Review of Caregiver Trends: Spring 2012

Medicare and very aggressive treatments: According to a careful analysis of over 200,000 Medicare beneficiary records, just what you may have been suspecting is true:  seniors with cancer continue to receive extremely aggressive treatment for their illnesses even as they are very close to death.  This includes those patients with very poor prognoses.  They, too, were getting chemotherapy less than ten days before they died.

The researchers who undertook this study had some recommendations.  They called for a review of all of the care received by individuals who are nearing the end of their lives, not just the medication regimens.   They also noted that patient preferences, so often overlooked in the anxiety and stress of the final days, need to be considered first when determining whether aggressive treatments should continue.  So often these treatments are exhausting and very, very difficult to endure.   More emphasis may need to be placed on comfort, time spent with loved ones, personal dignity and quality of life.

Dementia cases expected to double:  The World Health Organization (WHO) reports that the number of individuals suffering from dementia worldwide will be twice what it is today by the year 2030.  It is conceivable that by 2050 the current dementia population of 35.6 million will triple.  The sharp increases will be the result of the fact that more of us are living far longer.

According to WHO researchers, dementia strikes 1 in 8 people over the age of 65, and 1 in 2.5 people over the age of 85.  Alzheimer’s Disease is the specific diagnosis in 70 percent of dementia cases around the world.

Preparing for the dreaded colonoscopy This is rather a personal matter, but important nonetheless.  Getting ready for this procedure is hardly pleasant, and a new report indicates that as many as 25 percent of us to not properly cleanse our colons before the test, using shortcuts and otherwise ignoring or skipping the pre-procedure (at home) steps.  The trouble here is that doctors have a hard time seeing the walls of the colon in those of us who don’t follow closely enough the preparation instructions.  The study further recommends that, under these circumstances, doctors stop and reschedule the procedure — which will only make the whole thing even more anxiety-ridden.  So the best bet is to follow those instructions really carefully the first time.

The link between heart disease and gum disease is questioned:  We’ve been told for years now that gum health and heart health are linked, but there just isn’t enough scientific evidence to back the claim that heart attack and stroke are connected to gum disease.  This does not mean that it’s okay to ignore your teeth and gums.  An unhealthy mouth has been linked to other problems, including osteoporosis, diabetes and cancer.  There just isn’t, at present, a solid connection between the heart and gums beyond overall wellness.

The cost of prevention varies widely:  Preventative screening and testing is all the rage today, but being able to afford these examinations and tests will likely depend on where you have them done.  New studies indicate that the price of a preventative test (say, that colonoscopy) can vary up to 700 percent.  Prices are affected by things you may not expect: whether conducted in a physician’s office, clinic or hospital, or whether or not a healthcare facility specializes in a particular test.  And how the procedure is performed also determines how much it will cost.  For example, consider the colonoscopy again.  If the doctor decides that it is best done under general anesthesia, the price goes up considerably.

There really is no effective way for seniors and older adults to comparison shop for such tests, beyond asking about the price per procedure with all local doctors.  Price differences shouldn’t have a big financial impact on those with Medicare, provided a procedure is covered by their particular plan.  Those uninsured might find it helpful to shop around if this is possible and if there is time  — so long as the lowest price does not compromise the quality of care and level of medical expertise.

From AgingCare, LLC, and Anne-Marie Botek.


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