookies, taste test a recipe, or anything else they can do on their own. They’ll feel included and needed and part of the holiday cheer.

Reminisce with them

Many people feel nostalgic around the holidays, and people with dementia feel it even more. Listen to their stories of holidays past, and talk about some of your own favorite Christmas memories. Keep an eye out though, for blurring of past and present. If your loved one starts looking around for family members who have passed, or become anxious, change the subject to the current holiday.

Say “no” to nonessential tasks

The holidays are a time for giving, and if you can step outside your comfort zone to give a little more that is certainly great. However, you must remember that you’re a caregiver—and you can only give care when your own tank is filled up.

The holidays are for enjoying family time together, so remember to stop, enjoy the time, and take shortcuts in order to stay as present as possible.

National Family Caregivers Month

November is National Family Caregivers Month, and today we’d like to raise awareness about family caregiving.

Check out these astounding family caregiving statistics from caregiver.org:

  • About 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months.
  • The majority of caregivers (82%) care for one other adult, while 15% care for 2 adults, and 3% for 3 or more adults.
  • About 15.7 million adult family caregivers care for someone who has Alzheimer’s disease or other dementia.
  • The value of services provided by informal caregivers has steadily increased over the last decade, with an estimated economic value of $470 billion in 2013, up from $450 billion in 2009 and $375 billion in 2007.
  • The economic value of the care provided by unpaid caregivers of those with Alzheimer’s disease or other dementias was $217.7 billion in 2014.
  • 65% of care recipients are female, with an average age of 69.4.
  • Upwards of 75% of all caregivers are female, and may spend as much as 50% more time providing care than males.

Here at Regency Nursing, we are so proud of our incredible family members who make sure to stay involved in their loved one’s care. While they’ve entrusted their loved one to our care, they stay hands on and involved every day.

We’ve written about caregivers in the past, and we invite you to take a look at our archives for tips and advice for the unpaid family caregiver.

Here are some articles to get you started:

Male Caregivers: An Overlooked Population

Why You Should Join a Caregiver Support Group

Prevent Caregiver Burnout

Who Will Care For The Caregiver?

What is Respite Care?

Take a Break From Stress

Let us know in the comments what else you want to see on our blog for and about caregivers.

Have a wonderful weekend!

Male Caregivers: An Overlooked Population

What do you think of when hear the word “caregiver”?

You probably imagine a woman, often in middle age or later, working herself to the bone caring for an elderly spouse, parent, or other loved one. You probably don’t think of men.

But male caregivers are on the rise. Specifically for patients with Alzheimer’s and dementia, men account for almost 40 percent of caregivers. This is double the amount of male caregivers 15 years ago.

There are many factors that go into this huge increase, ranging from economic to societal. Another important factor is that more aging women have Alzheimer’s than men, putting their husbands in the caregiving seat.

Regardless of what’s causing it, the fact is, men make up a large percentage of caregivers. Most resources for caregivers, though, are geared to women. As an example, caregiver support groups are dominated by women, with very few men represented.

Today we’ll pay some attention to this neglected group, by bringing you some tips specifically for male caregivers.

1. Open up about your feelings.

While each individual man or woman deals with their emotions in their unique ways, men as a group tend to be more closed.

Caregiving, though, is a very tough and emotionally draining job. Caregivers, especially when they’re caring for a parent or spouse, experience a huge range of emotions on a daily basis. It’s important to talk them out and release them, so you don’t constantly carry the toxic load of guilt, resentment, fear, stress, and other emotions.

To help you process your feelings in healthy way, find at least one close friend or family member who can support you on this journey. Studies have shown that while men are more likely to talk to friends and coworkers about the practical aspects of caregiving, they’re slower to admit to emotional stress or depression as a result of it.

Don’t get caught up in trying to “be strong” and “take it like a man.” All humans need to express and release strong emotions and stress.

2. Give and get support.

Consider joining a support group, or starting one specifically for male caregivers. While most of the issues that come up in caregiving are universal for men and women, there are differences in the way they handle things. For example, women tend to be more emotional, while men are more practical-minded.

Men may feel safer to share their outlook among other men. Some men even find it easier to participate in online caregiver forums than attend in-person meetings. Try out both mediums, and see what works for you.

3. Don’t overlook self-care.

This is important for all caregivers, but an especially important reminder for men. Statistically, men don’t see their primary care physicians as often as women do, and they also don’t take their aches and pains as seriously.

Men: take care of yourselves. You owe it to the loved one you’re caring for, and you owe it to yourself.

Particularly if you yourself are elderly, it’s important to eat well, get enough sleep, and see your doctor when you feel ill.

4. Keep in mind the gender bias.

Unfortunately, a deeply held gender bias still exists in caregiving. Even if you are your parent’s primary caregiver, their doctors may still assume your sister is the one in charge. Make sure all medical providers involved in your loved one’s care know you are the one most knowledgeable about the patient’s condition, and they need to speak to you.

For the male caregivers reading this, have we missed anything? Let us know in the comments.

Celebrate Senior Citizens Tomorrow—And Every Day

Senior citizens, it’s time to celebrate!

It’s 30 years since the first National Senior Citizens day was declared by President Ronald Reagan. Tomorrow, August 21, is the 30th annual observance of Senior Citizens day.

Senior citizens today are more active, financially secure, and healthy than ever before. With average life expectancy hovering around age 80, we’re lucky to have our seniors around for years—long enough to benefit from the wisdom and experience you can only gain by living to old age.

photo of elderly woman talking, with george burns quote: "by the time you're 80 you've learned everything. you only have to remember it."

Reaching advanced age comes with unique difficulties. Physical and mental decline, increased risk of accidents, and costly medical bills are just some of the challenges seniors face as they age.

On Senior Citizen’s day, let’s support, honor, and show appreciation to our seniors, and recognize their achievements.

Here are some ways you can celebrate the senior citizens in your life:

  • Send them flowers
  • Visit them at home or long-term care residence, and spend some time with them
  • Call to chat if you can’t visit
  • Take them out for dinner
  • Thank them for everything they’ve done for you over the years
  • Listen to their stories
  • Ask their advice
  • Buy a gift—even the new blanket they need or crossword book they’ve wanted

Don’t live near your elderly loved ones? You can still show them you care with a special phone call, letter, email, or video call. You can also volunteer with local seniors who may not have family nearby.

Studies show living alone is one of the highest risk factors for depression and other mental health issues among seniors. Living alone can also be a health and safety risk for declining seniors who don’t realize their own limits. Celebrate the senior citizens in your neighborhood by visiting regularly and making sure they’re okay. If it seems they can no longer live alone, don’t hesitate to alert their families or your local social services.

This Senior Citizens day, we invite friends and family of our residents to Regency Nursing. Come visit, participate in the programming, and show your senior loved ones how much they mean to you.

Why You Should Join a Caregiver Support Group

Over 34 million Americans have provided unpaid care to an adult aged 50 or over in the last year. (Source) Nearly three-quarters of them are women, and they tend to spend at least 50% of their time caring for their loved one.

It can be tough and isolating as you devote your time and energy to caring for your elderly loved one. But if you’re a caregiving child, spouse, or other relative, you’re in good company. Seeking out other caregivers can help you feel less alone.

Caregiver support groups are a great way to meet other caregivers, share ideas and resources, and commiserate with people who actually know what you’re going through.

Benefits of Support Groups for Caregivers

We’ve talked before about preventing caregiver burnout, and joining a support group can help with that. The other members of your support group can provide invaluable resources and information, as well as an objective look at how you’re doing and how close to burning out you are.

Here are the top benefits of joining a caregiver support group:

  • Meeting with others in your situation will help you feel less lonely or isolated.
  • Support groups are non-judgmental environments where members don’t question your devotion to your care recipient.
  • Members of your support group can help you deal with the feelings of guilt, helplessness, anger, frustration, or other emotions that develop while caregiving.
  • Participating in a support group will provide valuable resources to help you feel more empowered and in control.
  • Your stress levels will go down when you have a supportive group of people rooting for you and providing information.
  • You’ll develop a clearer understanding of your loved one’s condition and prognosis, from people who have “been there, done that.”
  • Support groups are gold mines of practical advice, information about treatment options, reviews of hospitals, doctors, and long-term care facilities, and insurance problems.
  • You’ll improve your quality of life and your ability to care for your loved one.
  • With the help of your support group, you may be able to keep your loved one at home longer. And when it becomes time to move the patient to a skilled nursing facility, your group can help you deal with your conflicting emotions of guilt and relief.
  • Your experience with caregiving can help others just starting out in the caregiving journey.

Where to Find Local Support Groups

First check with your local hospital or community center; they should have a complete list of all local groups. Many nursing facilities or adult day care centers will host support groups, so that’s also a good place to look. For instance, our own Regency Gardens in Wayne hosts a monthly support group for people who care for loved ones with Alzheimer’s or dementia.

If you’re looking for a group that focused on your loved one’s specific conditions, check the websites associated with that condition. For example, the American Cancer Society has a searchable listing of local resources, including caregiver support groups, on their website.

Other common websites include:

While in-person meetings are the most beneficial, there are also countless facebook groups and online support groups for caregivers. If you find you really can’t get out to a weekly or monthly meeting, this might be a good substitute. Check here for a list of online support groups: https://www.seniorly.com/resources/articles/online-caregiver-support-groups

However you choose to get your support, joining a group will help you navigate the challenges of caregiving.

What To Do When Social Security Says You’ve Passed On

It’s rare, but it happens to real people. And it happens more often than you might think. Whether it’s due to a clerical error or a misreporting, the Social Security Administration sometimes declares people dead—when they are very much alive.

Every year, the Social Security Administration (SSA) mistakenly declares around 12,000 people dead. Considering about 2.8 million Americans die every year, the error rate is actually quite low.

But if you’re one of those 12,000 people who discovers they’re dead, you probably don’t care about the error rate. Being declared deceased can affect your life in many ways, such as:

  • you no longer receive Social Security benefits
  • your Medicare or other insurance is canceled, making you responsible for all your medical bills
  • your Medicaid benefits are cut off
  • your bank account is locked up

Besides for the many and varied financial ramifications of being officially dead, there will probably also be some emotional fallout. Nobody wants to hear, “Sorry, this person is deceased” when they try to make a doctor’s appointment or fill a prescription.

Fortunately, you can reverse your (erroneous) death, but it can take some time and effort. Dealing with government agencies  can also be an emotionally frustrating experience, so if you’re the senior dealing with this, you might want to enlist the help of a relative or friend. Residents of a long-term care facility like Regency Nursing can also turn to the in-house social worker or administration department for help.

Here’s How to Bring Yourself Back to Life:

The process doesn’t have to be long and drawn out, if you act immediately. Your first clue that something isn’t right may come when a check bounces or your prescription is rejected. Or you might get a notice from Medicare or your insurance company that your health coverage has been canceled.

However you first find out, it’s important to swing into action right away. The sooner you get your life back, the lower the financial impact.

The SSA has a section on their FAQ page telling you what to do if this happens to you.

  1. Go in person to your local Social Security office as soon as possible. Bring at least one original piece of identification, such as a current passport, driver’s license, or insurance card other than Medicare card.
  2. Social Security’s correction will automatically be forwarded to Medicare. They will reinstate your coverage as soon as they receive the notification.
  3. Once your record is corrected, the SSA will give you a letter, called “Erroneous Death Case – Third Party Contact,” to send to your bank, doctors, and other providers.
  4. Confirm with your insurance that any claims denied for no coverage will be reimbursed retroactively. If you had any checks bounce because the bank froze your account, ask the bank to waive those fees. The bank is not required to do so, but many times they will accommodate you.

If you act swiftly, you can reinstate your coverage in a matter of weeks. In my experience—I’ve dealt with four such cases in New Jersey in the last eight years—it can take anywhere from two weeks to two months for Medicare coverage to resume.

Part Two: Original Medicare vs Medicare Advantage

Welcome back to our two-part series about the costs and benefits of Original Medicare and Medicare Advantage. In our last post, we talked about how Original Medicare can leave you on the hook for thousands of dollars a year. One way to reduce that financial burden is to join a Medigap plan for as little as $60 a month. Today let’s discuss the other option: Medicare Advantage plans.

Medicare Advantage

Sometimes called Medicare Part C, Medicare Advantage (MA) plans must cover all services Original Medicare does, except hospice care. (When a patient gets admitted to hospice, their coverage automatically reverts to Original Medicare.) MA providers can also  offer other benefits—such as prescription drug coverage, dental care, and vision plans—in order to stay competitive.

As we explained last time, Medicare contracts with private insurance companies to offer Medicare Advantage plans. Medicare pays the private insurer a set amount per beneficiary per month, and they use the funds to cover your medical costs. Beneficiaries who choose MA plans are still part of Medicare, and still pay their Medicare Part B premiums. Some MA plans don’t charge above your Medicare premium, while other plans can cost as much as an extra $200 a month. The three most common types of plans are:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-for-Service (PFFS)

Each type of plan has different rules, restrictions, and networks. Approximately 21 percent of New Jersey seniors enrolled in an Advantage plan in 2017. Let’s explore the pros and cons of Medicare Advantage:

The Plus Side of MA: Extra Coverage

The main draw of MA plans is that they usually provide benefits for some of Medicare’s non-covered services. Prescription drug coverage continues to be a problem for seniors under Medicare. Part D, Medicare’s optional prescription drug plan, has serious gaps in coverage that can cost thousands of dollars a year. By contrast, many MA plans offer broad drug coverage with much smaller co-payments. Plus, they often offer dental and vision coverage, unlike Original Medicare.

When it comes to care in a skilled nursing facility, some MA plans don’t require the  3-day qualifying inpatient stay Original Medicare demands.

Another benefit is that while the co-payments are often higher than Original Medicare’s, most MA plans have an out-of-pocket maximum. That means once you’ve paid a certain amount of co-payments, your insurer will pay your out-of-pocket expenses for the rest of the year. If you need a surgery, for example, you’ll probably reach your out-of-pocket maximum fairly quickly—leaving you with no out-of-pocket costs for the rest of year. In Original Medicare, you always have to pay the 20% copay, regardless of how much you’ve already paid.

The Downside of MA: Less Standardization

Since private insurers administer the MA plans, they can apply their own rules to the Medicare plan. While the basic coverage is the same, the plans have much more flexibility in how to apply your coverage. Here are some of the things you can expect from a private insurer:

  • Higher premiums, deductibles, and co-payment amounts. These plan details can change from year to year.
  • Stricter rules for coverage of certain services and products. You may be required to get a referral  from your primary doctor in order to see a specialist. You may also be required to stick to doctors or hospitals in the plan’s network. Tip: HMO plans are generally cheaper than PPO, but restrict you to a smaller network of medical providers.
  • No guaranteed plan renewal. Advantage plans have annual contracts with Medicare, so if your provider chooses not to renew their contract, you’ll have to find a new insurer.
  • No out-of-state coverage. Original Medicare offers you a nation-wide coverage. It’s the same in every state, so if you travel often, you can use your Medicare coverage anywhere you go. Medicare Advantage often only covers you regionally.

Which Plan is Right for Me?

Now that you know more about Original Medicare and Medicare Advantage, you are more equipped to make the decision based on your personal circumstances. If you have high prescription medication costs, you might prefer an Advantage plan, while if you split your time between two states, Original Medicare is probably the way to go. Because MA plans are not standardized, make sure to check the benefits of each one before you choose a plan. A licensed insurance agent can help you find the plan to best suit your needs.

Original Medicare vs Medicare Advantage: A Two-Part Series

Which saves you more money, Original Medicare or Medicare Advantage?

The correct answer is, “it depends.” Both forms of medical coverage have unique costs and benefits.  You’ll make your choice based on different factors in your own situation, so there’s no definitive answer to the question.

In this article, we’ll explore Original Medicare, while next week we’ll talk about Medicare Advantage.

First, some definitions.

Original Medicare is, like its name suggests, Medicare in its Original form. Medicare is the federal health insurance program for seniors and certain younger people with disabilities. A small portion of every employee’s paycheck goes toward the Medicare tax, which funds the program. Under Original Medicare, seniors age 65 and older are automatically eligible for coverage in Part A and Part B. Part A covers inpatient services and Part B covers outpatient.

Medicare Advantage (MA) is a  private health plan that administers Medicare benefits. Private insurance companies contract with the federal government to provide these plans. MA plans must cover all the services Medicare covers, however they may have different rules, costs and restrictions on the services. In addition, many MA plans offer benefits beyond Original Medicare, such as dental and vision coverage.

Here’s a more detailed overview of each type of plan, and what you can expect to pay:

Original Medicare

On the face of it, Original Medicare looks cheaper than MA. If you or your spouse contributed to Social Security for at least 10 years, you get Part A free. Plus, the standard monthly premium for Part B is well below average for comparable private coverage.  The monthly premium will change based on your income and whether you’re receiving Social Security benefits at the same time.

While Original Medicare’s premiums certainly are low, they don’t present a full picture of the costs you’ll encounter. Medicare has a high cost-sharing ratio that can leave you with thousands of dollars of medical bills. Here’s what you have to pay with Original Medicare:

  • Deductible

    Medicare starts covering your medical bills after you meet your annual deductible. The Part B deductible is relatively low, just $183 for 2018. The Part A deductible is higher at $1340 per benefit period. (The benefit period ends when you haven’t gotten inpatient care for 60 days in a row, so you can have a few benefit periods in one year.)

  • Part A Coinsurance

    Part A covers inpatient hospital stays at 100% for the first 60 days once you meet your deductible. It covers 100% of skilled nursing care for the first 20 days. After the first 60 and 20 days respectively, there is a coinsurance per day. After 100 days of inpatient care, Part A coverage ends.

  • Part B Coinsurance

    Part B covers 80% of services, leaving the 20% coinsurance for you. Unlike most private insurance plans, there is no yearly limit on your out-of-pocket expenses, so expenses can add up after a while.

  • Non-covered Services

    Some medical expenses aren’t covered by Medicare at all. These include most prescription drugs, dental care, and vision care.

For some relief from the never-ending coinsurance payment, many Medicare beneficiaries opt to also take out a Medigap plan. Medigap plans are standardized supplemental plans that cover a lot of the out-of-pocket costs. The most popular plans in New Jersey average $100-$150, but you can get a plan for as low as $60 a month.

The other alternative to Medicare’s high out-of-pocket cost is enrolling in a Medicare Advantage plan. Look out for our blog post next week where we’ll discuss the pros and cons of Medicare Advantage.