Our Vision for Chronic Care

By Stuen, Cynthia | Aging Today, September/October 2008 | Go to article overview

Our Vision for Chronic Care


Stuen, Cynthia, Aging Today


Dear Mr. President:

The growing population of older adults in the United States inevitably means an increase in the prevalence of chronic conditions. When boomers reach retirement age, the population of adults aging with a disability will grow rapidly. Our current healthcare system primarily focuses on acute care and lacks the ability to allow interventions and rehabilitation that allow people with a chronic disabling condition to live as independently as possible.

An example from my own work is individuals experiencing age-related vision impairment. At Lighthouse International, a 103-year-old organization helping people of all ages overcome the challenges of vision impairment that cannot be corrected witii medicine, surgery or standard eyeglasses, we have found that the most common age-related eye disorders are macular degeneration, glaucoma, diabetic retinopathy and cataract

Fortunately, in the United States, cataract removal is very successful in more dian 95% of the cases. However, the other three disorders have no cure. Individuals affected by these conditions must learn to Uve with low vision or, in the case of diabetes, with the possible loss of all vision if the disease is not controlled. Well-documented evidence has shown that vision loss in elders contributes to increased falls, depression and an often needless loss of ability to work.

Although Medicare covers some charges by an ophthalmologist or optometrist delivering a specialized low-vision examination, it does not cover the prescribed optical devices allowing a person with impaired vision to continue living independendy.

Compounding the problem, Medicare does not cover the specialized vision-rehabilitation services provided by orientation and mobility specialists, vision-rehabilitation therapists or low-vision therapists - with one exception. …

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