Wellness programs

by L

Workplace Wellness Programs Are a Sham

Does your work have a ‘wellness program’? Is participation mandatory or voluntary? Do you like it? Hate it? Comfortable indifference?

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135 thoughts on “Wellness programs

  1. A prior job had a wellness program…the two benefits touted: (1) reduced cost to several gyms or exercise studios – about half you received the same discount through the health insurance program. (2) if you did an annual well-check (like a $20 copay at the time), did a specific online health survey before your appointment that you shared with your doctor (only check was that you logged in, took survey and printed) and brought back your payment receipt, THEN you got an extra day of unrestricted PTO.

  2. At my old job there was only a smoker’s surcharge so I didn’t have to participate in any of that wellness silliness. I agree with the article that work programs should not be doing blood tests and punishing people for things like BMI above some arbitrary #, which doesn’t seem to lead to adverse health outcomes (and I’d throw cholesterol levels and blood sugar levels in with that too.) I suspect most wellness programs are probably not following the latest science and health is so individual that I’m suspicious of blanket health recommendations put forth by employers who are not actually in the business of health.

  3. DH’s university has a wellness program, but it seems to attract Totebaggers with healthy habits rather than the overweight smoking staffers at which it is aimed. And, as typical in large organizations, the handful of seriously sick or injured people who rack up the highest health care costs have conditions far beyond the reach of a BMI analysis or blood pressure test.

  4. So funny how times change. My first job had a smoking room. It was a tiny, sad room with a little air cleaner, a table and tabloid magazines. My kids don’t believe it!

  5. Moxie, I think I’ve mentioned before that my junior high school had a designated courtyard for the kids who smoked.

  6. My first job had a smoking room.

    Remember when restaurants had smoking sections and people could smoke in bars?

  7. We have a wellness program. My colleagues’ healthcare issues are often associated with injuries mountain biking or skiing. One of my cubemates broke his hip mountain biking last week and, due to no cell service, had to walk to the nearest house to call his wife. Bummer.

  8. That was an excellent article, and it only got a single eye roll from me at the end where the author included, among a list of better alternatives for companies to promote wellness, sponsoring “community supported agriculture.”

    It’s just a reminder that you’re still reading Slate.

    Overall, it’s a good example, IMO, of the know-it-all earnest Totebaggers in society wielding their technocratic superiority to punish people who aren’t sufficiently like them.

  9. Overall, it’s a good example, IMO, of the know-it-all earnest Totebaggers in society wielding their technocratic superiority to punish people who aren’t sufficiently like them.

    Yet, I assume you support the conclusion. That folks who have poor health habits should pay more than those with good health habits?

  10. Rocky, there was a designated smoking area at my HS, too. The funny thing is, our HSs were/probably still are very similar demographically and achievement-wise. Can’t imagine what it would have been like at the LMC schools elsewhere on the peninsula or in the east bay, where, just assuming here, smoking was probably more prevalent.

    OT, we have a wellness program here. If we go to the annual screening we get $125. The most value I see is that when I compare my results with past results…I keep the sheet I get with all my numbers…I can see how things are over time. I bring them to my next doc appt and he says as long as things stay in line, then those simple tests are pretty much all I need (except those recommended things that can’t be done in an office conference room setting…colonoscopy in my case, pap/mammo for women in addition). There are also the myriad weight-loss, stress-buster, smoking cessation, etc programs the program-runners then endlessly harass us to attend if it’s indicated. There are also $ bounties for completing those programs.

  11. My first business trips were on Eastern Shuttle flights with smoking sections. Our high school had a smoking courtyard too.
    The university has banned smoking in buildings and would love to have an entirely smoke-free campus but football weekends would be a problem. Smoking is not allowed in the stadium but amazing numbers of fans sneak cigarettes in the indoor spaces and the rest of the smokers light up as soon as they leave.

  12. Since we’re talking about employee benefits this is somewhat applicable:

    Recently, they have resorted to hiring their 14-year-old daughter and her friends to step in.

    Increasingly, he said, he has to beg his 15-year-old brother to pick up shifts.

    I note the unquestioned assumption that kids should only work as a last resort/in the most dire of circumstances.

    http://www.nytimes.com/2016/09/19/technology/how-tech-companies-disrupted-silicon-valleys-restaurant-scene.html

  13. I work in a medical setting (on the admin, not clinical side), and we have a robust wellness program that they’ve set up over the last couple of years. Blood draw and questionnaire are annual – then you get sorted into one of two group: healthy or unhealthy (they don’t call it that, of course). Healthy is either normal weight (by BMI), or overweight with no weight related health problems (they have a list – diabetes, hypertension, high cholesterol, etc.). Unhealthy is overweight with w/problems, or BMI > or = to 30. If you make the healthy group, you get a $40 per person discount on the health insurance premiums (so $80/per month for me and DH). If you are in the other group, in order to get the discount, you have commit to a full program that includes meeting with a physician who specializes in weight loss and creates a plan for you, seeing a registered dietician, attending group classes, regular blood draws to track cholesterol, etc. It’s supposed to be pretty intense, but they’ve actually had some success in getting people to lose weight and change behavior. They piloted the program on our employees and are now offering it as a wellness program for other businesses in town and are offering it as a program that individuals can purchase if they want to lose weight. There is also a gym discount for both groups.

  14. “That folks who have poor health habits should pay more than those with good health habits?”

    Like forcing marathon runners to put a down payment on their knee surgeries?

    Define “poor.”

  15. When I worked at the health IT consulting place, they had an extremely fascist wellness program. I think some of it was because at least some of the employees had to go into the client hospitals, so for example, they tested for TB every year. But some of it was just awful, like the time they discovered that one of the developers had high blood pressure. They made him go home IMMEDIATELY, and he couldn’t come back until he had a doctors note saying he had started meds. At this company, you couldn’t work from home, so every day home came out of his PTO, plus we really needed him working on a project. Stupid.

  16. Like forcing marathon runners to put a down payment on their knee surgeries?

    Define “poor.”

    Sure. Any activities or behaviors that can be reasonably show to increase claims.

    If marathon runners need more knee replacements and also incur around the median in health expenses then they would get surcharged. If they need more knee replacements but their overall claim history is lower then they’d get a discount.

  17. We also had a smoking area at my junior high, though most kids preferred to smoke in the bathrooms (cue up Smokin in the Boys Room).

    When my DH was still teaching at a college, they imposed a smoking ban. One professor, an elderly, prominent mathematician, refused to stop smoking his cigars in his office. You could smell it all over when he was smoking. The problem was eventually solved when he passed away from cancer.

  18. Stupid.

    That would depend on what his blood pressure was. I know some guys who never go to the doctor as a matter of principle and without the note requirement of the note and being set home wouldn’t have done anything about it.

  19. I have a wellness program at work with money back. First you have to schedule the biometric screening when they have it, then if any of your metrics are off, schedule phone calls with a wellness consultant. I almost completed it the first year but something happened and I didn’t complete it. There were too many hoops to jump through. I have foregone the money rather than jump through the hoops. I am probably a minority in my workplace on this.
    I have been healthy so far and take reasonable care.
    Talking of reasonable care, when my parents do their health check ups in the home country, the bar for certain metrics is higher. But when they come here the bar is lower so some of the health metrics say “high” instead of “normal”.
    I wonder if the metrics here have gotten progressively stricter over the years.

  20. “Sure. Any activities or behaviors that can be reasonably show to increase claims.”

    What would be the surcharge for an employee getting pregnant over the age of 35?

    How about doing so through IVF and risking multiples?

  21. What would be the surcharge for an employee getting pregnant over the age of 35?

    How about doing so through IVF and risking multiples?

    That’s a question for you.

  22. I think Louise hit the nail on the head. For those who know the hoops are minimal due to good health and the benefit is significant, they are the most likely group to follow through. At the other end of the scale are those where the hoops are high (initial and follow on hoops due to poor health) and they have no desire to change. These folks are the least likely to follow through. Those in the middle, I think are motivated (1) if the money not spent is significant to them and/or (2) need support (even if just financial) to make a desired change.

  23. Rhett said “hat would depend on what his blood pressure was. I know some guys who never go to the doctor as a matter of principle and without the note requirement of the note and being set home wouldn’t have done anything about it.”

    But what right does the employer have to demand treatment? And having high blood pressure isn’t like having TB – he wasn’t endangering his co workers or any patients.

  24. But what right does the employer have to demand treatment?

    If he doesn’t like the terms of his employment he can find another job.

  25. We have a wellness program. I take the blood test, answer a bunch of online questions and have my doc fill out a form. In exchange, I get about $300 from the company over the course of the year. Easy money imho, as I want the tests done and want to see the doc at least once/year anyway. No idea what happens if your numbers aren’t good. If your spouse is on our medical plan and does all the steps, you get another $300 for him/her.

    We have all kinds of walking programs and Weight Watchers and all of that – it’s always the HR people and a handful of the same characters who do all of these.

  26. “What would be the surcharge for an employee getting pregnant over the age of 35?

    How about doing so through IVF and risking multiples?

    That’s a question for you.”

    Obviously that would never happen. But from a cost standpoint, I’m willing to bet that it’s far worse than being overweight. Which means that these aren’t based on “encouraging healthy choices” or lowering overall costs, but are just rooted in the Totebaggy hatred toward fat people, those who at the whole cookie.

  27. Louise – yes, the metrics have become more strict over the years, but as people reach 70 the latest data shows that they should be relaxed to avoid over prescribing of multi medicines with only marginal benefit to the elderly.

    I don’t agree with higher premiums based on raw metrics or even on behavior. No one is going to charge extra to or refuse to cover skiers or adult recreational athletes or families of travel team kids. Or prospective parents over an arbitrary age who need assistance in having a baby. Where does it start and stop – in some not so distant future, families with a bad genetic profile. Or people who live in a certain zip code or can be sorted by some sort of statistics into a higher risk profile. I am not even sure I agree with a smoker’s added premium, even though we are used to that by now.

  28. “But from a cost standpoint, I’m willing to bet that it’s far worse than being overweight. Which means that these aren’t based on “encouraging healthy choices” or lowering overall costs, but are just rooted in the Totebaggy hatred toward fat people, those who at the whole cookie.”

    ITA.

    And they are encouraging “healthy choices” which may be completely inappropriate for that person and not based on actual science. BMI is a ridiculous proxy for overall health and guidelines about what constitutes healthy are constantly changing or just downright at odds with other recommendations. Being fat does not necessarily mean you’re unhealthy and being thin doesn’t mean you’re healthy.

  29. Never had a wellness program. I think DH’s U has one, but DH doesn’t participate. Though, at least I got him to go to the doc regularly (yearly). He could stand to lose a few pounds, but the desire has to be on him. No program is going to “make” him regardless of a financial incentive. He’s driven by carbs and chocolate, not dollars.

    We had no smoking courtyard in HS. We just had people smoking in the lower level bathroom. Such fun.

    At my hospital, they have a sign near the door that says “please refrain from smoking in this area or idling cars. This is where our babies take their first breath of outside air and we’d like it to be as clean as possible”. I wonder if that sign changes behavior? This hospital specializes in babies.

    I’m so glad bars and restaurants are smoke free – I can actually enjoy them without the asthma attack.

  30. A guy that worked for me was married to a woman with terrible employee benefits. They tried for years to have a baby, and they finally turned to fertility specialists. He actually worked for 3 different banks in five years because they maxed out their fertility benefits at the first two banks. She finally delivered twin boys when he was working for the third bank. He was a first level officer performing controller functions for a product that had easily transferrable skills. At the time he jumped around, it was easy to get new jobs especially at his level. I still thought this was an interesting strategy, but it worked for them.

    I’ve worked for employers that had some sort of wellness programs, but many of them didn’t seem to be applicable in midtown NYC. Some of them offered discounts at certain local gyms, and I did take advantage of that benefit. It seemed to be the employees that were located in offices in places such as Texas, or Florida that would have the space for the actual wellness center.

    In the 90s, I toured the offices of MBNA and they spent a lot of time on a wellness program for their employees. They have since been swallowed up and are now part of B of A. When it was just MBNA, the employees would get certain pins that they could wear on their suit jackets to designate levels achieved in the program. There were extensive logs and sign ins. This was just when the internet was getting started, so everything was a manual log and check in. They even had gym clothing and the more you participated, the better clothes etc. I thought the whole thing was pretty invasive, and big brotherish.

  31. My colleagues with health issues like high blood pressure, being overweight who use the wellness program were already aware of their issues and I don’t think the wellness programs have influenced any dramatic change in behavior. Their conditions continue to be managed with medications, lifestyle changes are very modest or non existent.
    There are people who have made drastic changes as well but that was on their own.

  32. ““please refrain from smoking in this area or idling cars. This is where our babies take their first breath of outside air and we’d like it to be as clean as possible”. ”

    Oh that’s so fu(king insufferable. I don’t even smoke, but I’d be inclined to light up right there just for spite.

  33. My issue is more with this:

    In some 20 percent of cases — and as many as 30 percent — prescriptions for medication are never filled. Up to 50 percent of medications aren’t taken as prescribed.

    Medication noncompliance creates major headaches for patients and doctors alike down the road, and can sometimes be deadly. For example, someone with congestive heart failure who doesn’t take their diuretics correctly, regularly, will often wind up in the hospital again and again.

    To the degree that people are incurring costs by treatment non-compliance I think they need to bear some responsibility for that.

    http://www.theatlantic.com/health/archive/2012/09/the-289-billion-cost-of-medication-noncompliance-and-what-to-do-about-it/262222/

  34. So on the one hand, encouraging people to be healthy seems like a good idea in principle but then it seems more and more terrible the more you think about it.

    We have a “healthy actions” program where if you register online, then go to the doctor and they fill out your form, you get $300. Unfortunately, I keep forgetting to bring my effing form to the dr when I go, so it ends up that I forego the $300.

    I think I would use it more if there were discounts on our premiums – my pre-tax health insurance is about $1050 per month – or if we could get discounts on gym memberships that were more than $150 (that is like 1.5 months’ worth of membership).

  35. “In some 20 percent of cases — and as many as 30 percent — prescriptions for medication are never filled.”

    So what? I’ve had doctors in a couple instances prescribe Vicodin who said “fill it if you need it.”

    “Up to 50 percent of medications aren’t taken as prescribed.”

    It’s very rare that I ever finish a full course of antibiotics. If I’m feeling better, I tend to forget about them, or at the very least I don’t take it two or three times a day.

  36. My comments any provides a savings in insurance costs for non-smokers, then an additional savings if you choose to submit some metrics, done at the work health clinic or signed by your personal doctor. It includes waist size, in addition to blood test results. The total savings works out to be maybe $300 or so for the employee, with additional savings possible for a covered spouse. Also, the myriad health initiatives someone else mentioned, where they call you and offer programs. I do like the 24 hour nurse line, though

  37. It’s very rare that I ever finish a full course of antibiotics.

    You know that’s a horrible thing and leads to the development of antibiotic resistant bacteria, right?

  38. it is hard even for fully competent Totebaggers to comply with complicated medication regimens. For those with fewer cognitive gifts and family support, who may have to rely on layabout unemployed grandsons to pick up their prescriptions, and whose medical conditions further impair their ability to keep track of medications, the whole process is a slog. It’s amazing that compliance is as high as it is. And that doesn’t even take into account the challenges of paying for all of these drugs.

  39. Milo said “It’s very rare that I ever finish a full course of antibiotics. If I’m feeling better, I tend to forget about them, or at the very least I don’t take it two or three times a day.”

    You do realize that you are contributing to the rise of antibiotic-resistant superbugs?

  40. Milo,

    If I’m understanding you correctly you favor community rating where everyone pays the same regardless of their habits, health status, treatment compliance, etc?

  41. Rhett – I probably do, yes. While no system is entirely fair, as soon as you start designating who has an approved unhealthy habit and who has unapproved one, it becomes even less fair and far more problematic. (Imagine the AIDS surcharge you’d have to collect from gay employees!)

    I also think that, since we have ACA, they need to make the penalty for not having coverage a lot harsher.

  42. Now that I think of it, the company pays for memberships at the Lifetime Fitness next door. Quite a few people do this in the am and there’s a contingent at lunch, but I’ve never been interested. If you lived close enough to work that it’d be your neighborhood gym, it might be a good thing.

    As I recall, if you don’t go a certain number of times/month, you have to reimburse the company for part of your membership fee.

    Are companies just picking the easiest/cheapest things to measure that still affect health? Mammograms and MRIs and brain scans and genetic counseling questionnaires/screenings might reveal costlier problems but that’s an expensive way to see who’s “healthy.”

  43. Yeah, Milo, to pile on, please take the full course of antibiotics when they are prescribed for you. To stop before they’re done is silly.

    But your point about painkillers is valid…you might get a new Rx today for some ache, but you’ve already got some of that drug in the house from something else, and it’s still good, so you use that and don’t fill the scrip. No big deal IMO if there’s 100% non-compliance in this area..

    The issue is for the people who need their blood pressure / cholesterol / diuretic / etc maintenance drug(s) to keep their numbers kinda sorta or at least closer to the recommended levels. If they are 30-50% noncompliant and this causes more systemwide costs we all have to bear, then, yeah, I think this is a big issue. Goes to WCE’s frequent question of rationing. If people take their drugs as prescribed, there’s more slack in the system than otherwise, so when you or I need services we can get them.

  44. “In some 20 percent of cases — and as many as 30 percent — prescriptions for medication are never filled.”

    Well, since my doctor’s office got a new handy dandy electronic prescription programs, a significant number of medications have been filled by the Target in a similar sounding town to the one I use. The similar sounding town is about ten hours away, and no, I have never gone there to get meds. Also, painkillers get prescribed with an insanely high number of refills. I’ve never ever used an entire bottle, let alone refilled a painkiller prescription. How many of those cases are in the 20 percent?

    And to pile on, Milo, take all your antibiotics when they are prescribed.

  45. a significant number of medications have been filled by the Target in a similar sounding town to the one I use.

    Can you set your default pharmacy via their online portal?

  46. Milo – I have to add my voice to the chorus – please take them all!

    That said, I’m super compliant even with my pets. I have a very old, very sick cat who gets 4 meds in the am and 4 or 5 in the PM depending on the day and I never miss it. Now my floors are filthy and I forget to take the dry cleaning in a lot, but I’m on top of any and all meds!

    Watch the video (bottom left) of this link about over treatment. Really interesting both from a graphics perspective and challenging conventional wisdom about certain types of preventive care. DH and I have spent a lot of time discussing this.

    http://www.doc-patient-talk.com/

  47. “My first job had a smoking room. It was a tiny, sad room with a little air cleaner”

    My previous employer had one of these. It was informally referred to as “the cancer ward.”

  48. Can you set your default pharmacy via their online portal?

    No, nor can I do it when I am in the doctor’s office. At this point, I just look and see if they have put the right name in the computer.

  49. Milo – Take all your antibiotics (better choice) or don’t fill the script at all (worse choice for you but better for the rest of us than taking only some of them).

    I am compliant on medicines. However, I have had several things that I haven’t filled as they were if needed, but better to have the script on a Thursday afternoon than to feel worse over the weekend with nothing but (expensive on my plan) urgent care.

    My mom was compliant with meds while my dad wasn’t. Mom felt better more of the time. Dad would take them…feel better…not take them…start feeling worse…complain doctor did nothing to help him…repeat cycle!

    However, I think for the elderly – even though I always had an updated list of meds that I gave to the nurse at EVERY visit. ER, etc. – that there is not enough evaluation of the meds they are on or the consequences of radically changing them (such as in the hospital). Sometimes I think my mom took longer to recover solely based on her body’s reaction to changes in meds.

  50. At my first job we didn’t have smoking rooms, we had ashtrays on our desks. You could smoke anywhere – ashtrays in supermarkets, by the deli counter and in front of each checkout line. Ashtrays attached to the back of theater seats, smoking in airports and planes, restaurants, everywhere. Even if your host didn’t smoke there were always ashtrays, sometimes even lighters, available in their home. It seemed that every man carried a lighter, Zippos were the most popular and always lit a ladies cigarette whether you knew them or not. Totally different world.

  51. The Geneva Conventions specify that “Sufficient drinking water shall be supplied to prisoners of war. The use of tobacco shall be permitted.” Cigarettes on a par with water!

  52. My parents both get the smoking question. My Dad was a very light smoker who gave up years ago but he can’t say that he has never smoked. My kids have asked me questions about smoking. They tend to stare at smokers fascinated and have sometimes gotten a MYOB look. Our discussions then go on to the growing of tobacco, plantations, who grew it – a social studies lesson.

  53. My company gives a discount on medical premiums if you get a blood test, physical, and complete a questionnaire online. The discount might be $200/year. I do it, but hate it. The home office employees can get the blood work done at work. I work remote, so I have to order a blood test kit, prick my finger at home, drop blood onto a card, and mail it in. The online questionnaire sends me monthly emails about fitness, and sends me a notice about twice a month indicating that I need to login and stay up to date on my fitness goals (I can’t unsubscribe). From what I can tell, the overweight and unhealthy habit people I work with don’t participate in it, so I can’t imagine the company is benefiting. In fact, our health care plans are getting worse and premiums are increasing. yay!

    My DH hates to have big brother in his business, so he does not get a discount on premiums, even though his employer makes it so easy – just get a physical and watch a 10 minute wellness video.

  54. Last time my kid had antibiotics prescribed, he didn’t want to take them all & I had to go through the whole “kill every last one so survivors don’t get superpowers” spiel. Today, as he got them again, I requested as short a course as possible, said you’d think he’d be smart enough to know this by now, but last time I had to tell him….” So that’s where I stand on people taking all their antibiotics.

  55. About 6 mos ago I did a detailed post on my husband’s 15 different pills a day. He has a high bandwidth in house medication manager in me. Who gets calls about bp meds or diuretics or blood thinners or thyroid to drop one add another go to one half pill every other day on a third. Two weeks later it changes again.

    Personal responsibility is an important civil and community value. But I don’t trust any sort of bureaucracy or demographic subgroup or corporation or moral arbiter to define and enforce the parameters of my individual exercise thereof.

  56. Milo – everybody’s right about he antibiotics. You have to take them until all the bad bugs are dead. Except none of us know exactly when that is (we’re totally making up the 10 day thing). It’s imagination-based-medicine. But we are betting at guessing than you. ;)

    (If I wasn’t in an Internet hole I’d pull the nyt article on this).

  57. My extent of my current employer’s wellness program is to provide showers. Informally, cyclists are allowed to park their bikes in our warehouse.

    My former employer provided a pretty decent fitness room, outfitted with weight machines, cardio machines, light free weights, TVs, and a large mirrored area for exercise classes conducted by volunteers. When some volunteers asked about step and heavy rope classes, our employer provided those. We also had an outdoor basketball court, a par course around the parking lot, and a large field used for softball and soccer.

    Besides health, those facilities also promoted camaraderie and employee networking, and IMO really helped promote inter-departmental cooperation.

    That employer also arranged for discounts at a national health center chain that had a large local presence. DW and I took advantage of one of those discounts, and are still members at the same terms, $11/month for access to nearly all locations (the chain subsequently added some super-duper-deluxe locations which our membership does not include, with an exception for the location closest to our home).

    The only mandatory health screenings we had were job-related. E.g., those of us who worked with hazardous chemicals had our blood tested regularly. There were regular on-site health screening events, but those were all free and voluntary.

  58. When I recently asked this board for suggestions on apps to keep track of weight-lifting, the only reply was from someone who wanted me to pass along what I found. I’m sorry, but I can’t remember who it was The apps I’ve found that were made to record weight-lifting were all from specific programs, so designed with whatever the special thing in the program is. It might be possible to tweak them when you’re doing something different, but I don’t care to go through each one to find which is least resistant. I’ve been using a paper ( :o ) chart, from back in the day, but now am trying the exercise part of My Fitness Pal. If you know of anything better, please let me know!

  59. BTW, despite the limited wellness program my employer provides, our health insurance company provides a bit more, providing some financial incentives to regularly visit their wellness office to monitor some basic metrics like BP, cholesterol, blood sugar, and weight.

  60. Coincidentally, I am on day 2 of home sick today (which hit, of course, the very evening that DH flew abroad for a week for work). Ugh.

    OK, it’s off-topic, but I had to share this conversation between DS (10) and my mom on the way to school the other day:

    DS: So when will I need deodorant?
    G: When you go through puberty and get hair under your arms.
    DS: Are you going to try to talk about puberty?
    G: You asked me!
    DS: But not about puberty.
    G: But that’s when boys and girls turn into men and women and are able to have babies.
    DS: Why are you talking about this?
    G: When your mother was 4, I got her a book called “How Babies are Made.”
    DS: Now why did you do that? That probably upset her for years.

  61. Meme, I hope you have a good pillbox! I do not mean a hat. My parents each have a pillbox that’s a 7×3 (or 4, not sure) matrix, with spaces for several pill-taking times on every day of the week. There are some meds that change frequently, depending on readings from a test he does regularly. Getting everything squared away in one focused session on the weekend is immensely helpful to them! You might find it frees up time for you, when you add together all the times you currently pause each day to recall whether or not it’s time for pills A, B, C…M.

  62. “I wonder if the metrics here have gotten progressively stricter over the years.”

    When I first started getting my cholesterol measured, 240 was the cutoff above which a measurement would be flagged. Now it’s 200.

  63. Wellness programs were encouraged as a part of Obamacare. As I recall, when insurance companies spend too much money on administrative expenses (>10%?) they are supposed to return some funds back to the insured. BUT, employers can funnel this money into wellness programs.

    My company has a wellness program that 1) penalizes smokers (their insurance premium is $40/mo more, although I’m not sure how enforced) and 2) gives credits for health insurance (~$40/mo) to those who take a survey, have a physical, and have blood drawn. I work in data and can just imagine how my data is being evaluated (even in the aggregate), so choose not participate. The incentive money is just not enough for me to share my data with others (I would require a couple more zeroes).

  64. “So on the one hand, encouraging people to be healthy seems like a good idea in principle but then it seems more and more terrible the more you think about it.”

    It’s not a terrible idea, it’s that terrible policies have been implemented in attempting to encourage people to be healthy.

  65. I’m all for the carrot, less into the stick. It is a slippery slope once we start to try to measure who is worthy and who is not. It seems to appeal to our darker Puritanical impulses. It wouldn’t surprise me if we replaced the Scarlett letter “A” with a “F” for fat (except that you can see that people are fat which renders the letter unnecessary but you get my drift) What about the guy who is fit but does sky diving? It also seems like the rules are so often changing as Finn mentioned. I seem to think the recommendations on how much exercise you need seem to change all the time. Also since there are some people who make poor choices and some people who are the victims of genetics. Insurance isn’t about getting value for your money. The point is that you pay more than you use. No one complains about not using their homeowners insurance or their car insurance that they paid so much for. There are a lot of things that we pay for that we don’t use. Some people don’t use the schools, there are a number of roads I pay for that I’ve never driven on. I’ve never called the fire department or received food stamps – but I’m glad to have it there if I do need it.

  66. Saac – you might check out Beyond The Whiteboard. Tracks more than just weights but definitely tracks those. I think it costs a few dollars/month.

  67. DW’s company does a wellness thing where we can get up to $300 a year each in gift cards. One of my previous employers did weight watchers at work and it was awesome. I lost 60 pounds. I never would have done it of it wasn’t right there. I have no idea if it actually reduced my healthcare costs or saved them any money on premiums.

  68. Saac, did you just try searching the app store or Google play? I just did a search for “weight lifting log” in the play store and got a whole bunch of apps that look really good. I’m sure at of them have apple versions if you use apple or there are other apple-only ones.

  69. “Remember when restaurants had smoking sections and people could smoke in bars?”

    Rhett, that was the birth of sidewalk tables and outdoor serving.

  70. “Rhett, that was the birth of sidewalk tables and outdoor serving.”

    Tangent: I cannot understand the affinity people have for eating outside. I mean picnics are just meals with a ton more work, itchy grass and ants. And the tables on the sidewalk? Who wants that. With the noise and the exhaust and people passing by. I will allow a quiet back patio in temperate weather but sitting in the sun on a busy road with people is beyond me. I will also allow sitting at a table for a drink at a cafe in Paris but not in Rockville.

    Rant over.

  71. I’m right there with you indoors, Moxie. Outside it’s always either too hot or too cold, or too close to traffic, or too breezy, or the sun is straight in your eyes.

  72. Thank you RMS. I like being outside, don’t get me wrong but mealtime. Quiet and climate controlled.

  73. I like being outside, as long as it’s not direct sunlight.

    I like watching people and cars. I don’t care if it’s a quaint downtown or Einstein Bagels in a Rockville strip mall. I’m inside all the time for work; I want to be outside as much as reasonably possible.

    I need a job that keeps me outside.

  74. I hate wellness programs. I spend more time fighting with HR departments about these than anything else.

  75. Moxie, inside is not always climate controlled.

    When I was a kid, we’d often eat outside, especially during the summer, because it was cooler and more comfortable outside.

    There’s a local park where, before the homeless took it over, during weekdays at lunch, there would be a lot of people, mostly guys in trades, having their lunches under trees, watching the waves break. I think that’s a lot better than a lot of indoor locations.

  76. “I cannot understand the affinity people have for eating outside.”

    +1. Especially on the picnics. Never understood the appeal.

  77. NPR just told me that half of all privately own firearms in the United States are owned by 3% of the population. Within that 3%, each person owns an average of 17 firearms.

    😳

  78. That sounds about right. Your grandpa dies, your wife’s grandpa dies, your uncle dies, you inherit all their guns and your kids don’t have a place to keep them till after their done living in the dorms.

  79. Milo, that strikes me about right. I live in a house with 12 rooms (including the bathrooms and laundry room). So that’s a dozen guns right there. I have one car. Only one office and myself and my son. We are already up to 16, and I don’t have one on the patio or in a box near the pool. So I guess to protect myself, I need at least 18 (or 19 if I get one for the front patio).

    So an average of 17 seems about right spread across income levels.

  80. Moxie, I agree with you about outdoor dining in the US. Often it is directly off the parking lot. Most people I know IRL these days give me a strange, confused look when I say that’s unpleasant. I was also startled the first time I tried to request actual glasses and dishes the first time I ate outdoors at the mall, in a restaurant court. I had seen people using paper and wanted to avoid it. The response? They’re not allowed to let people take breakable dishes outside. Ay-yi-yi. The stupidity of thinking glass breaks on cement but not on the floor indoors is beyond me. It’s apparently not just a mall level rule either.

  81. I love eating outside. When the kids were small, eating outside near the parking lot was ideal – they could make noise, and the cars pulling in and out kept them entertained. Best of all was a particular restaurant with outdoor seating right by the Metro North tracks. The trains would whoosh by, the kids would yell train! and we would enjoy our cold beers and somewhat mediocre food.

  82. In the summer, indoor seating is often too chilled for me, and somehow I always end up right under the AC blower. Also, many restaurants are just too dang noisy, and the ones that aren’t are all stiff and formal.

  83. Milo, that article was on my FB a bunch today. Best line:
    “You know, it’s kind of like tattoos,” she said. “You can’t have just one.”

  84. Beyond the Whiteboard looks like it’s designed for crossfitters. I may try Fit note. Thanks, Risley and Denver!

  85. Indoor seating in many restaurants here is too cold. Here the restaurant patios are nice because the restaurants are in shopping/dining areas with benches to sit on and pedestrians strolling by. There are parking areas, so finding parking is not a problem. Small city features, I guess.
    I recall fondly Newbury Street in Boston, so much liveliness, energy, such people gazing but also very tight parking.

  86. With my mom did the whole matrix pill box thing, where I would go fill it every Sunday. The problem is that most of those are not well designed for people with low vision and reduced fine motor skills.

    I am hoping by the time I get to my 80s, there will be better solutions than there are now. I can clearly see that one of the HUGE benefits of assisted living is medication management.

  87. When MIL was at a rehab facility, we cleared out the medicine shelf in the kitchen. There were at least half a dozen of those pill containers, most of which were labeled with cryptic symbols for FIL, who died three years ago. And another half dozen partially empty prescription bottles, all of which were tossed over protests from BIL who thought that we could disregard the expiration dates. He also wanted to hang onto the handful of pills in an unmarked bottle but they went in the trash when he wasn’t looking. And yes, they are not supposed to go in the trash but no way was I leaving un-needed meds in a house of a senior with dementia.

  88. We use the 7 by 4 pill box filled on Sat night, but the blood tests and dosage changes usually come mid week, via phone call to DH who rarely wears his hearing aids around the house. I ask for the phone or call back to make sure. And at least once a week he forgets to take them, or takes some pills from the wrong slot. Or he drops a pill on the floor, or leaves one of the indistiguishable small half white pills in the box when he has to take the big morning pile of 10. When I say 15, it is 15 different meds, about 24 actually pills or half pills.

  89. DD, I know that and a person fully competent can be trusted to make judgments on which drugs are ok but a senior with memory issues and no online research capability cannot.

  90. My dad fills my 97 year old grandma’s pillbox weekly. AustinMom is spot on with the problem she has. Low vision and weak fingers make it difficult for her to open. When my dad or any of his siblings stop by to visit during the week they are always refilling the pillbox because meds are missing, doubled up in the wrong box, not taken, etc. They suspect that she probably is only taking half of what she is prescribed. But considering she is 97, I don’t think she cares. She has made it clear that she does not want to live to 100. And she is mad at the family for forcing a healthcare aid to come 3 days a week.

  91. Experince with my parents is similar to Meme’s – wrong slot, missed one (didn’t see or dropped), once got two slots open by mistake and took most of them before realizing it was too many pills (thankfully, nothing at 2x the dose was an issue). Only difference was pills adjusted by weight if an increase of more than 2 lbs that didn’t come off the next day or more than 5 lbs in a week (an issue with fluid retention in heart failure patients).

  92. Rhett – I should have sold our Wells stock yesterday. What a mess!

    Totally unrelated but Dh and I are trying to decide on appliances for our new kitchen. 3 younger kids – would you go with a 36″ or 42″ counter depth refrigerator (difference in cubic feet is 2 and not sure it’s worth the extra $1200 but on the other hand for resale the 42′ just looks bigger and it’s a family house in a family neighborhood). Also, does anyone have Thermador appliances? I’m leaning toward Wolf/Subzero but there is a compelling price difference and DH likes to save $ where he can.

  93. Scarlett, a senior with memory issues shouldn’t be managing his medications in the first place.

  94. +1 to Moxiemom on the outdoor dining. Exactly. I have many, many rants about the sidewalk dining. People here go absolutely batshit for sitting on the “patio” because our weather is such crap 8 months a year. But the “patio” is often just tables on the sidewalk. On one hot restaurant street near me, you can barely walk down the sidewalk in the summer weaving in & out of the sidewalk patios which hang over the space allotted with giant overhangs and flower boxes and heaters and all kinds of crap. It’s so annoying. Sidewalks are for pedestrians, not restaurants. (but the city makes money from the patio permits, so I guess it’s a losing battle)

    I love eating on my own back deck or on a nice restaurant patio OFF the street/on a rooftop, and I do enjoy sitting by a large open door/window which is next to the sidewalk patio, but on the actual sidewalk with dogs, buses, cars, and everything else walking by inches from your food? No

    This? Yes.

    This? No.
    http://ec12.cdn.cincopa.com/patio_pod_image_20069417006_o.jpg?o=4&res=66&cdn=ec&p=y&pid=651757&ph3=nt5kslytq1bmni5qwas0xs04oqshhkja!EXP149126400&d=AsDA7AgEfsAAjHJzAEl-5sD

    LFB – hilarious!

    thank you.

  95. Atlanta – Depends on your current counter depth. Our fridge sticks out past the counter and due to the L shaped kitchen we have to have the side-by-side or you can’t open the doors all the way. We were in a pinch when we bought the current one, which I hate. Have refrigerator envy of the freezer on the bottom and side-by-side doors that open to full width refrigerator on top.

    We are starting to look at new washer/dryer. Ours will be 13 years old in December – earlier front loader model. Any recommendations

  96. I absolutely love our french door, bottom freezer model fridge. I won’t go back to side-by-side or top freezer. Only issue is that the 8yo can’t reach the top of the fridge, but that’s not really a problem.

  97. Lauren,

    He admitted that Tolstedt was allowed to retire as a result of the scandal. Why not just fire her? Did he not want want her to talk? Was she was his loyal stodge doing his dirty work?

  98. but on the actual sidewalk with dogs, buses, cars, and everything else walking by inches from your food?

    That’s one of my favorite things in the world. I could sit there for hours watching the world go by. We have a game where we make up background stories of the people who are walking by.

  99. Atlanta – I would say yes to Wolf and hell no to Sub-Z. I have had good luck with KitchenAid built-in fridges.

  100. AtlantaMom – there are likely local or mail order pharmacies you could have do her pills in blister packs. Much easier to manage, month or more at a time. They’re annoying if get have med changes, but anything is an improvement over a bunch of bottles.

  101. I second what Ada said. If the pills don’t change much they do have services that package them so they just need to grab the pack and take the pills. Done.

  102. Austinmom, we replaced our old washer with Samsung top load washer recently. So far it seems great! Very quiet and efficient. And not expensive.

  103. Kate – really on the Subzero?? Interesting. DH is pushing a mix of appliances but I wasn’t sure how that would look.

  104. There was a Subzero fridge at a work retreat center that I used to go frequently to at my old job. It was ALWAYS on the fritz for repair. That’s my only experience with them, but it left a bad taste in my mouth.

  105. Atlanta – we have a thermidor oven and warming drawer. ~15 years old. They’ve worked well; the over keeps a true temperature.

  106. We just ordered the Thermador column fridge and freezer to replace the dying ones (the dying ones are sub-zero).

  107. Thanks L and Fred. DH is leaning towards Thermador but I do love the look of Wolf/Subzero. I think DH says the difference in the packages are $4 or $5k which is not insignificant. Kate I have heard good things about Kitchenaid too so will take a peak.

  108. “really on the Subzero?? ”

    Check Consumer Reports’ reliability info. IIRC, Sub-Zero has a pretty poor reliability record.

  109. Atlanta – unless you are putting 2 appliances right next to each other, I doubt you will notice if they are not the same brand.

  110. Thanks all, am leaning towards the Thermador now.

    Kate – I am guessing the fridge and single oven/microwave will be right next to each other but the designer wants us to pick appliances first so they can design around them.

  111. @ Atlanta – we have ‘mixed’ brands. Jennair range and dishwasher, Samsung counter-depth fridge. It all looks great.

    Advantage of Thermador range is you can also get it counter depth and it looks really great. Fits into cabinets/countertops much nicer than the others. I did not go with it as it does not have a delay start function. Only Wolf and Jenn Air do, and I could not do without that function. Ultimately decided on Jennair because I liked the layout better (6 burners with griddle on right, Wolf’s griddle in the middle). Jennair also about $3k less than Wolf – not enough to force the decision, but a nice savings since it’s the one I ended up wanting.

  112. “With that thin alley, you’d lose a lot of the HVAC savings by having a shared wall.”

    Besides the HVAC savings, I would think there would be maintenance savings as well. I imagine it would be a pain to paint the walls along those alleys, and they would also need to be kept clean to keep unwanted critters from taking up residence.

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