H. James

Drug Advertising
I think it's outrageous that drug companies should advertise the way they do on TV and Print. They are by-passing the Doctor/Patient relationship and hawking their wares directly to the public. The increased cost of drugs, due to this advertising has got to be significant. Someone needs to do something!
I for one will avoid any drug that I see an advertisement for if at all possible.

Stephen Bashore

Re: the Healthier US initiative:
June 2002 - What is this "age appropriate exercise" stuff? I'm almost 71 years old, and I and my 12-year-old granddaughter are joining 284 other people, many of whom are over 55, in taking part in Cycle South Carolina 2002, a 340 mile, 5 day bicycle ride from Hartwell, GA to Isle of Palms, SC, June 24-28. The President's 3 mile run is pretty good, but let's get some real challenges out there.

Alexander M. Gilchrist

Women and Retirement
I just want to say it's very hard to be a widow financially. My widows benefit stopped this month because I made over the limit earnings from my job. It won't start again till next year. I am 63 yrs and have to work to survive to pay rent, food, utilities, bills, car upkeep. I believe it would be a great help that widows can keep getting there widows benefits every month no matter how much they earn from a job. I know that when you are 65 yrs old this is true but it could also happen for widows when they hit a certain age--maybe 62 yrs old. It's very hard without a husband for a older women to have enough money to live on.
Lorraine
[See the report on Women and Retirement from the Senate Special Committee on Aging]

A Plea For Safer Transfusions
In 1993, I lost my 78 year old uncle due to a blood transfusion contaminated with Hepatitis C.  His original condition was pernicious anemia and that was why he was given transfusions. At the time, my mother said she checked and they said they were only testing randomly, that they didn't test every donation! I was shocked that this would be done.

My 84 year old mother was in the hospital recently in Galesburg and I asked a nurse about transfusions she received due to blood loss from a perforated ulcer. She said transfusions are "much safer now." We lost my mom, also, but not due to the transfusions. They actually helped her, but I do hope that blood is screened well and that when people donate or receive blood they can do it from now on with confidence that everything is clean on the giving end and that all blood is screened scrupulously, on the receiving end.
Sincerely,
Janice Powers

Transportation For Kidney Dialysis
Many elderly now receive kidney dialysis 2-3 times per week. For those ineligible for Medicaid to pay for the ride, who are unable to drive, and who have no one to drive them back and forth, this becomes a huge expense. This issue must be addressed by Medicare.
Name withheld

The Real Story On Obesity
The big problem is not with fat alone. It is the Omega-6 fats and transfats (partially hydrogenated vegetable fats). The biggest problem in the food pyramid is that increased intake of carbohydrates cause insulin to store fat, glucose and protein in the body cells. The intake of sugar and other high glycemic carbohydrates has grown logarithmically over the past few decades.
Karl H. Schumaker

What Happened To Prescription Drug Legislation?
Hey, thanks for the news .... How about a progress report on the seniors prescription drug benefits .... The US is giving away billions to foreign countries ...  How about something for us!
Name withheld
[Editor Note: Because of new budget deficits, Prescription Drug Legislation appears to be sidetracked for the current session of Congress. We will report any progress if Congress decides to address this issue.]

Preventing Drug Misuse in Seniors
Author: Audrey Ignatoff, M.S.

Preventing drug misuse in seniors is of critical concern to health care professionals, caregivers, and seniors themselves. In order for any prevention program to be effective, it must be a team effort involving both in art and a system.

Seniors comprise about 13 percent of the total U.S. population, yet consume from 25 to 33 percent of all prescription drugs. They also take over-the-counter drugs and home remedies in great quantities. Medications certainly play an important part in patient care, but the improper use of drugs may cause a variety of serious problems including drug misuse and abuse.

Drug misuse is the use of medications that result in social, psychological, and/or physical harm. Examples of drug misuse may vary from not taking necessary medications to becoming dependent upon psychoactive drugs. Problems with medications can develop from excessive use, under use, or the inappropriate mixing of drugs with other prescriptions, over-the-counter preparations, alcohol, and even certain foods. 

The cost of drug misuse and abuse among the elderly is staggering!  According to a 1995 article in USA Today entitled, "Prescription Misuse Costs Nation Billions," prescription drug related problems cost an estimated $75.6 billion and cause 119,000 deaths yearly. An analysis of the reasons for these costs indicates the following:

Both health care professionals and consumers must be aware of the components of this complex problem, such as it's nature, scope and patterns. It is  also important to understand the problems of adverse drug reactions, how the physiology of aging effects drug metabolism, problems of patients compliance, and the roles of the health care professionals, patients and caregivers in preventing drug misuse.

For example, it is important to be aware that about 85 percent of those over 65 do take prescription drugs, over-the-counter drugs, and home remedies on a regular basis. People over 65 take an average of 11 different prescription drugs per year. The incidence of adverse drug reactions in geriatric patients is from 2-3 times higher than for younger adults. Many of these drug reactions are caused by drug-drug interactions or food-drug interactions.

Also, the slowing down of bodily functions such as metabolism, blood flow and excretion can cause unpleasant or dangerous effects. The risk of adverse drug reactions increases with age with cardiovascular and psychoactive drugs being responsible for most incidents. Drug toxicity may cause symptoms such as confusion, dizziness, falling and incontinence and often mimics other symptoms of aging such as weakness, fatigue, absentmindedness, anorexia, and even Chronic Brain Syndrome. An elderly person with these toxic side effects can have a serious injury or be misdiagnosed as "Senile." This too often results in unnecessary or avoidable placement in a long-term care facility. 

Clearly, we must try to find solutions to this pervasive and insidious problem among our seniors if they are going to enjoy the quality of life that they deserve. Therefore, designing effective and systematic educational strategies  is critical. The strategies may vary according to the needs of the patients at a particular site. Developing a results-oriented program involves an evolving process as does any other art form.   Patients and caregivers can benefit from the following:
Learn to communicate effectively with health care professionals about medications.

Know what side effects each drug can have and which one signal danger. 

Learn to keep track of all medications and the directions for each.

Mistakes in drug taking behavior can be dangerous and costly.  It is critical to use prevention techniques when taking any medications.

Audrey Ignatoff, M.S
Senior Arts and Systems.

Back to Top

A Remedy For Nursing Shortages
This is the truth about the nursing shortage. In California, it takes a minimum of four years to train a nurse (this is for a nurse with an associates degree not a bachelor’s degree).  To prepare for nursing school, the student must attend college full time taking math, science, chemistry, microbiology, psychology, sociology and many other courses.  Once the student has finished his/her pre-nursing courses, s/he must apply to a nursing school.  Because there are so few schools, accepting only a few students, the nursing program is considered 'impacted'.  There are not enough seats in the program for the amount of students who apply to nursing school. 

For example, most colleges only accept 24-50 students a year.  The average wait to be accepted into a nursing school is about 9 months to one year.  If the student were finished with the pre-nursing courses and applied to a school in September 2001, they might get into a nursing school in September 2002 or possibly January 2003.

Once the student is accepted to the nursing school, another 2-3 years of nursing study are required before a nurse can sit for the RN degree.  During the process of the nursing studies, the student must support him/herself and bear the whole cost of education. There are very few scholarships available, despite the fact that the government has put out public relations press releases about scholarships available.  Public relations press releases to the contrary, financial aid programs for nurses are hard to get. For those who are lucky enough to be picked for the program, there’s a contract to work for 2 years in an underpaid hospital.

One of the problems with our nursing system is that it costs so much money to become a nurse and no one takes a real interest in helping the student.  To fill the nursing shortage, the medical industry has turned to nurses educated outside the United States.

What the public is not told is there is no quality control over the nursing schools that train these foreign nurses.  All a foreign nurse needs to do to go to work in the United States is to get a visa and pass the RN license exam.  This system has the potential to create problems. 

Just recently a physician friend admitted a man to the hospital.  There was a foreign trained nurse on duty who gave this patient poor care.  I believe she was trained in a foreign nursing school that was substandard.  The patient who was the recipient of this poor care had to be transferred to CCU because the nurse never picked up the phone to inform the physician that the patient's illness had become severe.

This is not an isolated case and we can expect to see it repeated over again in many hospitals as more foreign trained nurses are used.  Isn't it ironic that we are importing poorly trained foreign nurses while our nursing schools are in need of more money to expand nursing programs and nursing students must go into deep debt to finance their college courses.  Tell me, would you go into nursing if, once you graduate, you were more than $50,000 in debt? 

The government and private industry are complaining of a nursing shortage yet they have made few real changes.  If the government and private industry wants to increase the number of nurses, then they are going to have to do something to increase the number of nursing schools and assist the students with the tuition.

Megan Stewart Los Angeles, CA

Back to Top

Editor's note: We received a lot of letters on the Medicare premium increase. The following are reflective of the concerns expressed in these letters.] 

Mandatory Provider Coverage
As a dedicated reader of each issue, I follow links for hours at a time to learn, I applaud you for your excellent eZine. Adding this feature was great! 

I am concerned, as we still have no progress after 10 years on the cost of Medicines.  I currently am on Disability, am 53 years old, and the law allows the insurers to deny me coverage if I am under 65. 

SS Disability is my entire income, and my drug bill runs between $500-$800 per month, just do the math, and you can see how I live.  I make too much money to qualify for Medicaid, and too little to live on.  This community has helped a lot, through the churches, but one of the biggest reforms both Mr. Bush and Mr. Gore ran on was just this issue.   

One simple law would be to require ALL Medicare recipients to be covered, regardless of health status, as are the 65+ recipients.  The insurance companies are making money, although the Hospitals are not, and this is an inequity that needs addressing.
Name Withheld 

High Costs of Medical Care
I feel that the increases in Medicare premiums and the HMO's increases approved by Medicare are outrageous, They give a cost of living increase average about 22 dollars and now they take it all away, and the HMO we belong to increases premium from 20.00 to 42.00 dollars a month and co-pay for hospital stay goes from $0 to $375.00 for each stay. Living on social security only, this is an enormous increase I am very disappointed in the federal government. Thanks a lot.
Name Withheld 

High Costs #2
There are a lot of us Senior Citizens who have been paying exorbitant fees for supplemental insurance to back up our Medicare.  In our area, for instance, we have one option for a HMO and are restricted to one hospital.  Some of us don't like that particular hospital and don't feel we will get the best possible care in that hospital.  We have to pay $200 a month for supplemental insurance so that we can have a choice.  This isn't fair.  We need to have a choice in Arkansas.  Either that or the HMO's need to be forced to take the restrictions off the hospitals you can use or we need more choice of HMO's.
Name Withheld 

Medical Savings Account
A great many of the problems with insurance costs, drug costs, eyeglasses costs, etc. could be solved if the Medical Savings Account (MSA) could be made available for those of us on Medicare.  A trial program was authorized by the US Congress in 1997 but, as far as I have been able to determine, this was never implemented or available.  What can YOU / WE do to get such a program regenerated and implemented?   
Name Withheld 

Large Type Direction For Drugs
Whether it be a controlled or over-the-counter prescription, more and more the manufacturers are requiring all of us to have a super magnifying glass handy to read any of the instructions.  Perhaps if they used at least half of their advertising budget to print readable information we would have less misuse and errors.
James Ahia

Child Proof Caps and Seniors
Bravo to the senior who wrote complimenting Tylenol for providing a cap that arthritic hands can operate! I, too, wish that all doctors and pharmacies would at least ask if there are small children in the house before attaching a cap that it takes a small child or a hammer to remove.
Ruth Vacin

Drug Ads on Television
When is the government going to make the drug companies stop advertising on TV and magazines????? That is why the cost is so high on prescriptions. It is obvious that drug companies are making the people pay their costs of advertising. It is outrageous!!!! They banned cigarettes and liquor .Why not drugs??? They kill as many people too. Maybe more.
Stidham

Drug Directions in Braille?
Sure wish there was some way that prescriptions for the blind were accompanied with the directions for use in braille. I realize it is impossible to put that on the bottles, but you always get a paper with directions and information with your prescription, even if it's a refill. It would be a big help. Thank you,
Graceanne