What’s the Latest Problem with Veteran Benefit Claims?

“VA.gov has gaps, and veterans are falling into them,” said Rep. Matt Rosendale, R-Mont., who chairs the House Veterans Affairs subcommittee on technology, during a hearing recently. “This is a situation where the VA is badly in need of independent oversight.”

Military Times’ recent article, “Lawmakers demand accountability after VA loses track of vets’ claims,” reports that in August, VA leaders announced they’d found roughly 32,000 veterans’ disability claims delayed. Some of these cases date back years because of technical flaws in the department’s VA.gov filing systems. Two weeks later, officials acknowledged 57,000 more similarly delayed cases involving veterans trying to add dependents to their accounts.

VA officials said they would backdate veterans’ pay as soon as possible. However, the errors may have delayed potentially thousands of dollars in monthly payouts to individuals suffering from military-related illnesses or injuries.

Veterans Affairs Chief Information Officer Kurt DelBene noted that the errors are just a small portion of the more than seven million cases filed since early 2018. However, he also acknowledged that any mistake that causes financial harm to veterans is unacceptable.

“VA will resolve these issues, prevent them from happening again, and address them more quickly when needed,” he told lawmakers. “And most importantly, we’ll make sure that all impacted veterans get the benefits and services that they deserve as quickly as possible.”

However, several lawmakers said those promises aren’t enough.

“I think we have a problem with addressing the major issues in leadership and officials not being held accountable for things that they do or do not do in upholding their responsibilities to veterans,” said Rep. Morgan Luttrell, R-Texas. “My concern is that no one is holding [anyone] responsible for this.”

Earlier this month, in a letter to VA leadership, committee Chairman Mike Bost, R-Ill., commented that the problems are “just the latest in a string of electronic filing issues that continue to plague the department.”

Reference: Military Times (Sep. 26, 2023) “Lawmakers demand accountability after VA loses track of vets’ claims”

Should I Consume Olive Oil Every Day?

A study presented at NUTRITION 2023, the annual meeting of the American Society of Nutrition, looked at how olive oil intake and dementia-related death could potentially be connected. Prevention’s recent article, “Olive Oil Linked to Lower Risk of Dying From Dementia, Study Shows,” reports that researchers looked at data from more than 90,000 Americans—60,582 women and 31,801 men. The study took place over 30 years in which 4,749 participants died from dementia.

Researchers found that participants who consumed more than ½ a tbsp of olive oil each day had a 28% lower risk of dying from dementia than individuals who never or rarely consumed olive oil. They also saw that switching 5 g (or about 1 tsp) a day of margarine or mayonnaise for olive oil was linked to an 8–14% lower risk of dementia-related death.

The study noted that those who died of dementia were more likely to be APOe4 carriers, a gene that increases the risk of Alzheimer’s disease. However, they said the results were still consistent after adjusting for the genetic risk factors.

These findings suggest that olive oil may have beneficial properties for brain health and may play a part in lowering the risk of dementia-related death.

With its antioxidants and powerful anti-inflammatory compounds, olive oil has many health-protective benefits. Generally, olive oil may help reduce the risk of heart disease, boosting gut health, protecting brain health, and improving health parameters, like A1C levels associated with type 2 diabetes.

Diets like the Mediterranean diet that are rich in unsaturated fats have been found to have cardiovascular health benefits. Plus, studies have found that this diet plays a role in reducing the risk of cognitive decline in individuals at risk of dementia.

“Because olive oil is a source of unsaturated fat and a major component of the Mediterranean diet, incorporating olive oil into a healthy lifestyle may provide additional cardiovascular and brain health benefits,” the article explained.

Compared with rarely or never enjoying olive oil, having more than 1½ tsp of olive oil a day may be linked with a 25% reduced risk of fatal dementia. So, keep a small bottle of extra-virgin olive oil on the table so it’s available for drizzling onto your meals for its various health-protective benefits.

Reference: Prevention (July 29, 2023) “Olive Oil Linked to Lower Risk of Dying From Dementia, Study Shows”

Can My Barber Help Me Live Longer?

Up to 1 in 5 Americans will develop skin cancer in their lifetime, notes the American Academy of Dermatology.

What’s more, the rates of melanoma, the deadliest form of skin cancer, have increased in recent decades, reports Livestrong’s recent article, “Want to Age Well? Do This the Next Time You Get a Haircut.”

If skin cancer is detected at an early stage, when the cancer cells remain localized to the skin, it can often be cured with a simple procedure like a minor skin surgery or even a prescription cream.

That’s where your hairdresser comes in. In addition to cutting your locks, they can help spot growths on your scalp, ears, or neck.

Your scalp, neck, and ears get extensive exposure to the sun’s UV rays every day. That puts them at high risk for potential skin cancers. However, it’s hard to see these parts of your own body, so a new or unusual growth might go unnoticed for several months.

Hairdressers see our scalps most closely and regularly. They can be the first to spot something growing on these sites.

Since they spend so much time looking at scalps, ears, and necks each day, they often have a keen sense about whether a growth seems out of the ordinary. You can bring up the topic casually at your next haircut.

Before sitting down, let your hairdresser know you’re trying to be more proactive about your skin health. Ask them to let you know if they notice any unusual moles or spots while they wash and cut your hair.

Remember that your hairdresser isn’t a skin expert. However, think of them as an additional tool in your skin cancer prevention tactics arsenal.

They aren’t a substitute for good skin-care habits like wearing sunscreen (and sun-protective clothing) and seeing a dermatologist for an annual skin check.

Reference: Livestrong (June 25, 2023) “Want to Age Well? Do This the Next Time You Get a Haircut”

What Should I Know about Falls?

Over 25% of adults age 65 or older fall each year, and thousands of older adults break a bone, according to Very Well Health’s recent article, “Managing Pain as You Age.” Falls and fractures are common concerns for older adults, especially women with osteoarthritis. About a third of women over age 50 will break a bone related to osteoarthritis.

In addition to injury, this is a major issue for older adults, as people age 70+ have an increased risk of death after a fall. In one study, 4.5% of people 70 or older died after a ground-level fall compared to 1.5% of a younger population. Falls, if not deadly, also affect long-term mobility, overall health, and independence. In the same study, people 70 and older had longer hospital and intensive care unit (ICU) stays than their younger counterparts. Only 22% could function independently once released vs. 41% of the younger adults who had fallen.

However, there are ways to reduce the risks of serious, long-term effects from a fall. After a fall, staying calm and preventing further injury is essential. These include:

Relaxing by taking deep, calming breaths;
Staying still where you land and giving yourself time to recover from any shock the fall may have caused;
Assessing your condition and checking for possible injuries before moving; and
Calling 911 or ask someone nearby to help if there are any injuries.

If there are no injuries, you can roll to one side, rest, move to your hands and knees and transition to a chair. Even if you can get up on your own after a fall, seeing a healthcare provider is important. They can identify possible unnoticed injuries and determine health concerns that may have caused the fall.

If you have a fracture from a fall, treating it depends on the location of the break, the severity and other factors related to the individual and their injury. For example, a hip fracture is a common injury in older adults that may or may not require surgery. Traction is sometimes used to pull different parts of the body to help stretch the area around the broken bone for healing. With most fractures, it’s also important to use a splint or cast to keep the area from moving.

Reference: Very Well Health (Oct. 25, 2022) “Managing Pain as You Age”

How Much Does Medicare Pay for Nursing Home Stays?

How Much Does Medicare Pay for Nursing Home Stays?

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According to the AARP, the median monthly cost to live in a nursing home is $7,908 for a semi-private room. The options for paying for such care are limited. Fortune’s recent article, “Does Medicare pay for nursing home care? An expert helps make sense of the rules,” reminds us that there’s limited nursing home coverage under Medicare.

Medicare won’t pay for nursing home care but for certain stays under specific conditions. The program will pay for a nursing home stay, if it’s determined that the patient needs skilled nursing services, like help recovering after a medical issue like surgery or a stroke, but for not more than 100 days. For the first 20 days, Medicare will cover 100% of the cost. From day 21 to 100, the patient pays a $200 co-payment in 2023, and Medicare pays the balance.

To qualify, the individual would need at least a three-day stay as a hospital inpatient before the agency would approve payment for nursing home care for rehabilitation or skilled nursing care. Getting three days as an inpatient in a hospital is a challenge as hospitals are discharging patients quickly, and most patients aren’t staying for three nights. Hospitals also use what’s called observation status, where a patient is technically not admitted to the hospital. This affects beneficiaries’ ability to access Medicare coverage for rehabilitation or skilled nursing care in a nursing home. Observation status gives physicians 24-48 hours to assess if a patient should be admitted for inpatient care or discharged. This status can be costly for Medicare patients as the agency classifies it as outpatient care. As a result, beneficiaries may have to pay their share of that cost as a deductible, coinsurance, or copayment. Some patients also remain in observation status longer than the typical 24 to 48 hours.

To address this, Medicare has implemented the two-midnight rule. This rule stipulates that when a physician expects a patient to require hospital care for at least two midnights, they should admit them as an inpatient. However, two midnights spent under observation don’t count toward the three-day inpatient stay patients need to qualify for coverage in a nursing home or SNF. It’s not just a matter of the time spent in the hospital; it’s how the patient is classified.

The patient must be formally admitted as an inpatient to be classified as an inpatient.

Because each state regulates Medicaid eligibility differently, ask an experienced elder law attorney to guide you through the process and to help you find the best long-term care option.

Reference: Fortune (Aug. 29, 2023) “Does Medicare pay for nursing home care? An expert helps make sense of the rules”

What Should I Know About Stroke Recovery?

A stroke is a serious medical emergency that happens when blood flow is deficient to an area of the brain or bleeding in the brain. Sometimes, direct stroke intervention is necessary. This may include:

Blood thinners given intravenously (IV) for an ischemic stroke;
Direct injection of blood thinners into a blood clot for certain types of ischemic strokes;
Thrombectomy, where a thin tube (catheter) is threaded through blood vessels to a clot in the brain, and the clot is mechanically removed;
Surgical intervention for removal of blood for a hemorrhagic stroke; and
A craniotomy removes a small area of the skull to relieve severe edema (swelling).

VeryWell Health’s recent article, “Everything You Should Know About Stroke,” explains that close monitoring of neurological functioning, fluid and electrolyte concentration, blood pressure and blood glucose is needed in the first few days after a stroke. Brain damage from a stroke may sometimes cause a seizure, necessitating treatment with antiepileptic medication.

After stabilization, recovery can start, but note that recovery after a stroke is often gradual. Some people fully recover, but most have some impairment after a stroke.

Immediate medical care and consistent therapy can improve long-term outcomes. Patience throughout recovery is important because improvement doesn’t always adhere to a smooth and steady path.

Sometimes, complications can be prevented by taking proactive measures. Choking or pneumonia, possibly due to difficulty swallowing, is an especially concerning risk. Weakness and sensory changes can increase the chances of bedsores and blood clots. Weakness and vision changes may lead to falling after a stroke.

Rehabilitation should be customized to specific deficits that happen after a stroke. For example, many people require physical therapy to help with improving muscle control and strength. Speech and swallow therapy is crucial to avoid choking and aspiration pneumonia.

Recovery can frequently be slow over the next few weeks. For some, recovery continues for up to a year.

Reference: VeryWell Health (Feb. 27, 2023) “Everything You Should Know About Stroke”

How Do I Make a Care Plan for Mom?

Medicare typically doesn’t pay for basic assistance, and families often don’t try to determine how to provide this care until there is a health crisis, which can lead to unnecessary stress, conflicts and escalating costs.

Nerd Wallet’s recent article, “Create a Care Plan for Older Parents (or Yourself),” says that making a care plan well in advance lets families organize, locate appropriate resources and determine ways to pay for care before a crisis hits.

A care plan is thinking through the logistics of what you’ll need as you age, so that you are prepared when the poop hits the fan with aging. A way to cope is to plan for temporary rather than permanent disability. Ask what kind of help you or your loved one might need after a hip or knee replacement. How well is the home set up for recovery? Who would help with household tasks? Contemplating a two- or three-month disability with an eventual return to health is less daunting but involves much of the same planning as a more lasting decline.

Many seniors would like to stay in their current homes as they age, something called “aging in place.” That typically means relying on family members for care, using paid workers, or both. However, if family members will be tapped, discuss the logistics, including whether and how much they will be paid. If home health aides will be hired, consider who will supervise the process.

Look at any savings that can be tapped and whether the senior may qualify for government help, such as veterans benefits, Medicaid, or state programs. Families may want to consult an elder law attorney for personalized advice.

It is important to look at the current home as “aging friendly.” An occupational therapist can suggest adaptations allowing the older person to remain in the home if they’re disabled. The sooner you get this evaluation, the more time you’ll have to prepare. Even if the home supports aging in place, the neighborhood might not. Consider how the older person will socialize, get groceries, and make it to health appointments if they can no longer drive.

An independent living or senior living facility could provide more amenities. However, these typically don’t provide long-term care. Therefore, see if the senior is okay with moving again later or whether they should begin with an assisted living or continuing care facility that can provide more help.

Once you have a plan, capture the details and share it with family members or others who may be involved. Revisit the document periodically as circumstances change. Aging planning is an ongoing process.

Reference: Nerd Wallet (Aug. 24, 2023) “Create a Care Plan for Older Parents (or Yourself)”

Should I Enroll in Medicare Before I Retire?

A recent survey found that a third of those nearing retirement age (62-64) who plan to keep working past 65 don’t understand they can sign up for what is often more affordable Medicare coverage, even while they’re still employed.

Kiplinger’s recent article, “Yes, You Can Sign Up for Medicare While You’re Still Working,” says that with retirement further away for many, some people must get some help understanding their options. The article answers some common questions concerning retirement postponement and Medicare coverage, including common misperceptions.

Your retirement decision is personal and dependent on your situation. Access to health coverage is one of the primary reasons that the average age at which people retire is going up. In a survey of more than 1,000 American older workers, 31% of those with employer insurance say health care is their primary reason for working, and 53% say it’s one factor. Whether you are continuing to work based on career fulfillment or health coverage, having a plan in place for handling your Medicare decisions before you turn 65 can streamline the transition off of your employer-sponsored health insurance.

Most working seniors don’t have to enroll in Medicare. It’s not required that all seniors make the jump as soon as they hit 65. However, there are some situations where it’s mandatory. It is important to be aware of these exceptions to ensure that there are no gaps in your coverage. If you delay your signup, you might end up paying for it: your small company’s group plan can deny your claims if they find you’re eligible for Medicare. There are also financial penalties for late enrollment, so if you work for a small company, you must be ready to make the leap to Medicare coverage, regardless of your retirement plans.

Employees approaching retirement and those who have reached retirement age say they’re mostly happy with their employer health benefit packages. However, hesitation and misconceptions about Medicare prevent workers from shopping for better plans. If Original Medicare is unaccompanied by a prescription drug plan (Part D) or a Medigap supplement, it may be less than your current employer-sponsored level coverage. Most individuals who sign up for Medicare don’t sign up for Original Medicare alone. You should couple your Original Medicare plan with a prescription drug and Medigap plan. Each Medigap plan (plans A to N) offers a different level of coverage that demands careful consideration in terms of weighing which plan best fits your needs.

Another option, aside from Original Medicare plus a Medigap plan, would be to go with a Medicare Advantage plan (Part C). Medicare Advantage plans are usually less expensive, and some plans have no monthly premium.

Reference: Kiplinger (Oct. 11, 2022) “Yes, You Can Sign Up for Medicare While You’re Still Working”

Why Is Stretching So Important?

Stretching — especially before bed — is an excellent aid for longevity. It has many benefits, from easing stress and improving sleep to reducing inflammation and menopause symptoms (among many more), says Livestrong’s recent article entitled, “Want to Age Well? Do This Every Night Before Bed.” Here are the benefits of stretching before bed for older adults (and everyone else), plus which bedtime stretches are best.

It Eases Stress. Stretching profoundly stimulates the body’s parasympathetic nervous system, which is responsible for resting, digesting, and healing the body. That’s why a mindful stretching practice before bed is an effective tool to help ground us and inhibit the sympathetic nervous system for better health.
It Reduces Inflammation. Regular stretching can have a great effect on decreasing inflammatory markers in the body. Gentle stretching at a low intensity can help you relax and stimulate the parasympathetic nervous system, which has an inflammatory regulating response.
It Can Improve Your Sleep Quality. Age is linked to difficulty falling and staying asleep. Therefore, winding down before bedtime can be challenging for many people. Stretching can also positively affect your sleep.
It Lowers Your Risk of Injuries (Including Falls). Stretching increases the force-length relationship of your muscles, so your muscles can both produce and manage a greater amount of force at various lengths. This can help decrease muscle and tendon-related injuries. Longer muscle lengths may allow the body to maintain balance and avoid falls, which is especially important as we age more effectively.
It Increases Blood Flow. Stretching can stimulate the parasympathetic nervous system, dilating the blood vessels to the muscle. Therefore, stretching would also theoretically increase blood flow to the muscles. That’s especially important because some older adults deal with blood flow-related health issues.
It Decreases the Frequency and Severity of Leg Cramps. Leg cramps are more common in older people because the tendons (the connective tissues that attach muscles to bones) shorten as you age. The frequency and severity of leg cramps also relate to poor hydration levels and nutrition deficiencies. Since older people are more likely to be dehydrated and lack certain essential nutrients, this puts them at a greater risk. Stretching at night may alleviate leg cramps.
It Helps With Menopause Symptoms. Light to moderate stretching can likely improve symptoms of menopause, such as hot flashes, sleep problems and mood fluctuations.

Reference: Livestrong (June 1, 2023) “Want to Age Well? Do This Every Night Before Bed”

How to Pay for Hearing Aids

Untreated hearing loss has been linked to a higher level of depression, cognitive decline, dementia, falls, visits to the emergency room, and hospital stays. Despite this, says an article from ncoa Adviser, “Financial Assistance for Hearing Aids: A Complete Guide for Older Adults,” fewer than 15% of adults who need hearing aids use them, and the average person takes nearly nine years to go about getting a pair after being told they have hearing loss.

Part of the reason for the delay is financial. Resources for getting hearing aids vary from state to state, and even county to county, which can be confusing. Here’s how to get started.

First, check with your health insurance company to see what’s covered and ask about additional services. You’re not just buying an appliance. Hearing aids require activation and fitting, and other unexpected out-of-pocket costs may occur. Sometimes the easiest way to verify insurance is to have a hearing aid clinic check into it.

Except in five states—Arkansas, Connecticut, Illinois, New Hampshire, and Rhode Island—insurance providers are not required to cover hearing aids as part of health care for adults. Medicare Parts A and B don’t cover the cost of hearing aids or fitting exams. Still, Medicare Part B covers hearing and balance exams ordered by a doctor and an annual audiology appointment to evaluate hearing loss. Whether or not Medicare Advantage, aka Medicare Part C, provides coverage depends upon the plan.

Medicaid coverage varies by state and plan. Many people with Medicare and Medicaid can sign up with select insurance companies and get coverage at no additional cost, but the coverage varies. Also, the quality of the hearing aids may differ.

Active duty military service members and family members diagnosed with hearing loss meeting the coverage criteria may be eligible to receive hearing aids through a TRICARE-approved provider. For veterans, the VA has hearing aid benefits. They should reach out to their local office or representative. The VA website has information on how to apply for VA hearing health care and find the nearest provider.

Federal employees of the American Federation of Government Employees (AFGE) have access to discounted hearing aids, including a free hearing exam, discounted hearing aids, and aftercare support.

Those with mild to moderate hearing loss can now consider over-the-counter hearing aids. Note that the cost of the device you are buying is a third of the price. The rest of the costs are services, so be sure what services are bundled into the offerings. Instead of relying on online reviews, research trusted sources. You’ll want to clearly understand the return policy, warranty coverage for damage and loss, and customer service.

Reference: ncoa Adviser (July 2, 2023) “Financial Assistance for Hearing Aids: A Complete Guide for Older Adults”

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