The Internet of Medical Things
The Internet of Medical Things
The Centers for Medicare and Medicaid Services are looking to the future of the US health care system, and it is projected to be overloaded with seniors needing medical care. In 2010 the US elderly population accounted for about 13 percent of the US population yet accounted for 34 percent of the total health care expenditure. That percentage will continue to increase because of increasing longevity in the growing senior community. Depending on the region, estimates about the future costs of elderly health care may more than double between the ages of 70 and 90.
Government medical programs and services, insurers and manufacturers are tasked with finding ways to reduce the enormity of health care costs in particular as it pertains to senior care needs solutions. Lower costs and increasing efficiencies are the mandates to address the looming potential expenditure crisis. Enter the Internet of Medical Things (IoMT).
Digital technologies and their application to senior medical needs offer the best hope to address existing and future needs. You may have already read about the Internet of Things (IoT) which is a network of devices such as home appliances, software actuators, and vehicles including wheelchairs, not traditionally extended to internet connectivity. The IoMT is similar but reserved for a collection of medical devices and their applications that connect to healthcare information technology systems through online computer networks. The medical devices are digitally linked to Wi-Fi that allows machine to machine communication and throughputs of data collection. The captured data can be stored and analyzed all the way from individual to metadata levels. The importance of controlling senior medical costs now and in the future cannot be understated.
Vitals-tracking wearables are already well-known medical devices. These devices monitor everything from daily physical activity levels, hypertension, cardiac ailments, diabetic levels and more. The devices send vital signs over the internet to medical monitoring staff who can alert health care providers when vital signs are out of the patient’s range of normal. Vitals-tracking wearables are also used in assisted living facilities, nursing homes and hospitals to help nurses and off-site physicians continuously monitor seniors’ vital signs passively.
Medication adherence tools are an electronic reminder system for proper consumption of prescription and other medications. These tools reduce the chances of missing or overdosing on medications. Medical adherence tools can decrease the number of hospitalizations or 911 calls prompted by the potentially serious consequences of improper dosing of medications thus saving costs on unintended medical attention.
Virtual home assistants are increasingly found in senior homes providing daily assistance such as environmental controls, medical advice, calendar reminders, as well as social connections to family and friends which reduces the risk of isolation and therefore can reduce depression. All of the benefits that a virtual home assistant can provide considerably reduce unnecessary life stresses and health problems which reduce costs.
Biomarker portable diagnostic devices are a staple in the senior age group as they need to be tested more frequently than most segments of the population. Rather than a trip to a pathology lab for blood testing et al., these smart and portable diagnostic devices can allow the senior to perform testing in the comfort of their own homes and get results that are formatted to be instantly shareable with medical care providers. The convenience factor and proactive nature of these devices allow for more frequent testing which can lead to early disease detection and its treatment which lowers the costs of health care.
Emergency assistance, fall detection, and “navigation guidance” back to their residence for dementia patients are all part of the personal emergency response systems available to seniors. Some of the fall detection systems are now equipping seniors with sensor belts that can identify a change in gait and can even deploy airbags to prevent injuries due to unintended falls. Fall-related health care costs can be staggering as it can include hospitalization in the event bones are broken, or a severe head injury occurs. These fall detection systems will trigger alerts to designated emergency contacts in the event of fall, emergency medical need, or re-homing of dementia or Alzheimer patient.
Seniors with disabilities including sensory and cognitive impairment can use disability assistance tools to control selection and volumes of streaming music, on-off switch programs for televisions, lights and thermostat controls. Many of these systems are being developed for voice recognition to reduce the need to interact with screens and buttons. Some of the existing tools include customizable colored buttons installed in the residence of the senior that alerts them to perform daily tasks like brushing their teeth. Upon completion of the task, the senior presses the button and the device activates the next task in the customized sequence. When a senior can manage their environment without the constant need for supervision, it lowers health care costs.
Nearly everyone is familiar with the concept of the smart implant known as the pacemaker that controls the heart rhythm of the wearer and can communicate patient data via smartphone apps to their physician. Now there are newer smart implants. These include glucose sensors, dedicated readers, smart knee, shoulder and spine implants, and orthopedic implants which can communicate post-surgery performance. These implants provide real-time data of patient condition to medical professionals who quickly assess if early intervention is required when a problem arises thus lowering medical costs.
Smart home senior facilities have arrived. Residences receive wrist-worn wearables that can free up care providing staff as the devices are tied into machine learning and predictive analytics determining insights into deviations from the senior’s daily routine. Some are designated into three types of color-coded alerts such as red for night wandering or potential fall, orange for changes in the routine of daily living such as irregular eating, and yellow for environmental issues such as leaving a stove on or a refrigerator open. This technology allows health care professionals to monitor patients while multi-tasking other facility operational tasks saving health care costs. Similarly, family caregivers can use remote monitoring tools that enable oversight without having direct contact with their loved one. Alerts are sent when daily routines are detected to deviate from the norm allowing the family member to contact their senior to ensure all is well. Remote monitoring tools can help family caregivers remain at work and on task in their own lives while still adequately watching over their loved one.
While the internet of medical things holds great promise to curb excessive increases in senior health care costs, there are some cautionary tales. What if an internet service provider “goes down” and no Wi-Fi is available to maintain connectivity to health care professionals? Lately, the number of natural disasters in this country calls attention to what will happen to senior digital monitoring when the lights go out during a fire, flood, hurricane or tornado. Will there be a backup generator to keep the devices online? Will there be anyone in the affected disaster zone online to interpret the medical data a vital tracking wearable uploads? What if the medical device fails for mechanical reasons? Can all aging seniors cope with this level of technology? While these remain potential disaster scenarios the more massive disaster is not addressing the overwhelming costs of senior health care for an increasingly elderly population. The internet of medical things is the logical, efficient, and effective solution for now.
If you have questions about what you have read or would like to speak with us about you or a loved one’s legal needs, please don’t hesitate to reach out at 1.800.660.7564 or email us at email@example.com.
Neuroscientists’ Sleep Recommendations for Women
Neuroscientists’ Sleep Recommendations for Women
Sleeping is one of the most important things you can do for your overall health and well being. The amount of sleep you get is particularly crucial if you are a woman – new studies indicate the traditional recommendation of eight hours is not enough. If you are a woman aged 50 or older, you will likely live longer than the men in that same age group. A longer lifespan presents additional challenges to staying healthy, and as a woman, if you do not get enough quality sleep, it will negatively impact your health.
Biological differences between the genders play a role in sleep needs. Neuroscientist research has concluded that women need more than eight hours of sleep each night or they are not well rested. The general reason for this is that the female brain is more active than the male counterpart and requires more rest to recover and repair itself from the damage that was done throughout the day.
While you sleep many things are taking place; the body can recover and repair itself from the happenings of the day. Compounds are being synthesized for energy while cells and organs get replenished. The Mayo Clinic reports that lack of sleep increases the risk of daytime sleepiness, weight gain, heart disease, and reportedly forms of dementia like Alzheimer’s. Alzheimer’s disease is thought to be caused by an excess of amyloids (aggregates of proteins) in the brain. As women go into a deep state of sleep, these proteins get cleared from the brain. There is a connection between the quality and quantity of women’s sleep and a healthy brain. Nearly 66% of people living with Alzheimer’s are women, and surveys show that 40% of adult Americans get less than 7 hours of sleep per night – the overall average amount of time spent sleeping for all adult Americans is 6.9 hours. Lack of sleep for women has disastrous consequences for their health.
Proper hours and quality sleep decrease stress levels, which is beneficial to cardiovascular health. Good sleep affords women better attention capabilities, better memory function and may increase creativity. Sleep also helps the body to maintain a healthy weight as women with proper rest lose more fat, provided they are eating healthy foods. Plenty of sleep also supports a woman’s skin and overall appearance. The adage “beauty rest” is a real thing.
There are some things that women can do to help improve the quality of their sleep. Exercising on a daily basis is key to proper rest. Turning off the television and putting away the cellular phones at least one hour before bedtime allows your brain to wind down to a more restful state and gets you away from the blue light emissions that can affect the quality of your sleep. Avoid alcohol and coffee before sleeping and develop a healthy bedtime routine. Have a set time for lights out and stick with it. Make sure your mattress and pillow suit your sleep needs.
Women require more sleep than their male counterparts. Sadly, many women may not know this or have a feeling of guilt if they take the time to sleep more. However, a well-rested woman is capable of being more productive during her day than a tired one. A well-rested woman has a much better chance of being healthy and disease free. It is essential to take the proper steps to ensure you or the women in your life are getting enough sleep. Taking care of your physical self through adequate sleep is one of the most important things a woman can do – it can help you remain healthier as you age. To have a successful and enjoyable life in your later years, plan for sleep and make it a priority to get enough of it. Planning for your later years and striving to be fit both physically and mentally are a necessity for successful aging. Women have unique needs that must be addressed. Contact our office today and schedule an appointment to discuss how we can help you with your planning and care by calling 1.800.660.7564 or by emailing us at firstname.lastname@example.org.
The Surprising Health Risks of Hearing Loss
The Surprising Health Risks of Hearing Loss
The findings from a 10 year study by the Journal of the American Medical Association have reported a link between hearing loss and health risks. The risks include a 50% greater risk of dementia, a 40% greater risk of developing depression and a nearly 30% higher risk of accidental falls. While hearing loss is becoming more prevalent in younger people due to the use of earbuds and noise pollution, it is the elderly population who are more quickly and significantly affected by adverse health risks because of their hearing loss.
There is a wide range of reasons that account for hearing loss. Some are genetic while others include noise exposure, medications, head injuries, and infections. While hearing loss is a frustrating experience for those who have it, along with their loved ones, the worst option is to ignore the condition. The sooner your hearing is tested, the better your ability to proactively save yourself from associated health risks due to hearing loss. According to John Hopkins University, brain scans indicate that loss of hearing has even been associated with more rapid rates of brain atrophy.
One of the first symptoms of hearing loss is trouble detecting high-pitched or soft sounds. This form of hearing loss is associated with stereocilia, which is the damaging of the fragile hair cells that convert sound waves into electrical signals your brain can understand. For example, high-pitched sounds might include children’s voices while soft sounds include phone conversations or background noise in a restaurant. If you are having any trouble hearing these softer or high-pitched sounds, make an audiologist appointment for a hearing assessment to get a baseline reading. Loss of hearing contributes to social isolation and the longer you wait to address hearing loss, the greater the risk of cognition problems. Meaning, you may hear the words but not be able to process their meaning.
Other than cost, there is no downside to hearing aids anymore. They are discreet, easy to learn how to use, and professionally adjustable over time to compensate for increased hearing loss. Once you factor in the cost of a potential fall, increased risk of dementia, social isolation and depression, the cost of a hearing aid is comparatively minimal. If your hearing loss is profound already, there are cochlear implants, which are devices implanted into the inner ear to stimulate the auditory nerve. These devices can help to restore sound perception in adults with more extreme hearing loss. Your walking motor skills are dependent upon your hearing to pick up subtle cues that help you maintain your balance. Hearing loss mutes these critical cues and makes your brain work harder to pick up sounds, which can then interfere with some of the mental processes needed for safe walking.
While it is not yet proven that treating hearing loss can prevent dementia, unintended falls, or social isolation and depression, it is important to investigate as more than two-thirds of adults over the age of 70 have significant hearing loss that can impact their everyday quality of life. Older adults with hearing problems left untreated also incur substantially higher overall costs of health care. At the ten-year mark of untreated hearing loss in an older adults, the incidence of hospitalization increases by 50% or so. There are also higher rates of hospital readmission and an increased likelihood for emergency room visits when compared to those elderly adults without hearing loss.
Communication between patient and health care provider is also problematic for those adults with hearing loss. A patient has less participation in their health care plan and can often become confused as to their diagnosis and possible courses of action for treatment. Also, following instructions post appointment or hospital discharge can be problematic. Costs associated with untreated hearing loss have prompted both health care companies and insurers to find better ways to serve patients with hearing loss.
Nearly 27 million Americans age 50 or more have hearing loss while only one in seven uses a hearing aid or implant device. Hearing is often the most overlooked of the five human senses: taste, sight, touch, smell, and sound. Your ability to hear is incredibly important and the longer you put off addressing a hearing problem, the greater the possibility of associated adverse health events. Make good hearing part of your overall plan to age successfully. Like retirement planning and elder law planning, the sooner you address the issue, the better the outcome will be. Contact our office today and schedule an appointment to discuss how we can help you with your planning by calling us at 1.800.660.7564 or by emailing us at email@example.com.
Senior Living Options When Care is Needed
Senior Living Options When Care is Needed
As Americans age, living options can become a concern. Available options are tied to the resources a senior has to cover living costs, and vary widely in cost, assistance, and care provided. In addition to budget considerations, seniors must also realistically consider the needs they have and what senior living option best fits those needs.
Nursing homes, or skilled nursing facilities, are one option for senior living. These facilities are for seniors who can no longer live independently. They provide care for seniors with illnesses or mental conditions that cause them to require monitoring and medical care on a full-time basis. For example, many nursing home patients have dementia, are confined to a wheelchair, or spend most of their time in bed. Their conditions require that medical attention be available around the clock.
Nursing homes also provide the option for short term care, where patients come and stay for a limited time after major medical events such as strokes or heart attacks. In these facilities, the residents generally live in semi-private rooms and all meals are provided. Medicare may help cover the cost of skilled nursing facilities, assuming the resident meets certain financial requirements. Long term care insurance may also pay for nursing home care. Otherwise, a nursing home resident pays privately, which can often bring financial hardship upon the family. As a result, many families work with an elder law attorney to discuss care options as well as payment options for that care.
Assisted Living Facilities
Another option for senior living is assisted living facilities. These facilities are ideal for seniors who are still independent but may need some assistance with activities of daily living, as well as meals, cleaning, or other daily self-care tasks. These facilities usually offer a more private living conditions. Since residents may be fairly independent, assisted living facilities are an appealing option because they often offer a variety of activities and opportunities for seniors to interact with one another and to stay active. Assisted living facilities are generally paid for privately with a few exceptions, including long term care insurance or partial assistance from Medicaid.
Independent Living Communities
An independent living community is another viable option for senior living. These communities are for independent, active seniors who enjoy the idea of living in a community. Independent living communities are much like living in a condo or as a part of a community with an HOA. Often maintenance, housekeeping, and landscaping are part of what is included with living in these retirement communities. Many seniors choose this type of community when they are no longer able or no longer wish to maintain a home. The housing options for independent living communities range from detached homes to apartments. Another benefit of retirement communities is the wide range of amenities and activities available. Seniors are often lonely and living among other seniors can provide friendship and companionship. Residents in independent living communities pay privately, and the cost varies from one community to another.
Memory care facilities provide a more specialized senior living option for seniors who have serious cognitive impairments, such as Alzheimer’s or dementia. These facilities are much like assisted living facilities, but cater to cognitive impairments. They may even be a specialized part of an existing assisted living facility. The staff at memory care facilities have specialized training that helps them better assist residents with cognitive impairments. They are often planned intuitively to help patients who may become easily disoriented. These facilities also give extra consideration to security for residents who may wander due to their cognitive impairment. If a senior needs this kind of care, it is important to plan and look for facilities that provide it ahead of time.
Senior living options vary greatly in care and cost. It is important that seniors have conversations with their families about the needs they have or may have in the future, as well as the cost of the type of care they wish to have. The earlier the planning begins, the better off the senior and the family will be when the time comes to seek alternative living options. This planning should be a part of the overall legal and financial plan of the senior. If you have any questions, please contact us at 1.800.660.7564 or visit our website: www.covertlaw.com.
Creative Financial Approaches to Long Term Care Services
Creative Financial Approaches to Long Term Care Services
Long term care insurance was sold aggressively in the 1980s, 90s and thereafter to offset the costs of seniors needing to live in a nursing home, assisted living or needing at home health care. Now, however, the business of long term care insurance has dramatically changed. What was once over 100 insurers providing LTC policy for sale has shrunk to a pool of less than twenty insurers who continue to sell the health care product. The big financial problem was that the majority of insurers had badly underestimated the longevity of these long term care policy holders and how many claims would be filed during their lifetime. The model became unsustainable from a business perspective.
As reported by the Wall Street Journal (https://www.wsj.com/articles/millions-bought-insurance-to-cover-retirement-health-costs-now-they-face-an-awful-choice-1516206708) the industry is now in financial turmoil and has turned to the old adage of privatize the gains and socialize the losses; the translation being that millions of people age sixty-five or older with long term care policies are facing steep rate increases. It is not uncommon for a policy holder to face a fifty percent increase in their premium while some of the worst cases are upwards of ninety percent. Because the industry itself used such poor benchmarks and miscalculated projections, policy holders are seemingly left with two choices: Pay the money or leave your coverage after paying into it for years, and sometimes decades.
What if you want a different choice? Everyone would agree that being priced gouged for premiums as you age is inherently unconscionable but if the policy is discontinued what then will happen to the peace of mind long term care brings? What was once the safety net of senior aging care (without becoming a burden to family members) is rapidly disappearing.
CNBC has recently reported about this very issue and suggests getting financially creative for long term care. (https://www.cnbc.com/2018/02/27/heres-a-surprise-source-you-can-tap-for-long-term-care-services.html) There is a surprising source that you can tap in order to maintain protection for yourself but it requires planning, professional help and time. Do not delay.
The financially creative premise is to become asset poor, impoverished, and qualify for Medicaid which pays for nursing home care and services. This does not mean the legacy you built during your lifetime will not go to your selected inheritors. On the contrary the assets you own must move out of your name to qualify for Medicaid. The assets will then shift to your designated beneficiary since to qualify you as an individual cannot have over $2,000 in assets.
To begin you will need to retain the services of a qualified elder law attorney, who may also bring in an accountant and a financial advisor. Ideally, you will be able to wait five years before needing long term care and the help of Medicaid. If there are assets transferred during the “five year lookback” it may be subject to penalties or make the applicant ineligible for some period of time requiring them to pay out of pocket.
Now with time on your side it becomes critical to select the right vehicle for transfer. These can be annuities but more often tend to be irrevocable trusts. The assets in the irrevocable trust are no longer under the control of the older person and can provide protection from certain creditors. The vehicle chosen for transfer of assets is very important not only for the older individual but the recipient as well. In the case of an outright gift of appreciated assets (i.e. stocks or real property) there would be no stepped up cost basis which could lead to crushing capital gains taxes when it is time to sell. An elder law attorney with input from your accountant and financial planner can help you choose the right transfer of wealth plan.
Elder law attorneys are closely watching changes in Medicaid,, as Congress is often proposing legislation to change the program.. Be certain your elder law attorney is up to speed on the current requirements, as the eligibility requirements can change very quickly in each state, and sometimes each county.
Though you may never have thought you would find yourself creatively trying to qualify for Medicaid while protecting assets, the current long term care premium prices preclude a large portion of seniors from being able to pay the cost of the policy. Genworth Financial reports the national median cost of a private nursing home room to be $97,455 a year. It doesn’t take long to be wiped out at that cost without long term care. Medicaid may be your solution and time is of the essence for planning.
Contact our office today and schedule an appointment to discuss how we can help you with your planning.
Covert | Law
Covert | Law
Your Plan. Your Family. Their Future.
- - We Take Care of Families: Today - Tomorrow - Forever - -
NEIL R. COVERT, Attorney at Law
Clearwater - Sarasota - Fort Myers - Naples
© 2018 Neil R. Covert, P.A. - - All Rights Reserved.