Healthy Aging at Your Library: Connecting Older Adults to Health Information

1. Healthy Aging at Your Library:Connecting Older Adults to Health Information Karen Vargas, Consumer Health Outreach Coordinator National Network of Libraries of Medicine, South Central Region

2. Agenda • Older adults and health • Health information access and utilization • Evaluation of health resources • Training and programs • Recommended resources

3. Aging in America

4. Early Boomers reached 65 in 2011

5. According to the CDC • The number of Americans aged 65 years or older during the next 25 years will double to about 72 million. • By 2030, older adults will account for roughly 20% of the U.S. population. • 2 out of 3 older Americans have multiple chronic conditions, and treatment for this population accounts for 66% of the country’s health care budget http://www.cdc.gov/aging/

6. Causes of Death • Heart Disease - #1 cause of death adults over age 65 • Cancer - #2 cause of death adults over age 65 From the CDC WISQARS (Web-based Injury Statistics Query and Reporting System) for 2010 http://www.cdc.gov/injury/wisqars/

7. A note about Alzheimer’s Disease • Right now, as many as 5.4 million Americans have Alzheimer’s Disease • The number of people with AD doubles for every 5-year interval beyond age 65. • Alzheimer’s is the 5th leading cause of death for adults aged 65 years and older • Medicaid spending for older adults with Alzheimer’s disease is nine times higher http://www.cdc.gov/aging/aginginfo/alzheimers.htm

8. Birds do it, bees do it… Top 5 reasons to talk about seniors sexual health • The majority of older Americans are sexually active • 15% of new cases of HIV are people over 50 • Most older adults have not discussed sex with their doctors • If we can have this conversation today, it’s that much easier to handle it when it comes up at the reference desk • #1 reason: VIAGRA

9. Health Literacy

10. Access + Utilization =Health Literacy • Health Literacy: • “The degree to which individuals have the capacity to obtain, process and understand basic health information and services need to make appropriate health decisions.” (Healthy People 2010) • ACP Foundation Video: http://www.youtube.com/watch?v=ImnlptxIMXs

11. Costs of Low Health Literacy • Annual health care costs for individuals with low literacy skills are 4 times higher • Patients with low literacy skills were observed to have a 50% increased risk of hospitalization • Patients with low health literacy and chronic diseases have less knowledge of their disease and fewer correct self-management skills NPSF Ask Me 3 Resources: Stats at a Glance http://www.npsf.org/wp-content/uploads/2011/12/AskMe3_Stats_English.pdf

12. Why is an understanding of Health Literacy important for older adults? • Adults age 65 and older have lower health literacy scores than all other age groups • Only 3% of older adults surveyed had proficient health literacy skills The 2003 National Assessment of Adult Literacyhttp://nces.ed.gov/naal/

13. Additional factors affecting understanding of health information • Vision and hearing changes • Cognitive changes • Additional Disabilities U.S. Department of Health and Human Services, Quick Guide to Health Literacy of Older Adultshttp://www.health.gov/communication/literacy/olderadults/literacy.htm

14. And to make things worse... • Multiple conditions • Many, many medications • Talking to doctors • Internet comfort levels

15. Talking to Doctors: The New World Order • Before 1972,doctors told patients what they wanted patients to know, and what they wanted patients to do. • 1972 – AHA Patient Bill of Rights • “The patient has the right and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information about his or her diagnosis, treatment, and prognosis.”

16. Your health depends on the questions you ask • Questions are the Answer http://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/index.html • The 10 questions you should know Or • Build your own personalized list of questions

17. Older Adults and the Internet

18. 80 is the new 60 • 56% of seniors over 65 use the Internet • 70% of these seniors use the internet on a typical day • 53% of seniors that use the Internet have looked for health information online Pew Internet & American Life Project http://www.pewinternet.org/

19. What about Boomers? • Born between the years 1946 and 1964 (in 2013 boomers are between 49 and 67 years old) • 80% of younger baby boomers use the Internet • 81% of younger online boomers have looked for health information; 84% of older boomers Lee Rainie, “Baby Boomers and Technology” March 28, 2012 Pew Internet and American Life Project http://www.pewinternet.org/

20. However, of seniors over 75… • Only 34% of this age group use the Internet • 38% of non-users in this population say that the main reason they don’t use the internet or email is that they’re “just not interested” • Only 4% of non-internet users in this population said they would like to start using the internet and email in the future Kathryn Zickuhr, Mary Madden “Older Americans and Internet Use” Pew Internet & American Life Project. June 6, 2012. http://www.pewinternet.org

21. Medicare Part D For discussion: If 66% of adults over 75 are NOT using the Internet, how are they choosing among the discount drug care programs online through the Medicare Web site?

22. Evaluation of Health Resources • Not a real drug. Not a real disorder. A spoof.

23. ABCs (+U) of Evaluation • Accuracy • Authority • Bias • Currency • Coverage • Usability

24. Evaluate Resources for Usability • Font size • Glare-free background color/paper • Clear organization • “White” space • Short sentences • Jargon-free, definitions of medical terms included • Information in short segments • Meaningful images

25. Web Usability ClickHEREto Win!!!!! • Additional Features for the Web • Mouse-free controls • No flashing images or distractions • High contrast • No “watermarks” • Step-by-step navigation • Read-out-loud features • Highlighted text (hyperlinks) in dark color (other than blue)

26. Exercise 1: Usability Evaluation • Take a look at the following websites and evaluate their usability: • http://familydoctor.org/ • http://nihseniorhealth.gov/ • http://www.aarp.org/health/ • http://www.afar.org/infoaging • http://www.nia.nih.gov/health/publication

27. Library Programs

28. SHARING: Program Ideas • What programs for senior health information are offered by your library? • What programs are you thinking about offering? • What problems do you encounter with programming for seniors? • What solutions have you found?

29. Program Ideas • Wii! • Exercise • Relationships/dating • Sexual Health • Drug side effects • Managing Medications • Medicare • Choosing nursing homes/assisted living • Memory issues/keeping mind active • Local resources

30. More Program Ideas • Caregiving • End of Life planning • Hospice • Evaluating health information • Health Fraud • Legal issues • Alternative medicines • Dancing

31. Collaborate! • You can’t do it alone. • Senior organizations: • Area Agencies on Aging • Disease specific organizations (Alzheimer's Assoc.) • Neighborhood senior centers • Jewish Community Centers • Hospitals and Clinics • University Health Science Libraries • American Society on Aging • National Council on Aging

32. How do I find partners? • NN/LM Membership Directory • http://nnlm.gov/members/adv.html • 2-1-1 Texas • https://www.211texas.org/211/

33. Some information about Medicare • http://www.medicare.gov • 1-800-MEDICARE (1-800-633-4227) • Health insurance for people age 65 or older (or with certain disabilities) • Part A: Hospital • Part B: Medical • Part C: Advantage Plans (HMOs and PPOs) • Part D: Prescription Drug Coverage

34. How can libraries help with Medicare? • Libraries can: • distribute Medicare publications • host outreach and education events • assist patrons in accessing Medicare.gov • To learn about how to participate in the CMS National Medicare Training Program: http://www.cms.hhs.gov/NationalMedicareTrainingProgram/

35. Teaching Health Information on the Internet

36. Why We Teach Health on the Internet to Older Adults • Bridge Digital Divide • Increase confidence • Increase knowledge of health conditions and healthy lifestyles • Help people know how to talk to doctors • Increase skills in evaluating health information resources

37. SHARING: Tips for Online Training • What tips do you have for training seniors with online health information or online information in general?

38. Teaching Observations • Seniors are very hungry for health information • Seniors are eager to learn • Learning a new technology may be anxiety producing • Transportation can be a problem

39. Teaching Tips • Provide hands-on practice and repetition • Use health topics they are interested in (HBP) • Provide regular access to computers • Teach small groups, low teacher/student ratio

40. Teaching Resources • Beanworks: Computers, Older Adults, and Libraries • http://beanworks.clbean.com/computers-older-adults-and-libraries/ • Carol Bean, Palm Beach County Library • Includes mousing tutorials • Helpful articles • Other training materials

41. More Teaching Resources • NIHSeniorHealth: Helping Older Adults Search for Health Information Online:A Toolkit for Trainers • http://nihseniorhealth.gov/toolkit/toolkit.html

42. Exercise 2: Train the Trainer • Working with a partner, • Take a few minutes to review the NIHSeniorHealth training module in your packet • Talk with a partner • Present interesting features to class • For trainers? • For students (seniors)?

43. Even More Teaching Resources • MLA Senior Seminars: Power Points and handouts for training http://www.mlanet.org/resources/consumr_index.html#senior • Reliable Sources of Health Information • Your Medicine: Play it Safe • Medicine Record Form • Buying Prescription Medicine Online: A Consumer Safety Guide

44. HEALTH RESOURCES

45. NIHSeniorHealth • http://nihseniorhealth.gov • Health information for older adults • Partnership of National Institute on Aging and National Library of Medicine • Information comes from National Institutes of Health • Senior-friendly features (large text, sound, contrast) • Information in bite-sized pieces

46. MedlinePlus • http://medlineplus.gov • Links to reliable, understandable health websites • Health Topics for Seniors • Easy-to-read articles • Slideshows that have sound and contrast • Medical dictionary • Medical encyclopedia with large illustrations • Links to local services • English, Spanish and other languages • No Advertisements!

47. NIH MedlinePlus Magazine

48. National Institute on Aging • http://www.nia.nih.gov • Free publications (English and Spanish) • Alzheimer’s Disease Education and Referral Center (ADEAR) • Database of more than 300 national organizations that provide help to older adults.

49. CDC Healthy Aging • http://cdc.gov/aging/ • Health Topics • Data and Statistics • Reports • Focus on Prevention

50. Nursing Home Compare • http://www.medicare.gov/nursinghomecompare/ • From the Center for Medicare and Medicaid Services • Allows consumers to compare information about nursing homes • Links to Hospital Compare, Physician Compare, Dialysis Facility Compare, and more