NANASP NEWS 
November 10, 2016
 
  
 
Surgeon General's Healthy Aging in Action Report

Healthy Aging in Action: Advancing the National Prevention Strategy was prepared by the National Prevention, Health Promotion, and Public Health Council (National Prevention Council). The Centers for Disease Control and Prevention provides ongoing administrative, scientific, and technical support for the operations of the National Prevention Council.

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Key Takeaways:

Page 27: Promote older adults' access to healthy foods.
At the White House Conference on Aging, the U.S. Department of Agriculture (USDA) issued a proposed rule to increase accessibility to critical nutrition for homebound, older Americans and people with disabilities by enabling Supplemental Nutrition Assistance Program (SNAP) benefits to be used for services that purchase and deliver food to these households. The President's fiscal year 2017 budget proposed nearly $850 million for Nutrition Services programs for older adults, a $14 million increase over the 2016 enacted level, allowing states to provide an estimated 205 million meals to more than 2 million older Americans nationwide. The budget also includes a new proposal to invest in evidence-based innovations to help ensure that funding for Nutrition Services programs is spent as efficiently as possible to maximize the impact of these funds.

Page 30: Protect older adults from elder mistreatment.
At the White House Conference on Aging, CMS released a proposed rule to update the quality and safety requirements for more than 15,000 nursing homes and skilled nursing facilities to improve quality of life, enhance person-centered care and services for residents in nursing homes, improve resident safety, and bring these regulatory requirements into closer alignment with current professional standards. The National Institutes of Health also convened a state of the science workshop on elder abuse with researchers, clinicians, and others to review the science on understanding and preventing abuse; screening tools to identify abuse victims; effective interventions and research in related areas like child abuse and domestic violence that might inform research on elder abuse; and gaps and opportunities in this field of research. An estimated 10 percent of older adults are the victims of elder mistreatment, including physical abuse, emotional abuse, sexual abuse, exploitation, neglect, or abandonment. Establishing accurate estimates, however, is complicated because of state variations in the definition of elder mistreatment, the absence of a national database, and underreporting. Enhancing understanding of the extent of elder mistreatment, as well as its risk and protective factors, is critical for designing and implementing effective prevention and intervention efforts.

Page 34: Increase older adults' access to and use of clinical preventive services.
Clinical preventive services can prevent or detect disease earlier when treatment is more effective. These services include screenings for chronic conditions such as high blood pressure and diabetes, immunizations for diseases such as influenza and pneumonia, and counseling about personal health behaviors such as smoking and physical activity. The U.S. Preventive Services Task Force provides a complete list of all recommended services. Healthy People is an HHS initiative that sets 10- year national objectives for improving the health of all Americans. In 2010, Healthy People 2020 added "older adults" as a new topic area with the goal of improving the health, function, and quality of life of older adults. One objective for older adults is to increase the proportion of that population who are up to date on a core set of clinical preventive services. Older adults do not always obtain important preventive services that are critical for avoiding disease and disability. In 2014, only about two out of five adults 65 and older were up to date on all of a core set of preventive services.

Page 35: Increase access to and availability of preventive dental services.
Oral health is an important but often overlooked component of older adult health. More than 37 percent of adults aged 65 years and older have not had a dental visit in the last 12 months. Poor oral health can affect an older adult's overall health and well-being and is often associated with several chronic diseases and conditions, such as diabetes, cardiovascular diseases, pulmonary diseases, rheumatoid arthritis, cognitive impairment/ Alzheimer's disease, and some types of cancers (oral cavity, gastrointestinal tract, bladder, liver, kidney, and pancreatic). In addition, older adults often do not have dental insurance or adequate dental insurance, and those with the poorest oral health are economically disadvantaged and members of racial and ethnic minorities. There are also disparities in oral health outcomes, such as tooth loss and gum disease, among Americans residing in different geographical areas. Preventive dental services include oral health screenings, regular dentist checkups, and patient counseling on behavioral risk factors for oral disease and conditions. These services are important even if older adults do not have natural teeth and have dentures, to ensure gum health. The HRSA funded 420 health centers to increase access to integrated oral health care services and improve health outcomes for health center program patients. The National Academies of Sciences, Engineering, and Medicine report Improving Access to Oral Health Care for Vulnerable and Underserved Populations provides a roadmap for the important and necessary next steps to improve access to oral health care, reduce oral health disparities, and improve the oral health of the nation's vulnerable and underserved populations.

Page 40: Expand the availability of home- and community-based services.
Home- and community-based services (HCBS)-such as professional and family in-home personal care, adult day care, home health, home-delivered meals, and case management-are associated with improved physical and mental health. HCBS may also delay or prevent nursing home placement. Recent analyses found that as states spent more on Older Americans Act programs and Medicaid HCBS, the number of nursing home residents with low ADL-care needs decreased. Home-delivered meals were particularly effective, perhaps because meal drivers became aware of issues among isolated and home-bound older adults. Under the Affordable Care Act there have been multiple Medicaid investments to provide home-and community-based services and supports. The law improves existing tools and creates new options and financial incentives for states to provide HCBS and supports. The Home- and Community-Based Services State Plan Option enable states to target home- and community-based services to particular groups of people, to make services accessible to more individuals, and to ensure the quality of the services provided. The Community First Choice State Plan Option provides increased federal matching funds to states that provide HCBS to individuals who might be served in an institutional setting.

Page 40: Expand the availability of home- and community-based services.
Home- and community-based services (HCBS)-such as professional and family in-home personal care, adult day care, home health, home-delivered meals, and case management-are associated with improved physical and mental health. HCBS may also delay or prevent nursing home placement. Recent analyses found that as states spent more on Older Americans Act programs and Medicaid HCBS, the number of nursing home residents with low ADL-care needs decreased. Home-delivered meals were particularly effective, perhaps because meal drivers became aware of issues among isolated and home-bound older adults. Under the Affordable Care Act there have been multiple Medicaid investments to provide home-and community-based services and supports. The law improves existing tools and creates new options and financial incentives for states to provide HCBS and supports. The Home- and Community-Based Services State Plan Option enable states to target home- and community-based services to particular groups of people, to make services accessible to more individuals, and to ensure the quality of the services provided. The Community First Choice State Plan Option provides increased federal matching funds to states that provide HCBS to individuals who might be served in an institutional setting.
 
Page 51: Combat ageism through culture change efforts, education and training, and intergenerational activities.
Ageism can take many forms and can exacerbate the social exclusion of older adults. Furthermore, ageism by the larger society can lead to negative self-perceptions about aging, which in turn have been linked to decreased physiological and cognitive functioning, as well as an increased mortality risk. The Reframing Aging initiative, developed by eight leading aging organizations, provides an example of the importance of shifting public perceptions about aging.
 
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