and we know the polypharmacy is a huge deal. so my argument for years has been, maybe it's a good thing that many of these people are non-adherent. they may be saving their own lives. so i really think whatever we do, we've got to be talking about this in a way that makes sense to people. we also don't talk -- i didn't hear anybody talk about health literacy, for example. a few years ago that was really hot. i think we've got to come back to the hot health lit erroeracy issues. a feiser case study, i think, a woman -- chronic kacare conditi, a woman taking care of her child who had an ear infection. kept coming back. the ear infection was getting worse and worse and worse. a liquid antibiotic she was putting in the ear instead of the mouth. she figured, ear infection, put the medication in that. we also know from the work on hot spots, for example, in camden, that there was a gentleman there many of you probably know this particular case. i think it's very telling. a person with diabetes who kept coming back into the er. a certa

over-medication, or what we sometimes call polypharmacy, is one of the biggest health issues for the elderly. it's been estimated now, that about 1/3 of all hospital admissions for the elderly are somehow related to medication problems. that's a horrifying figure, but on the other hand, it means that we should be preventing about 30% of the hospital admissions for the seniors if we get a better understanding of these medication issues. dr. lipson: one may find that using that little bit less potent medication which has less side effects may be much better for a senior than using the big gun which also causes big side effects. problems with declining health, or increasing disability can make it difficult for the elderly to manage on their own. about 1 in 5 elderly people need help from another person in performing daily living activities. assisted living can be something as simple as helping people with their medicines, and providing transportation to their doctor's appointments. it can be more than that. it can be assistance with bathing, assistance with dressing, reminder services a

and we know the polypharmacy is a huge deal. my argument for years is maybe it is a good thing many of these people are not adhering to. maybe they are saving their own lives. whatever we do we need to talk about this in a way that makes sense to people. we also -- i didn't hear anybody talk about health literacy for example. a few years ago that was really hot. we need to come back to the health literacy issue. i remember one of the cases looked at this was a woman -- chronic care condition. a woman who was taking care of her child who had an ear infection and kept coming back and it was getting worse. if there was a liquid antibiotic she was putting in the year instead of the mouth because nobody showed her. she figured the year infection but the medication in that. and the work on hot spots for example in camden. there was a gentleman many of you know this particular case. it is very telling. a person with diabetes who kept coming back into the er. there was a certain pattern. someone said let me see you give your insulin and