The Medicare Funding Warning Response Act of 2008 would require HHS to develop a plan to ensure that at least 50 percent of the care provided by Medicare would be covered by value-based or pay-for-performance measures by the year 2013. That move could saddle family physicians with much of the cost of meeting the requirement because many of the performance measures apply to primary care, said Kevin Burke, director of the AAFP’s Division of Government Relations.

Under the Medicare Funding Warning Response Act of 2008, the federal government could also withhold a portion of payments to physicians based on their ability to meet quality and efficiency standards, forcing them to compete for limited payments, Burke said. Certain quality-related provisions, such as those dealing with electronic health records, pricing transparency and value-based purchasing, would not be implemented unless they saved money.

Source: www.aafp.com

Eat colorful Fruits and vegetables.Load up on spinach, berries,apples, and carrots are all high in antioxidants and fiber.

Eat Fish. Tuna, and salom are rich in omega-3 fatty acids. Try eating 2-3 servings of fish per week.

Do Not Smoke.If you smoke, quit right now. Smoking triples your risk of dying by increasing your blood pressure and making blood more prone to clot, which can lead to heart attacks and strokes. Within a year of quitting, you will decrease your risk of a heart attack by 50 percent.

Balance exercise and your diet. Try to balance the calories you take in with the calories you burn by physical activity.If you have a bigger middle section, you are more likely to have fat in and around your abdominal organs where it can be released into the bloodstream as dangerous fatty acids that contribute to clogged arteries. For women, a waist size more than 30 inches is a red flag.

Exercise. Aim for at least 30 to 60 minutes of physical activity daily. Exercise – in any form - will lower your blood pressure, reduce stress and boost your “good” cholesterol.

Do not use salt. Keep your blood pressure at 120/80 mmHg or below. As women age, they become more salt-sensitive, which contributes to elevated blood pressure. Women over the age of 50 should cut sodium intake to 1,500 mg a day.

According to a new study published in February 2008,issue of Archives of Internal Medicine abnormal mammography and breast biopsy results are more common among women who take hormone therapy that combines oestrogen and progestin.The study also found that hormone therapy interferes with the effectiveness of both breast cancer screening methods.

The study findings are based on an analysis of 16,608 postmenopausal women who participated in the Women’s Health Initiative clinical trial, from 1993 to 1998. Women were randomly assigned to receive a combination of oestrogen daily (0.625 mg conjugated equine estrogens) plus progesterone daily (2.5 mg medroxyprogesterone acetate) (n = 8,506) or placebo (n = 8,102). Each participant received mammography and a breast examination yearly, with biopsies performed based on the physicians’ clinical judgment.

During the 5.6 years of the study, 199 women in the combined hormone therapy group and 150 women in the placebo group developed breast cancer. Abnormal mammography results were more common among women who were taking hormones (35%) compared with women who were assigned to placebo (23%). The women taking hormones also had a 4% greater risk of having an abnormal mammography after 1 year and an 11% greater risk after 5 years.Breast biopsies also were more common among women taking hormones (10%) compared with those assigned to placebo (6.1%).

“Although breast cancers were significantly increased and were diagnosed at higher stages in the combined hormone group, biopsies in that group less frequently diagnosed cancer (14.8% vs 19.6%),” the authors, led by Rowan T. Chlebowski, MD, PhD, Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles, Medical Center, Los Angeles, noted. “After discontinuation of combined hormone therapy, its adverse effect on mammography modulated but remained significantly different from that of placebo for at least 12 months.”

The use of combined hormones may increase breast density, which increases the risk of breast cancer and could also delay diagnosis; however, the authors noted that breast density was not measured in this study.

“Use of conjugated equine oestrogens plus medroxyprogesterone acetate for approximately 5 years resulted in more than 1 in 10 and 1 in 25 women having otherwise avoidable mammography abnormalities and breast biopsies, respectively, and compromised the diagnostic performance of both,” the authors concluded. “This adverse effect on breast cancer detection should be incorporated into risk-benefit discussions with women considering even short-term combined hormone therapy.”

Source: Archives of Internal Medicine, February 25, 2008

People with mild dementia had more crashes and are almost 4 times more likely to fail road tests.

Seniors with early Alzheimer’s disease were involved in more traffic crashes and performed worse on road tests than drivers without cognitive impairment, a new study finds.

Researchers at Rhode Island Hospital and Brown University, confirm previous reports of potentially hazardous driving by people with early stage Alzheimer’s disease . The study also shows that some people with mild dementia are able to continue driving safely for short or even extended periods of time.

The study consisted of 84 people with early Alzheimer’s and a control group of 44 age-matched people without any cognitive impairment. The study was conducted over two to three years. The participants’ driving abilities were assessed through self-reports, family reports and a standardized road test.

Are you one of the many American’s that has left their childhood faith?

The new “U.S. Religious Landscape Survey” of religious affiliation by the Pew Forum on Religion and Public Life found that more than a quarter of adult Americans have left the faith of their childhood to join another religion or no religion at all.

The survey depicts a highly fluid and diverse national religious life. If shifts among Protestant denominations are included, then it appears that 44 percent of Americans have switched religious affiliations. The catholic faith tops the survey with the highest percentage of people leaving and the unaffiliated churches are trending are gaining more memebrs than any other faith.

Read the full article at www.nytimes.com

After initially resisting their disclosure, the Bush administration on Tuesday published the names of 131 nursing homes with poor inspection records and said some were already showing signs of improvement.The list released by the Centers for Medicare and Medicaid Services represents troubled facilities cited as a “special focus facility,” a designation used to identify those that merit more oversight. For these homes, states conduct inspections at six-month intervals rather than annually.

You may view the full report below:

On the Net:

The nursing home list can be found at:

http://www.cms.hhs.gov/CertificationandComplianc/Downloads/SFFList.pdf

Senate Special Committee on Aging:

http://aging.senate.gov/

Many senior living community representatives find that the most asked question by seniors and their families in search of a senior living community or nursing home is, “How is the food?”. So what do you think the representative would say? Terrible? I highly doubt that, I’m sure they would ensure that it is wonderful and that you will love it. Do you think that is true?

Here are some tips on trying to find out the truth out about their food. I recommend asking the current residents how they like the food. You can even ask to have a meal to see how you like it. Trying the food is the best way for you to tell if it meets your standards. Remember, they are cooking for a big group of people and not every meal is going to be perfect. I am sure that there will be a few complaints, but overall you should be looking for a flexible menu and fresh ingredients.

Signs and symptoms

Knowing the signs and symptoms of a stroke may make it possible for the right care and to get immediate treatment. The signs and symptoms of stroke usually occur suddenly; frequently there’s more than one.

Signs and symptoms include:

• Sudden numbness, weakness, or paralysis of your face, arm or leg — usually on one side
• Sudden dizziness, loss of balance or loss of coordination
• Sudden difficulty speaking or understanding speech (aphasia)
• Sudden blurred, double or decreased vision
• A sudden, severe headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between your eyes, vomiting or altered consciousness
• Confusion, or problems with memory

For most, a stroke gives no warning or signs. One possible sign of an impending stroke is a transient ischemic attack (TIA). A TIA is a temporary interruption of blood flow to a part of your brain.The signs and symptoms of TIA are the same as a stroke, but they last for a shorter period. It can be several minutes and to 24 hours and then go away without any apparent permanent effects. It is possible to have more than one TIA, and the recurrent signs and symptoms may be similar or different.

Men and women who are moderately fit reduce their stroke risk. Most People can reach that fitness range by walking briskly for only 30 minutes 5 times a week.Stroke is nation’s third-leading cause of death.In its stroke prevention guidelines, the American Stroke Association recommends at least 30 minutes of physical activity of moderate intensity on most days of the week.

Visit American Stoke Association for more information.

What is a Living Trust? By: Vicki Rubin-Howton, Attorney at Law

A living trust can be an important part-and in many cases, the most important part-of your estate plan. It is a written legal document that partially substitutes for a will. With a living trust, your assets (your home, bank accounts and stocks, for example) are put into the trust, administered for your benefit during your lifetime, and then transferred to your beneficiaries when you die.

Most people name themselves as the trustee in charge of managing their trust’s assets. This way, even though your assets have been put into the trust, you can remain in control of your assets during your lifetime. You can also name a successor trustee who will manage the trust’s assets if you ever become unable or unwilling to do so yourself.

Generally, a living trust is a revocable trust (sometimes referred to as a revocable inter vivos trust or a grantor trust). Such a trust may be amended or revoked at any time by the person or persons who created it (commonly known as the trustor(s), grantor(s) or settlor(s)) as long as he, she, or they are still competent.

Your living trust agreement:

• Gives the trustee the legal right to manage and control the assets held in your trust.
• Instructs the trustee to manage the trust’s assets for your benefit during your lifetime.
• Names beneficiaries (person/charitable organization) who receive your trust’s assets when you die.
• Gives guidance and certain powers and authority to the trustee to manage and distribute your trust’s assets.

The trustee is a fiduciary, which means he or she holds a position of trust and confidence and is subject to strict responsibilities and very high standards.

Vicki Rubin-Howton, Attorney at Law
rubinlaw@sbcglobal.net
Office: 714-541-2004
Cell: 949-939-0896

DISCLAIMER: This site and any information contained herein are intended for general informational purposes only and should not be construed as legal or tax advice. Seek competent legal counsel for advice on any legal matter. Courtesy of the State Bar of California.