Keeping Up With An Aging America


By Paula Spahn

In 2009, when I took over as primary writer of a New York Times blog called The New Old Age, I figured I could probably keep it going for three years or so. Then, I’d run out of things to say about aging and caregiving.

Wrong. Now a twice-monthly column that appears online and in the print Science Times section on alternate Tuesdays, The New Old Age lives — and the list of subjects I hope to tackle keeps lengthening.

With more than 20 percent of the American population projected to be over 65 by the year 2030, per the Census Bureau, I’m unlikely to run out of material. The ranks of caregivers, both familial and professional, keep growing. Researchers and physicians learn more about aging bodies and minds, what helps and what doesn’t; public policy changes, but not fast enough. There’s always more to talk about.

Started in 2008 by the former Times reporter Jane Gross, The New Old Age has covered a slew of topics: various kinds of senior care facilities; health decisions from vaccinations (elders don’t get enough) to colonoscopies(elders get too many); and whether it makes sense to move into the same retirement community as your mother.

We look at broader social trends, like why older adults are getting arrestedand shacking up more often, and why they’re not seeing dentists often enough.

Of course, aging ends only one way. So we also talk a lot about advance directives, hospice and other kinds of end-of-life care, and the slowly growing number of states with aid-in-dying laws.

Readers chime in via the comments section, sometimes in droves. Though we expected to hear mostly from caregivers, elders themselves — increasingly online — weigh in, too.

Column ideas come from all over. I read medical and gerontology journals and field suggestions from geriatricians and researchers. My physical therapist told me about an anti-vertigo maneuver. I hear directly from elders and caregivers via Facebook and Twitter. And I sometimes wrote about my father and his transitions, until his death in 2012.

Now, no friend or colleague discussing her aging parents within 30 feet of me is safe from my slightly nosy — O.K., highly nosy — questions, because I’m always looking for personal stories that illustrate larger issues.

People have been generous about sharing their experiences. They know how stressed family caregivers can feel, how invisible or diminished older adults can be made to feel, yet how creative and rewarding these later years can also be. They want The Times to discuss those issues.

A recent favorite idea, about caregivers’ isolation, came from a reader, Marcy Sherman-Lewis of St. Joseph, Mo. When she messaged me via Facebook, she was stewing: The owner of a hair salon she’d patronized for years had asked her to stop bringing her husband along. He has dementia, so Ms. Sherman-Lewis can no longer leave him at home alone.

“What am I supposed to do, keep him in a crate in the car?” she said when I called. Almost 400 commenters offered sympathy and counsel, expressing their own frustrations and fears.

And readers sometimes turn to us when other efforts to bring change fall short. My editors and I take some satisfaction in a series of stories about a retirement facility in Norfolk, Va., which began barring residents in its assisted living and nursing units from its swanky waterfront dining room. Only independent living residents could eat there, management decreed.

The residents’ families had held meetings, consulted the county ombudsman and hired a lawyer, to no avail. When The New Old Age (and the Norfolk paper) began to pay attention, not only did management back down, but the Department of Justice also investigated and found violations of the Federal Fair Housing Act. A consent order mandating nondiscriminatory policies followed, along with fines and compensation for those harmed, putting the whole industry on notice.

The most recent New Old Age column, an admittedly wonky one, looks at a problem almost nobody thinks or knows much about — until an elder lands in the hospital and learns that Medicare won’t cover rehab costs afterward. Why? Because the patient was classified as under “observation,” and wasn’t actually admitted to the hospital as an inpatient.

I’ve been following this bizarre distinction — someone occupies a hospital bed for several days, gets examinations and meds and tests, so how is she not an inpatient? — for years, after learning about it from Brown University researchers. An arcane and confusing policy, it can have major financial and health consequences for someone who can’t pay thousands of dollars out of pocket for a nursing home after a hospital stay.

So when a recent ruling by a federal judge cleared the way for a class-action lawsuit, The New Old Age revisited the subject, with the help of a 63-year-old in Massachusetts who worries about his 84-year-old mother in North Carolina. She spent more than a month in a hospital last spring, yet faces a stiff nursing home bill because — as he was startled to learn — she was under observation all that time.

We returned to the subject because, like him, lots of readers probably still don’t know about observation status. Now, they will.

~ by Butch on September 21, 2017.

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