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Survey highlights gaps in healthcare for elderly

Tuesday May 8, 2012
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Large majorities of older Americans experience significant gaps in their primary care, according to a new national survey by the John A. Hartford Foundation.

The poll focuses exclusively on Americans age 65 and older and assesses whether, in the past 12 months, patients received important medical services to support healthy aging, including an annual medication review, a falls risk assessment and history, depression screening, referral to community-based health resources and discussion of their ability to perform routine daily tasks and activities without help.

This type of low-cost, low-tech geriatric care supports a healthy aging process, according to a news release, by managing and lowering patientsí risks of a number of preventable health problems that can erode quality of life, increase healthcare costs and cause disability and even death. Yet only 7% of older adults surveyed received all the recommended services. Meanwhile, 52% percent reported receiving none or only one, and 76% received fewer than half.

"We feel this survey highlights why expert geriatric care is needed," Christopher Langston, PhD, program director of the John A. Hartford Foundation, said in the news release. "Older people need different care, and when they donít receive these kinds of evidence-based interventions, as many donít, the result is a lot of preventable disability and suffering,"

Falls

The poll reveals a lack of intervention on falls even among people at elevated risk. Advanced age is a known risk factor for falling, yet 75% of respondents 80 and older said their physician has not talked to them in the past 12 months about how to avoid falling. Taking multiple medications is another known risk factor, yet 71% of people regularly taking five or more medications said they were never counseled on avoiding falls.

Even among older adults who made 10 or more doctor visits in the last year, 57% said their physician had not talked with them about how to avoid falling down.

Wellness visits

Since January 2011, Medicare has offered the Annual Wellness Visit, which is free for patients (no co-pays or deductibles) and pays physicians nearly three times as much as an average office visit. However, 68% of older adults surveyed had not heard of the benefit or were not sure whether they had heard of it, and only 17% said they had received their visit. (The self-reported number may be overstated, with Medicareís records suggesting the figure is only 6.5 percent.)

"Older adults need to be made aware of this benefit, the opportunity it provides and the importance of wellness to ensure a good quality of life," Tara Cortes, RN, PhD, FAAN, executive director of the Hartford Institute, said in the news release.

Geriatrics education

Of survey respondents, 93% expressed support for requiring all medical and nursing students to take classes and training in caring for older people (which most are not presently required to do, according to the news release). And 63% said they believed they would "get better care" if their physicians, nurses, social workers and other health professionals had more geriatrics training.

The John A. Hartford Foundationís first-ever public poll — "How Does It Feel? The Older Adult Health Care Experience" — was conducted between Feb. 29 and March 3 by Lake Research Partners. The poll surveyed 1,028 Americans ages 65 and older and had a margin of error of 3.1 percentage points.

More details are available in a PDF at http://bit.ly/IK3WiV.


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