In general, elder abuse refers to intentional or neglectful acts that lead to, or may lead to, the harm of an older adult. The abuse may be physical, emotional, psychological, verbal, sexual, or financial. Neglect and abandonment are also types of elder abuse and, in many states, self‐neglect is also considered a form mistreatment.

Elder abuse prevention programs, including Adult Protective Services (APS) programs, are available nationwide to investigate and intervene when allegations of abuse are reported. To find APS and other programs in your community, enter your ZIP code or city and state in the search bar at the top of this page or speak with an information specialist at the Eldercare Locator at 1-800-677-1116.

National Center on Elder Abuse

This website provides resources on elder abuse prevention, including information on reporting suspected cases of elder abuse.

National Domestic Violence Hotline

The Hotline is a nonprofit organization that provides crisis intervention, information, and referrals to victims of domestic violence, friends, and families. Reach the Hotline 24 hours a day at 1-800-799-SAFE (7233) or TTY 1-800-787-3224.

Legal Assistance

The legal issues of older adults are often more critical than those faced by other segments of the population. Such issues may include income security, housing, utilities, protective services, abuse, neglect and age discrimination. It is important for older adults to understand their rights and seek advice when necessary.

The Older Americans Act supports legal service programs that provide and enhance important protections for older adults. To find services in your community, enter your ZIP code or city and state in the search bar at the top of this page or speak with an information specialist at the Eldercare Locator at 1-800-677-1116.

National Consumer Law Center

This website offers an extensive array of publications specifically for older consumers.

Federal Trade Commission: Identity Theft

This website is a one-stop national resource to learn about the crime of identity theft. It provides detailed information to help deter, detect, and defend against identity theft.

Consumer Financial Protection Bureau

This website offers information and tools to help consumers navigate financial choices. The site also includes easy-to-understand guides to help financial caregivers managing someone else’s money.

Federal Communications Commission

This website offers information to help consumers know their rights and what you can do if you have a billing problem.

Long-Term Care (LTC) Ombudsman Program

Authorized under the Older Americans Act, the LTC Ombudsman Program provides advocates for residents of long-term care facilities. The Program works to resolve problems of individual residents and bring about changes at the local, state and national levels to improve resident care and quality of life. To find an ombudsman in your community, enter your ZIP code or city and state in the search bar at the top of this page or speak with an information specialist at the Eldercare Locator at 1-800-677-1116.

National Long-Term Care Ombudsman Resource Center

This website provides additional information about the long-term care ombudsman program and residents’ rights in long-term care facilities.

A new study estimates more than one in 10 older Americans binge drink. That’s an increase from the previous decade. The study, from the Journal of the American Geriatrics Society, determined binge drinkers 65 and older were more likely to be men; they’re also more likely to use tobacco or cannabis.

Binge drinking is defined as five or more drinks at a time for men, and four or more drinks at a time for women. Researchers say the habit can be more dangerous for older people, putting them at risk for a range of health problems.

One of the findings of the study is that an estimated 70 percent of all hospitalized older persons, and up to 50% of nursing home residents, have alcohol-related problems in general.

“When we think about binge drinking, the image we usually think about is younger adults or college students, but this is in fact a growing trend in older Americans,” said Dr. Tara Narula on “CBS This Morning” Wednesday. “It’s been under-reported in both the scientific literature and in the media, but the problem is that the alcohol has a very strong effect on people who are older. They’re more vulnerable to the health problems than even a younger population.

“Currently around 10.6% of older Americans are binge drinkers. In the previous decade, it was anywhere from 7% to 9%. So, that number is growing. Also growing just general increase in alcohol use and any sort of harmful alcohol use.”

Co-host Anthony Mason asked, “Is it more dangerous for older Americans?”

“It can be,” Dr. Narula replied. “There are a couple of reasons why. They are more sensitive to the alcohol, so they’re at a higher risk of getting impaired at the same level that might not impair somebody who’s younger. Many of them have chronic health problems. In fact, in this series, 24% of them had [conditions] like diabetes, hypertension, or cardiovascular disease. So [binge drinking] can exacerbate those. It can allow them to develop new problems, like pancreatitis or gastritis or certain cancers.

“Many of them are on prescription medication that might interfere. Also, it increases the risk of injury or accidents and falls in people who already may have issues with balance or coordination or reflexes.”

When asked about guidelines for binge drinking for older Americans, Dr. Narula said, “Really no American who is older should be drinking more than three drinks a day. If you have some sort of chronic disease or on prescription meds, you should speak to your doctor and they may recommend something even lower. Low-risk drinking is less that two drinks a day for a man, or one drink a day for a woman.

“It’s really important that doctors screen for this and also educate about it. A lot of these people may be at home drinking alone. Nobody really knows what’s going on. The problems may be attributed to, ‘Oh, they’re getting older, that’s why they’re confused and falling.’ It can be a little silent unless we actually look for it.”

The study noted that for the metabolism of a person who is 65 years or older, drinking two or three beers at that age has the same effect as seven or eight beers on someone at age 20. “They’re exquisitely sensitive to it,” said Dr. Narula.

Mason asked, “What do you do if you have a loved one who’s doing this? How do you deal with this?”

“I think a lot of people tend to shy away from it or avoid it; they don’t know how to deal with it,” said Dr. Narula. “I think it’s important to be compassionate, loving and respectful to these older Americans you may feel have a problem, but also you want to be proactive. You want to address it, because early intervention is really essential.

“One of the things that can be helpful is seeking advice from a professional who can guide you as to what type of treatment they should be getting, and interestingly how to approach them. Should it be a doctor that approaches them? Maybe a friend might be better or a family member.

“All of the recommendations really say, don’t use the world alcoholic; don’t talk to them while they may be intoxicated. You wait ’til they’re sober. Be patient, be direct with them. You don’t want to treat them like a child. You want to treat them like an adult, with respect, when you approach them.”

Clinical ResearchGerontologyHealth Care Research

Middle-aged adults who develop functional impairments—difficulty performing activities of daily living (ADLs) such as bathing and dressing—are at higher risk for hospitalization and nursing home admission than unimpaired adults the same age, according to an NIA-supported study. The findings, published online in JAMA Internal Medicine, raise questions about how clinicians can help those in midlife prevent or delay struggles with daily activities that affect health and quality of life.

Researchers at the University of Pennsylvania and the University of California, San Francisco, wanted to find out how middle-aged adults became functionally impaired and if their impairments posed the same risks as in older adults. Nearly 15 percent of adults age 55 to 64 are functionally impaired, meaning they have difficulty performing one or more of six basic ADLs: bathing, dressing, transferring (such as from a bed to a chair), toileting, eating, and walking across a room.

The researchers analyzed health data for 5,540 adults age 50 to 56 from the nationally representative Health and Retirement Study (HRS). None was functionally impaired when they entered the HRS in 1992, 1998, or 2004, but 1,097 of them (19.8 percent) reported that they developed an impairment in at least one ADL by age 64. Examining data reported every 2 years through 2014, the researchers found that functionally impaired participants had a significantly higher risk of hospitalization and nursing home admission than participants their age without functional impairment. The risk of death in the two groups was about the same after adjusting for factors such as health status and health behaviors like smoking.

The study found similar risks for hospitalization and nursing home admission, as well as for death, in the 857 HRS participants (15.5 percent) who developed trouble performing at least one instrumental ADL. These activities include managing money, managing medications, shopping for groceries, preparing meals, and making telephone calls.

The authors noted that not all functional impairments are permanent; sometimes they are temporary or disappear and then recur. Participants with functional impairments were more likely to be women, racial or ethnic minorities, unmarried, and to have lower socioeconomic status. They also had poorer health status and were more likely to smoke, exercise infrequently, and lack health insurance.

As in older adults, functional impairment in middle-aged adults can affect health and quality of life, the authors concluded. Clinicians could address risk factors such as chronic disease, depression, and obesity to prevent or delay functional impairment, and intervene to prevent adverse outcomes in middle-aged adults who become functionally impaired.

This study was supported in part by NIA grants K23AG045290, K76AG057016, P30AG044281, K24AG049057, and R01AG0478897.

by in Health

You probably don’t remember having chickenpox as a child or getting a chickenpox vaccine. You probably haven’t given the illness a passing thought in decades. But you might want to think about it now. While chickenpox is usually an illness reserved for children, it can come roaring back in adulthood as shingles.

If you have had chickenpox, you are at risk of shingles, and you won’t soon forget the severe pain it can cause. There is no telling if and when shingles will strike, but luckily there are vaccines available to help prevent it. Here are a few things you should know about shingles.

Shingles is an illness that is related to chickenpox and caused by the same virus: the varicella-zoster virus. Before the chickenpox vaccine was developed, most children got chickenpox at some point. After you contract chickenpox, the virus remains in your body. Later in life, the virus can become active again and cause shingles.

Most children today receive a chickenpox vaccine. Like the natural virus that causes chickenpox, the vaccine virus can also become active later in life and cause shingles. However, people who had a chickenpox vaccine have a lower risk of getting shingles than people who had chickenpox.

The first sign of shingles is usually pain, which can be severe. After a few days, a person with shingles may develop a rash and fluid-filled blisters. Shingles can also cause burning, numbness, itching, and sensitivity to touch. It usually affects only one area of the body at a time, often appearing as a stripe of blisters on one side of the torso. People with shingles are contagious to those who have not had chickenpox or the chickenpox vaccine, but they are only contagious while they have open sores. If somebody catches the virus from a person with shingles, they will develop chickenpox, not shingles.

If you have had chickenpox, you can get shingles at some point during your lifetime. Almost one in three Americans will get shingles at least once, and the risk increases with age. Older adults and people with a weakened immune system have a higher likelihood of being hospitalized with complications. The most common complication of shingles is severe pain after the shingles rash has healed, and the risk for this complication also increases with age.

There are some medications available that can improve some of the shingles symptoms. These antiviral medicines do not cure shingles, but they can shorten the duration and lessen the severity of the illness. Contact your doctor when shingles symptoms appear and start treatment as soon as possible. Other treatments for shingles include pain management options like numbing cream and pain relievers.

A shingles vaccine can lower the risk of getting the illness. It is recommended for everyone over age 50, even if they have been vaccinated in the past or if they have had shingles.

“Although most people who get shingles only get it once, it is possible to get it multiple times,” says Skyler Peterson, executive director at Carrollton Health and Rehabilitation Center. “The risk of getting more than one bout of shingles is higher for elderly people and others with weakened immune systems. It is important to get the shingles vaccine, whether or not you have had the illness, to help prevent recurrences.”

If you think you may have shingles, visit your doctor as soon as possible to get treatment. If you haven’t had shingles, or even if you have, get a vaccine to give yourself the best protection from the illness.

by Sally C. Pipes

Earlier this year, the Trump administration proposed a rule that would have ensured that tens of billions of dollars of hidden rebates and discounts went to patients. Sadly, the White House just chose to abandon this sensible, bipartisan reform. 

It’s a shame President Trump did not see this effort through. Millions of patients would have benefited from the change in the form of lower pharmacy bills and better health outcomes. 

The rule impacted Medicare Part D, the federal prescription drug benefit for roughly 45 million seniors. Under Part D, private insurers compete to sell prescription drug plans to Medicare beneficiaries. The government subsidizes and regulates these plans, but largely lets the private sector take the lead.

As a result of this competition, beneficiaries can choose from dozens of plans, each with different premiums, copays, and formularies — the lists of medicines covered by plans. 

Insurers often hire pharmacy benefit managers (PBMs) to design their drug benefits. PBMs decide which drugs to include on formularies and how much patients will have to pay out-of-pocket. 

Drug makers offer massive discounts to PBMs — $166 billion in 2018.   

PBMs keep a small slice of these rebates for themselves and hand most of the rebates back to insurers, who use them to lower premiums. 

Those savings do little good for the sickest patients who need many prescriptions. When these patients get to the pharmacy, they generally fork over copays or coinsurance — a set percentage of a drug’s cost.

President Trump wanted to reform this system to bring relief to America’s sickest patients: those in need of multiple drugs. His now-dead rule would have made it illegal for drug companies to offer rebates to PBMs and insurers, unless those middlemen pass the savings directly to patients through lower copays and coinsurance.  

Seniors could have seen significant savings under the policy. Sharing 100 percent of rebates would save diabetes patients $3.7 billion each year. That’s around $800 per patient.  

Another estimate found if the proposal were enacted, patients battling cancer, autoimmune diseases, and other debilitating conditions could have saved $20 billion over the next decade.  

President Trump’s plan would have saved lives. Cost concerns are one of the most common reasons for patients to skip their pills. Medication non-adherence kills around 125,000 Americans a year. Patients live longer when copays and coinsurance are lower — it’s as simple as that.

The president’s decision to scrap the proposal is bad news for patients. Let’s hope the Trump administration suggests a viable alternative soon. 

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The False Promise of Single-Payer Health Care (Encounter 2018). Follow her on Twitter @sallypipes.