Category Archives: 50 Plus Community

The changing world of blog

It’s been an interesting year in electronic evolution.  Blogging to micro-blogging.  Google+ vs. Facebook.  Twitter vs. the world.  PC to iPad to PDA and iPhone4S…

All in all, the world of communication continues to change and amaze.  I’ve been blogging since 2004, when who even knew about blogs?  I certainly didn’t have a clue.  Started on Blogger, evolved to WordPress, then WP pro with customizability that allowed me, who knew nothing about coding, to be able to function in the world of website creators.  Now, 8 years later, with literally millions of bloggers, the amount of work to stay ahead of the competition is daunting.  Whereas I used to be just one of a few writers who opined on careers for the 50 plussers and the white elephant in the room…yup…ageism, I am now one of many who talk, blog, lecture and critique any and all things that affect us (those with grey roots showing or even fully white-haired!…not forgetting my balding male readers either.)

It’s been wonderful building up an audience of readers.  About 10,000 of you have access to what I write on what used to be a daily post, and now less frequent, basis.  For a few months I’ve been asking myself why I blog less now than I did a year ago?  There are a few big reasons.  None of them have to do with readership…because, you, my readers, who email rather than comment, who Facebook message me rather than post on the wall, are who keep me motivated to talk about whatever hits me on any given day.  Here are the big reasons I’ve posted less in the past year than in any other year:

  1. My business is very busy (in addition to social media, I run a successful pet services business in the central San Fernando Valley, call Pooch Buddies!).  Yes, it’s a really rough economy and to stay ahead and afloat, I really do work 365/24/7.  Not only do I, a single woman, support a family of 3 (plus dog), but I’m responsible for livelihoods of 4-6 staff at any given time of the year, and the comfort of hundreds of people’s loved pets…a responsibility I don’t take lightly.  If I can’t keep a full schedule for some of the best people who have ever worked for me, then I fail them.  They are willing and eager to take as much work as they can get and I do my darnedest to keep their days full so they can keep their apartments, cars and fill their bellies.
  2. I lecture on online networking for career challenged 50 plussers, and so I do my part to stay abreast of changes to how the economic outlook affects career networking and how to overcome the significant challenges of finding work when you may have been unemployed now anywhere from 2 – 5 years.  That takes up a bit of my time.
  3. I  moved in September.  The home I bought was not supposed to be a fixer…but yes, it has needed a lot of work, and I’m really tight with my money, so taking on the challenges of being my own contractor has been overwhelming (but I’ve saved a ton of money that I didn’t have to spend in the first place!)
  4. My DroidX.  I have a smartphone.  When I bought my DroidX, I was torn between the ubercool iPhone and the new Google-based android technology.  I bought my DroidX because of the screen size (honking big) and because I use Google platforms for every aspect of my business (yes…the BEST there is and all for free…for ANY small business owner, Google is the way to go.)  I can do almost anything that I can do on my PC on my smartphone, out in the field.  Transfer money?  In a snap.  Send out PayPal invoices?  Less than a minute.  Keep track of all my staff, field schedules and be reachable in a millisecond?  Yup.  Internet, apps, you name it, I can do it.  The ONLY thing I hate doing on my smartphone is trying to type a blog post.  I can easily write a Facebook or Twitter microblog, but writing a lengthy post is not fun. I’m a fast thinker and a fast typist and I can type as fast as I think…on a PC.  So trying to write a post on my droid is torture, even with the fab WordPress app.  Even worse, is that I catch all the breaking news as I want it on my phone and get a million ideas for posts every day, but by the time I’m sitting at my desk at 8 or 9 or 10 or 11 pm, I’m just too darn tired to muster the energy to write about what (only 5 hours later) is now OLD news.

So, once again, I’m looking at ways to get out my thoughts, quickly, timely to the breaking news and moments of introspection that you like to read…but I’m not certain that blogging will continue to be it.  Blogging is now considered almost mainstream media.  I get scores of press releases every day on who wants to plug what for what occasion..but I’m not that kind of blogger.  Every now and then you’ve seen me review or mention something cool on the Gen Plus list (like Sony music releases…which are generally fantastic and relevant to our age demographic and deserve any and all attention), but I’d rather review movies and the theater and music and the arts, than the latest invention to help someone who’s fallen down get up off the floor, or plug a pharmaceutical.  We are not a geriatric demographic and I’m not the source you are going to for help with your aging parent or siblings when you do start looking for those resources.  I adore my advertisers and welcome them, but a plugging blogger I am not.

I believe I’ll be heading a bit more toward the micro-blogging arena (I think…not sure…still ootzing over what and how).  I haven’t worked it out yet, and I’ll continue to blog as I figure it out, but in the meantime, make sure to go to my Facebook link on the Gen Plus website and hit LIKE to become a fan (that’s how you’ll get my posts) or follow me on Twitter (www.twitter.com/genplus).

I’m not a political pundit or an economic analyst…there are tons of those…

I’m still exceedingly frustrated and heartbroken over the millions of 50plussers (and a lot of late 40-somethings) who literally can’t get a door to open to them.

I’d like to find the right way to help extend network, so I’m thinking it might a combo of Facebook, LinkedIn and Twitter, but the wheels are still turning looking for the next best thing.

If you have thoughts, opinions, feel free to share.  If you prefer to read blog posts rather than micro-posts, feel free to let me know.  If you’ve come up with the next best thing, I want to know about that, too.

Gotta run.  Gotta check out what my staff are up to via my very, very smartphone.  Love you all.

Planning for the future — much-needed resources for women

Last month, Elinor Ginzler, AARP spokesperson, held a Q&A webconference about an important new public education campaing , Decide.Create.Share, meant to increase awareness among women of the importance of assessing future needs and planning for their unique lifestyles and goals with long-term care. 

There are several long-term care planning resources featured at http://www.aarp.org/decide. They include a quiz to determine how ready one is for the future, and easy, free, and practical tips that women can use to stay on track. There are also video clips of boomer women Patricia, Jeannie and Mary Ann, who share their personal stories of why and how they’re planning for their futures.  

In this extremely challenging economy, without a certain future ahead, it is critical that women really take a deep look at how they are assessing their future needs — from all angles:  home, community, legal, health and, of course, finances.  The campaign encourages women to look at these needs.  According to a recent AARP survey,  

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59% of women ages 45 to 64 haven’t determined how they’ll pay for their long-term care needs.

More information on why long-term care is a women’s issue can be found here.  

I asked Elinor a few questions specifically for this readership.  Below are the questions and Ginzler’s responses:  

Gen Plus: Families are no longer living near each other in many cases. What type of planning needs to take place before a parent is either in financial or medical distress? What kind of low- or no-cost support is available?

Note: Elinor Ginzler grew up in a New Jersey suburb, spending most weekends at her grandparents.  Both sets of grandparents were in NY…about an hour away from her parents home.  As she grew up in the mobile Boomer generation, she moved 223 miles away (she can be that exact because she drove the route home to her family often enough). 

Ginzler:   Planning to take care of them includes planning to take care of yourself as well. [There has to be] open communication, it really starts with open conversations across the generations of how the people want to have their needs met as they get older. And, absolutely knowing the medical conditions, understanding the medical systems that we’re working in, that your parents are dealing with, are going to make a big difference. If you are getting engaged in these kinds of conversations at a time of a crisis scenario, potentially Mom has fallen and broken her hip and is being transported 500 miles away to the nearest hospital, that’s the worst possible time to be having this conversation. If you have had those conversations ahead of time and know how Mom wants to receive her care, who her physicians are, where her Medicare card is, you’re going to be so much better situated in being able to step in a provide some assistance. If you’re a boomer woman, you want to turn around right after that experience, and have that conversation with your children as well, so they know what your wishes are and they know how you want to be cared for. 

There is an amazing network of aging resources out there at the community level, many people don’t know about it, this is a federally funded and federally mandated program from the Department of Health and Human Services from the Administration on Aging, and it is called the Aging Network. Every community across the United States has an Aging Office. It might be called the Office on Aging, it might be called the Office of Elderly Affairs. You can find out where that office is through a website that’s run by a government funded program and operated by the National Association of Area Agencies on Aging. It’s www.eldercare.gov and if you go to that website, you can be linked by zip code to the aging office nearest that zip code, and it would be your family member’s zip code, if that’s who you’re concerned about. They’re going to be able to tell you all of the community resources that are available, those include low-cost, no-cost, sliding scale, everything from community-based programs that provide meals, all the way through in-home care agencies. So, very important to know where your aging office is, for yourself, and for your family members as well. 

Gen Plus: Many older women are easy targets for con artists, how can you assess who are the best and most trust-worthy resources for a woman without financial knowledge? 

Ginzler: It is pretty horrific to know that today in the United States how much scamming is going on, essentially, what I would call financial exploitation. It’s financial abuse in some cases if you think about it, taking advantage of somebody who does not know. 

Ginzler notes that AARP recommends using a  professional certified financial planner to help guide you through some of this important financial decision-making.  In addition, she says to ask for references, contact those references, and have very open conversations. 

You might be seeking some legal advice related to your financial situation. There are attorneys that are recognized as elder law attorneys that do know how to plan for the future. You can find your elder law attorneys through your local bar association, and if you go through that, you at least know that they have recognized themselves as being experts in this area, and have been acknowledged by that bar association to at least be appropriate to be reached. You also have to interview several, be a wise shopper. When we go out to buy a pair of shoes, we usually try on several pairs before we buy the pair that fits the best. You should do that with the person you’re seeking to engage in some pretty significant and important decision-making. Talk to more than one individual and pick the one that’s the best match to you. 

Gen Plus: For a woman who recognizes that she doesn’t have enough financial resources to support herself once she can no longer earn, what are the three most important things she should do? 

Ginzler: I think that’s a great question, and I love lists of things to do, so here’s what I would say that woman, many of us that are in that category, should do. One: think about how long you think you need to be in the workplace, because that’s going to be an important decision-maker. Two: make yourself a budget and I would actually recommend that you use the tools on the aarp.org website, to create that budget for yourself today and in the future. And I would say the third thing you need to do is look at the tools that are on our website, aarp.org/decide, that are going to help you craft that plan for the future and help you in that decision making now, that will lead to a really rich future for yourself, rich in a broad way. 

Some solid resources, once again, from AARP.  If anywhere in your New Year’s resolutions, financial concerns are in your top ten, then head over to the site and check out some of these great planning tools.

And just HOW do I become a Facebook Fan?

A few readers wanted to understand exactly how to become a fan of a Facebook page.  It used to be a bit more complicated, so Facebook has simplified the process.  I’d love ALL of my readers to become Facebook fans of Gen Plus (here’s the page to link to: http://www.facebook.com/pages/Gen-Plus/86433647956 ) because it helps me build presence on my fan page AND I can send out group announcements really easily (like Facebook Privacy issues, or unusual contests or media announcements that might not be right on the blog, but that would benefit you, the reader.)

Here’s the step by step.  Either go to the link above, or from my blog page (you can click on the title of the article if you read from email subscription).  That will take you to my Facebook fan page for Gen Plus (see image below) and click on the LIKE button right next to the Gen Plus name.  If you don’t have a Facebook account then you’ll be prompted to create one.  It’s up to you whether or not you want to explore Facebook, but it’s a wonderful way to get and stay in touch with people you know from around the world.  Your kids and grandkids are on Facebook.  Why not you?  My blog posts stream there and it is super easy to make comments via Facebook and to build a bit of community.  So have fun.  If you still are having trouble, email me at wspiegel@genplususa.com and I’ll give additional instruction. 

Sunset Daze coming to a retirement community near you…

By now, you’ve probably seen commercials WE tv’s new reality show,  “Sunset Daze”,  which follows an active & eclectic group of retirees as they live out their golden years skydiving, dating, partying, and checking off their bucket lists.  

I had the pleasure of previewing the premiere episode and I have to say I got a few chuckles and had to dry my eyes a couple of times, too.  The demographic is a bit older than many of my readers, but we’re not that far behind and the issues (especially dating) will resonate with you.  A “lite”, fun, don’t-take-yourself-too-seriously, way to enjoy a 1/2 hour of your time — I actually watched the full episode, which means it held my interest.

As always, with any reality show, the draw is the characters you meet — the first show follows the women and they were worth the peek (love the ex-nun).  I’m sure the episodes with the men will be just as entertaining. 

The show premieres on April 28 at 10 pm | 9c on WE tv.  Click on the link for a sneak peek!  Sunset Daze Sneak Peek!

Happy Birthday, Ronni

There is a wonderful blogger, Ronni Bennett, who has been chronicling her life (and that of those aging around her) within the framework of political, personal and world view.  I love her blog…why?  She’s a straight-shootin’, say it like it is, kind of gal.  She is well-informed, does her research on whatever topics she is posting on and takes the reader right into her life…for the good and bad.  Today is her birthday and on this day, she has given her readers very good insight into her journey to find a new home (moving from Maine [and previously NY] to Oregon).  She’s chronicled every step of the journey — from selling her home to travelling to Oregon to find a new place…and today, on her birthday,  she shared all the thought process that went into her choice of home

Because I get her articles on a feed (like many of you do with my posts), I don’t often take the time to comment on her articles directly.  But there was one point she made today that resonated with me, greatly, that I want to share with you. 

I did look at a lot single family home listings. There was a charming Victorian in my price range that I kept going back to and a few others with (relatively) small yards that I liked. But most also had stairs, sometimes quite a lot, to the front door and many of the most attractive were two-stories with the bedrooms upstairs.

I’m fine with that now, but I don’t know how much longer that will be so. An elevator building or first-floor apartment, as I chose, are better bets for old age – I don’t want to have my bed in the dining room someday.

Bizarrely, just this past week, I picked up my niece from a playdate (my sister had some kidney surgery, so I was super aunt for the week) and as I was talking to the little girl’s mom, I noticed a bed in the living/dining room.  The mother told me that this was, in fact, her grandmother’s house, and her 96 year old grandmother, who could no longer navigate stairs now had her (hospital) bed in the dining room.  She moved from dining room bed, to eat at the dining room table, and back to bed again.  No doubt she enjoyed the life in the house and having her granddaughter close by.  I stopped and chatted with the grandmother for awhile (because when you meet a 96-year old, you really should talk to them a bit…you never know what you’ll learn — this grandmother was appalled at how little of LA current Angelenos actually knew.  She had travelled all over LA by the now extinct  famous electric streetcars that actually supported commuting and didn’t impact the environment!)

I couldn’t get the image out of mind — this woman in her lifelong home — getting ready to die in her dining room.  And that is the image that shot into my mind as I read Ronni’s post. 

I can only hope that as I make my own transitions from decade to decade I can be logical enough to make the right, tough decisions for my own future.

Excellent insights.

Life (Part 2) — a shout out to PBS

Just got a tickler from PBS on their series Life (Part 2) which premiers nationwide on September 13. (check local listings.)  It is a series aimed at us — the 78 million plus boomers.  The series explores how we dealing with aging [me?…not so well!  LOL)] and how we are going to have to overcome the societal, physical and financial obstacles that come with it to [hopefully?] live a vibrant and fulfilling second part. If you shoot down the post, there is a video excerpt from one of the segments on the Generation Gap.  Too true! 

From the release:

Hosted by Emmy winning New York Times journalist Robert Lipsyte, the series provokes, entertains, and educates boomers on a wide range of topics from plastic surgery, boomer dating and successful boomer marriages, to getting rid of the boomer belly, keeping a fit mind and body, and fighting ageism while looking for an encore career. With wit, insight, and the experience of having made the passage himself, Lipsyte engages in candid dialogue with a wide range of guests including Joy Behar, Martha Stewart, Phil Donahue, Gail Sheehy, David Hyde Pierce, Billie Jean King, and Governor Mike Huckabee among many others.

The website at(www.pbs.org/lifepart2) features video, and a blog written by the Host, and other resources. Facebook at www.facebook.com/lifepart2 and Twitter www.twitter.com/life_part2

The only thing that got my old goat in the press release (probably penned by a 20-something?) is that our “time” is referred to at “this new ‘old age'”.  Well, I relate to the series, but at 50 and as a small business owner with a 9 year old, I can assure you that this ain’t old age in any form.  But I am interested — particularly on this focus:

“With the economy’s downturn, baby boomers have been particularly affected – with the shrinking of their life savings, loss of their jobs, and the ageism they confront when looking for a new career,” says Life (Part 2) executive producer Naomi S. Boak, who also produced the critically acclaimed and Emmy Award-winning PBS documentary The Forgetting: A Portrait of Alzheimer’s. “This show is designed to inspire boomers’ own self exploration of how they can make a fresh start at any age… of how they can live 20 or 30 more years of vigor, engagement and impact, defying ageist stereotypes while still having a clear-eyed view of the challenges that come with this new territory.”

Enjoy the clip and support the series.

Natalie Cole…Definitely Still Unforgettable.

What could be better on a Friday night than slipping off my shoes, sipping a glass of rich red wine, munching on bits of cheese and chocolate and…listening to the newly released “Still Unforgettable”, a just lovely album by Natalie Cole. The eight-time Grammy winner, who has recently revealed her battles with Hepatitis C, has come up with a wonderful showcase album for her timeless voice and incredible phrasing. This exploration of American Pop Standards includes a heartwarming interpretation of “Walking My Baby Back Home”, once again, in a duet with her late father, Nat King Cole.

And to get your next few Fridays off to a great start, Rhino Records has sent me a give-away copy that I’m going to randomly select a winner from my subscriber list. If you want to be in the draw and you are not yet a subscriber, just add your email to the subscribe me box. If you don’t want to subscribe to the email feed, then just shoot me an email and I’ll add your name into the mix, too! I’ll draw names and announce the winner next Friday for inclusion in the following week’s Blogging Boomers Carnival.

For a preview, click on any of the Listening Party Links:

Quick Time
Windows Media Audio
Real Player

You can also purchase I-Tunes.

Official Site http://www.nataliecole.com/
Official MySpace – www.myspace.com/nataliecole

Very cool online interactive interview!

Yesterday I had the pleasure of interviewing Gail Rentsch about her new book, “Smarter Women Don’t Retire—They Break Free: From Working Full-Time to Living Full-Time through my Careers group on Eons.com.

It was a novel idea, lots of fun, and if you missed it, head over to the Q&A and get a feel for the concept of the online interview yourself!

So Much to Share…So Little Time!

I’ve got some book reviews coming your way, but in case you want to get a head start on your mid-summer line up, here’s one for the boys…


Bob Morris’ ASSISTED LOVING True Tales of Double Dating With My Dad (HarperCollins June 2008)

What would you do if your eighty-year-old father dragged you into his hell-bent hunt for new love? Bob Morris, a seriously single son, tells you all about it in this warm, witty, and wacky chronicle of a year of dating dangerously.

This father-son memoir has received some wonderful reviews:

“But it’s the journey, not the destination, so the saying goes, and in pursuit of romance, this father and son get a second chance at finding each other; theirs is the resounding love affair at the center of the book… And by way of good manners, let me thank you, Bob Morris, for your heartfelt contribution to the canon of father-son memoir; an expression of civility, a grace note unto itself.”- Dinah Lenney, for the LA Times

“Never losing sight of the complex relationship between aging parents and adult children… the inspirational memoir captures all the needed laughs and emotions that go with love and life in the waning years of parent-child bonding..”- Publishers Weekly

You can check out Bob’s website at www.assistedloving.com for videos of him and his dad!

AND one for the gals…

How do women retire nowadays? Well according to this book, they don’t!

What will you do when you retire? Wave that “red flag” question in front of a woman who fought for any scrap of work success she now claims, and then watch anticipation angst kick in as she thinks about the “what next” stage of her life – the one that comes after her kids are grown, her career has plateau-ed, her spouse is getting antsy, and her friends are primarily work-related.

The Transition Network (TTN), a nation-wide community of women who are re-imagining retirement, have written
Smart Women Don’t Retire—They Break Free: From Working Full-Time to Living Full-Time to help women deal with the “what next” question.

Smart Women Don’t Retire—They Break Free is a blueprint for women redefining retirement. It’s a practical guide showing how to choose what to do next, whether it’s pursuing a new career, volunteering, or becoming an entrepreneur. This book shows you how to create your own whole new set of life choices.


Praise for Smart Women Don’t Retire – They Break Free


“This book compiles concrete evidence that the angst of friends and colleagues is, in fact, part of a flood of concern across the nation. The good news is, we are not alone. The better news is, there are some answers here, or at least signposts that point the way to new possibilities.” —Lynn Sherr, Correspondent, ABC TV

“In the next decade a huge number of women will be making a work-related transition from a lifetime career to whatever comes next . . . This book provides a valuable orientation to this process; it is rich in practical advice and inspiration.” —Jennie Chin Hansen, President, AARP
“Every woman 50+ should read this book . . . regardless of where they are on their retirement journey!” —Jeri Sedlar, coauthor of Don’t Retire, REWIRE! senior advisor to the Conference Board on the Mature Workforce

More Information: http://www.thetransitionnetwork.org/
http://www.smartwomendontretire.com/

Health Care Work Force Too Small, Unprepared For Aging Baby Boomers; Higher Pay, More Training, And Changes In Care Delivery Needed To Avert Crisis

Last week I received a media preview of a comprehensive new monster report that has just been released today, by the Institute of Medicine. The report warns of a looming crisis regarding our aging population and health care inadequacies. And it isn’t that we don’t already know most of this in general. However, the numbers that the report assigns to the challenges ahead will have some government heads spinning. If this doesn’t make SOME notice the elephant in the room, then I don’t know what will.

WASHINGTON — As the first of the nation’s 78 million baby boomers begin reaching age 65 in 2011, they will face a health care work force that is too small and woefully unprepared to meet their specific health needs, says a new report from the Institute of Medicine. The report, Retooling for an Aging America: Building the Health Care Workforce, calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. Medicare, Medicaid, and other health plans should pay higher rates to boost recruitment and retention of geriatric specialists and care aides, said the committee that wrote the report. The committee set a target date of 2030 — the year by which all baby boomers will have turned 65 or older — for the necessary reforms to take place.

“We face an impending crisis as the growing number of older patients, who are living longer with more complex health needs, increasingly outpaces the number of health care providers with the knowledge and skills to care for them capably,” said committee chair John W. Rowe, professor of health policy and management, Mailman School of Public Health, Columbia University, New York City. “The sheer number of older patients in the coming years will require trying new models for delivering health care and the commitment of greater financial resources,” he added. “If our aging family members and friends are to live as robustly as they can and in the best health possible, we must have a work force of adequate size and competency to take care of them.”

Work Force Shortage Threatens Quality of Care

Several reports show an overall shortage of health care workers in all fields, but the situation is worse in geriatric care because it attracts fewer specialists than other disciplines and experiences high turnover rates among direct-care workers — nurse aides, home health aides, and personal care aides. For example, there are just over 7,100 physicians certified in geriatrics in the United States today — one per every 2,500 older Americans. Turnover among nurse aides averages 71 percent annually, and up to 90 percent of home health aides leave their jobs within the first two years.Older adults as a group are healthier and live longer today than previous generations, the report notes. Even so, individuals over 65 tend to have more complex conditions and health care needs than younger patients. The average 75-year-old American has three chronic conditions, such as diabetes or hypertension, and uses four or more prescription medications, the committee found. Dementia, osteoporosis, sensory impairment, and other age-related conditions present health care providers with challenges they do not often encounter when tending to younger patients.

All Providers Should Be Competent in Geriatric Care

Virtually all health care providers treat older patients to some extent during their careers — and likely will do so even more frequently given that one in five Americans will be 65 or older by 2030 — so they need a minimal level of competence in geriatric care, the committee concluded. Health care workers should be required to demonstrate competence in basic geriatric care to maintain their licenses and certifications. All health professional schools and health care training programs should expand coursework and training in the treatment of older individuals.To deliver care more efficiently and alleviate the shortage of adequately trained workers, the report calls on the health care professions and regulators to consider expanding the roles and responsibilities of health care providers at various levels of training. For example, if a certified nursing assistant is able to administer certain medications, a professional nurse would have more time to concentrate on more complex patient needs. Additional research is needed on how to prepare health care workers to assume expanded roles, the committee noted.Because insufficient training can leave direct-care workers unprepared for the demands of their jobs and lead to high turnover rates, the federally required minimum number of hours of training for direct-care workers should be raised from 75 to at least 120. More training is required for dog groomers and manicurists than direct-care workers in many parts of the country, the report notes.

Higher Salaries, Financial Incentives Needed

While the number of older patients is rapidly increasing, the number of certified geriatric specialists is declining. Medicare, Medicaid, and other health plans need to pay more for the services of geriatric specialists and direct-care workers to attract more health professionals to geriatric careers and to stanch turnover among care aides, many of whom earn wages below the poverty level.Salaries of doctors, nurses, pharmacists, social workers, and others who specialize in geriatric care lag behind those of their counterparts in other fields. A geriatrician earned $163,000 on average in 2005 compared with $175,000 for a general internist, despite the extra years of training required for a geriatric career. Physicians who choose dermatology can earn over $300,000 a year. Registered nurses who work in nursing homes or other long-term care facilities earn less on average than their counterparts, despite working longer hours with more overtime. Medicare’s low reimbursement rate for primary care is the foremost reason that geriatric specialists earn lower salaries, given that so much of their income comes from the government program. Medicare should increase its reimbursement rates for services delivered by geriatric specialists, the report urges.Direct-care workers are more likely to lack health insurance and use food stamps than workers in other fields. The median wage for direct-care workers in 2005 was $9.56 an hour. To boost wages, states should allocate funds to be added to the Medicaid payments that cover the majority of services provided by direct-care workers, the committee stated.

Family Members, Other Informal Caregivers Need Training

The report calls for health care facilities, community organizations, and other public and private groups to offer training programs to help family members, friends, and other informal caregivers provide proper assistance to their loved ones and to alleviate the stress they may feel in coping with an older friend’s or relative’s needs. Health professionals should regard patients and informal caregivers as an integral part of the health care team, the committee added. Between 29 million and 52 million family members, friends, and others tend to aging parents or other older individuals. More than 90 percent of older adults who receive care at home rely in part on informal caregivers and nearly 80 percent rely solely on family or friends. However, little is done to ensure informal caregivers have the necessary knowledge and skills. State attorneys general should recognize training programs for unpaid caregivers as a way that nonprofit hospitals could meet their requirement to provide benefits to their local communities in exchange for their tax-exempt status. In addition, federal agencies should support the advancement of assistive technologies that can help older patients manage their conditions and handle the basic activities of daily life and also can help informal caregivers take care of their loved ones.

Medicare Hinders Delivery of Quality Care

Although a comprehensive examination of Medicare was not the focus of this study, the committee noted several ways that the program hinders the provision of quality care to older adults, including Medicare’s low reimbursement rates, its focus on treating short-term health problems rather than managing chronic conditions or age-related syndromes, and its lack of coverage for preventive services or for health care providers’ time spent collaborating with a patient’s other providers. Medicare and other public and private insurance plans need to remove disincentives that prevent health care providers from adopting new models of care delivery — such as interdisciplinary team care — that could improve patients’ health and lower costs, the report says. The committee acknowledged the complexities of making changes to Medicare and the financial crisis facing the program, which is predicted to run out of money by 2019. It was beyond the committee’s purview to recommend a detailed plan for how to re-engineer Medicare. The study was sponsored by the John A. Hartford Foundation, Atlantic Philanthropies, Josiah Macy Jr. Foundation, Robert Wood Johnson Foundation, Retirement Research Foundation, California Endowment, Archstone Foundation, AARP, Fan Fox and Leslie R. Samuels Foundation, and Commonwealth Fund. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.

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