by Ronnie Bennett
“Until about 18 months ago, most nights I slept for about four hours; five hours when I was lucky. There was a time, more than a decade ago, that an evening dose of melatonin kept me asleep for the more traditional seven or eight hours and I felt so much better then.
“But after a couple of years it stopped working.”
(Illustration by Matt Saunders for The Washington Post)
by Hawken Miller
“When Jackson Reece lost his arms and legs to sepsis after already being paralyzed, he thought his life was over. It was video games that brought him back.
There are many medications that can be used to treat mood disorders. But finding the right one can be a lengthy process, and the choice can be more complicated than you might imagine. Just because a particular drug worked for a friend doesn’t mean it will work for you. Psychiatrists and doctors who prescribe antidepressants choose a particular drug and dosage based on many factors, including the following:
- Diagnosis. Certain drugs are a better choice for specific symptoms and types of depression. For example, an antidepressant that makes you sleepy may be better when insomnia is an issue. The severity of your illness or the presence of anxiety, obsessions, or compulsions may also dictate the choice of one drug over another.
- Side effects. You may first want to choose a drug based on which side effect you most want to avoid. Medications vary in the likelihood they will cause such problems as sexual effects, weight gain, or sedation.
- Age. As you age, your body tends to break down drugs more slowly. Thus, older people may need a lower dose. For children, only a few medications have been studied carefully.
- Health. If you have certain health problems, it’s best to avoid certain drugs. For example, your doctor will want to consider factors such as heart disease or neurological illnesses when recommending a drug. For this reason, it’s important to discuss medical problems with a primary care doctor or psychiatrist before starting an antidepressant.
- Medications, supplements, and diet. When combined with certain drugs or substances, antidepressants may not work as well, or they may have worrisome or dangerous side effects. For example, combining an SSRI or another antidepressant with the herbal remedy St. John’s wort can boost serotonin to dangerous and, in rare cases, fatal levels. Mixing St. John’s wort with other drugs—including certain drugs to control HIV infection, cancer medications, and birth control pills—might lower their effectiveness. Women receiving tamoxifen for breast cancer should take an antidepressant that does not interfere with tamoxifen’s effectiveness. Eating certain foods, such as aged cheeses and cured meats, while taking an MAOI can cause a dangerous rise in blood pressure.
- Alcohol or drugs. Alcohol and other substances can cause depression and make antidepressants less effective. Doctors often treat alcohol or drug addiction first if they believe either is causing the depression. In many instances, simultaneous treatment for addiction and depression is warranted.
- Personal and family mental health and medication history. If you or a member of your family has had a good response to a medication in the past, that information may guide your choice. Depending on the nature and course of your depression (for example, if your depression is long-lasting or difficult to treat), you may need a higher dose or a combination of drugs. This may also be true if an antidepressant has stopped working for you, which may occur after you’ve used it for some time or after you’ve stopped and restarted treatment with it.
- Cost. Since all antidepressants are roughly equivalent in their effectiveness, you won’t lose anything by trying a generic version first.
- Your preference. Once you have learned as much as you can about the treatment options, your doctor will want to know what approach makes most sense given your lifestyle, your interests, and your judgment.
For more on diagnosing and finding the right treatment on the different types of depression, read Understanding Depression, a Special Health Report from Harvard Medical School.
SOURCE: Harvard Medical School
Self-Determination Housing Project Webinar Series: Assistance Animals Explained – October 17 at 2:30 PM
Do you have tenants, case workers, or other clientele that are requesting to have assistance animals in their unit? Do you work with clients who are having to interact with hesitant landlords because they have a service animal? If so, you might be wondering what rights tenants and landlords have when it comes to assistance animals. Tune in to our webinar, Assistance Animals Explained, to find out:
- What SDHP does and how you can use our services
- What a reasonable accommodation is
- And rights both landlords and tenants have when it comes to assistance animals
Webinar scheduled for October 17, 2019 from 2:30 PM – 3:30 PM ET
This training is recommended for landlords and property managers, autism service coordinators, mental health caseworkers, ID housing caseworkers, hospital liaisons, and other providers serving individuals with disabilities.
Register for the webinar here, and feel free to share this information with colleagues and those in your network who are interested in this topic.
**If you have any questions about the training or need to request a disability related accommodation, please contact SDHP @ email@example.com.
“How a shared-space solution helped a New England town save money and serve residents of many ages”
“The exterior of Swampscott High School and (inset) the shared entrance sign.” – PHOTO COURTESY SYMMES MAINI & MCKEE ASSOCIATES
by Sally Abrahms, AARP Livable Communities
“The Swampscott Senior Center on Boston’s North Shore was ailing. Housed in an old Victorian house, the center had three flights of stairs and limited on-street parking. The only handicap accessible area was in the windowless basement, where the staff served lunch and offered bingo and exercise class twice a week.
“Sometimes, only two people would show up for a meal. The senior center wanted to relocate, but municipal funds and land within Swampscott’s 3.05 square miles were limited. A new, stand-alone senior center was not in the cards. Meanwhile, the town’s public schools were overcrowded. A new high school was needed.
“Fast forward to today: Swampscott, Massachusetts — population 14,000 — now has both the senior center and the high school it long needed. In fact, the two facilities share a plot of land and are essentially one, with the ground-level senior center occupying a 7,500-square-foot space that’s attached to the high school. Here’s how it happened.”
“Every fall, the 60 million Americans who use the health plan can compare options and save money. Here’s what to consider.”
Credit: Corey Brickley
by Mark Miller
“If you’re enrolled in Medicare but worry about the cost of health care, your chance to do something about it is right around the corner.
“Most people enroll in Medicare when they become eligible at age 65. But every fall, they have the opportunity to change their coverage during an enrollment season that runs from Oct. 15 through Dec. 7. This is the time of year when you can switch between original fee-for-service Medicare and Medicare Advantage, the all-in-one managed care alternative to the traditional program. You also can re-evaluate your prescription drug coverage — whether that is a stand-alone Part D plan, or wrapped into an Advantage plan.
“It’s a good idea to do a checkup on your coverage, even if you are happy with your current choices.”
Free, Objective, Expert Medicare Counseling
“The APPRISE program offers free Medicare counseling to older Pennsylvanians. APPRISE counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance.”
Each county’s Area Agency on Aging has APPRISE counselors to help you understand the options and opportunities.
Harrisburg, PA – The Department of Aging is warning Pennsylvania seniors, their families, and caregivers about a new scam targeting older adults. DNA testing has become extremely popular in the past few years for people looking to learn more about their family history and health, and scammers are now targeting Medicare beneficiaries with a fraudulent DNA testing service. These scammers offer “free” genetic testing, claiming it is covered through Medicare, as a means for the senior to avoid disease or to find the right medications. This is simply an effort to gain access to a senior’s personal Medicare information, which can lead to access to financial information and more.
“Unfortunately, scammers continue to develop ways to target seniors,” said Secretary of Aging Robert Torres. “It’s a major priority to circulate new scam tactics to the public as we discover them to help older adults and their loved ones be one step ahead of potentially being a victim of these criminals.”
The Administration for Community Living (ACL) suggests the following tips to avoid being scammed:
- Do not accept genetic testing services, including a cheek swab, from someone at a community event, a local fair, a farmer’s market, a parking lot, or any other large event.
- Always be cautious about giving out your personal information, including your Medicare number.
- If you receive a genetic testing kit in the mail, don’t accept it unless it was ordered by your physician. Refuse the delivery or return it to the sender and keep a record of the sender’s name and the date you returned the items.
- Always review your Medicare Summary Notice or Explanation of Benefits. The words “gene analysis” or “molecular pathology” may indicate questionable genetic testing.
The U.S. Department of Justice estimates that one in 10 older adults is a victim of elder abuse, and according to the Senate Special Committee on Aging, for every case of elder abuse reported, five go unreported. This reporting rate is even more troubling in financial abuse cases, which estimates that only one in 14 cases is reported.
If you or a loved one have already received a genetic testing cheek swab or screening that was not ordered by a trusted provider, or have any concerns about possible fraud, find and contact your local Senior Medicare Patrol (SMP) here or call 1-877-808-2468.
Anyone can report elder abuse by calling the 24-hour statewide elder abuse hotline at 1-800-490-8505, or by contacting their local Area Agency on Aging. Pennsylvania law protects those who report suspected abuse from retaliation and civil or criminal liability; all calls are free and confidential.
“‘We Need Each Other’: Seniors Are Drawn to New Housing | Arrangements Older Americans are exploring housing alternatives, including villages and home-sharing.” – The New York Times
Finding a place to live for too many people is a serious challenge; co-housing or home sharing provides a viable option. This article, Here’s an idea worth “sharing.”, is about a test program that’s being used in northeast Pennsylvania. This article, too, takes a closer look at the concept of shared housing.
“Credit: Jackie Molloy for The New York Times
“After her husband died, Freda Schaeffer was left on her own in a three-bedroom house in Brooklyn. ‘I was lonely,’ she confessed. And she worried about finances, because ‘there’s a lot of expenses in a house.’
“Tom Logan, who had moved east from California, found that his disability payments from the Department of Veterans Affairs didn’t stretch very far in New York City. ‘I needed a place to stay, or I could be homeless,’ he said.
“Enter the matchmaker, a home-sharing program operated by the New York Foundation for Senior Citizens. It pairs people who have extra living space — but want company, help with chores, extra income or all three — with those desperate for affordable housing.”
“The realities of homelessness upend many common assumptions about its causes—and potential solutions—an expert argues.”
“Antonio DeSilva, who is currently homeless, plays with his dogs outside his tent on September 09, 2019 in Los Angeles, California.” (Credit: Mario Tama/Getty Images)
“On a single night in January 2018, the US Department of Housing and Urban Development collected nationwide data to determine there are now about 553,000 homeless people across the country—or nearly the same number as the entire the population of Albuquerque, New Mexico.
“While that is an improvement on the estimated 647,000 homeless Americans in 2007, it also reflects a lingering inability to solve a four-decade-old national crisis.
“What exactly caused the American homeless rate to reach and sustain such heights? Some have cited the shutting of mental hospitals in the 1970s. Others have pointed to the lack of safety nets for military veterans with post-traumatic stress disorder.”
Pennsylvania’s “Estate Recovery Program allows the commonwealth to recover Medical Assistance payments from the estate of an individual who was 55 years of age or older when they started receiving nursing facility services or home and community-based services. These payments must have been provided on or after August 15, 1994, the effective date of the Act.”
“Established under federal law, this program requires the Department of Human Services to recover the Medical Assistance costs from the estates of individuals who have died. Repayment is required for the amount the state paid, even if the individuals paid part of the bill themselves or through insurance. If an individual 55 years of age or older received certain Medical Assistance benefits and dies, the department will reimburse the Medical Assistance program by recovering these costs from the assets of the person’s estate. An estate exists when a person dies and his or her assets are distributed by will or state law. All monies collected by the Medical Assistance Estate Recovery Program are returned to the Department of Human Services’ long-term care programs to assist others in need of long-term care services.”
Click on the graphic to download the Medical Assistance Estate Recovery Plan Program.