Witnesses at a Washington, D.C. hearing on the Medicare Advantage program by the House Ways & Means health subcommittee welcomed a proposal by program managers to let issuers add chronic care benefits to the 2019 benefits packages, reports Think Advisor . However, some suggested that limiting access to those benefits to enrollees might be unfair to beneficiaries staying with the traditional Medicare fee-for-service program. Karoline Mortensen from the University of Miami voiced concerns that adding chronic care benefits to Medicare Advantage, but not to the traditional fee-for-service program, could raise fairness issues. "Make sure traditional fee-for-service enrollees are not left out," she argued. Still, Mortensen said a challenge for Medicare Advantage managers and observers has been working out how to build adjustments for enrollees' socioeconomic status into plan quality ratings. Meanwhile, Clover Health's Andrew Toy noted benefits for technology could be important to helping keep people with chronic health problems in their homes. He also said permitting more flexibility for telemedicine benefits could help plan issuers comply with Medicare Advantage provider network adequacy standards, especially in rural regions. Jack Hoadley from the Georgetown University Health Policy Institute said he thinks consumers need one-on-one help with understanding and selecting Medicare Advantage plans, in addition to access to the MedicareAdvantage plan selection website.

A new Wells Fargo survey found 66 percent of financial crimes against seniors are committed by those closest to the victims, such as family members, friends, or other trusted persons, reports InvestmentNews . Typical forms of fraud include using ATM cards and stealing checks to take money from the victim's accounts. Abuse by in-home caregivers also can include keeping change from errands, paying bills that do not belong to the victim, asking victims to sign falsified time sheets, spending their work time on the phone, and not doing what they are paid to do. The poll also cited "government scams," "granny scams," "prize and sweepstakes fraud," and "sweetheart fraud" as practices that fraudsters use to scam seniors. Government scammers masquerade as officials demanding that victims wire cash or use prepaid debits or gift cards to pay bogus IRS tax bills, or they may provide fake Medicare services at makeshift mobile clinics to bill insurance companies. Wells Fargo found almost one in five Americans 65 and older have been affected by financial abuse, and every year up to $36.5 billion is lost to financial exploitation, criminal fraud, and caregiver abuse.

A Quest Diagnostics study of more than 10 million urine tests conducted on behalf of U.S. employers found the percentage of American workers and job applicants testing positive for illicit drugs in 2017 was 4.2 percent, holding steady from 2016, reports the Wall Street Journal . In the general workforce, 5 percent of tests came back positive for an illicit substance, up from 4.9 percent in 2016. Fewer U.S. workers tested positive for prescription painkillers last year, but cocaine, methamphetamine, and marijuana use surged. In all, 2.6 percent of the general workforce showed positive results for marijuana, although Quest says fewer customers are requesting the marijuana test. Positive tests for marijuana rose in states that recently legalized the drug for medical or recreational use. Positive tests for opiates, such as morphine and oxycodone, dropped sharply by 17 percent in 2017 from the year before. That decline likely reflects continuing crackdowns on illegal or excessive opioid prescriptions. Although marijuana is still illegal at the federal level, 30 states and the District of Columbia have adopted laws legalizing it in some form, says the National Conference of State Legislatures. Even in states that have eased or repealed restrictions on buying, selling, and using marijuana, the legal status of the drug is unstable, notes Fisher Phillips attorney Danielle Urban.

A study published in Psychological Medicine found good relationships, social engagement, better everyday functioning, good physical and mental health, and high-quality care correlated with better quality of life for people with dementia, reports EurekAlert . "This research supports the identification of national priorities for supporting people to live as well as possible with dementia," says University of Exeter Professor Linda Clare. "While many investigations focus on prevention and better treatments, it's equally vital that we understand how we can optimize quality of life for the 50 million people worldwide who have dementia. We now need to develop ways to put these findings into action to make a difference to people's lives by supporting relationships, social engagement, and everyday functioning, addressing poor physical and mental health, and ensuring high-quality care." Demographic factors such as gender, education, marital status, income, or age did not have an association with quality of life in people with dementia, and neither did the type of dementia. Variables tied to poor quality of life include poor mental or physical health, problems such as agitation or apathy, and unmet needs. Factors connected to better quality of life include good relationships with family and friends, being included and involved in social activities, being able to manage everyday activities, and religious beliefs.

Northwestern Mutual's 2018 Planning & Progress Study found almost eight in 10 Americans are "extremely" or "somewhat" worried about affording a comfortable retirement, while 66 percent are convinced they will likely outlive their retirement savings, reports Think Advisor . The study estimates that one in three Americans have less than $5,000 in retirement savings and one in five have zero savings; one in three polled baby boomers had less than $25,000. In addition, 75 percent of Americans think it is "not at all likely" or only "somewhat likely" that Social Security will be available when they retire. Nevertheless, 46 percent of adults have made no preparations for the probability that they could outlast their savings. Moreover, these concerns may be spurring people to work longer, with the survey finding 38 percent of working Americans expect to retire at 70 or older while 33 percent anticipate retiring in the more traditional 65-to-69 age bracket. Of the 55 percent of Americans who believe they will have to work past age 65 out of necessity, 73 percent cited "not enough money to retire comfortably" as the main motivator. Sixty-one percent cited Social Security being insufficient to cover their needs and 52 percent cited rising costs such as healthcare. "Continuing to work later in life should be a personal choice, not a mandatory requirement for survival," says Northwestern Mutual's Rebekah Barsch. "Proactive financial planning can be the difference between a desired and a default retirement lifestyle."

The growing number of renters in major U.S. cities reflects residents' increasing motivation to opt for rental housing because it offers a more flexible lifestyle than homeownership, reports the Washington Post . This attitude is especially pronounced among baby boomers, who highly desire mobility, convenience, and community. Boomers' push for mobility is driven by the realization that they no longer need large suburban homes as their children are grown and out of the house. Rather, they are choosing to rent in urban areas that offer more flexibility for travel and the option to leverage the equity in their homes. Many boomers also are working longer than the previous generation, and they still want to be close to their job. In terms of convenience, renting is an attractive substitute for busy boomers who are ready to give up home-maintenance tasks. Apartment owners/managers are helping this trend by offering perks such as package storage, fitness centers, and pools, as well as hotel-like concierge services to enhance the resident experience. The third factor boomers value is community, as modern apartment amenities are designed to encourage socialization. Boomers appreciate this because they may be exiting a social network as they relocate from the suburbs.

Experts are suggesting some American workers wait to retire until age 70, as drawing Social Security benefits later can raise income, an especially valuable factor as pensions become less available, reports the Associated Press . An analysis of about 300 different retirement income methods by the Stanford Center on Longevity found the optimal strategy for middle-income retirees to have a reliable source of income through retirement is to wait until age 70 to claim Social Security, when benefits peak. The researchers also recommend employees use the required minimum distribution calculation to determine how much to take from personal savings. Some retirees may have to significantly reduce their living costs. The team says some employees will need to work "just enough" to cover living expenses until age 70 in order to put off claiming Social Security benefits. A recent Willis Towers Watson survey of nearly 5,000 workers found that 37 percent expect to work beyond age 70, versus 30 percent two years ago. "Financial pressures are driving many employees to retire later," says Willis Towers Watson consultant Pat Rotello. "Employees with money worries are more likely to keep working past normal retirement age to help sustain their income."

Some doctors say adult children of aging parents with dementia who own guns need to talk about removing those firearms from the home, reports Reuters . Researchers estimate that one in three people aged 65 and older in the U.S. is a gun owner, and another one in eight live with someone who owns a gun. They predict as many as 12 million Americans with dementia could be living in a household with a gun by 2050. The authors of an opinion piece published in the Annals of Internal Medicine note there currently are no valid screening tools to help determine when it is time to take away guns. Moreover, federal gun laws do not ban the purchase or possession of guns by persons with dementia, while only Texas and Hawaii cite dementia or similar conditions in their state ordinances. The researchers suggest the best time to have the discussion about gun removal would be before dementia advances, when older adults can still make up their own minds about when and how they might be willing to give up access to guns. They also say families might consider a "firearms retirement date," when their parents will give up any guns in the home to avoid the potential for these weapons to be in the house when they can no longer store them or use them safely. Another suggestion is for older adults to designate a trusted person to have the authority to remove their guns when the time comes.

Kronos believes rehiring former employees is a good idea, one that contradicts most human resource practices, reports the Society for Human Resource Management . Assuming the employee is skilled and left on good terms, the employer could gain a valuable, capable worker who is familiar with and likes the company and who may return with new talents. Other potential benefits include saving money on recruiting and training costs. However, the employer may have changed significantly since the former employee left, while current workers may resent that one of their own did not win the position given to the former employee, and colleagues may question whether the rehired worker will leave again. Kronos' Dave Almeda points to a basic change in the employer-employee relationship, noting, "Historically, the employers held all the power. They provided the jobs, set the wages, and data wasn't transparent to job seekers. Today, driven by the war for top talent and new technologies, the paradigm has shifted." Kronos also thinks "boomerangs" can become strong corporate brand ambassadors for the organization. LaSalle Network CEO Tom Gimbel advises firms considering to rehire a former employee to first "look back at their exit interview and refresh your memory on why they left." He says "the biggest positive is that if they're coming back, it's probably because they really like the company and want to be there."

A study published in Nature Chemistry found cholesterol in the brain triggers amyloid-beta molecule aggregation, which plays a central role in the development of Alzheimer's disease, reports Medical Xpress . The researchers determined cholesterol accelerates amyloid-beta clustering by a factor of 20. "The question for us now is not how to eliminate cholesterol from the brain, but about how to control cholesterol's role in Alzheimer's disease through the regulation of its interaction with amyloid-beta," says University of Cambridge Professor Michele Vendruscolo. "We're not saying that cholesterol is the only trigger for the aggregation process, but it's certainly one of them." Vendruscolo suggests targeting the newly-identified association between amyloid-beta and cholesterol could make it possible to design drugs that maintain cholesterol homeostasis, and consequently amyloid-beta homeostasis, in the brain. "This work has helped us narrow down a specific question in the field of Alzheimer's research," he says. "We now need to understand in more detail how the balance of cholesterol is maintained in the brain in order to find ways to inactivate a trigger of amyloid-beta aggregation."