Monthly Archives: September, 2019

“Sudden switch from hospital to nursing home can leave families scrambling” – The Buffalo News

Healthcare transition often can present a confusing scenario. This article is from The Buffalo News (Buffalo, NY) and is specific to New York, but the issue of transition applies everywhere.

“Staffing levels, health inspections and whether a facility has been fined for conditions that could harm residents are all public information and easily accessible through the federal Nursing Home Compare website that rates nursing homes. But many families don’t have the information at the very moment they need it most.”

1011008986 Henry NURSING HOME KIRKHAM“Already two hours late, Roberta Novack waits patiently in a corner for an ambulance team to arrive to transport her brother Henry Kostrzewa, 52, to his latest stay at the Buffalo Center for Rehabilitation & Nursing on Delaware Ave. in Buffalo This was on Saturday, July 28, 2018.” (Robert Kirkham/Buffalo News)

by Lou Michel

“The call from the hospital jolted Henry Kostrzewa’s sister. Erie County Medical Center was going to discharge the 52-year-old disabled welder and she needed to help him pick a nursing home.

“The clock was ticking.

“Kostrzewa had been informed he could end up personally responsible for his hospital bills because he had been ‘medically cleared’ to move into a nursing home.

“Roberta Novack told her younger brother not to sign anything. She feared he would end up in a facility unable to provide quality care for the bone infection in his spine that had kept him bedridden for months following a hip replacement surgery.”

Click here to read this article at The Buffalo News in its entirety.


“Updated Long-Term Services and Supports Fact Sheet Published”

ltss article

The AARP Public Policy Institute has released a new fact sheet about long-term services and supports. The sheet provides updated information from a similar LTSS publication in 2017. The 2019 edition examines LTSS and covers topics including:

  • What LTSS encompass;
  • Who needs LTSS;
  • Who provides LTSS; and
  • Where people with LTSS reside.
Click here to visit the Genworth “Cost of Care Survey 2018” Webpage.

“For Older Patients, an ‘Afterworld’ of Hospital Care” – The New York Times

“Long-term care hospitals tend to the sickest of patients, often near the end of their lives. Many will never return home.”

never home againCredit: Monica Jorge for The New York Times)

by Paula Spahn

“The Hospital for Special Care in New Britain, Conn., had 10 patients in its close observation unit on a recent afternoon. Visitors could hear the steady ping of pulse monitors and the hum of ventilators.

“The hospital carefully designed these curtained cubicles to include windows, so that patients can distinguish day from night. It also placed soothing artwork — ocean scenes and landscapes — on the ceilings for those who can’t turn over and look outside.

“All these patients had undergone a tracheostomy — a surgical opening in the windpipe to accommodate a breathing tube attached to a ventilator — when they arrived from a standard acute-care hospital. Some had since been weaned from the ventilators, at least for part of the day.”

Read this New York Times column in its entirety, click here.

Loneliness and social isolation – focus is there, solutions are emerging

fighting social isolation

Aging in Place Technology Watch and GreatCall have published a new white paper about initiatives to fight social isolation — a few of the points are excerpted here:

What has changed in the past two years?  First, the research.  Once the correlation between social isolation and poorer health outcomes was made, the volume of research spiked. From its pre-correlation measurement in the 1996 UCLA Loneliness Scale, a number of other surveys have been released that include correlation with health care costs, economic status, and lifestyle preferences. In late 2017, research from AARP’s Public Policy Institute concluded that socially isolated older adults cost the U.S. health system an additional $6.7 billion in health-related spending. Newer research from the National Institute on Aging is focusing on the connections between loneliness, long viewed as a predictor of cognitive decline, and other health risks, including:  high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.

Social isolation – is this a worsening 21st century phenomenon? Is social isolation more of a problem today than in the past. And, what is the prognosis for the future? The recent AARP report zeroed in on the key predictors of loneliness, sometimes referred to as “perceived social isolation.” Living situations and marital status may provide a clue to societal changes that result in social isolation and loneliness. In 2018, the Administration for Community Living (ACL) released its survey profile of older Americans (age 65+). It showed that while only 14 percent of the 65+ population lives alone, almost half (45 percent) of women aged 75+ live by themselves. According to Pew Research, among those 65 and older, the divorce rate has tripled since 1990.

A top predictor of loneliness is size and quality of one’s social network.  To assess these elements and their connection to loneliness, the AARP respondents were asked for both the number of people in their lives who have been supportive in the past year and the number with whom they can discuss matters of personal importance. From the study: “As expected, as one’s social network increases, loneliness decreases. Also as expected, as physical isolation decreases (the factor which included items such as disability status, number of hours spent alone and household size), so does loneliness.”

Health limitations can exacerbate social isolation. While loneliness and social isolation are emerging as public health issues, less has been published about the health issues that may lead to social isolation: mobility limitations, depression, cognitive impairment and hearing loss.  In another study, older adults with mobility impairments were more likely to report being isolated from friends. These surveys underscore the fact that elderly people are the most likely to experience social isolation and its related health effects. According to a UK study, those who provide care — including family caregivers such as children or spouses — are also known to experience loneliness in their roles and would benefit from greater societal appreciation and possible interventions such as respite care.

Untreated hearing loss contributes to social isolation.  According to government statistics, among adults aged 70 and older with hearing loss who could benefit from hearing aids, fewer than 30% have ever used them. Denial and unreimbursed cost ($2400/ear) are factors, and delay in acquiring them can worsen the isolation.  Hearing aids today also offer features that include fall detection, smartphone integration, and AI capabilities.  Moving forward, Medicare Advantage plans are beginning to contribute to a portion of the cost. Audiologists play a role in managing user expectations and training an individual to adjust to the change from little or no sound to the noisy environment of stores, restaurants, office buildings and streets.

Click here to read the full white paper.

What are Vet Centers?

Vet Center logo with drop shadow effect

Vet Centers are community-based counseling centers, providing social and psychological services including professional readjustment counseling to eligible Veterans and active duty service members, to include members of the National Guard and Reserve components and their families.

Vet Centers also play a significant role in VA’s Emergency Response mission to assist communities. MVCs and Vet Center staff deploy in response to shootings and support emergency response efforts to natural disasters and wild fires.

Who is eligible?

Veterans and active duty service members who:

* Have served on active military duty in any combat theater or area of hostility;
* Experienced a military sexual trauma (MST)
* Provided direct emergent medical care or mortuary services to the casualties of war, while serving on active duty, or
* Served as a member of an unmanned aerial vehicle crew that provided direct support to operations in a combat zone or area of hostility
* Vietnam Era Veterans who accessed care at a Vet Center prior to January 1, 2004.

Vet Center services are also provided to family members or loved ones of Veterans and service members for military-related issues when it is found to aid in the readjustment of those that served, or to help cope with the deployment of the service member. This includes marriage and family counseling and bereavement counseling for families who experience an active duty death.

What makes Vet Centers unique?

Non-traditional hours (including evenings and weekends), services without time limitation and at no charge. Individuals do not need to be enrolled in VA Healthcare Services, do not need a disability rating or service connection and can access Vet Center services regardless of discharge character.

What makes Vet Centers different than VA’s Mental Health?

While Vet Centers are not a part Mental Health in the VAMCs, they are connected through coordination and bi-directional referral. Vet Center staff are licensed professionals who offer a non-medical approach to counseling and do not provide medication management.

How do Vet Centers reach Veterans and service members?

Outreach specialists and counselors participate in a myriad of outreach events in local communities and host various events in order to create face to face connections and get eligible individuals connected to Vet Center Services.

80 Mobile Vet Centers are on the road or out in the community, extending the reach of Vet Centers through focused outreach, direct service provision and referral. Many of these communities are distant from existing services and are considered rural or highly rural.

How can I refer someone to a Vet Center for services?

If you think someone may benefit from Vet Center services, please call your nearest Vet Center or encourage the Veteran or service member to call or stop in.

Lancaster Vet Center

Harrisburg Vet Center


“Opioid crackdown forces pain patients to taper off drugs they say they need” – The Washington Post

pain“Hank Skinner and his wife, Carol, are no strangers to pain, having collectively experienced multiple illnesses and surgeries. Hank relies on a fentanyl patch but is now being forced to lower his dosage.” (Salwan Georges/The Washington Post)

by Joel Achenbach and Lenny Bernstein

Carol and Hank Skinner of Alexandria, Va., can talk about pain all day long.

“Carol, 77, once had so much pain in her right hip and so little satisfaction with medical treatment she vowed to stay in bed until she died.

“Hank, 79, has had seven shoulder surgeries, lung cancer, open-heart surgery, a blown-out knee and lifelong complications from a clubfoot. He has a fentanyl patch on his belly to treat his chronic shoulder pain. He replaces the patch every three days, supplementing the slow-release fentanyl with pills containing hydrocodone.

“But to the Skinners’ dismay, Hank is now going through what is known as a forced taper.”

“Sexual assault in the military … “

mil sex assault

“is a problem widely recognized but poorly understood. Elected officials and Pentagon leaders have tended to focus on the thousands of women who have been preyed upon while in uniform. But over the years, more of the victims have been men.

“On average, about 10,000 men are sexually assaulted in the American military each year, according to Pentagon statistics. Overwhelmingly, the victims are young and low-ranking. Many struggle afterward, are kicked out of the military and have trouble finding their footing in civilian life.

“For decades, the fallout from the vast majority of male sexual assaults in uniform was silence: Silence of victims too humiliated to report the crime, silence of authorities unequipped to pursue it, silence of commands that believed no problem existed, and silence of families too ashamed to protest.”

Read this report in its entirety at The New York Times.

Millersville University offers two presentations that veterans can appreciate.

MU programs for veteransfor free tickets to these productions.

The Interpreters – On Screen/In Person | September 26, 2019 @ 7:00 PM

OPINION: “The Trick to Life Is to Keep Moving | What my friendship with a woman 51 years my senior taught me about growing up.” – The New York Times

“Cora taught me that there are worse things than dying — that getting older is a process of losing your children to distance and coping with incontinence and memory loss, yes, but also of becoming more unapologetically yourself.”

keep moving


“For many people, roommates and romances are the most important relationships of their late teens and early 20s. For me it was Cora Brooks, a poet and activist 51 years my senior. She taught me how to make bread without measuring the flour or water or yeast, to not fear improvising. Through Cora I learned slowness and grace.

“Cora taught me that there are worse things than dying — that getting older is a process of losing your children to distance and coping with incontinence and memory loss, yes, but also of becoming more unapologetically yourself. She got angry at the government, at the Vermont Yankee Nuclear Power Station, at her body’s failings, at her family. Her secret to recovering from multiple strokes? Turn on the radio and teach herself to dance, step by wobbly step. ‘The trick is to keep moving,’ she told me.”

Read this opinion column in its entirety at The New York Times.


“At War: The first Marine in my battalion to die by suicide” – The New York Times

by Thomas Gibbons-Neff, Domestic Correspondent

My battalion’s mortar platoon lived on the bottom floor of the barracks at Camp Lejeune and those Marines were always a pain. But they were good at their jobs and on the weekends, when the weather was good, they would have a barbecue down by the smoke pit.

marinesMarines from First Battalion, Sixth Marines rest between patrols during the battle for Marjah, Afghanistan, in February 2010.” via Thomas Gibbons-Neff

Tim Ryan was one of those mortarmen. He had a thick Boston accent, and one time I ran into him at Charlotte Douglas International Airport. I think it was predeployment leave. We were both flying to Boston, and he was on an earlier flight. But when they announced the boarding process, he barely moved from the airport bar. He had been drinking alone most of the afternoon, so I helped him up and did what I could to get him to his gate. He was happy to be going home.

Tim was the first Marine in our battalion who killed himself after our unit got back from Afghanistan in July 2010. He was 23, and he died on May 7, 2011. He would not be the last. From then on, it seemed like every six months someone we knew died. In total, at least nine Marines from my unit have died since coming back from that deployment.

Two months before Tim there was Joey Schiano, a Marine from my battalion with whom I shared a recruiter in Connecticut. He wrapped his Volkswagen around a tree.

Soon, my friends and I were in a never-ending pursuit, trying to understand why our friends were dying long after we had returned from overseas. It’s a question we still haven’t been able to answer, nor it seems has anyone in the military or veterans community.

In 2018, 321 active-duty members took their lives: 57 Marines, 68 sailors, 58 airmen and 138 soldiers, according to The total was the same as 2012, which was the Continue reading →