Finally, a Vision for Care Referrals That Will Improve Outcomes

Picture this: you’re one of millions of Americans who needs care at home either because of aging, dementia, recovery from surgery or other disabilities.  You’ve got a family—and often an unpaid caregiver who helps with your care.  They’re part of an elaborate team of caregivers, physicians, therapists and non-medical assistance.  I’ve lived this first-hand as I’ve cared for my mother, and I’ve spoken to literally hundreds of families in the same situation.

Insurance companies and other employee benefit programs often deliver these care recommendations.  They do the best they can considering maintaining these programs—and the underlying data—is not their primary business.  Unfortunately, they struggle to extend these programs across the whole company so that each member-facing group can leverage the same data to provide the best care referrals to their members. I’ve just assumed it was one of those “not-yet-solvable” situations, as healthcare technology is always a bit slower than other industries.  So we did the best we could and used what was not an ideal support system.

The Future of Care Referral Programs

I think I finally found a vision for the future.

I ran into a white paper from SNAPforSeniors that really caught my eye.  If SNAP can deliver on this vision—and if insurance companies, call centers and other providers have the vision and foresight to adopt it—it will dramatically change the outcomes of care coordination as part of the age in place movement.  More important, it will give families like mine the peace of mind that we are getting referred to the best matched providers for our care.

I know this vision may not concern some of you, but I highly recommend you check it out.  These types of ideas are the ones that are going to make the biggest impact. If you think your family would benefit from your insurer adopting programs like this, you should let them know.

Here’s the link to the paper –

Fear of Falling and Fall Prevention Programs

Falling for the elderly is devastating and has many lasting consequences such as pain, injury, loss of independence, and costly medical bills. In fact, fifty percent of older adults who have fallen in the past year have a fear of falling. In 2005, 15,800 people 65 and older died from injuries related to unintentional falls.

A fear of falling, like most other fears is embarrassing. For this reason, many seniors do not share this fear with their families or doctors. Women are more likely to report a fear of falling, although men are more likely to die from falls.

The Impact of a Fear of Falling

A fear of falling can result in reduced activity.  People who are afraid of falling may completely stop or modify how they do things. These individuals naturally walk more slowly, however are able to walk significantly faster when asked to do so. A consequence of reduced activity is weak muscles, which could lead to or exacerbate a fall.

People of all ages value their independence, but seniors seem to be the only age group at risk of losing their independence because of a fall. In 2009, the CDC reported that people 75 and older who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer.

Muscles weakened due to inactivity compromise social interaction and increase the risk of isolation and depression.  A fear of falling also increases the risk of falling, and causes depression, while  depression and/or anxiety have disruptive affects on quality of life. There are also enormous financial costs associated with falling.

Financial Costs of Falling

Falls are expensive and make up a large component of health care costs. According to a 2009 report by the CDC, the total direct cost of all fall injuries for people 65 and older exceeded $19 billion in 2000. By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars). The average cost of a fall for an older adult totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services. Furthermore, these costs did not include the long-term effects of falls such as dependence on others, lost time from work, household duties, and reduced quality of life.

Fall Prevention Programs


EnhanceFitness is an evidence-based group exercise program for older adults at all levels of fitness to help them become more active, energized, and empowered to sustain independent lives. EnhanceFitness focuses on endurance training, flexibility, balance, and strength training. Six months after the program participants exhibited 10-30% better physical, emotional, and social health scores.


FallProof is another fall prevention program that boosts balance and lowers the risk for falls. Older adults who complete the program demonstrate reduced fear-of-falling and higher physical activity levels. There are three different levels or classes to the program. Mobility I is for the older adult beginning to experience balance problems. The Mobility II program is for the senior who already has a history of falls and requires the use of walkers, wheelchairs and other aids. The third and newest addition to the FallProof program is a water based program. FallProof H2O uses the properties of water to work on balance and mobility. It is for the person who lacks the confidence in balance, or has chronic joint and limb pain.

Matter of Balance

The Matter of Balance program focuses on the fear of falling, and encourages consistent physical movement to reduce the likelihood of falling because of weak muscles.   Participants learn to view falls and fear of falling as controllable, and set realistic goals for increasing activity. Participants also realize ways they can change their environments to reduce fall the risk of falling, and learn simple exercises to increase strength and balance.

Photo credit: Pnikosis

About the Author: Ryan Malone is the founder of InsideElder Care and author of the ByFamilies, For Families Guide to Assisted Living. He regularly speaks and advises families about how to improve their aging loved one’s quality of life. Ryan is also the president of SmartBug Media, a content marketing agency that helps companies increase leads, customers and influence. You can read more from Ryan on the SmartBug Media blog or follow him on Twitter.

Top Brain Fitness Programs for Sustaining Mental Acuity

In aging seniors, healthy brain function is about more than just memory and coordination; everyday tasks, relationships, hobbies and quality of life are all affected.  It stands to reason that the more aware and capable you are of cognitive reasoning and performing independent living activities the higher your self confidence and emotional health.

The nation’s largest study on brain fitness was performed in 2002 by the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) and their results showed that a large percentage of participants over the age of 65 improved memory, reasoning and information-processing speed when they participated in training for five days per week.  In addition, the study showed a 47% lower risk of dementia in participants who worked crossword puzzles four days a week than those who only worked the puzzles once a week.  These results play into the notion of “Use it or Lose it” when it comes to cognitive aging.

Furthermore, an Australian study consisting of 30 peer-reviewed papers in controlled trials found that, as people experienced these lifestyle benefits they were also able to live longer and therefore reduce health care expenses.

Along with these studies, it is widely known that many seniors regularly engage in crossword puzzles, Sudoku and similar brain training games to slow dementia and aging.  Many software companies have tapped into this need by creating games and exercises that aid in sustaining mental acuity.  It has been reported that the brain fitness software market grew from $225 Million in 2007 to $265 Million in 2008.  Here are the top three systems that claim to reduce dementia rates in seniors.

Posit Science

Posit Science claims that their products will help the user “think faster, focus better, and remember more.”  Their software programs are designed for either a PC or a Mac. Each priced at $395.00

  1. Brain Fitness Program: Six programs that allow you to “Remember more & Feel Sharper” by practicing matching items, distinguishing objects, memory recall and story telling.
  2. InSight: Five programs designed for “Better Focus & Learn More” focusing on visual precision.
  3. DriveSharp: Two programs that deal with divided attention and increased processing times so that you will “Drive Carefully & React Faster”

Dakim BrainFitness

Dakim offers two brain training concepts for seniors.

  1. A complete self-contained console that only needs a high-speed internet connection but does not require a keyboard, mouse or software program installation.  It is marketed to both the individual senior and the senior living provider.  After the initial purchase of $2,299 for the touch-screen console, more than 150 games are available for a $19.95 per month subscription.
  2. 2. New brain fitness software to be released this April for $349.99, which includes a one-year subscription.


CogniFit is a web-based system that does not require you to install software or purchase a console.  Instead you access the programs through their website.  Both programs described below are priced based on the following subscription terms: $19.95 per month, $99.50 for 6 months, or $170 annually.

  1. CogniFit Personal Coach:  This program addresses overall cognitive skills and claims to improve memory and focus, and increase processing time.
  2. CogniFit Senior Driver: Similar to other driving programs, this system is designed to improve reaction time, handle multiple driving tasks and focus on potential road threat recognition.

About the Author: Ryan Malone is the founder and managing editor of Inside Elder Care and the author of the By Families, For Families Guide to Assisted Living.  He can be reach on Twitter at @RyanMalone.