New Updated Materials

NAFC has been busy this year with updating website content and editing our educational materials with the latest information. Be sure to check out our newly updated information on Overactive Bladder and Pelvic Organ Prolapse. If you would like to order one of the new educational pamphlets be sure to visit the online store. 

We have also had some great newsletters that have gone out be sure to check them out below:

• Navigating Pelvic Organ Prolapse: Help & Hope - By Sherrie Palm
• Get That App and Get Active Again - Review by Nancy Muller, PhD
• Conservative Treatment For Bowel Leakage - By Kristen Ambrose, MS, CCRC, Steve Heymen, PhD and William Whitehead, PhD
• Solutions From Sleepless Nights - By Linda Garvin, RN, MSN
• After Pelvic Floor Reconstruction - By Lizanne Pastore, PT 
• Coping with The Shortage of Primary Health Care Physicians - By Paul Griner, MD 

Technology for Aging in Place : A Market Overview

How does the aging in place technology market evolve?

The marketplace of products for Boomers represents a conservative $2 billion market. This market will continue to grow as 14% of Boomers have expressed interest in helping their parents as they age. The expected market growth between 2010 and 2020 is to at least $20 billion. The changes will be attributed to:

1. Role & need-based hubs that will emerge and grow.

“As hub-and-spoke portals mature, they will offer concierge service for consumers to view and share information, as well as to purchase targeted products and solutions.”

2. Aging in place provider silos will overlap (home design, healthcare services).

“In the future, role-or need-based hubs-and-spokes, with their caregiver- and older adult-focused lenses on need, will force convergence of aging-related categories.”

3. New developments and remodels will offer aging in place technologies.

Senior housing options will begin to become standard as “Boomers will expect home networks, webcams, and voice-activated security for personal emergency response – and aging in place vendors will leverage them to build more sophisticated and connected applications.”

4. Vendor standalone market entries will morph into solutions, designed for all.

“Today’s high product prices and one-off innovations will be replaced with integrated low-cost solutions and the evolutions of hubs (on and off line) that will force vendors to find customers through them.”

Recognition to Laurie M. Orlov & The Journal on Active Aging

Working with Doctors on Patient Engagement

Is the answer changing the physician culture? Do doctors need to accept a greater dialogue with patients?
According to Health Affairs,” patients with the lowest activation levels have average costs 8% higher than those with the highest range on an activation scale.” Are doctors still using that information to their advantage and better engaging patients?
There are some continuing medical education credits (CME) available for physicians who are learning about ways to increase patient engagement and communication skills, but this should be required more. Another option is to offer patients some training and certification in patient engagement, where they could receive lower premiums from their insurance company as an incentive if they complete the training.
Ultimately, it is found that “doctors aren’t incentivized to allow patients to ask questions or take a greater role in their care.” I attended a Health Affairs workshop where it was deemed that in order for doctors to take a greater role in patient engagement, “pay models need to be developed to reward doctors for helping patients take a greater role in planning their care.”
Above all, providers need to find better ways to listen to patients and their families because patients want a regular, personal doctor, someone who they can go to and feel cared for and receive continuous care.

By the numbers:
Blue Shield of California Foundation found that initially only 47% of patients wanted to be part of their decision-making. However, after being presented with information on options for their care they number jumped to 81% of patients wanting to be part of the shared decision making process.

8x8 Rule

Until recently, nearly everyone learned the “8X8 rule”. That is to say, we were all advised to consume eight 8-ounce glasses of pure water per day.  However, recent findings suggest that not only is the adherence of this rule unnecessary, but that the rule itself is based on a misunderstanding. In the 1940s, the Food and Nutrition Board of the National Research Council advised the population to consume one milliliter of water per one calorie of food. Given the typical diet of 1,900 calorie per day, the math indeed comes out to about 64 ounces, or eight 8-ounce glasses, of water per day. However, the Council also mentioned that most of this water is actually found in prepared food. Therefore, it would be redundant to consume the 64 ounces in pure water. Somehow, this last piece of information got lost in translation and the 8X8 rule was born.

According to Heinz Valtin, M.D., a kidney specialist, there is no scientific evidence to support this claim. In 2002, Valtin published a study that examined hard copied literature as well as literature found in electronic databases for surveys, studies, and research that might support the 8X8 rule. The study consulted nutritionists specializing in the field of food and fluid intake. This extensive examination yielded only findings supporting the claim that fluid intake throughout the day has little effect on one’s overall health. It is important to mention that this conclusion is only meant to be applied to the average, healthy individual leading a relatively sedentary lifestyle in a moderate climate. Eight glasses of water per day may certainly be advisable in hotter climates or unfamiliar climates, as well as during a particularly active day or given some medical conditions. The overall idea here isn’t to stop drinking water or to even restrict fluid intake. To provide a take-home message, drink water, or any other fluid (the study also found that hydration can in fact be obtained through even the most forbidden of beverages, like soda and alcohol) according to what your body needs. 

For the complete study and follow-up commentary, visit http://ajpregu.physiology.org/content/283/5/R993.long

Work with Your Doctor

To insure you get the most out of your annual checkup with your primary care physician, talk to your doctor about a plan to become healthier and follow the steps below:

1. Partner with your doctor. You should be the expert on your body and your feelings. Dr. Oz suggests that, "knowing as much as possible about any health conditions you have - and about treatment options - can boost your well being, save money and help you sidestep drugs and procedures you don't need." 
2. Come prepared. Bring a list of the prescription drugs, over the counter medicines, and supplements you take. Have any questions or concerns? Write them down ahead of time so you don't get distracted or forget. And most importantly don't forget your health insurance information.
3. Set health goals with your doctor. (ex. losing weight, lowing blood pressure) Make sure you set a target with a done by date. If the goal is a big one, break it down into mini or daily steps.
4. Dr. Oz also suggests that a patient goes armed with these basic questions for your primary care doc:

• Are you concerned about any aspect of my health?
• Do you have any recommendations about what I can do on my own (like exercising or diet changes) to improve my health?
• Do I need to lose or gain weight?
•  Are there tests I need based on my age for other reasons?
• When should I come back for a follow up appointment?
• Do I need to see a specialist about anything? 

Do you go prepared to your annual appointment?

New FDA Approvals for OAB

Last week, the U.S. Food and Drug Administration approved the following treatments for overactive bladder:

• Oxytrol for Women, the first over-the-counter treatment for overactive bladder in women ages 18 years and older. Oxytrol for Women contains oxybutynin, a medicine that helps relax the bladder muscle. Oxybutynin belongs to a class of drugs known as anticholinergics. It is the first drug in this class to be made available over-the-counter for treatment of overactive bladder. Oxytrol for Women is a patch that is applied to the skin every four days. The patch delivers 3.9 milligrams of oxybutynin per day.
• Botox (onabotulinumtoxinA) to treat adults with overactive bladder who cannot use or do not adequately respond to a class of medications known as anticholinergics. When Botox is injected into the bladder muscle, it causes the bladder to relax, increasing the bladder's storage capacity and reducing episodes of urinary incontience. Injecting the bladder with botox is performed using cystoscopy, a procedure that allows a doctor to visualize the interior of the bladder while Botox is being injected.

Overactive bladder is a condition in which the bladder squeezes too often or squeezes without warning. Symptoms include leaking urine (urinary incontinence), feeling the sudden and urgent need to urinate, and frequent urination. Overactive bladder affects an estimated 33 million Americans, the majority of whom are older women. Click here for more information about additional treatments for overactive bladder.

Live More this New Year

Happy New Year! With the new year brings new year's resolutions. Do you have a new year's resolution? Is it to lose weight? Even though 80% of weight loss occurs through dietary habits, the 20% that comes from exercise is important for living a healthier, longer life. Health benefits associated with physical exercise:

1. Reduces the risk of dying prematurely.
2. Reducses the risk of dying from heart disease.
3. Reduces the risk of developing diabetes.
4. Reduces the risk of developing high blood pressure.
5. Helps reduct blood pressure in people who already have high blood pressure.
6. Reduces the risk of developing colon cancer.
7. Reduces feelings of depression.
8. Reduces feelings of anxiety.
9. Helps control weight.
10. Helps build and maintain healthy bones, muscles, & joints.
11. Helps older adults become stronger and better able to move about without falling.
12. Promotes psychological well-being.
13. Reduces stress.
14. Reduces the change of dementia.
15. Increases neural plasticity (the ability of brain cells to change in response to experiences).
16. Increase the speed of wound healing.
17. Reduces nicotine cravings for people who are trying to quit smoking.
18. Increases reflex speed and improves balance for individuals who have experienced a stroke.
19. Helps older adults maintain their driving ability.
20. Reduces food cravings.