Update on delivery portals
1. Accessing delivered packages left on the front porch can be a real problem for people with limited mobility. I have developed a box that fits in my kitchen window that will allow UPS, etc. drivers to open the little door, insert the package, and I can retrieve the package from inside, even from a wheelchair. I’d like to see something like this become as common as grab bars in homes for those aging in place. The local Area Agency on Aging organization wrote a letter of support for the concept.
On a related note, it is not well known but USPS will bring your mail to your door if you install a box and get a letter from a doctor saying that getting mail from your mailbox is unduly difficult for you. The form to file with your local post office is 1528. One problem is that there can be no one else able to pick up the mail living in your house. This would appear to discriminate against people who have someone living in the house rather than alone. See more at #2 below.
Another issue is that medications left in a mailbox on a hot day are subject to degradation. Yet I’ve seen no studies examining the scope of this problem or the cumulative effect on public health. An increasing number of prescriptions are being sent by USPS or private carriers.
Protect Medicaid-Funded Home and Community-Based Services
2. Most of us want to age in our own homes. And Medicaid-funded home and community-based services (HCBS) make that possible for millions of Americans.
But even though HCBS support aging in place and save money by avoiding costly institutionalized care, supply is not keeping up with demand. Home and community-based services include personal care, home-delivered meals, and case management. These programs support the entire family, enabling individuals to stay gainfully employed as tax-paying citizens, save for retirement, and care for their children.
Yet every year, an average of 656,000 people are on waiting lists for Medicaid home and community-based services, with an average wait time of 45 months. Learn more here.
More on Form 1528 (USPS delivery to the door)
3. The USPS apparently doesn’t keep records of how many people take advantage of this service. They don’t advertise the service. The service must be renewed annually with a new doctor’s note. No reminder is sent to ask for renewal. Criteria for the doctor’s note:
- The patient’s full name and the specific address for which the delivery change is being requested.
- The doctor’s printed name, signature, and professional contact information.
- A description of the physical condition, illness, or handicap that creates a hardship.
- A clear statement that the physical condition makes it a physical challenge or impossibility for the patient to travel to and collect mail from their existing mailbox (e.g., curbside, cluster box, or neighborhood delivery unit).
- A declaration that receiving mail delivered to the door is a medical necessity due to the severity of the patient’s condition.
Key Considerations
- Advanced age alone is typically not a qualifying factor; the hardship must stem from a physical impairment or illness.
- The approval is temporary and must usually be renewed annually with an updated doctor’s statement.
- The completed PS Form 1528 and the doctor’s letter should be submitted to the local Postmaster at the post office that delivers the mail.
Link to form 1528 here.
Handling the sensory changes of aging
4. While many understand that hearing and vision loss come with age, it’s not always easy to notice that these conditions can change. While some may be inevitable, others can be prevented or ameliorated. Auditory processing starts deteriorating in middle age, with lower and higher frequencies becoming harder to hear. According to the World Health Organization, about 20% of people in their 60s are hearing-impaired and about 40% in their 70s. For those over 80, more than two-thirds can expect to have some hearing loss. For those with mild cases, studies show dementia risk nearly doubles within 12 years. If hearing loss is moderate, the risk of dementia nearly triples, and it’s about fivefold the risk for those with severe hearing loss. In recent years, hearing aids have been deregulated, allowing greater accessibility with electronic earbuds. Online, search “earbuds for hearing impaired” for more affordable options.
Vision changes typically begin in middle age, when many require reading glasses for close work. Older people who have used progressive scan or multifocal lenses should consider changing to single focus lenses. When you start to fall, your eyes will automatically look down. If you have bi- or trifocals, you will look down into a blur and your chances of catching your fall diminish. Having readers for that close work and a pair of glasses for nearsightedness is a better option.
See more here on other sensory changes of aging and how to deal with them.
It’s that time of year – Time to Review Your Medicare Coverage
5. By now, you should have received the Annual Notice of Change from your Medicare Advantage or Prescription Drug Plan. This notice outlines updates to your coverage for the coming year, and it’s important to review it carefully as your plan may have changed.
Some people may instead receive a Service Area Reduction notice. If you receive this notice, it means your current plan will not be available next year and you’ll need to take action and enroll in a new plan. If your current plan is not renewing, you will have the Annual Enrollment Period, as well as a Special Enrollment Period, that will allow you to enroll in a new plan between October 15 – December 31 to begin January 1.
If you are enrolled in a stand-alone Prescription Drug Plan, you may receive notice that your plan has changed, and you may be automatically moved into a new plan offered through the same insurance company. It is important to review the details.
Read more here.
The lost wallet
6. I lost my wallet for 6 hours last week. The first time ever. I just figured it was one of those things I thought would never happen. It was pretty traumatic. And it also made me think my cognitive skills were waning. So I wanted to pass on a few things about how to avoid losing a wallet and what to do to make it less traumatic if it does happen.
- Establish one specific, prominent spot for the wallet (and keys) and always put it there immediately upon coming home.
- Attach a small Bluetooth tracker (like an AirTag (under $20), Tile, or similar brand) to your wallet or slide one into a card slot. This allows you to use your smartphone to ping the wallet (making it ring) if it’s misplaced nearby, or check its last known location on a map if you left the house.
- Always keep it in the same pocket or section of a purse. This applies to keys also.
- Right now. Take a photo of all your cards (front and back). That will help replace them if needed.
- Reduce wallet contents to the essentials.
Falls, Fractures and Fatalities: Surprising Risks in Your Medicine Cabinet
7. A dramatic increase in the number of prescription drugs older Americans take may be contributing to more deaths from falls. Is your med risky? Why are elderly Americans (particularly those 85 and older) so much more vulnerable to dying because of a fall? Perhaps older people everywhere suffer the same fate. But in other high-income countries that might serve for comparison, the rate of deaths from falls has actually dropped over the past 30 years.
One difference that might help us understand what is going on is the rate of prescriptions. After all, older people have always contended with vision problems, physical frailty, cognitive impairment or clutter that is a trip hazard. Those things probably haven’t changed much since the year 2000. Today, though, older people are taking more medications. Older Americans take far more than those living elsewhere.
Full article from People’s Pharmacy here.
Six science-backed ways to protect and improve your memory
8. One thing I wish I had, is a notebook of my life. Just one page per year of anecdotes. Not an autobiography or a journal. But just random and consequential things I did in a given year. It would help to have baseline data that would help connect people, places, events, etc. to things that are locked up in my brain and just need a little prompting to release. Tell your grandkids to start one.
But forgetfulness doesn’t have to be an inevitable part of life. At a basic neurological level, your memories reside in the connections between neurons – in your synapses, of which you have hundreds of trillions. So it’s not that your brain lacks the capacity to remember everything (researchers have found that, on average, ordinary people remember about 5,000 faces, which is plenty). It’s more that lots of things you might want to remember don’t make it into your long-term memory in the first place.
The good news is there’s a range of techniques you can use to shift information from your brain’s short-term cache to its long-term archive. In neurological terms, this involves processing them in the brain’s hippocampus before they’re distributed across the neocortex. The even better news is that using these techniques – along with looking after your memory and overall health – can help keep it stronger for longer.
Full article from BBC Science Focus here. I just wish there was a way to more easily forget the things you’d rather not remember.