Garden State elders are healthier than in the recent past, as they benefit from better nursing-home care, greater access to healthy food, and more physical activity, a nationwide study of the health of the senior population found.
Those improvements helped boost New Jersey to 16th place nationwide, a rank 10 spots higher than the state received last year, the America’s Health Rankings Senior Report 2016 noted. But the survey also found that too many seniors still end up in hospitals and often die there, sometimes after intense and costly medical treatment, regardless of how they had hoped to see their life end.
The annual study, first launched four years ago by the United Health Foundation, the nonprofit formed in 1999 by the United Health insurance company, compares states in categories that include personal behaviors, community engagement, state policy, clinical statistics, and medical outcomes. Researchers compile data from multiple sources to measure education level, poverty, hospital infection rates, prescription drug coverage, vaccine levels, volunteerism, and more to assess the overall health and wellness of the state’s senior population.
This was the first year United Health also looked at the health of each state’s middle-aged population, 50 through 64 years, and compared their behaviors and outcomes to those of the same age group in 1999. Nationwide, the study found half as many middle-age individuals smoke today, but one in two is likely to have diabetes and one in four is likely to be obese.
“These higher rates of diabetes and obesity are expected to put significant strains on the Medicare program and the overall healthcare system,” the report states, noting that one out of every three Medicare dollars is now spent on diabetes care — an amount that is destined to rise significantly as the baby boomer generation ages.
“Diabetes is also associated with potentially serious complications that contribute to additional use of health resources and poor health status for the nation’s seniors. Hospitalizations, heart attacks, kidney failure, and hearing loss are all more common in seniors with diabetes,” the authors stated. Obesity can also lead to a host of complications, including heart disease and diabetes, while driving up the costs of healthcare, they noted.
These concerns will pose a particular problem for the 25 states that will see their senior population jump more than 50 percent by 2030. New Jersey has a much slower growth rate, but the current population of 1.3 million seniors is still likely to swell by more than 40 percent over the next decade and a half.
[related]New Jersey received specific praise for its diabetes management programs, for reducing the number of falls seniors suffered — the state ranked second to Hawaii — and for the high number of quality nursing-home facilities, which increased 20 percent over the past year. Nearly 85 percent of Medicare beneficiaries got regular diabetes care, as needed, securing New Jersey a third place for disease management after Massachusetts and Florida.
In New Jersey, the Division of Aging Services coordinates a wide variety of programs designed to help older residents stay healthy and avoid hospitalization. Gov. Chris Christie shifted the division from the state’s health department to the Department of Human Services several years ago, spokeswoman Nicole Brossoie said. Among other things, the division coordinates several state-supported programs to help seniors get prescription drugs and, in 2014, launched a program to better coordinate long-term care for a number of older patients.
The state’s efforts are enhanced and supported by the work of the 21 Area Agencies on Aging, Brossoie said, which coordinate caregiver programs and various in-home services. These agencies also operate nutrition centers and deliver meals to some 5 million seniors annually, she said.
But work remains. According to the United Health survey, New Jersey’s problems include the high percentage of hospital readmissions — nearly 16 percent of seniors — and the significant number of patients who find themselves in intensive-care units during their last six months of life. The state ranked last nationwide for late-life ICU use, with nearly 23 percent of seniors spending time there in their last half year. The nationwide average was just over 14 percent.
In addition, more than one in four seniors die in a hospital in New Jersey, compared with 21.5 percent nationwide. This puts the Garden State third from the bottom, with only New York and Hawaii having more seniors die in such facilities.
A growing awareness of this disconnect between how patients hope to die and how their end-of-life care actually plays out has prompted a number of efforts to encourage aging residents to plan for the end-of-life care they want and make sure they communicate these desires, in writing, to family members or caregivers. The New Jersey Health Care Quality Institute has led a program in three communities called “Conversations of Lifetime” through its Mayors Wellness Campaign. Samaritan Healthcare & Hospice, a 36-year-old organization in Marlton, has run similar programs in communities across South Jersey.