A Good Day at the White House—#AGSProud


Heading into the East Room of the White House.

The White House Conference on Aging (WHCOA) was this week. It’s a once-in-a-decade gathering of people who are passionate about older Americans. The next time this conference occurs, I’ll be 66 and my siblings will be in their 60s with one turning the corner to 70. With a little luck and some healthy choices, we’ll be active and engaged with our communities well into our golden years.

One thing that is clear from the 2015 conference is that, as a country, we still have a lot of hard work to do if our communities are going to be ready for me and my siblings. That said, I was proud to represent geriatrics health professionals at the WHCOA and it gave me hope that the type of future we envision for older adults could be a reality (especially on the cusp of some momentous news today from the U.S. Senate—you’ll just have to keep reading to find out more!).


President Obama giving his remarks.

First, the things that made me proud…

Falls Prevention Takes Center Stage at the Centers for Disease Control & Prevention: In 2001, the American Geriatrics Society (together with the British Geriatrics Society and the American Academy of Orthopedic Surgeons) released our first Guideline for the Prevention of Falls in Older Persons, with an updated guideline issued in 2010. This was seminal work, and not just for the AGS. In fact, our most recent guideline informed the U.S. Centers for Disease Control and Prevention (CDC) work on creating the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) initiative that was announced at the WHCOA. STEADI provides educational tools to healthcare professionals that can help them identify individuals at risk for falls, understand how to modify certain risks that they are likely to find, and learn how to implement effective options for preventing falls altogether. The CDC has been working with Epic Systems Corporation (an electronic health record technology provider) and EPIC will be rolling out a clinical support tool for falls assessment. This resource will make it easier for ALL healthcare providers to screen for falls, intervene to reduce risk, and provide follow-up care. AGS members are leading the STRIDE study that is testing a multifactorial fall injury prevention strategy that is being co-funded by the Patient-Centered Outcomes Institute (PCORI) and the National Institute on Aging (NIA). I’m proud of AGS and our members—we built the foundation for STEADI and, looking towards the WHCOA in 2025, I expect that we will have progressed even further in our understanding of how to prevent older adult falls.

Medicare & Geriatrics Health Professions Funding: President Obama had some good news for geriatrics health professionals, as well—noting that we are working to implement Medicare payment models that support the quality rather than the quantity of care. AGS has been at the forefront of efforts that will benefit beneficiaries by ensuring that clinicians are supported to provide care coordination, care transitions, and advance care planning. We continue to advocate for payment models that support geriatrics health professionals in doing what they love to do: maximize the function and quality of life of the older adults they serve. Look for more news from us on the recently released 2016 proposed physician fee schedule rule in the coming weeks.

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Staying Sharp: Tips to Keep Your Brain Healthy

A great way to keep your mental sharpness at its peak is to think of your brain as a muscle. Just as exercising your muscles helps keep you healthy and active, exercising your brain can help protect your memory and fight the effects of diseases affecting the brain, such as Alzheimer’s disease or other forms of dementia.

To help keep your mental skills sharp, make these healthy habits part of your daily routine:

Stay in shape. Physical activity isn’t just great for yourmuscles; it’s good for brain power, too. Being active for 30 minutes a day, at least three days a week, helps increase blood flow to the brain to keep it healthy. What’s more, exercise may even help new brain cells to grow! Walking is the perfect exercise for most people—you can walk outdoors on nice days or indoors at a mall or community fitness center. The only equipment you need is a well-fitting, comfortable pair of shoes. Other excellent activities include dancing, gardening, housework, cycling, and swimming.

Get regular health check-ups. High blood pressure, diabetes, depression, and not eating properly can interfere with mental sharpness. See your healthcare provider regularly to make sure your health problems are under control—and to nip any new problems in the bud. To stay on top of your health concerns, make sure to follow your healthcare provider’s advice, too.

Check your meds. Some medications, including ones taken for depression, anxiety, sleeping problems, or pain, can dull your memory. Talk to your healthcare provider about all the medications you may be taking and ask if any could be causing memory issues.

Get plenty of sleep. While you’re sleeping, your brain renews itself, so getting less than 7 to 8 hours of sleep a night (some people may require more or less sleep) can make it harder to concentrate and stay mentally sharp. Healthy sleep habits include:

  • Shutting off the TV, cell phone, tablet, and computer 30 minutes before bedtime.
  • Listening to soft, calming music before bed.
  • Making sure your bedroom is dark and quiet.
  • Avoiding caffeinated drinks like coffee after 3:00pm.
  • Avoiding heavy meals too close to bedtime.
  • Setting a regular time for going to bed and waking up.

Become a social butterfly. Spending time with others can help keep your brain sharp. You can try volunteering, joining a club, or taking on a part-time job. Sign up for discussion groups at a senior center, or learn how to play bridge or other group games. Doing crossword and jigsaw puzzles are other great options for staying mentally engaged.

Eat a varied diet. Meals that include plenty of fruits and vegetables, whole grains, low-fat dairy, lean proteins, and healthy fats such as olive oil and avocados are good for your brain. Fish is especially important because it contains omega-3 fatty acids, which your brain needs to stay healthy.

Defuse your stress. Stress can make even the sharpest people feel forgetful. Engage in activities that calm you down, such as yoga, prayer, or meditation. Walking in nature is also a great way to relax.

Medicare Proposes Paying for Advance Care Planning

Have you ever wondered about all those codes you see on a bill or chart at your healthcare provider’s office?  If you’re covered by Medicare—the nation’s largest insurer dedicated exclusively to helping older people with their health expenses—chances are they’re part of a payment system known as the physician fee schedule.  Medicare pays eligible providers for their services based on the codes they use to bill for the patient visit.

Each year, experts from the Centers for Medicare & Medicaid Services (CMS) review, refine, and tweak the types of services included in the physician fee schedule to make it more responsive to patient needs and professional advice. The proposed schedule for 2016 was just released this week, and it’s got some important new updates that will benefit older Americans.  In particular, CMS is now proposing covering advance care planning (ACP), which would offer patients an important outlet for talking with healthcare providers about their long-term needs and expectations.  Many people have questions about what ACP is and how it works, and the infographic below from the American Geriatrics Society is a helpful guide to the basics when it comes to this important new service.

ACP Infographic_07 06 15

Interested in learning more or taking action?  Consider sharing this post or some of the ACP-related resources posted by the Health in Aging Foundation to Twitter (@HealthinAging) and Facebook (Facebook.com/HealthinAging).  You can also submit a comment of support to CMS to let them know you value ACP as part of your care.

Alzheimer’s & Brain Awareness Month


Sharon A. Brangman, MD
Professor of Medicine
Division Chief, Geriatrics
Director, Central New York Alzheimer’s Disease Assistance Center

SUNY Upstate Medical University

Summer is definitely in full swing: the temperatures are rising, the days are getting longer, and the world is looking a bit more…purple. That may sound strange, but it’s part of a new initiative championed by the Alzheimer’s Association to commemorate the first Alzheimer’s and Brain Awareness Month this June.

In the spirit of Alzheimer’s and Brain Awareness Month, it’s important to understand what Alzheimer’s disease really is (and what it isn’t) and what you can do if you’re concerned about the condition, already living with it, or supporting someone who has been diagnosed.

Dementia and Alzheimer’s: What’s the Difference?
Alzheimer’s disease and dementia are often lumped together, but they aren’t the same thing. Dementia is the umbrella term that covers a wide range of symptoms related to loss of memory and thinking skills severe enough to affect a person’s ability to perform everyday activities. Alzheimer’s disease accounts for 60 to 80 percent of all dementia cases. Vascular dementia, which can follow a stroke, is the second most common type. Additionally, many other, often-reversible conditions like thyroid problems or vitamin deficiencies can cause dementia-like symptoms.

Despite what many people think, dementia isn’t a normal part of aging. Many people have memory loss issues—but that doesn’t mean they have dementia or Alzheimer’s. Those two conditions mean something very different, which is why it’s so important to get a check-up from a healthcare professional if you’re concerned about your cognitive abilities and the potential for developing Alzheimer’s disease. Continue reading

Multiple Chronic Conditions and You

Nancy Lundebjerg casual

I have multiple chronic conditions (MCCs). There—I’ve said it: in my mid-50s, I already have MCCs. Fortunately, nothing is life-threatening, but I do need to keep track of my arthritic toe, my eyesight, and a bit of acid reflux. My friends and I also talk about our weak bladders—likely the precursor to being incontinent later in life, but for now we are managing with the philosophy (in my case, after speaking with my gynecologist): “If there’s a bathroom, we should use it because we never know when we’ll spot another one!”

You’re probably wondering why I’m sharing all of this on the Health in Aging blog. After all, at my age I don’t yet qualify as an older adult. But thinking about all of your conditions any time you get a new diagnosis, try a new vitamin, or are prescribed a new medicine is important at any age. It’s particularly important as you get older, and the American Geriatrics Society (AGS) and the Health in Aging Foundation have tools you can use to create care plans with your providers that take into account all of your conditions and your preferences.

So just what is a chronic condition? Simply put, it’s a physical or mental condition that lasts a year or more and requires ongoing medical attention and/or limits what you can do on a daily basis. At one point, my arthritic left toe was limiting how far I could walk, which, for a New Yorker, had a big impact on my quality of life. Even now, post-surgery, the toe requires an orthotic and monitoring by my doctor. Cute little shoes are basically not an option!

MCC Tools for You
According to Medicare data, more than two-thirds of beneficiaries have 3 or more chronic conditions. If you—or someone you care for—has MCCs, the AGS Health in Aging Foundation has tools that can guide you as you work with clinicians to plan a course of care that takes into account your goals and also helps to prevent having a bad outcome. I always start with our A-Z chapters, as these provide a general overview of a topic and serve as a road map to AGS Health in Aging Foundation resources and those from other organizations. Our chapter on Managing Multiple Health Problems is based on a piece that we created to assist health professionals who are caring for older adults. You can also find other tools, including advice from Drs. Cythia Boyd and Matt McNabney.

Tools for Your Clinicians
The tools and resources that we provide on HealthinAging.org are drawn from the health professional resources of the AGS. In 2012, AGS developed “Guiding Principles for the Care of Older Adults with Multimorbidity: A Stepwise Approach for Clinicians,” which provides a stepwise approach (or one based on a series of stages or steps) for any clinician who is caring for someone with MCCs. One of our primary goals in creating this document was to help clinicians who do not have training in geriatrics and who are treating patients for one or more of their chronic conditions. This is why, with funding from the Agency for Healthcare Research and Quality (AHRQ), we created and released our MCC Geriatrics Evaluation and Management Strategies (GEMS) app this past May and are currently disseminating it to our specialty physician partners. The MCC GEMS app provides a short overview of the guiding principles for busy clinicians as well as some suggested tools that can be helpful to them in managing their older patients.

I know I need to take an active role in managing my own healthcare. That’s why I look for information from trustworthy sources whenever I have a decision to make. Having worked with leaders in the field of geriatrics and gerontology on creating HealthinAging.org, I also know that the information we provide is based on the best evidence available and that it can help you (or someone you love) make healthcare decisions that are consistent with your goals and preferences.

About the Author
Nancy Lundebjerg is the Chief Executive Officer of the American Geriatrics Society and the AGS Health in Aging Foundation.