Anyone at any age can have a drinking problem. Uncle George always liked his liquor, so his family may not see that his drinking is getting worse as he gets older. Grandma Betty was a teetotaler all her life until she started having a drink each night to help her get to sleep after her husband died. Now, no one realizes that she needs a couple of drinks to get through each day.

These are common stories. The fact is that families, friends, and healthcare workers often overlook their concerns about older people drinking. Sometimes trouble with alcohol in older people is mistaken for other conditions related to aging, for example, a problem with balance. But, how the body handles alcohol can change with age. You may have the same drinking habits, but your body has changed.

Alcohol may act differently in older people than in younger people. Some older people can feel “high” without increasing the amount of alcohol they drink. This “high” can make them more likely to have accidents, including falls and fractures and car crashes. Also, older women are more sensitive than men to the effects of alcohol.

Drinking too much alcohol over a long time can:

Lead to some kinds of cancer, liver damage, immune system disorders, and brain damage

Worsen some health conditions like osteoporosis, diabetes, high blood pressure, stroke, ulcers, memory loss and mood disorders

Make some medical problems hard for doctors to find and treat—for example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack.

Cause some older people to be forgetful and confused—these symptoms could be mistaken for signs of Alzheimer’s disease.

Learn more about how alcohol affects older women.

How Alcohol Affects Safety

Drinking even a small amount of alcohol can lead to dangerous or even deadly situations. Drinking can impair a person’s judgment, coordination, and reaction time. This increases the risk of falls, household accidents, and car crashes. Alcohol is a factor in 30 percent of suicides, 40 percent of crashes and burns, 50 percent of drownings and homicides, and 60 percent of falls. People who plan to drive, use machinery, or perform other activities that require attention, skill, or coordination should not drink.

In older adults, too much alcohol can lead to balance problems and falls, which can result in hip or arm fractures and other injuries. Older people have thinner bones than younger people, so their bones break more easily. Studies show that the rate of hip fractures in older adults increases with alcohol use.

Adults of all ages who drink and drive are at higher risk of traffic accidents and related problems than those who do not drink. Drinking slows reaction times and coordination and interferes with eye movement and information processing. People who drink even a moderate amount can have traffic accidents, possibly resulting in injury or death to themselves and others. Even without alcohol, the risk of crashes goes up starting at age 55. Also, older drivers tend to be more seriously hurt in crashes than younger drivers. Alcohol adds to these age-related risks.

In addition, alcohol misuse and abuse can strain relationships with family members, friends, and others. At the extreme, heavy drinking can contribute to domestic violence and child abuse or neglect. Alcohol use is often involved when people become violent, as well as when they are violently attacked. If you feel that alcohol is endangering you or someone else, call 911 or get other help right away.

For More Information About Alcohol Use and Safety
National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
1-888-696-4222
[email protected]
www.niaaa.nih.gov

by Kenneth E. Thorpe

The Trump administration has a new plan to reduce Americans’ out-of-pocket drug bills. It’s sure to face opposition from entrenched special interests. But if the administration succeeds in implementing the plan, patients will greatly benefit.

The proposed rule would reform how drug companies and insurers interact, especially in Medicare’s Part D prescription benefit, which covers about 45 million seniors and Americans with disabilities. The government doesn’t administer its own prescription plans. Instead, it allows private insurers to sell coverage to beneficiaries. 

Those insurers decide which drugs to cover and use this power as negotiating leverage. Through the “pharmacy benefit managers” they hire to administer their benefits, insurers pressure pharmaceutical companies to offer big rebates on medicines.

These rebates aren’t shared at the pharmacy with patients, though. So the bigger the rebate, the more money insurers and PBMs earn. Insurers typically use the savings they wrangle to lower premiums for their entire beneficiary pool; PBMs typically keep their share of the savings. 

The administration’s proposed rule, if enacted, would force insurers to use share any discounts at the point of sale, thus reducing patients’ out-of-pocket costs. 

The rule wouldn’t just save patients money. It would also improve patients’ health by making it easier to afford a wider range of drugs. Insurers would no longer have an incentive to steer patients towards more expensive products with substantial, hidden discounts.

Consider how insurers currently block patients from accessing “biosimilars,” which are knockoff copies of “biologic” medicines. Biologics are complex drugs grown from living cells. 

Biosimilars aren’t technically generics, since there are slight molecular differences between biosimilars and the biologics they mimic. They almost always work as well as they’re brand-name counterparts, but are notably less expensive.

Insurers often refuse to cover biosimilars, since manufacturers offer few discounts. They instead cover the higher-priced, innovator biologics that come with big, hidden rebates. 

For instance, nearly all Medicare prescription drug plans cover the brand-name diabetes biologic Lantus, but only 17 percent cover its biosimilar, Basaglar. 

Such behavior hurts patients. Many patients skip doses or decline to fill their prescriptions due to high out-of-pocket costs. It’s estimated that so-called drug “non-adherence” causes 125,000 deaths each year.  

Luckily, the administration’s new proposal prohibits drug companies from offering rebates to Medicare Part D insurers, unless those insurers use the savings to reduce patients’ out-of-pocket costs.  

Thanks to this rule, insurers would no longer have a reason to steer patients towards expensive brand-name drugs when low-cost generics and biosimilars are available. The reform could save Medicare Part D beneficiaries as much as $25 billion by 2029.  

Under the status quo, insurers face perverse incentives to steer patients towards higher-cost drugs. The administration’s proposed rule would fix this broken system, save patients money, and give them access to a wider range of lifesaving medicines. 

Kenneth E. Thorpe is a professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease. This piece originally ran in the Buffalo News.

Ventura County Library Adult Literacy READ Program is now recruiting adult volunteer tutors who would like to help other adults improve their reading and writing skills. No teaching experience is required and the training is free. The next five-week tutor training series in Ventura will be starting soon.

The READ program trains adult volunteers to provide free one-to-one reading instruction for adults in need of basic literacy skills. Instruction in basic literacy includes the development of phonetic reading skills combined with communication skills. Ventura County Library is encouraging residents to take this opportunity to volunteer as a tutor or encourage someone you know to take advantage of the free program.

After completion of the five-week training, tutors will meet with their adult learners at the Hill Road Library in Ventura. Tutoring is scheduled by the availability of the tutors and the learners.

Illiteracy is an issue that can be debilitating in so many ways for adults who never received the proper instruction. Adults who are unable to read have a much more difficult time with many daily activities that others may take for granted, along with a clear disadvantage in today’s competitive job market.

For more information about how you can support literacy and make a difference in someone’s life, call (805) 677-7160.

Getting some shut-eye can be one of the best parts of the day, but as you age, it can become more difficult to do so. Older adults can have a more difficult time getting to sleep, whether it is due to medications, stress, or other factors.

Anh Nguyen, PACC Resource for Ensign Services, says many elderly people suffer from insomnia and are sleepy during the day. “Excessive tiredness is not only frustrating, but it can lead to difficulty driving and performing other daily activities,” she says. “It is important for people suffering from sleep problems to talk to their doctor about changes that can help them sleep better.”

Although sleep troubles are common among the elderly, you don’t have to chalk it up to getting older. Some lifestyle changes can make a big difference in getting a good night’s sleep. Here are a few things you can do-or not do-to make your sleep more sound.

If you are having trouble sleeping at night, it is important to talk to your doctor before you head to the pharmacy and grab some over-the-counter sleep aids. A recent poll found that 46 percent of older adults have trouble falling asleep one night or more each week, but most of them did not talk to their doctor about the problem. Of those polled, 14 percent said they regularly take a medication or supplement to help them sleep. However, sleep aids are not meant to be used long-term and can cause problems for elderly individuals. Older people can experience confusion, constipation, and a higher risk of falls. Before reaching for a sleep aid, talk to your doctor about the best way to tackle your sleepless nights.

People who have trouble sleeping may use alcohol to help them fall asleep. While alcohol can make a person fall asleep faster, it can also have some unintended consequences that lead to a lower quality of sleep. Alcohol can cause a person to wake up frequently at night and earlier in the morning, both of which may make a person tired during the day.

A major contributor to disrupted sleep and feeling tired during the day is sleep apnea, though many people may not know they have it. Sleep apnea causes a person to stop breathing for periods as they sleep. If people tell you that your snoring can be heard in other rooms or that you stop breathing at night, talk to your doctor about getting tested for sleep apnea.

One tip that is often recommended for better sleep is something called “sleep hygiene.” Sleep hygiene includes all the activities you do during the day that affect how well you sleep at night. Good sleep hygiene practices include establishing a regular bedtime, staying away from caffeine within a few hours of bedtime, and starting a pre-bed ritual. It also helps to take a short afternoon nap and exercise regularly.

Make your bed and your bedroom a restful sanctuary. Keep it cool, dark, and quiet. Try using blackout curtains to limit the amount of light entering your room. Visit a website like soundproofexpert to learn more about how to soundproof your walls to ensure that you won’t be woken by loud noises and disruption. You could even invest in some earplugs if your house is particularly noisy at night. Make your room a calm place, without bright and loud electronics. Keep a book by your bedside rather than a screen.

If going to sleep is difficult for you, you are not alone. Many older adults have a hard time falling asleep for a variety of reasons. Give these tips a try, and be sure to talk to your doctor about any underlying problems that could be contributing to your sleep issues.