With the next flu season approaching, the time is right for hospitals and other healthcare communities to consider implementing a mandatory vaccination program for seasonal influenza, reports HealthLeaders Media . "It's really important for healthcare personnel to be vaccinated because they are in really close contact with the most vulnerable of our populations," says Terri Rebmann with the Institute for Biosecurity at Saint Louis University. "If the healthcare personnel become infected, regardless of whether or not they have symptoms, when they shed the influenza virus during ... care activities, they can then expose those really high-risk beneficiaries." According to the Centers for Disease Control and Prevention, during the 2015-2016 flu season, there was a vaccination rate of more than 95 percent for healthcare workers whose employers mandated their inoculation for seasonal influenza, versus a 79 percent vaccination rate overall among healthcare employees. "The research has shown that the mandatory vaccination policies are the strongest indicator of high vaccination rates among healthcare personnel," Rebmann notes. She also says mandatory vaccination for health workers is recommended by the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, and the Pediatric Infectious Diseases Society. In May, the Association of Occupational Health Professionals in Healthcare issued a position paper recommending flu shots for healthcare workers, and asked "administrators to consider a policy that makes annual influenza vaccination mandatory (with medical exemptions) or offer alternatives to vaccination such as requiring the use of surgical masks for ... care by healthcare workers who refuse the vaccine."

Thanks to advancements in healthcare, technology, education, and more, demographics are changing and aging populations around the world are expanding rapidly. This inspires opportunities to improve the quality of the aging experience — by alleviating social isolation and loneliness and increasing engagement among older adults. To support, highlight, and help achieve this mission, the idea for In Good Company: The 2018 Optimal Aging Innovation Challenge was born. Do you have an idea, technology, service community resource, or other solution that could improve quality of life for older adults? Submit your proposal by September 28, 2018 . Learn more .

Google parent company Alphabet is planning to invest $375 million into Oscar Health in anticipation of the privatization of Medicare, reports Forbes . The insurer will use the investment to enroll in Medicare Advantage (MA), a popular health plan that policymakers are seeking to expand by easing rules. "We will continue to build a member experience that lowers costs and improves care, and to bring Oscar to more people — deepening our expansion into the individual and small business markets while entering a new business segment, Medicare Advantage, in 2020," says Oscar Health CEO Mario Schlosser. MA plans contract with the federal government to offer more benefits and services to seniors than traditional Medicare, such as disease management and nurse help hotlines, with some also delivering vision and dental care and wellness programs. Earlier this year, the Centers for Medicare & Medicaid Services finalized new policies, "reinterpreting the standards for health-related supplemental benefits" in the MA program to include additional services "that increase health and improve quality of life, including coverage of non-skilled in-home supports and other assistive devices." Slightly less than 35 percent of Medicare beneficiaries are currently MA enrollees, but enrollment is forecast to hit 50 percent market penetration by the end of 2025. "We're in the individual market, we're in the small employer market, and we're going into Medicare Advantage in 2020," Schlosser says.

The AAA Foundation for Traffic Safety says older drivers typically outlive the age when they are capable of safe driving by seven to 10 years, but more than 80 percent never discuss this with their family or doctor, reports the Washington Post . In 15 percent of cases when this discussion is held, it comes after a crash or traffic infraction. The AAA estimated that in 2016, more than 200,000 drivers older than 65 were injured in crashes and more than 3,500 of them died. "This research shows that older drivers can be hesitant to initiate conversations about their driving capabilities, so it is important that families encourage them to talk early and often about their future behind the wheel," advises AAA Foundation for Traffic Safety Executive Director David Yang. "With early discussion and proper planning, older drivers may extend their time on the road." Only 17 percent of older drivers discuss driving issues with their doctor or family, and when they do, the most common reasons are falling asleep at the wheel or trouble staying in a traffic lane. "Despite your best efforts to appropriately handle a conversation about driving, some older adults will respond with anger, denial, or embarrassment," notes AAA Mid-Atlantic's John B. Townsend II. He suggests avoiding unloving words or attitudes, while previous AAA research found older drivers who have stopped driving are almost twice as likely to become depressed and nearly five times as likely to enter a long-term care community as those who remain behind the wheel.

A study published in BMJ Open of 15 countries found absenteeism is lower and presenteeism higher when managers offer help and support to employees with depression, reports Reuters Health . Moreover, employees who live in a country with a larger number of managers who avoid discussing depression tend to take more days off work. Managers who said they had one or more employees with depression responded variably across the countries, but managers in Asian countries tended to avoid those employees. Managers in Mexico were most supportive, with 67 percent saying they had offered help, as did 56 percent in South Africa and Spain. Among individual employees, those working in smaller companies or with high educational attainment tended to take more time off due to depression. Employees living in high-GDP countries also took slightly more time off, though at the national level, higher GDP was associated with rates of presenteeism. Individually, men aged 45-64 with medium to low education levels also tended to have higher levels of presenteeism, while 25-to-44-year-olds tended to have lower levels of presenteeism. "Managers at the top set the tone, which cascades into workplace policies and training programs that other managers can use to support their employees," says Sara Evans-Lacko of the London School of Economics and Political Science. "Managers often don't know what to say or don't want to make it worse, but talking about it helps." David McDaid of the London School of Economics and Political Science notes the Organization for Economic Co-operation and Development (OECD) is reviewing its mental health policies.

A study published in Medical Care found Medicare beneficiaries nationwide have low rates of preventive care visits, with older adults of minority race/ethnicity having the lowest rates of all, reports News-Medical . Researchers examined data on nearly 15,000 Medicare fee-for-service beneficiaries, 66 or older, participating in the nationally representative Medicare Current Beneficiary Survey from 2011 to 2013. Use of the Annual Wellness Visit (AWV) was low, with only 8.1 percent of Medicare beneficiaries using it in 2011. In that year, the rate was highest for white people and lowest in black people, while by 2013 the overall rate of AWV use rose to 13.4 percent. The greatest increase was seen in black people, whose rate of use nearly tripled to 15.4 percent. Generally, AWV use was lower in racial/ethnic minority groups versus white people. Following adjustment for income and education, racial/ethnic group was no longer a statistically significant factor. AWV use was lower for beneficiaries in rural areas and higher for those who had a usual place for healthcare, apart from the emergency room. "While the Medicare AWV may help to reduce racial/ethnic health disparities, efforts will be needed to increase its use — not only by minority patients, but for the entire Medicare population," says Kimberly E. Lind with the University of Colorado. "Education and income inequality by race and ethnicity have been a historical constant and remain a problem."

A study from the University of Pennsylvania's Wharton School of Business published in the Penn Wharton Budget Model warns Social Security will be depleted faster than the government claims, reports Financial Advisor . This is because officials have failed to account for the future spike in the national debt, which will reduce the projected growth of the payroll tax base. "Using a model that incorporates future macro-economic forces, Penn Wharton projects that the Social Security trust fund depletes in 2032," the study says. "More importantly, we project much larger future annual cash-flow shortfalls. Relative to the payroll tax base, we project a cash-flow shortfall in 2032 that is 36 percent larger than the Trustees' estimate for that year. By 2048, our projected cash-flow shortfall is 77 percent larger than theirs." The study says Social Security's senior and disability programs will be on "a path that is not sustainable" if predictions are accurate. Increases in the national debt reduce the tax base on which Social Security tax is charged because a rise in debt lowers the capital stock, reducing GDP and work, and making the tax base contract, both for Social Security and general federal revenues. With less investment there is less production and therefore less work and lower salaries to tax. The Committee for a Responsible Federal Budget says the federal debt could nearly triple as a share of GDP if Congress makes the Trump tax cut and spending increase permanent.

Massachusetts Gov. Charlie Baker last week signed a law designed to improve the diagnosis and treatment of Alzheimer's disease in the state, reports the Boston Globe . Under the law, physicians, physician assistants, and nurses must undergo training in diagnosis, treatment, and care of people with Alzheimer's and other forms of dementia before they can acquire or renew their licenses. In addition, physicians who have diagnosed Alzheimer's are required to inform a family member or legal representative of that person about the diagnosis. Furthermore, all hospitals must develop and deploy a plan for recognizing and managing persons with dementia by no later than Oct. 1, 2021. The Massachusetts Health & Hospital Association's Patricia M. Noga says hospitals had already started working on their Alzheimer's strategies even before the law was finalized. "No other state in the country has something like this," notes Daniel C. Zotos of the Alzheimer's Association's Massachusetts/New Hampshire Chapter. He cites a survey of Medicare beneficiaries estimating that 50 percent of Americans with Alzheimer's have not been diagnosed, and half of those with a diagnosis have not been informed about it.

Employees forgoing retirement are becoming an essential part of the workforce, which is changing workplace dynamics and forcing managers to accommodate an older and more multigenerational labor pool, reports the Wall Street Journal . Firms must now contend with large numbers of workers who are up to six decades apart in age, and create opportunities for young employees to advance while also ensuring veterans feel valued. To maintain productivity and innovation, they must persuade multigenerational employees to work together. "Managers have to identify what skills and strengths each individual employee can contribute and confront their own biases so they can move their teams beyond labels," says Retirement Wisdom's Joe Casey. Also challenging is persuading older workers, often fearful of losing their jobs, to help younger workers. Managers also have to rework the typical strategy of having employees work with others their age. Younger and older employees can exchange skills and perspectives on mixed-age teams, and younger employees may follow advice more easily from older colleagues than from peers because they know they are not vying for the same things. Reverse or reciprocal mentoring programs also encourage multigenerational knowledge sharing. Although managers often think most benefits are focused on particular groups of employees, evidence suggests they are universally applicable across generations.

HIV is known to cause many unique health concerns in older adults, with infectees often exhibiting comorbidities and characteristics associated with older age much sooner than their age-matched HIV-negative counterparts, reports Infectious Disease Advisor . Weill Cornell Medical College Professor Eugenia L. Siegler and University of Colorado Denver-Anschutz Medical Campus Professor Kristine M. Erlandson offer strategies to better care for older adults with HIV to address major health issues in this population. One study seeks to tie clinical information from electronic medical records to a survey so correlations between mental health concerns, socioeconomic concerns, and clinical data can be made. "The goal is to glean information that will help better inform the care and support services provided to older adults with HIV," says Siegler. Meanwhile, Erlandson cites a study that found "both moderate- and high-intensity exercise resulted in significant improvements in function among both people with and without HIV, and higher-intensity exercise led to greater improvements in strength, particularly in those living with HIV." Siegler also notes, "Frailty likely appears earlier in HIV-infected people than it does in their uninfected counterparts, and it is a predictor of morbidity and mortality. She says "frailty ... by definition, it is a marker of vulnerability, and it is difficult to reverse once it has been established. Keeping socially engaged and physically active may help forestall frailty even in the setting of other chronic problems."