Fears of being placed in a nursing home preoccupy a supermajority of older adults as in surveys about their course of aging they consistently ranked memory loss, financial insecurity and losing independence as their top three concerns. Yet, after age 80, the risk of being placed in a nursing home increases significantly. Seniors of advanced age experience what is termed “functional aging”, that is an inevitable, progressively declining continuum in functional ability from having a stable capacity to perform daily activities through a state of physical vulnerability (influenced by cognitive loss) in which the person is losing independence. At advanced ages, some caregiver support becomes necessary for many, and for some, a nursing home admission.

As Medicare’s chronic care management “CCM” payment program begins its third year, there is expectation that more physicians will sign-onto bill CCM thanks to recent revisions to the program which increases monetary incentives while reducing some onerous eligibility requirements. Seniors are now living with more chronic illnesses: 68.4% of older adults have two or more chronic conditions while 36.4 % have 4 or more chronic conditions.

As we grow older, our ability to maintain the kinds of social contacts we had grown accustomed to naturally contracts. Senior Americans become less mobile, particularly driving, lose friends, children move and socializing can become too taxing to those with declining health. Consequently, older adults can become socially isolated and are prone to developing chronic loneliness. Even couples, with one suffering significant health issues and/or disabled from engaging in meaningful companionship, are prone to becoming lonely.

The benefits of exercise among seniors in late life can be significant. There is consensus among private and public health organizations that physiological benefits can be achieved even by frail elders and the oldest of the population.

An ongoing challenge for the elderly is the handling of their visits to a hospital emergency room. Many seniors visit an emergency department (ED) and, despite hours or in some cases days of monitoring and treatments received in what appears to be an inpatient bed, they come to learn that they were never admitted inpatient, but rather, were placed on “observation status,” pending a decision to admit, which never materialized.