Seniors navigating — and surviving the healthcare system

On a recent weekday morning, a gathering of Island seniors made their way to the Shelter Island Senior Activity Center on South Ferry Road for the weekly Silver Circle meeting. Inside, the center quickly filled with animated conversations on multiple topics. But once the topic turned to healthcare, the attendees were focused, sharing serious concerns on the issue, even though residents continued to inject humor into the sobering conversation.

While discussing preventative measures to health risks, center director Lauire Fanelli looked to Lorna Laspia, a 93-year-old World War II Navy veteran, asking, “Lorna, you can’t have salt, right?”

Ms. Laspia eyed Ms. Fanelli for several seconds before replying, “I can eat whatever I want.” Laughs echoed around the table when she added, “I’m not dying hungry.”

When Sharon O’Hara retired, she didn’t foresee how much healthcare costs would hinder her enjoyment of life. She moved to Shelter Island at 18 from Maryland, and has lived here ever since. Since retiring, however, she’s experienced multiple problems with the current healthcare system, particularly its rising costs.

At times, Ms. O’Hara said, she feels “like a deer in headlights.”

Fortunately, Shelter Island’s senior center provides a community meeting place with programs to help maximize independence and quality of life, Ms. O’Hara and other residents said. Services include transportation to medical appointments and to run errands, home-delivered meals and minor household repairs, as well as social meetings and field trips off-Island.

“It’s invaluable,” Ms. O’Hara said.

Ms. Fanelli is a psychiatric nurse practitioner, although she’s experienced in many branches of care, working in geriatrics, neurology and dementia for 20 years. She uses her expertise to help Island seniors, advising them and distributing general information on health but also on specific ailments.

Some Island seniors worry about continuing to be able to live on the Island, Ms. Fanelli said, where many of them have resided and worked for years, due to increasing costs of healthcare along with a rising cost of living. Rather than accepting their current circumstances, some seniors have taken an active approach to reaching solutions, she said, adding that the familiar adage, “the political is personal,” applies here.

To that end, Ms. O’Hara is writing to Congress, voicing her concerns about healthcare for seniors, and is being encouraged by Ms. Fanelli. President Trump and his administration have to get a feel for what the sentiment is in communities, Ms. Fanelli said, rather than just respond to the needs of large organizations.

The Shelter Island Library recently invited Stony Brook University Professor Andrew M. Flescher, and Howard Goldstein, a specialist on the Affordable Care Act (ACA) compliance, also known as Obamacare, to speak on the subject of healthcare legislation today. The two experts agreed that the government must deal seriously with the finances of healthcare, otherwise its programs are in danger of collapsing.

A year ago, CNN Money reported, “Some health insurers, such as Aetna, have recently announced they would pull out of the Obamacare exchanges, saying Obamacare patients have turned out to be sicker and costlier than expected.”

Though the ACA mitigated the cost of prescription drugs for seniors, according to the advocacy group National Committee to Preserve Social Security and Medicare, those drugs may be of an inadequate generic brand. Ms. Fanelli recalled a man she once knew who switched prescriptions to lower the cost of his antidepressant medication, but felt it was not working as well. When he asked his pharmacist, she told him the generic medication was roughly a third the strength of his old medication.

One proposed solution to senior’s facing the difficulty of navigating the health care system and its costs is palliative care, which Ms. Fanelli strongly advocates for. Palliative care is a mandated system in countries such as Australia and New Zealand offering information and a support system upon diagnoses of chronic illnesses. According to the World Health Organization, palliative care relieves suffering by means of “early identification … and treatment of pain and other problems, physical, psychosocial and spiritual.”

Countries that offer palliative care have higher life expectancies, despite the United States leading total world spending in 2015 with $158.7 billion on medical and health research and development, according to a report by Research America. The United States currently ranks 42nd in life expectancy, at 77.9 years, according to a report by USA Today.

“We have the best research, but people are dying sooner,” Ms. Fanelli said, “Our outcomes are not as good as they should be.”

In lieu of a government-mandated system, Ms. Fanelli has started to implement one at the Senior Foundation by pairing seniors with the same illness so they can exchange information, as well as giving them the research she finds. Two people she’s has teamed up are Ms. O’Hara and Donna King, who broke off from the recent meeting to discuss an article they had recently read.

By the end of the conversation at the center, many attendees were nodding in agreement to one conclusion: Though an essential service, healthcare has become too expensive for those on fixed incomes.