Hope Lives: Lung Cancer Awareness Month

Did you know that lung cancer is the leading cause of cancer deaths? It claims more lives than colon, breast, and prostate cancer combined.

November is Lung Cancer Awareness Month, and the International Association for the Study of Lung Cancer (IASLC) wants more research and more treatment breakthroughs in the fight against the deadly cancer.

Each new study or discovery about lung cancer brings new hope to cancer patients and their families. More research makes more survivors, says IASLC, and raising awareness is the first step.graphic from IASLC for Lung Cancer Awareness Month shows a white ribbon with the trachea superimposed on it.

What is Lung Cancer?

Lung cancer develops when abnormal cells begin to grow uncontrollably in one or both lungs. The cells form tumors, usually in the cells that line the air passages.

The tumors can be either benign or malignant, and they block the lung’s main function of providing oxygen to the blood. When the tumors are malignant, they can also metastasize and spread to other areas of the body—such as the brain. When lung cancer becomes metastatic, it is usually not curable.

There are two main types of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer. Non-small cell lung cancer accounts for the vast majority of lung cancer cases. There are several sub-types of NSCLC, each originating from different types of lung cells.

The three main forms of NSCLC are:

  • Adenocarcinoma—cancers that start in cells that secrete mucus and other substances. This is the most common form of lung cancer, accounting for about 40 percent of cases. It tends to grow slower than other forms of cancer, and is often caught in the early stages.
  • Squamous cell carcinoma—cancers that develop in squamous cells, the flat cells that line the airways. Around 25 – 30 percent of all lung cancers are squamous cell carcinoma, and it most often linked to smoking.
  • Large-cell carcinoma—cancer that grows and spreads quickly, making it harder to treat. It accounts for 10 – 15 percent of cases.

Treatment for NSCLC depends on the stage at which the cancer was caught. In early stages, surgery to remove the affected area may be enough. Based on individual cases, chemotherapy may also be recommended to reduce the chances of the cancer coming back.

Later stages of cancer are treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of several treatments. The more advanced or widespread a cancer is, the harder it is to treat and the worse the prognosis. 

Symptoms of Lung Cancer

There are very few symptoms of lung cancer in the early stages, so it’s hard to catch early. People at higher risk of lung cancer should talk to their doctors about getting screened annually, since there isn’t enough information about the benefits of regular screening.

Anyone who experiences the following symptoms should see their doctor immediately for a full workup:

  • Persistent coughing
  • Coughing up blood, even a small amount
  • Shortness of breath
  • Chest pain
  • Hoarseness
  • Losing weight unexpectedly

Risk Factors of Lung Cancer

Smoking is by far the leading cause of lung cancer. But even being regularly exposed to secondhand smoke can raise your risk of developing lung cancer.

Other risk factors are exposure to radon gas, asbestos, and other airborne carcinogens, since our lungs are the first defense against these toxic substances.

Lastly, family history of lung cancer can also raise your risk of developing it yourself.

If you have one or multiple of these risk factors, discuss your options with your doctor. You may want to get screened annually, since some studies do show a significant benefit to regular screening. Medicare does cover annual low-dose chest CT scans for eligible beneficiaries.

If you smoke, you should also quit smoking as soon as you can. Even if you’ve smoked for years, quitting today can still reduce your risk of lung cancer! Every year that you’re smoke free reduces your risk more, to the point that a person who hasn’t smoked in 10 years has half the risk of dying from lung cancer than a person who’s still smoking.

The Great American Smokeout

Tomorrow, November 15, The American Cancer Society will host their annual “Great American Smokeout. It’s a 24-hour challenge to be completely smoke-free.

For more information, visit www.cancer.org/great-american-smokeout


Medicare Advantage Plans Closer to Covering Long-Term Care

The Centers for Medicare & Medicaid Services announced in May that Medicare Advantage plans can expand their coverage of supplemental benefits. Starting in 2019, Medicare Advantage plans will be able to offer coverage of services like respite care, non-hospice palliative care or home safety modifications. Industry experts are saying this can move Medicare Advantage closer to covering long-term residential care one day.

A major downside of Medicare as it’s currently formulated is that it doesn’t cover custodial long-term care. That means if a senior doesn’t need specific skilled nursing care, but can no longer live on their own, they either need to pay for the facility out of pocket, or exhaust all their assets to go on Medicaid. Paying for long-term care is a huge financial burden on many seniors who aren’t eligible for Medicaid. The new rules will allow Medicare Advantage plans to cover in-home support services, like help with activities of daily living. Such coverage may one day lead to coverage of non-skilled nursing facility stays.

How Big is This Change Exactly?

While the changes will probably be modest in the beginning, the paradigm shift is huge. Until now, Medicare Advantage plans mainly covered whatever Original Medicare covered, with some additions like dental or vision coverage. Now, in an attempt to save more in preventable medical expenses in the long run, they will have an expanded definition of “health-related” services. The new guidelines, according to CMS, will “consider an item or service as primarily health related if it is used to diagnose, compensate for physical impairments, acts to ameliorate the functional/psychological impact of injuries or health conditions, or reduces avoidable emergency and health care utilization.”

This opens the door for long-term care services to gain coverage under CMS. In the beginning it may cover home-health services, and then it may eventually expand to cover some nursing home expenses.

Of course, these services will be subject to restrictions and requirements for coverage. Your doctor or other healthcare provider would have to recommend the service, and there will likely be copious paperwork. It’s also likely that the Medicare Advantage plans will decide eligibility for specific services based on the member’s medical needs and history. Either way, the program expansion is great news for Medicare Advantage members, and will probably increase the private plans’ share of the Medicare market.

Here are some services you can expect to see covered next year:


Funding your Skilled Nursing Facility Stay

We’ve spent all week celebrating skilled nursing care and paying tribute to our amazing staff, residents and families. The American Health Care Association, who established this special week back in 1967, says NSNCW provides an opportunity to recognize the role of skilled nursing care centers in caring for America’s seniors and individuals with disabilities.

And it’s an important role. Approximately 15 percent of the US population is over age 65, and a large portion of them will need skilled nursing care in the next five years. One of the first things seniors and their families ask when they find out they need skilled nursing care is, “How will I pay for this?” Nursing home care can cost a pretty penny; the average price in New Jersey hovers around $100,000 a year. So what’s a middle-to-lower class senior supposed to do when they need the specialized care only a skilled nursing facility can offer?

Financial experts recommend you start planning your long-term care in your 50s or earlier. This can include opening a savings plan to self-fund your care, taking out a long-term care insurance plan, or some combination of the two. But even if you or your parents haven’t planned for long-term care, you still have options.

Who Funds Long-Term Care?

Many people assume Medicare will cover their long-term care needs. In truth, Medicare only covers the first 100 days of nursing care, and then only when certain conditions are met. Think of Medicare as the option for short-term nursing care. If, for instance, your parent needs a few months of rehab after a nasty fall, Medicare will cover their inpatient rehab and skilled nursing care. The general expectation is that your parent will recover and be able to move back home after a short time.

In long-term situations, the patient must either pay privately or get onto Medicaid to cover their care. Medicaid is state-run health insurance for the needy. However, many middle-class seniors find that joining Medicaid is the best option for funding their nursing home stay. To qualify for Medicaid, you generally have to exhaust all your assets. There are many legal ways to lower your net worth to the point where you can be eligible for Medicaid. Some of those options include an income spend-down or creating a trust.

Here are some articles about Medicaid and the application process, written by Regency’s own Judah Gutwein, L.N.H.A.:

Let Me Educate you on Medicaid Eligibility, on njnursing.com

Medicaid Medically Needy Program, on wellness.com

Applying for Medicaid, on senioradvisor.com

Medicaid Specialist vs Elder Law Attorney, on senioradvisor.com

Medicaid Personal Needs Allowance, on njnursing.com

And of course, feel free to contact us directly at Regency Nursing  if you have any questions about applying for Medicaid.

Beating Alzheimer’s

Last week we talked about green leafy vegetables‘ role in improving brain function. Today we’ll explore another delicious vegetable that may prove to be the cure for Alzheimer’s disease.

beets on a wooden table


Beets are root vegetables with striking purplish-red flesh. They’re delicious both raw and cooked, and they’re essential in a healthy diet.

Beets are rich in fiber and contain a variety of vitamins and minerals, including B vitamins, iron, copper, magnesium, and potassium. Among its health benefits are lowered blood pressure, reduced risk of heart disease, increased endurance, and improved liver function.

Now researchers say beets can slow down the progression of Alzheimer’s disease.

Here’s how it works: the signature physiological characteristic of Alzheimer’s is beta-amyloid buildup in the brain. Amino acids called amyloid beta proliferate in the brain. They form large clusters called beta-amyloid plaques that accumulate and disrupt normal neuron function. These beta-amyloid groupings also cause an inflammatory response in the nervous system, which further advances the disease.

New research finds that beets contain a compound that may slow this process. The chemical betanin—the pigment responsible for beets’ deep red color—interacts with amyloid beta. It prevents this accumulation of the harmful proteins in the brain.

The researchers conducted experiments with betanin, and found the pigment reduced the damage caused by amyloid beta by 90 percent. While the scientists were clear that betanin will not completely prevent Alzheimer’s disease, it does appear to slow the growth of beta-amyloid plaque.

This is promising news for drug developers, who can experiment with this widely available pigment in new drug formulas.

For the rest of us, it’s another reason to eat those tasty red orbs.



Maximize your Visit with Grandma


boy and girl hugging their grandparents

Loneliness is a real issue for residents in nursing homes. They are far from their families and everything familiar. Even though they are surrounded by people—residents and staff who sometimes become cherished friends—there is no replacement for family. Family and friends are important for residents’ emotional, and even physical, well-being.

But it’s hard to visit when Grandma is in later stages of dementia and can no longer communicate. You feel uncomfortable and not sure how to fill the silence. Does your presence even make a difference?

The answer is yes. Your loved one is still there underneath the dementia or other illness, and family visits help her connect to the person she used to be. Regular visits from family and friends are essential in keeping that connection alive.

Here are five tips to help you pay a meaningful visit to your loved one:

1. Come at a good time

Schedule and consistency is very important for seniors, especially seniors with dementia. Make sure to come at a time when your visit will not interfere with your loved one’s schedule. The afternoon is usually the best time to visit. In the morning, the staff is busy getting the residents dressed and ready for the day. Your relative may feel uncomfortable if you’re present while they are being attended to. If you’re not sure when the best time to visit is, call ahead to find out. The nurses can also tell you when your loved one is at his or her best.

2. Bring family photos or the local newspaper

Bring along snapshots of people and places in their lives to help residents feel more connected. You can bring family photos to show off, and update your relative on the lives of loved ones. You may want to compile a photo album or scrapbook with both old and new photographs. Your relative can flip through the snapshots when you’re not there, and nurture the connection to his past life. Photos from when he was young are especially helpful, since dementia patients often remember their youth much better than their adult life. You can even personalize her room with family photos, favorite wall art, decorative pillows, and knikknacks that are meaningful to her.

You can also bring the local newspaper from their community and read sections they may be interested in. If Dad was an avid sports fan, you can read the sports news and scores for his favorite teams. Even if your loved one can’t respond, just hearing about topics they used to enjoy may bring them comfort.

3. Go for a stroll

If your relative is up to it, take them on a walk around the facility. If the weather is nice, you can take them outside. Our gardens and patios at the different Regency facilities are stunning year-round, and residents and their guests enjoy sitting outside and imbibing the calming effects of our lovely campuses.

4. Bring children along

Don’t be scared to bring children to the facility. Children are natural icebreakers, and their lack of inhibition helps with awkward moments. Bring along something for them to do, such as a picture book or small project. New readers can practice their reading skills with Grandma, or tell about new things they’ve learned.

5. Touch a lot

Affectionate touch is a basic human need. Most of the touch your loved one is getting, while gentle, is for care and hygiene only. Give them a lot of hugs during your visit. Try massaging his hand gently or giving her a back rub.

Bonus Tip: Act natural

Be yourself, that’s who your relative wants to see. It may be hard to see your loved one’s mental and physical abilities deteriorate, but make sure to act real. Speak slowly and clearly if their hearing is impaired, but don’t patronize them or speak to them like a child. Treat them naturally, with the respect and dignity they deserve!

Natural Disasters and the Elderly

I just came across a fascinating article published this month by Wynne Parry in Live Science regarding the effect of natural disasters on the elderly.

Heat waves, storm flooding aggravated by rising sea levels and other extreme events associated with climate change can affect everyone when they hit, but the danger isn’t shared equally.

One segment of the population — the elderly — is particularly vulnerable when disaster strikes.

In Louisiana, about 71 percent of those who died as a result of Hurricane Katrina were older than 60, and nearly half were older than 75, according to a 2006 federal report. About two weeks after Hurricane Sandy hit in 2012, the New York Times reported that close to half of those who died in the storm were 65 or older. Many of these elderly victims drowned at home; others died from storm-related injuries, hypothermia and other causes.

The Brooklyn Verrazano Bridge during Hurricane Sandy
The Brooklyn Verrazano Bridge during Hurricane Sandy

We are intimately aware of the effects of Sandy on the senior population in the barrier islands of NJ. During this time, Regency facilities provided a crucial safe haven for the many elderly evacuees from both the local hospitals and the community.

Regency Founder and President, David Gross, worked hand in hand with senior hospital officials, to accept many elderly patients under relaxed guidelines and with utmost compassion and dedication. Regency nursing centers were thus a beacon of hope for entire communities during these trying times.

So why are disasters so difficult on the elderly?

Click here to read the article.