Catherine Owens only

Response #1

Fatima, you have a great post with regards to advocating elderly populations. I certainly agree with your proposed new policy to provide financial assistance for the elderly on limited income or no insurance and assist with their prescription medications. I have a lot of elderly patients in the clinic who have limited coverage of insurance or no insurance at all. Sometimes, I even had a hard time looking for substitute for such medications like Ciprodex eardrops that costs like $160 for otitis media. And most of the time, I have to prescribe the cheapest medication because that’s all they can afford. Poverty rates increase with age, with 23% of people 75 years of age or over poor or near-poor, in contrast to 16% of those 65-74 years of age. Older adults experience the effects of healthcare disparities more dramatically than any other population group. Elderly minorities are particularly vulnerable to low incomes. Low-income elderly Americans experience more health problems and have greater use of health services with the associated cost for treatment and medication than higher income elderly. Low income elderly people are particularly vulnerable because they are more likely to be experiencing health problems that require medical services than those who are economically better off, but are less to afford needed care because of their low incomes. Although Medicare provides basic health insurance to promote access to care, it is not an all-inclusive comprehensive and free medical plan for the elderly poor and near-poor. Even with Medicare’s basic protection, the cost for premiums, cost-sharing, and uncovered services can compromise access to care. Financial concerns can still impede access to needed medical care especially for those who have the most health needs (Rowland & Lyons, 1996). To assure Medicare’s adequacy for the coverage in the future, it is important to maintain assistance with financial obligations and additional benefits that Medicaid provides today. It is critical to either maintain the Medicare-Medicaid partnership for the low-income elderly or to provide direct federal assistance to supplement Medicare for the elderly poor. Access to comprehensive, quality health care service is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. With the population of Americans 65 and older expected to nearly double, to more than 70 million by 2030, providing high quality, cost-effective healthcare to older adults is imperative. Without such guarantees, Medicare’s notable progress in reducing gaps in service use between poor and non-poor elderly could be undone and millions of low-income elderly Americans could have their access to medical care compromised (American Geriatrics Society, n.d.-b).

References:

American Geriatrics Society. (n.d.-b). Public policy & advocacy. Retrieved August 4, 2014, from http://www.americangeriatrics.org/advocacy_public_policy/

This website provides resources relating to policy priorities, health care reform, workforce issues, payment reform, care coordination, quality and patient safety, and research.

Rowland, D., & Lyons, B. (1996). Medicare, Medicaid, and the elderly poor. Health Care Financing Review, 18(2), 61-85. Retrieved from Walden Library databases.

Response #2

Karla, you have an excellent post. I certainly agree with your advocacy policy to provide information of programs available in the community. Most of our elderly patients in the clinic are forgetful and confused with their medications due to polypharmacy and most of them have low literacy skills. Inadequate health literacy is highly prevalent in older adults. Limited health literacy among elderly people has been associated with increased health disparities, poor health outcomes, poor use of health care services, poor overall health status and high mortality rates. Individuals with inadequate health literacy have lower verbal ability for oral expression and verbal communication; lower mental processing ability for speed and efficiency of thought, comprehension of text and numerical information; poorer memory ability for recalling spoken instructions; lower perceptual speed ability for performance of e-health searches; and poorer executive function ability for critical thinking, weighing options, and making decisions and inferences (Nguyen et al., 2013). To effectively manage a health condition among older adults, it is imperative for us to know the literacy skills of our patients. Health literacy is the degree to which a person have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Greater access to reliable health information can provide tangible benefits to elderly patients especially when making minor and major health decisions (U.S. Department of Health and Human Services, 2009). One of the programs that support this advocacy is the Service Program for Older People (SPOP). SPOP is dedicated to enhancing the quality of life of adults age 55 and older and to fostering their independent living through the delivery of comprehensive mental health and supportive services, advocacy, and education (Service Program for Older People, n.d.). As an advocate nurse practitioner, we have to consider our patient’s literacy skills and teach them according to the level of their understanding. By recognizing their literacy skills, we can easily manage our patients and ensure their capabilities in complying to their treatments or medication regimen. Indeed, having information on hand can open up the door to many different possibilities and meet unique needs.

References:

Nguyen, H. T., Kirk, J. K., Arcury, T. A., Ip, E. H., Grzywacz, J. G., Saldana, S. J., & ... Quandt, S. A. (2013). Cognitive function is a risk for health literacy in older adults with diabetes. Diabetes Research & Clinical Practice, 101(2), 141-147. doi:10.1016/j.diabres.2013.05.012

Service Program for Older People. (n.d.). Retrieved from http://www.spop.org/

U.S. Department of Health and Human Services, (2009). Improving Health Literacy for Older Adults. Retrieved from www.cdc.gov/healthliteracy/pdf/olderadults.pdf