The American Medical Association (AMA) has adopted a new policy to streamline long-term care insurance while also making it less expensive and more innovative, reports Healio . Under the policy, current employees and retirees will be automatically enrolled, while Medicare, Medicare Advantage, and Medigap plans will be urged to offer stronger benefits. "Our hope is that the policies and recommendations we are making today will provide feasible steps forward to alleviating the financial strain on families and Medicaid of providing long-term services and supports," says AMA board member Stephen R. Permut. "With demand for long-term services and supports likely doubling over the next 30 years, the time for action and forward-facing reforms is now." The new AMA policy supports improved access and affordability of private long-term care insurance; the transferability and portability of long-term care insurance via an opt-out option; innovation of long-term care insurance product design; allowances for limited or optional supplemental benefit for long-term services and supports under Medigap plans; permission for Medicare Advantage plans to provide long-term services and supports; a respite care benefit offered as an option through Medigap and Medicare Advantage plans; the launch of a back-end public catastrophic long-term care insurance program; incentivization of states to improve home and community-based services regarding availability; and improved integration of health and social services.

The Trump administration's efforts to make senior abuse a "law and order" issue has led to critical new initiatives and allocations of resources mainly through the U.S. Department of Justice, reports National Association of Nutrition and Aging Services Programs Executive Director Bob Blancato in Next Avenue . "The Department's previous funding of the National White Collar Crime Center, and now its efforts to create law enforcement partnerships around the country, is particularly helpful in prosecuting perpetrators," he notes. "The agency's 10 regional Elder Justice Task Forces bringing together federal, state, and local prosecutors, as well as law enforcement and other key stakeholders, are essential in the battle against a growing exploitation market." Blancato also cites efforts from the Administration for Community Living (ACL) to channel funding from the Elder Justice Initiative to set up a home for Adult Protective Services (APS) and the National Adult Maltreatment Reporting System, the first national APS system featuring centralized and improved data collection on senior abuse, neglect, and exploitation cases. President Trump's signing of the Senior Safe Act is also significant, as it "exempts financial institutions and their employees from liability when trained employees report potential exploitation of an older adult to a governmental agency," Blancato notes. However, he warns of the opioid epidemic as a challenge requiring local, state, and federal collaboration on solutions that will probably need additional funding to relieve cash-short APS, federal agencies, and nonprofits.

Federal records indicate one in five Medicare beneficiaries sent from the hospital to a nursing community come back within 30 days, often for potentially preventable conditions, reports Kaiser Health News . These rehospitalizations occur 27 percent more often than for the Medicare population at large. "There's this saying in nursing communities, and it's really unfortunate: 'When in doubt, ship them out,'" says Harvard Medical School Professor David Grabowski. "It's a short-run, cost-minimizing strategy, but it ends up costing the system and the individual a lot more." Beginning in October, the government will offer nursing communities bonuses or penalties based on their Medicare rehospitalization rates. Congress' Medicare Payment Advisory Commission estimates that the rate of potentially avoidable rehospitalizations declined to 10.8 percent in 2016 from 12.4 percent in 2011. "There's still a high rate of inappropriate readmissions," Grabowski notes. Medicare remunerates hospitals a set rate to care for someone depending on the average time it takes to treat them with a given diagnosis. That means that hospitals profit by earlier exit and lose money by keeping people longer, even though seniors may need a few extra days. Still, nursing communities have to hospitalize residents, since keeping them out of hospitals requires regular examinations and speedy laboratory tests, which add costs. Moreover, most residents are covered by Medicaid, which is typically the lowest-paying insurance plan.

A study published in the Journal of the American Geriatrics Society found short and long daily sleep duration, as well as hypnotics, are risk factors for dementia and death in Japanese seniors, reports Healio . The researchers examined the link between self-reported daily sleep duration and dementia and mortality risk in community-dwelling adults 60 years and older without dementia. The investigators grouped participants into categories based on their daily sleep duration, including less than five hours per day, five to 6.9 hours, seven to 7.9 hours, eight to 9.9 hours, and 10 hours or more. In general, 294 participants developed dementia and 282 died during follow-up. There were significantly higher incidence rates of dementia and all-cause mortality in seniors who reported sleeping less than five hours per day and 10 hours or more per day compared with those who reported daily sleep duration of five to 6.9 hours. These associations were consistent when adjusting for other confounders in those who reported daily sleep duration of less than five hours and in those who reported 10 hours or more. Moreover, older adults who used hypnotics and had any sleep duration had a 1.66 times higher risk for developing dementia and a 1.83 times higher risk for mortality versus non-hypnotics users who reported five to 6.9 hours of daily sleep.

A new study from the Workforce Institute at Kronos Incorporate suggests companies are undermining their own employee experience with outdated attitudes about time off, productivity, and workload, reports IndustryWeek . The investigators warn these attitudes could potentially cause "a global employee burnout crisis." The study found 47 percent of employees have had a time-off request rejected by their employer within the last year, while 26 percent had a vacation request denied, 22 percent were not permitted to use personal time, 16 percent could not use sick time, and 10 percent noted their employer rejected a bereavement request. Meanwhile, 41 percent of employees globally think prevention of employee burnout is a top priority for their employers. In addition, 90 percent of employees believe their organization can improve scheduling, with 33 percent wanting solutions that make it easier to swap shifts, seek coverage from colleagues, or opt into open shifts for more hours, particularly through mobile phones and tablets. "Organizations that build a culture of trust — especially those that empower employees to work at the times or locations they find most beneficial — will benefit from stronger employee engagement, higher productivity, and improved retention," says Simon Porter on the Workforce Institute board. "Engaged employees often recognize flexibility is a two-way street, which is why they will also be more willing to adjust their own schedules to accommodate times of high demand that require extra or discretionary effort, off-hours work."

The state of a firm's day-to-day workplace IT systems can have a large impact on attracting and retaining skilled workers, according to a new study by Harvard Business Review Analytic Services. Fifty-five percent of respondents said their company's workplace tech — the digital apps and platforms employees use to do their jobs — factor into decisions by applicants to accept job offers - or not. Another 51 percent said outdated technology impacts their ability to retain skilled workers, reports the Wall Street Journal . David Mayer, an Insight Enterprises vice president and general manager, said tech-savvy workers are beginning to expect "highly personalized user experiences," but those expectations aren't always reflected in a company's tech priorities, which in recent years has become focused on customers. Some 55 percent of more than 3,000 global CIOs and other IT executives surveyed earlier this year by Harvey Nash and KPMG cited "enhancing customer experience" as a top business priority.

The U.S. Centers for Disease Control and Prevention estimates that overall rates of suicide in the United States have risen 25 percent since 1999, and caregivers are especially concerned about this trend among seniors, reports WCPO . "We have seen an increase in seniors seeking help," says Butler Behavioral Health Services CEO Randy Allman. "We've seen an increase in why they're coming: social isolation, feeling lonely, feeling like they're not in a purposeful lifestyle, lack of healthcare, lack of activities." The United Health Foundation reports that senior suicide has climbed 12 percent nationwide since 2014, and older Americans, men in particular, may develop suicidal urges as their personal independence and social connections disappear. "It doesn't surprise me that we see more complex social issues for the senior population because they're growing," Allman notes. "We need to make sure there's the necessary funding attached to that for local services." This includes funding for social programs such as Butler Behavioral Health, and for efforts such as those in Maple Knoll Village, a retirement community where residents take frequent coordinated trips to restaurants, concerts, and other activities outside the community. Allman suggests a straightforward question is sometimes the best approach to learn whether seniors are suicidal. "Many times, when someone is asked, 'Are you feeling suicidal?' — just very directly — that person is glad that someone asked them," he says.

AstraZeneca and Eli Lilly have announced a halt to their global trials of their anti-Alzheimer's drug lanabecestat following a panel's conclusion that the medication was likely to be ineffective, reports the Financial Times . They said an independent monitoring committee determined the primary targets were "not likely" to be met. This development marks a new setback for beta secretase cleaving enzyme (BACE) inhibitors, following Johnson & Johnson's decision in May to discontinue a trial into another BACE inhibitor because of safety issues. Lanabecestat was granted Fast Track designation in 2016 from the U.S. Food and Drug Administration, permitting the AstraZeneca-Eli Lilly partnership to accelerate its research. "The complexity of Alzheimer's disease poses one of the most difficult medical challenges of our time, and we are deeply disappointed for the millions suffering from this devastating disease," said Lilly Research Labs President Daniel Skovronsky.

Millennials are very optimistic about their financial futures, TD Ameritrade learned in a survey. On average, they expect to retire at age 56, and 53 percent expect to become millionaires, reports Plan Adviser . Twenty-five percent do not expect to get married, and 25 percent do not plan on buying a home. Additionally, 30 percent do not plan to have children. Twenty percent do not expect they will be able to pay off their student loans; collectively, Millennials have $1 trillion in student loan, credit card and other debt, TD Ameritrade says. Seventeen percent have not yet achieved financial independence from their parents. In most cases, moving out of the home triggers being financially cut off. On average, Millennials expect to begin saving for retirement at age 36, and 28 percent do not plan to ever retire.

A study published in the Annals of Family Medicine found the Visual Association Test (VAT) of associative memory is a valuable tool for assessing dementia risk in people with a small decline on the 30-point Mini-Mental State Examination (MMSE), reports Neurology Advisor . A total of 2,690 subjects were tested, and investigators evaluated the change in MMSE score over two years along with the VAT score at two years to see whether these tests could predict dementia diagnosis in the following four to six years. Electronic health records supplied information on dementia status at two-year intervals. A lowering of the total MMSE score of two points over a two-year period correlated with greater odds for developing dementia, based on logistic regression analysis. When the VAT score was imperfect and the MMSE score decline one point over two years, there were additional higher odds for developing dementia. Furthermore, the predictive value of a two- or three-point MMSE score reduction rose when the VAT score was imperfect. A one-point reduction on the MMSE score was linked with a doubled risk for dementia if the VAT score was imperfect. Researchers determined the VAT "can help to distinguish those at increased risk of developing dementia (requiring counseling, additional examination, or both) from those in whom watchful waiting is justified."