Caregiving Archive

Medicare Advantage plans are offering home visits to healthy people who have their own doctors. Their purpose isn't clear.

For many of the 17 million people insured by a Medicare Advantage plan, the offer of a home visit may come as a surprise. (Medicare Advantage plans, which cover about a third of Medicare recipients, are offered by private companies approved by Medicare, and Medicare reimburses those companies for part of the care they pay for.) According to the Centers for Medicare & Medicaid Services, home visits are on the increase among people with these plans, and not just among the sick or housebound. Patients who are healthy and mobile are also being offered home visits, and millions have undergone them.

What are home visits?

The home visit—which typically lasts 45 minutes to one hour and includes a physical exam, health history, and lab tests—is conducted by a nurse practitioner or physician under contract to the insurance plan. The results are forwarded to the person's primary care provider for follow-up. The insurers stress that the home visits are not a substitute for an annual physical or recommended screening tests.

Although poor health can lead to unhappiness and a shorter life, unhappiness alone is not associated with a shorter life span, according to a recent report from the Million Woman Study. That investigation has followed hundreds of thousands of women throughout the United Kingdom beginning in 1996 and has tracked deaths among the participants.

In the third year of the study, the women were asked to rate their health, happiness, stress, feelings of control, and whether they felt relaxed. When the researchers looked at data from 720,000 women with a median age of 59, they found that 83% reported being generally happy and 17% said they were unhappy. During 10 years of follow-up, 4% of participants died. When the researchers factored out poor health, which was strongly associated with unhappiness, they found that the risk of dying was essentially the same for happy and unhappy women. The study was published online Dec. 6, 2015, by The Lancet.

The U.S. Preventive Services Task Force recently updated their guidelines on screening for depression. This time around, they recommended widespread screening through primary care practices, plus gave special attention to women who are pregnant or recently gave birth. These matter-of-fact, achievable guidelines and goals have the potential to reap enormous health benefits.

There’s almost always something we can do to improve our health and well-being — even at the end of our lives. Palliative care is designed to improve the quality of life for people with life-threatening illnesses and their families by keeping a person comfortable and making sure his or her values and preferences guide the medical team’s actions. For this reason, good communication with your care team — and your loved ones — is essential, even before you or a loved one has developed a serious illness.

This ancient practice can transform the way you think about food and set the stage for a lifetime of healthy eating.

Like most of us, you've probably eaten something in the past few hours. And, like many of us, you may not be able to recall everything you ate, let alone the sensation of eating it. According to a 2011 report from the U.S. Department of Agriculture, the average American spends two-and-a-half hours a day eating, but more than half the time, we're doing something else, too. Because we're working, driving, reading, watching television, or fiddling with an electronic device, we're not fully aware of what we're eating. And this mindless eating—a lack of awareness of the food we're consuming—may be contributing to the national obesity epidemic and other health issues, says Dr. Lilian Cheung, a nutritionist and lecturer at Harvard T.H. Chan School of Public Health.

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The microorganisms that inhabit your body can be valuable allies in reducing inflammation and treating disease.

Not too long ago, we thought of all germs as enemies to be destroyed with antibacterial soaps and antibiotic drugs. In the last few years, it's become apparent that the war on microbes is not just a futile enterprise, but also one that could be harmful to our health. The more we learn about the human microbiome—the trillions of single-celled organisms that colonize our skin, nose, digestive system, and vagina—the more we realize that the microscopic critters that live on us and in us may be as important to our health as our body cells.

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Experts' advice has changed as we've learned more about the connection between physical activity and health.

If exercise could be packed into a pill, it would be the single most widely prescribed and beneficial medicine in the nation.

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Men who need a regular reminder to stay active can get a little help from these electronic friends.

Your body is wired to receive and respond to feedback. You easily identify pain, discomfort, and fatigue and are quick to make changes to correct the problem.

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In the journals

A study published in the journal Frontiers in Aging and Neuroscience (Aug. 25, 2015) has found that fitness levels in older adults correlates with activation in areas in the brain's frontal lobe responsible for executive function—mental skills used to manage time, plan and organize, and remember details. The researchers examined brain imaging and cardio fitness data from 128 adults ages 50 to 80. Cardio fitness level was determined by measuring maximal oxygen consumption (VO2 max) while a person walked at increasing speed on a treadmill. Executive function skills were measured by how fast and accurately a person responded to computer stimuli like numbers and letters.

The results: People with a higher cardiorespiratory fitness level showed greater brain activation in the frontal lobe. They were also better at performing two simultaneous tasks compared with a single one. This is important since older adults have more difficulty processing multiple tasks, says the researchers. While this study found a link between good cardio health and better cognitive function, more research is needed to show you can improve your brain function by increasing your fitness.