For an older adult who has spent a lifetime making decisions about where to go, when to get up and how to live, entering a skilled nursing facility should not mean that every decision involving mobility suddenly becomes someone else’s.
As California physical therapists who work in nursing-homes, we confront this tension every day.
Another summer of extreme heat is sending many Californians to hospitals and emergency rooms in growing numbers.
Behind the numbers are people without access to cool places, workers laboring in unsafe conditions, children attending schools without enough shade and residents managing chronic health conditions in homes that trap heat. In too many cases, we can only infer their stories.
Two years ago, my son James was invited to speak at the Department of Justice in Washington, D.C. at an event celebrating the 25th anniversary of Olmstead v. L.C.
The 1999 Supreme Court case said people with disabilities have a right to receive care in their own homes and live in the community, rather than being forced to live in segregated institutional care facilities.
Large hospital systems in California — and the rest of the country — have been buying up independent physician offices under the guise of streamlined care. In reality, these acquisitions drive up fees and costs for patients without improving care at all.
The math does not work — not for physicians, and not for patients — until policymakers can fix the significant dangers associated with vertical integration.
Many doctors don’t see or don’t want to see Medi-Cal patients. It’s all about pay. In fact, the latest federal government adjustment reduced physician fees by 2.8 percent, exacerbating the problem. California voters passed Proposition 35 in November 2024, to increase pay to doctors treating Medi-Cal patients, but it hasn’t been implemented yet.
The payment pressure doesn’t just affect who gets seen, it also shapes how they’re seen.
It strikes me that embarrassment is a huge barrier to participation in physical activity for aging people, and it’s not even the most substantial one. Other obstacles include lack of money or transportation to attend an age-appropriate exercise class. In some cases, older adults are hobbled by arthritis or are wheelchair-bound. And sometimes taking a walk isn’t a viable option when a neighborhood doesn’t feel safe or the sidewalk is cracked and pitted.
I’ve spent my career protecting kids from Big Tobacco. But you don’t need to be an expert to understand that candy-flavored tobacco products were created to hook kids on nicotine.
Unfortunately, this isn’t stopping Big Tobacco. The industry is on a hot streak of weakening federal tobacco regulations, making it essential for California’s leaders to defend our flavor ban and keep our kids safe.
Every year, an estimated 1 or more million patients venture from California to Mexico to obtain medical treatments and medicines, and a large contingent of these are aging people.
Cost is the main reason to make the trip for 60 to 70 percent of patients, said Arturo Vargas Bustamante, a professor in the UCLA Fielding School of Public Health.
The most popular treatments among older patients who cross the border are dental services.
California closely monitors whether nursing home residents fall. Regulators track incidents, facilities report them and safety policies revolve around preventing them.
Yet a more fundamental question often goes unasked: Can residents walk?
When safety becomes the only measurable outcome, unintended consequences can follow.
Like most parents, my wife and I want our daughter to be kind, happy and safe — but what does safety really mean?
What kind of safety can we ensure in a society deeply rooted in sexism and patriarchal violence? How do we teach her to be safe — without instilling a fear of men or of people who’ve committed past harms? How do we show her to be strong without masking her vulnerability? To be assertive yet expansive in her compassion?