Input: How to prevent Peripheral Arterial Disease (P.A.D.) ?

Output: Treatment and prevention for P.A.D. often includes making long-lasting lifestyle changes, such as - quitting smoking  - lowering blood pressure  - lowering high blood cholesterol levels  - lowering high blood glucose levels if you have diabetes  - getting regular physical activity  - following a healthy eating plan that's low in total fat, saturated fat, trans fat, cholesterol, and sodium (salt). quitting smoking lowering blood pressure lowering high blood cholesterol levels lowering high blood glucose levels if you have diabetes getting regular physical activity following a healthy eating plan that's low in total fat, saturated fat, trans fat, cholesterol, and sodium (salt). Two examples of healthy eating plans are Therapeutic Lifestyle Changes (TLC) and  Dietary Approaches to Stop Hypertension (DASH). </s>


Input: What are the treatments for Peripheral Arterial Disease (P.A.D.) ?

Output: Yes. In some people, lifestyle changes are not enough to control P.A.D. Surgery and other procedures may be needed. These may include bypass grafting surgery, angioplasty, a stent, or a procedure called atherectomy (ath-eh-REK-to-mee). - Your doctor may recommend bypass grafting surgery if blood flow in your limb is blocked or nearly blocked. In this type of surgery, a blood vessel from another part of the body or a man-made tube is used to make a graft. This graft bypasses (goes around) the blocked part of the artery, which allows blood to flow around the blockage. This surgery doesn't cure P.A.D., but it may increase blood flow to the affected limb.  Your doctor may recommend bypass grafting surgery if blood flow in your limb is blocked or nearly blocked. In this type of surgery, a blood vessel from another part of the body or a man-made tube is used to make a graft. This graft bypasses (goes around) the blocked part of the artery, which allows blood to flow around the blockage. This surgery doesn't cure P.A.D., but it may increase blood flow to the affected limb. - Angioplasty is used to restore blood flow through a narrowed or blocked artery. During this procedure, a catheter (thin tube) with a balloon or other device on the end is inserted into a blocked artery. The balloon is inflated, which pushes the plaque outward against the wall of the artery. This widens the artery and restores blood flow.  Angioplasty is used to restore blood flow through a narrowed or blocked artery. During this procedure, a catheter (thin tube) with a balloon or other device on the end is inserted into a blocked artery. The balloon is inflated, which pushes the plaque outward against the wall of the artery. This widens the artery and restores blood flow. - A stent (a small mesh tube) may be placed in the artery during angioplasty. A stent helps keep the artery open after the procedure is done. Some stents are coated with medicine to help prevent blockages in the artery. A stent (a small mesh tube) may be placed in the artery during angioplasty. A stent helps keep the artery open after the procedure is done. Some stents are coated with medicine to help prevent blockages in the artery. - A procedure called atherectomy (ath-eh-REK-to-mee) may be used to remove plaque buildup from an artery. During the procedure, a catheter (thin tube) is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off the plaque. The bits of plaque are removed from the body through the catheter or washed away in the bloodstream (if theyre small enough). Doctors also can do atherectomy using a special laser that dissolves the blockage. A procedure called atherectomy (ath-eh-REK-to-mee) may be used to remove plaque buildup from an artery. During the procedure, a catheter (thin tube) is used to insert a small cutting device into the blocked artery. The device is used to shave or cut off the plaque. The bits of plaque are removed from the body through the catheter or washed away in the bloodstream (if theyre small enough). Doctors also can do atherectomy using a special laser that dissolves the blockage. </s>


Input: what research (or clinical trials) is being done for Peripheral Arterial Disease (P.A.D.) ?

Output: The National Heart, Lung, and Blood Institute (NHLBI) supports research aimed at learning more about peripheral arterial disease (P.A.D.). For example, NHLBI-supported research on P.A.D. includes studies that - explore whether group walking sessions increase physical activity in people who have P.A.D.  - compare how effective certain exercise programs are at reducing leg pain in people who have P.A.D.  - examine how inflammation and insulin resistance affect people who have P.A.D.  explore whether group walking sessions increase physical activity in people who have P.A.D. compare how effective certain exercise programs are at reducing leg pain in people who have P.A.D. examine how inflammation and insulin resistance affect people who have P.A.D. Much of this research depends on the willingness of volunteers to take part in clinical trials. Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions. Carefully conducted clinical trials are the fastest and safest way to find treatments that work in people and ways to improve health. For more information about clinical trials related to P.A.D., talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials. - http://www.nih.gov/health/clinicaltrials/  - http://www.clinicaltrials.gov/  - http://www.nhlbi.nih.gov/studies/index.htm  - https://www.researchmatch.org/  - http://www.cleverstudy.org/ http://www.nih.gov/health/clinicaltrials/ http://www.clinicaltrials.gov/ http://www.nhlbi.nih.gov/studies/index.htm https://www.researchmatch.org/ http://www.cleverstudy.org/ </s>


Input: What is (are) Peripheral Arterial Disease (P.A.D.) ?

Output: Here are links to more information about P.A.D. from the National Heart, Lung, and Blood Institute. -  What Is Peripheral Arterial Disease?  -  Atherosclerosis  -  The DASH Eating Plan  - Facts about P.A.D.   - Facts about P.A.D. (Spanish)  - Facts About P.A.D. for African Americans  -  Keep the Beat: Heart Healthy Recipes  - Smoking and Your Heart  -   Your Guide to Physical Activity and Your Heart  -  Stay in Circulation: Take Steps to Learn about P.A.D. - Stay in Circulation: Take Steps to Learn about P.A.D. Wallet Card  - Your Guide to Lowering Your Blood Pressure with DASH  -  Your Guide to Lowering Your Cholesterol with TLC What Is Peripheral Arterial Disease? Atherosclerosis The DASH Eating Plan Facts about P.A.D.  Facts about P.A.D. (Spanish) Facts About P.A.D. for African Americans  Keep the Beat: Heart Healthy Recipes Smoking and Your Heart  Your Guide to Physical Activity and Your Heart Stay in Circulation: Take Steps to Learn about P.A.D. Stay in Circulation: Take Steps to Learn about P.A.D. Wallet Card Your Guide to Lowering Your Blood Pressure with DASH Your Guide to Lowering Your Cholesterol with TLC For print resources and materials on P.A.D. visit http://www.nhlbi.nih.gov/health/public/heart/pad/index.html </s>


Input: What is (are) Rheumatoid Arthritis ?

Output: An Inflammatory, Autoimmune Disease Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It can cause mild to severe symptoms. Rheumatoid arthritis not only affects the joints, but may also attack tissue in the skin, lungs, eyes, and blood vessels. People with rheumatoid arthritis may feel sick, tired, and sometimes feverish. Rheumatoid arthritis is classified as an autoimmune disease. An autoimmune disease occurs when the immune system turns against parts of the body it is designed to protect. Rheumatoid arthritis generally occurs in a symmetrical pattern. This means that if one knee or hand is involved, the other one is, too. It can occur at any age, but usually begins during a person's most productive years. Affects More Women Than Men Rheumatoid arthritis occurs much more frequently in women than in men. About two to three times as many women as men have the disease. Learn more about how rheumatoid arthritis occurs.  Effects Vary Rheumatoid arthritis affects people differently. Some people have mild or moderate forms of the disease, with periods of worsening symptoms, called flares, and periods in which they feel better, called remissions. Others have a severe form of the disease that is active most of the time, lasts for many years or a lifetime, and leads to serious joint damage and disability. Although rheumatoid arthritis is primarily a disease of the joints, its effects are not just physical. Many people with rheumatoid arthritis also experience issues related to - depression, anxiety  - feelings of helplessness  - low self-esteem. depression, anxiety feelings of helplessness low self-esteem. Rheumatoid arthritis can affect virtually every area of a persons life from work life to family life. It can also interfere with the joys and responsibilities of family life and may affect the decision to have children. Treatment Can Help Fortunately, current treatment strategies allow most people with the disease to lead active and productive lives. These strategies include pain-relieving drugs and medications that slow joint damage, a balance between rest and exercise, and patient education and support programs. In recent years, research has led to a new understanding of rheumatoid arthritis and has increased the likelihood that, in time, researchers will find even better ways to treat the disease. </s>


Input: What causes Rheumatoid Arthritis ?

Output: Actual Cause Is Unknown Scientists believe that rheumatoid arthritis may result from the interaction of many factors such as genetics, hormones, and the environment. Although rheumatoid arthritis sometimes runs in families, the actual cause of rheumatoid arthritis is still unknown. Research suggests that a person's genetic makeup is an important part of the picture, but not the whole story. Some evidence shows that infectious agents, such as viruses and bacteria, may trigger rheumatoid arthritis in people with an inherited tendency to develop the disease. However, a specific agent or agents are not yet known. Not Contagious It is important to note that rheumatoid arthritis is not contagious. A person cannot catch it from someone else.  Learn more about the causes of rheumatoid arthritis. </s>


Input: What are the symptoms of Rheumatoid Arthritis ?

Output: Swelling and Pain in the Joints Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints. Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. A person also feels sick, tired, and sometimes feverish. Rheumatoid arthritis generally occurs in a symmetrical pattern. If one knee or hand is affected, the other one is also likely to be affected. Diagnostic Tests Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Common tests for rheumatoid arthritis include - The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. -  The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis.  The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. Other common tests for rheumatoid arthritis include - the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body  - a test for white blood cell count and  - a blood test for anemia.  the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body a test for white blood cell count and a blood test for anemia. Diagnosis Can Take Time Symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. The full range of symptoms develops over time, and only a few symptoms may be present in the early stages. Learn more about how rheumatoid arthritis is diagnosed. </s>


Input: What are the treatments for Rheumatoid Arthritis ?

Output: Most Symptoms Are Treatable Doctors use a variety of approaches to treat rheumatoid arthritis. The goals of treatment are to help relieve pain, reduce swelling, slow down or help prevent joint damage, increase the ability to function, and improve the sense of well-being. Current treatment approaches include - lifestyle modification  - medications  - surgery  - routine monitoring and ongoing care.  lifestyle modification medications surgery routine monitoring and ongoing care. Balance Rest and Exercise People with rheumatoid arthritis need a good balance between rest and exercise; they should rest more when the disease is active and exercise more when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed. Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and manage weight. Exercise programs should take into account the persons physical abilities, limitations, and changing needs. Learn more about the health benefits of exercise for older adults.  More information about exercise and physical activity for older adults can be found at  Go4Life, the exercise and physical activity campaign from the National Institute on Aging. Reduce Stress People with rheumatoid arthritis face emotional challenges as well as physical ones. The emotions they feel because of the diseasefear, anger, and frustrationcombined with any pain and physical limitations can increase their stress level. Finding ways to reduce stress is important. Regular rest periods can help and so can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress. For more information on exercise classes, you may want to contact the Arthritis Foundation at 1-800-283-7800. Learn about relaxation techniques that may relieve tension. Eat a Healthful Diet Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. See  Eating Well as You Get Older  for more about healthy eating. Reduce Stress on Joints Some people find using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but also on ankles and feet. A doctor or a physical or occupational therapist can help a person choose a splint and make sure it fits properly. Other ways to reduce stress on joints include - self-help devices (for example, zipper pullers, long-handled shoe horns)  -  devices to help with getting on and off chairs, toilet seats, and beds  -  changes in the ways that a person carries out daily activities.  self-help devices (for example, zipper pullers, long-handled shoe horns) devices to help with getting on and off chairs, toilet seats, and beds changes in the ways that a person carries out daily activities. Medications Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs  include methotrexate, leflunomide, sulfasalazine, and cyclosporine. DMARDs  include methotrexate, leflunomide, sulfasalazine, and cyclosporine. -  Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids.  Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. - DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. -   Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available.  Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biologic response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage. Surgery In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Surgery may also improve a person's ability to perform daily activities. Joint replacement and tendon reconstruction are two types of surgery available to patients with severe joint damage. Routine Monitoring and Ongoing Care Regular medical care is important to monitor the course of the disease, determine the effectiveness and any negative effects of medications, and change therapies as needed. Monitoring typically includes regular visits to the doctor. It also may include blood, urine, and other laboratory tests and x rays. Monitor Osteoporosis Risk People with rheumatoid arthritis may want to discuss preventing osteoporosis with their doctors as part of their long-term, ongoing care. Osteoporosis is a condition in which bones become weakened and fragile. Having rheumatoid arthritis increases the risk of developing osteoporosis for both men and women, particularly if a person takes corticosteroids. Such patients may want to discuss with their doctors the potential benefits of calcium and vitamin D supplements or other treatments for osteoporosis. See What is Osteoporosis? to learn more about this disease. </s>


Input: what research (or clinical trials) is being done for Rheumatoid Arthritis ?

Output: Scientists are making rapid progress in understanding the complexities of rheumatoid arthritis. They are learning more about how and why it develops and why some people have more severe symptoms than others. Research efforts are focused on developing drugs that can reduce inflammation and slow or stop the disease with few side effects. Identifying Possible Triggers Some evidence shows that infectious agents, such as viruses and bacteria, may contribute to triggering rheumatoid arthritis in people with an inherited tendency to develop the disease. Investigators are trying to identify the infectious agents and understand how they work. This knowledge could lead to new therapies. Why More Women Than Men? Researchers are also exploring why so many more women than men develop rheumatoid arthritis. In the hope of finding clues, they are studying complex relationships between the hormonal, nervous, and immune systems in rheumatoid arthritis. For example, they are exploring whether and how the normal changes in the levels of steroid hormones such as estrogen and testosterone during a person's lifetime may be related to the development, improvement, or flares of the disease. Scientists are also examining why rheumatoid arthritis often improves during pregnancy. Learn more about current research on rheumatoid arthritis. Interested in Clinical Trials? The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at Clinical Trials.gov.  To see a list of current clinical trials on rheumatoid arthritis, type "rheumatoid arthritis" into the search box. </s>


Input: What is (are) Rheumatoid Arthritis ?

Output: Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It can cause mild to severe symptoms. People with rheumatoid arthritis may feel sick, tired, and sometimes feverish. Sometimes rheumatoid arthritis attacks tissue in the skin, lungs, eyes, and blood vessels. The disease generally occurs in a symmetrical pattern. If one knee or hand is involved, usually the other one is, too. It can occur at any age, but often begins between ages 40 and 60. About two to three times as many women as men have rheumatoid arthritis. Learn more about how rheumatoid arthritis occurs. </s>


Input: What causes Rheumatoid Arthritis ?

Output: Scientists believe that rheumatoid arthritis may result from the interaction of many factors such as genetics, hormones, and the environment. Although rheumatoid arthritis sometimes runs in families, the actual cause of rheumatoid arthritis is still unknown. Research suggests that a person's genetic makeup is an important part of the picture, but not the whole story. Some evidence shows that infectious agents, such as viruses and bacteria, may trigger rheumatoid arthritis in people with an inherited tendency to develop the disease. The exact agent or agents, however, are not yet known. It is important to note that rheumatoid arthritis is not contagious. A person cannot catch it from someone else. Learn more about the causes of rheumatoid arthritis. </s>


Input: What are the symptoms of Rheumatoid Arthritis ?

Output: Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. The pain of rheumatoid arthritis varies greatly from person to person, for reasons that doctors do not yet understand completely. Factors that contribute to the pain include swelling within the joint, the amount of heat or redness present, or damage that has occurred within the joint. </s>


Input: How to diagnose Rheumatoid Arthritis ?

Output: Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As part of the diagnosis, your doctor will look for symptoms such as swelling, warmth, pain, and limitations in joint motion throughout your body. Your doctor may ask you questions about the intensity of your pain symptoms, how often they occur, and what makes the pain better or worse. </s>


Input: How to diagnose Rheumatoid Arthritis ?

Output: There is no single, definitive test for rheumatoid arthritis. Common tests for rheumatoid arthritis include - The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis. However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease.  The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis. However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. - The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis.  The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. Other common tests for rheumatoid arthritis include - the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body   - a test for white blood cell count   - a blood test for anemia.  the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body a test for white blood cell count a blood test for anemia. X-rays are often used to determine the degree of joint destruction. They are not useful in the early stages of rheumatoid arthritis before bone damage is evident, but they can be used later to monitor the progression of the disease. Learn more about how rheumatoid arthritis is diagnosed. </s>


Input: What are the treatments for Rheumatoid Arthritis ?

Output: Medication, exercise, and, in some cases, surgery are common treatments for this disease. Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. People with rheumatoid arthritis can also benefit from exercise, but they need to maintain a good balance between rest and exercise. They should get rest when the disease is active and get more exercise when it is not. In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Several types of surgery are available to patients with severe joint damage. Joint replacement and tendon reconstruction are examples. </s>


Input: What are the treatments for Rheumatoid Arthritis ?

Output: Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine.   - Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids.   - DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra.   - Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available.  DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra. Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biological response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage. </s>


Input: What is (are) Rheumatoid Arthritis ?

Output: Rest. People with rheumatoid arthritis need a good balance between rest and exercise; they should rest more when the disease is active and exercise more when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed. Exercise. Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can help people sleep well, reduce pain, maintain a positive attitude, and manage weight. Exercise programs should take into account the persons physical abilities, limitations, and changing needs. For more information on exercise classes, you may want to contact the Arthritis Foundation at 1-800-283-7800. Learn more about the health benefits of exercise for older adults.  More information about exercise and physical activity for older adults can be found at Go4Life, the exercise and and physical activity campaign from the National Institute on Aging. Diet. Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. An overall nutritious diet with the right amount of calories, protein, and calcium is important. Some people need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis. See Eating Well as You Get Older  to learn more about healthy eating.  Joint Care. Some people find that using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Assistive devices may help reduce stress and lessen pain in the joints. Examples include zipper pullers and aids to help with moving in and out of chairs and beds.  Stress Reduction. Finding ways to reduce stress is important. Regular rest periods can help and so can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress.  Learn about relaxation techniques that may relieve tension. </s>


Input: What is (are) Diabetic Retinopathy ?

Output: Can Cause Vision Loss, Blindness Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina in the back of the eye. A healthy retina is necessary for good vision. If you have diabetic retinopathy, at first you may notice no changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes. Four Stages The four stages of diabetic retinopathy are - mild nonproliferative retinopathy  - moderate nonproliferative retinopathy  - severe nonproliferative retinopathy  - proliferative retinopathy. mild nonproliferative retinopathy moderate nonproliferative retinopathy severe nonproliferative retinopathy proliferative retinopathy. The first stage is mild nonproliferative retinopathy. At this earliest stage, there are small areas of balloon-like swelling in the retina's tiny blood vessels. The second stage is moderate nonproliferative retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked. The third stage is severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas send signals to the body to grow new blood vessels for nourishment. The fourth stage is proliferative retinopathy. At this advanced stage, the signals sent by the retina for nourishment cause the growth of new blood vessels. These new blood vessels are abnormal and fragile. The new blood vessels grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result. Other Diabetic Eye Diseases In addition to diabetic retinopathy, other diabetic eye diseases that people with diabetes may face are cataract and glaucoma. See this graphic for a quick overview of diabetic eye disease, including how many people it affects, whos at risk, what to do if you have it, and how to learn more. </s>


Input: What causes Diabetic Retinopathy ?

Output: Who Is at Risk? All people with diabetes -- both type 1 and type 2 -- are at risk for diabetic retinopathy. People with diabetes are also at increased risk for cataract and glaucoma. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression. How Vision Loss Occurs Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. Macular edema can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema. Macular edema can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema. Have Dilated Eye Exams The National Eye Institute (NEI) urges everyone with diabetes to have a comprehensive dilated eye exam at least once a year. If you have diabetic retinopathy, you may need an eye exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care.  Watch an animation to see what a comprehensive dilated eye exam includes. </s>


Input: What are the symptoms of Diabetic Retinopathy ?

Output: Diabetic retinopathy often has no early warning signs. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year to detect the disease before it causes damage to your vision. Vision Changes May Indicate Bleeding In the early stages of diabetic retinopathy, you may not notice any changes in your vision. But if diabetic retinopathy reaches its final stage, proliferative retinopathy, bleeding can occur. If this happens, at first, you will see a few specks of blood, or spots, floating in your vision. If spots occur, see your eye care professional as soon as possible. Early Treatment is Important You may need treatment before more serious bleeding or hemorrhages occur causing vision loss or possibly blindness. Hemorrhages tend to happen more than once, often during sleep. See how to find an eye care professional.  Here is a list of questions to ask your eye care professional. Sometimes the spots clear without treatment, and you will see better. However, bleeding can reoccur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs. If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely treatment will be successful. Detection Diabetic retinopathy and macular edema are detected during a comprehensive eye exam that includes a visual acuity test, dilated eye exam, and tonometry. A visual acuity test is an eye chart test that measures how well you see at various distances. During the dilated eye exam, your eye care professional checks your retina for early signs of the disease, including - leaking blood vessels  - retinal swelling such as macular edema  - pale, fatty deposits on the retina -- signs of leaking blood vessels  - damaged nerve tissue leaking blood vessels retinal swelling such as macular edema pale, fatty deposits on the retina -- signs of leaking blood vessels damaged nerve tissue Watch an animation showing what a comprehensive dilated eye exam involves. With tonometry, an instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test. If your eye care professional believes you need treatment for macular edema, he or she may suggest a fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment. </s>


Input: What are the treatments for Diabetic Retinopathy ?

Output: Preventing Disease Progression During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. Treatment for Macular Edema Research found that that prompt treatment of macular edema with anti-VEGF drugs, with or without laser treatment, resulted in better vision than laser treatment alone or steroid injections. When injected into the eye, these drugs reduce fluid leakage and interfere with the growth of new blood vessels in the retina. In some cases, focal laser treatment is used along with the eye injections. Your doctor places up to several hundred small laser burns in the areas of the retina around the macula that are leaking. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed. Treatment for Diabetic Retinopathy Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision. Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding.  Learn more about laser treatment.  Vitrectomy If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye. Scatter laser treatment and vitrectomy are effective in treating proliferative retinopathy and in reducing vision loss. Once you have proliferative retinopathy, you always will be at risk for new bleeding. You may need treatment more than once to protect your sight.  Learn more about a vitrectomy.  Have Dilated Eye Exams The National Eye Institute (NEI) urges everyone with diabetes to have a comprehensive dilated eye exam at least once a year. If you have diabetic retinopathy, you may need an exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care.  Watch an animation to see what a comprehensive dilated eye exam includes.  Research The National Eye Institute, or NEI, is conducting and supporting research that seeks better ways to detect, treat, and prevent vision loss in people with diabetes. This research is conducted through studies in the laboratory and with patients. For example, researchers are studying drugs for the treatment of proliferative retinopathy that may reduce the need for laser surgery. A major study has shown that better control of blood sugar levels slows the onset and progression of retinopathy. The people with diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve disease. Better control also reduces the need for sight-saving laser surgery. </s>


Input: What is (are) Diabetic Retinopathy ?

Output: Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision. If you have diabetic retinopathy, at first you may notice no changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes. See this graphic for a quick overview of diabetic eye disease, including how many people it affects, whos at risk, what to do if you have it, and how to learn more. </s>


Input: What is (are) Diabetic Retinopathy ?

Output: The four stages of diabetic retinopathy are - mild nonproliferative retinopathy  - moderate nonproliferative retinopathy  - severe nonproliferative retinopathy  - proliferative retinopathy mild nonproliferative retinopathy moderate nonproliferative retinopathy severe nonproliferative retinopathy proliferative retinopathy Nonproliferative retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels. Moderate nonproliferative retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked. Severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment. Proliferative retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. </s>


Input: Who is at risk for Diabetic Retinopathy? ?

Output: All people with diabetes -- both type 1 and type 2 -- are at risk for diabetic retinopathy. People with diabetes are also at increased risk for cataract and glaucoma. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression. See how to find an eye care professional. </s>


Input: What causes Diabetic Retinopathy ?

Output: Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema. </s>


Input: What are the symptoms of Diabetic Retinopathy ?

Output: Diabetic retinopathy often has no early warning signs. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year.  Learn more about a comprehensive dilated eye exam. </s>


Input: What are the symptoms of Diabetic Retinopathy ?

Output: At first, you will see a few specks of blood, or spots, "floating" in your vision. If spots occur, see your eye care professional as soon as possible. You may need treatment before more serious bleeding or hemorrhaging occurs. Hemorrhages tend to happen more than once, often during sleep. Sometimes, the spots clear without treatment, and you will see better. However, bleeding can reoccur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs. If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely treatment will be effective. </s>


Input: What is (are) Diabetic Retinopathy ?

Output: In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment. </s>


Input: What are the treatments for Diabetic Retinopathy ?

Output: Research found that that prompt treatment of macular edema with anti-VEGF drugs, with or without laser treatment, resulted in better vision than laser treatment alone or steroid injections. When injected into the eye, these drugs reduce fluid leakage and interfere with the growth of new blood vessels in the retina. In some cases, focal laser treatment is used along with the eye injections. Your doctor places up to several hundred small laser burns in the areas of the retina around the macula that are leaking. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed. </s>


Input: What are the treatments for Diabetic Retinopathy ?

Output: During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision. If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye. </s>


Input: What are the treatments for Diabetic Retinopathy ?

Output: Both focal and scatter laser treatment are performed in your doctor's office or eye clinic. Before the surgery, your doctor will dilate your pupil and apply drops to numb the eye. The area behind your eye also may be numbed to prevent discomfort. The lights in the office will be dim. As you sit facing the laser machine, your doctor will hold a special lens to your eye. During the procedure, you may see flashes of light. These flashes eventually may create a stinging sensation that can be uncomfortable. You will need someone to drive you home after surgery. Because your pupil will remain dilated for a few hours, you should bring a pair of sunglasses. For the rest of the day, your vision will probably be a little blurry. If your eye hurts, your doctor can suggest treatment. </s>


Input: What is (are) Diabetic Retinopathy ?

Output: If you have a lot of blood in the center of the eye, or vitreous gel, you may need a vitrectomy to restore your sight. If you need vitrectomies in both eyes, they are usually done several weeks apart. A vitrectomy is performed under either local or general anesthesia. Your doctor makes a tiny incision in your eye. Next, a small instrument is used to remove the vitreous gel that is clouded with blood. The vitreous gel is replaced with a salt solution. Because the vitreous gel is mostly water, you will notice no change between the salt solution and the original vitreous gel. </s>


Input: What are the treatments for Diabetic Retinopathy ?

Output: Yes. Both treatments are very effective in reducing vision loss. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care. Although both treatments have high success rates, they do not cure diabetic retinopathy. Once you have proliferative retinopathy, you always will be at risk for new bleeding. You may need treatment more than once to protect your sight. </s>


Input: what research (or clinical trials) is being done for Diabetic Retinopathy ?

Output: The National Eye Institute, or NEI, is conducting and supporting research that seeks better ways to detect, treat, and prevent vision loss in people with diabetes. This research is conducted through studies in the laboratory and with patients. For example, researchers are studying drugs for the treatment of proliferative retinopathy that may reduce the need for laser surgery. </s>


Input: What to do for Diabetic Retinopathy ?

Output: If you have diabetes, get a comprehensive dilated eye exam at least once a year. Proliferative retinopathy can develop without symptoms. If it gets to this advanced stage, you are at high risk for vision loss or even blindness. Macular edema can develop without symptoms at any of the four stages of diabetic retinopathy. You can develop both proliferative retinopathy and macular edema and still see fine. However, you are at high risk for vision loss. Your eye care professional can tell if you have macular edema or any stage of diabetic retinopathy. Whether or not you have symptoms, early detection and timely treatment can prevent vision loss.  See this glossary for basic terms about diabetic retinopathy. </s>


Input: What is (are) Diabetic Retinopathy ?

Output: National Eye Institute  National Institutes of Health  2020 Vision Place  Bethesda, MD 20892-3655  301-496-5248  E-mail: 2020@nei.nih.gov  www.nei.nih.gov  Find eye health organizations that address diabetic eye disease. </s>


Input: How to prevent Prescription and Illicit Drug Abuse ?

Output: Many Reasons for Abuse Drug abuse, whether prescription or illicit drugs, can have serious consequences, particularly for older adults. That is why prevention is key. However, there are many different reasons why people abuse drugs and become addicted to them. These reasons need to be taken into account when considering how to best prevent drug abuse. Family members, friends, pharmacists, and health care providers can all be involved in preventing drug abuse among older adults. Preventing Medication Abuse There are steps that you as a patient can take to prevent abuse of prescription medications and its consequences. - When visiting the doctor or pharmacist, bring along all prescription and over-the-counter medicines that you take -- or a list of the medicines and their dosages (how much you take and how often). Your doctor can make sure your medicines are right for you and make changes if necessary.  -  Always follow medication directions carefully.   - Only use the medication for its prescribed purpose.  - Do not crush or break pills.   - If you are not sure how to take a medicine correctly, ask your doctor or pharmacist. He or she can tell you how to take a medication properly and about side effects to watch out for and interactions with other medications.  - Ask how the medication will affect driving and other daily activities.   - Do not use other people's prescription medications, and do not share yours.  - Talk with your doctor before increasing or decreasing the medication dosage. When visiting the doctor or pharmacist, bring along all prescription and over-the-counter medicines that you take -- or a list of the medicines and their dosages (how much you take and how often). Your doctor can make sure your medicines are right for you and make changes if necessary. Always follow medication directions carefully. Only use the medication for its prescribed purpose. Do not crush or break pills. If you are not sure how to take a medicine correctly, ask your doctor or pharmacist. He or she can tell you how to take a medication properly and about side effects to watch out for and interactions with other medications. Ask how the medication will affect driving and other daily activities. Do not use other people's prescription medications, and do not share yours. Talk with your doctor before increasing or decreasing the medication dosage. - Do not stop taking a medicine on your own. Talk to your doctor if you are having side effects or other problems.  - Learn about the medicines possible interactions with alcohol and other prescription and over-the-counter medicines, and follow your doctors instructions to avoid these interactions.   - Answer honestly if a doctor or other health care professional asks you about other drug or alcohol use. Without that information, your doctor may not be able to provide you with the best care. Also, if you have a substance problem, he or she can help you find the right treatment to prevent more serious problems from developing, including addiction. Do not stop taking a medicine on your own. Talk to your doctor if you are having side effects or other problems. Learn about the medicines possible interactions with alcohol and other prescription and over-the-counter medicines, and follow your doctors instructions to avoid these interactions. Answer honestly if a doctor or other health care professional asks you about other drug or alcohol use. Without that information, your doctor may not be able to provide you with the best care. Also, if you have a substance problem, he or she can help you find the right treatment to prevent more serious problems from developing, including addiction. For tips on safe use of medicines for older adults, see  Taking Medicines Safely."  Preventing Illicit Drug Use Preventing illicit drug use in older adults requires first knowing what contributes to it. For people of all ages, an individuals biology (including their genetics) and the environment, as well as how the two act together, determine a persons vulnerability to drug abuse and addiction -- or can protect against it. For example, being exposed to drugs of abuse in youth, living in a community where drug use is prevalent, having untreated mental disorders, such as depression, or dealing with difficult transition periods such as retirement or loss of a spouse can all make an older adult more vulnerable to drug abuse. Prevention Requires Various Approaches Prevention efforts must focus on gaining a better understanding of the factors that promote illicit drug use in older adults. Prevention also includes finding ways to stop drug use before it worsens and leads to health problems, including addiction. Family members can play an important role by being aware of an older relatives well-being and possible drug abuse, and stepping in to help at an early stage, if necessary. Doctors should ask their older patients about potential drug abuse and make referrals as needed. </s>


Input: What is (are) Prescription and Illicit Drug Abuse ?

Output: Addiction is a chronic disease in which a person craves, seeks, and continues to abuse a legal (medication, alcohol, tobacco) or an illicit (illegal) drug, despite harmful consequences. People who are addicted continue to abuse the substance even though it can harm their physical or mental health, lead to accidents, or put others in danger. For more on drugs and the brain, see  Drugs, Brains and Behavior: The Science of Addiction. </s>


Input: What is (are) Prescription and Illicit Drug Abuse ?

Output: Physical dependence is a normal process that can happen to anyone taking a medication for a long time. It means that the body (including the brain) is adapting to the presence of the drug, and the person may require a higher dosage or a different medication to get relief; this condition is known as tolerance. They may also suffer from withdrawal or feel sick when they stop taking the medication abruptly. However, the symptoms of withdrawal can usually be prevented or managed by a physician, which is why it is so important to talk to a doctor before stopping a medication. Someone who is addicted to a drug may also be physically dependent on it, but rather than benefitting from the drugs effects, an addicted person will continue to get worse with continued or increasing drug abuse. An addicted person compulsively seeks and abuses drugs, despite their negative consequences. </s>


Input: What are the symptoms of Prescription and Illicit Drug Abuse ?

Output: A persons behavior, especially changes in behavior, can signal a possible substance abuse problem. For example, you may notice that an older adult seems worried about whether a medicine is really working, or complains that a doctor refuses to write a prescription. He or she may have new problems doing everyday tasks or withdraw from family, friends, and normal activities. Other possible warning signs include - rapid increases in the amount of medication needed  - frequent requests for refills of certain medicines  - a person not seeming like themselves (showing a general lack of interest or being overly energetic)  - "doctor shopping" -- moving from provider to provider in an effort to get several prescriptions for the same medication  - use of more than one pharmacy  - false or forged prescriptions. rapid increases in the amount of medication needed frequent requests for refills of certain medicines a person not seeming like themselves (showing a general lack of interest or being overly energetic) "doctor shopping" -- moving from provider to provider in an effort to get several prescriptions for the same medication use of more than one pharmacy false or forged prescriptions. </s>


Input: What is (are) Prescription and Illicit Drug Abuse ?

Output: The prescription medications most commonly abused by people of any age are opioids (painkillers), depressants, and stimulants. Doctors prescribe opioids to relieve pain and, sometimes, to treat severe coughs and diarrhea. Common opioid prescription medications include the following: - morphine (MS Contin, Kadian, Avinza), which is used before and after surgical procedures to treat severe pain  - codeine (Tylenol with Codeine, Robitussin AC), which is prescribed for mild pain  - hydrocodone (Vicodin, Lortab, Zydone), which is prescribed to relieve moderate to severe pain  - oxycodone (OxyContin, Percodan, Percocet, Tylox, Roxicet), which is used to relieve moderate to severe pain   - fentanyl (Duragesic), which is a strong pain medication typically delivered through a pain patch and prescribed for severe ongoing pain  morphine (MS Contin, Kadian, Avinza), which is used before and after surgical procedures to treat severe pain codeine (Tylenol with Codeine, Robitussin AC), which is prescribed for mild pain hydrocodone (Vicodin, Lortab, Zydone), which is prescribed to relieve moderate to severe pain oxycodone (OxyContin, Percodan, Percocet, Tylox, Roxicet), which is used to relieve moderate to severe pain fentanyl (Duragesic), which is a strong pain medication typically delivered through a pain patch and prescribed for severe ongoing pain For more on opioids, see  What Are the Possible Consequences of Opioid Use and Abuse?" Depressants are used to treat anxiety and sleep disorders. The types of depressants that are most commonly abused are barbiturates (Secobarbital ,Mebaral and Nembutal) and benzodiazepines (Valium, Librium, and Xanax). For more on depressants, see What Are the Possible Consequences of CNS Depressant Use and Abuse?"  Stimulants are used to treat narcolepsy (a sleep disorder), attention deficit hyperactivity disorder (ADHD), and depression that has not responded to other treatments. These medications increase alertness, attention, and energy. Stimulants include methylphenidate (Ritalin and Concerta), and amphetamines (Adderall). For more on stimulants, see  What Are the Possible Consequences of Stimulant Use and Abuse?" </s>


Input: What causes Prescription and Illicit Drug Abuse ?

Output: Medications affect older people differently than younger people because aging changes how the body and brain handle these substances. As we age, our bodies change and cannot break down and get rid of substances as easily as before. This means that even a small amount of a medicine or a drug can have a strong effect. If you take medications the wrong way or abuse illicit drugs, this can have a serious effect on your health and make existing health problems worse. As people age, they may also become more sensitive to alcohols effects. For more information on the dangers of mixing alcohol and medicines, see Alcohol Use and Older Adults." </s>


Input: What is (are) Prescription and Illicit Drug Abuse ?

Output: Marijuana is the most abused illicit drug among people 50 and older. </s>


Input: What are the treatments for Prescription and Illicit Drug Abuse ?

Output: Although under federal law, marijuana is illegal to use under any circumstance, in some states doctors are allowed to prescribe it for medical use. However, solid data on marijuanas health benefits is lacking, and for smoked marijuana many health experts have concerns about the potential negative effects on the lungs and respiratory system. The U.S. Food and Drug Administration has not approved smoked marijuana to treat any disease. They have approved two medications that are chemically similar to marijuana to treat wasting disease (extreme weight loss) in people with AIDS and to treat nausea and vomiting associated with cancer treatment. </s>


Input: What are the symptoms of Prescription and Illicit Drug Abuse ?

Output: Not always. Some warning signs, such as sleep problems, falls, mood swings, anxiety, depression, and memory problems -- can also be signs of other health conditions. As a result, doctors and family members often do not realize that an older person has a drug problem, and people may not get the help they need. </s>


Input: What are the treatments for Prescription and Illicit Drug Abuse ?

Output: Depending on the substance(s) involved, treatment may include medications, behavioral treatments, or a combination. A doctor, substance abuse counselor, or other health professional can determine the right treatment for an individual. Treatment helps people reduce the powerful effects of drugs on the body and brain. In doing so, treatment helps people improve their physical health and everyday functioning and regain control of their lives. Once in treatment, older adults do just as well or better than younger adults. </s>


Input: What are the treatments for Prescription and Illicit Drug Abuse ?

Output: People can receive treatment as outpatients (they live at home and visit the doctor or other provider) or through inpatient services (they live temporarily at a special facility where they get treatment). The support of family and friends is important during the treatment process. </s>


Input: What are the treatments for Prescription and Illicit Drug Abuse ?

Output: The first step in a substance treatment program is often detoxification (detox), the process of allowing the body to get rid of the substance. Detoxification under medical supervision allows the symptoms of withdrawal to be treated, but is not addiction treatment in and of itself. (Withdrawal is the sick, sometimes unbearable feeling that people have when trying to stop or cut down on a substance they have become addicted to or have been taking for a long time.)The type of withdrawal symptoms and how long they last vary with the substance abused. For example, withdrawal from certain stimulants may lead to fatigue, depression, and sleep problems. Unsupervised withdrawal from barbiturates and benzodiazepines can be dangerous. </s>


Input: What are the treatments for Prescription and Illicit Drug Abuse ?

Output: Different types of medications may be useful at different stages of treatment to help a person stop abusing a substance, stay in treatment, focus on learning new behavioral skills, and avoid relapse. Currently, medications are available to treat addiction to opiates, nicotine, and alcohol, but none are yet approved for treating addiction to stimulants, marijuana, or depressants. Medications for substance abuse treatment help the brain adjust to the absence of the abused substance. These medications act slowly to stave off drug cravings and prevent relapse. For example, buprenorphine, marketed as Subutex or Suboxone, is prescribed by approved physicians to treat people who are addicted to opiate drugs, such as painkillers or heroin. Buprenorphine is useful in the short-term detoxification process by helping ease withdrawal symptoms and in the long-term by staving off cravings and helping prevent relapse. For more on treating opioid addiction, seeTreating Addiction to Prescription Opioids." For information on treating addiction to depressants, see  "Treating Addiction to CNS Depressants."  For information on treating addiction to stimulants, see  Treating Addiction to Prescription Stimulants." </s>


Input: What are the treatments for Prescription and Illicit Drug Abuse ?

Output: Behavioral treatment helps people change the way they think about the abused substance and teaches them how to handle or avoid situations that trigger strong drug cravings. Behavioral therapies can make treatment medications more effective, help people stay in treatment longer, and prevent relapse. There are four main types of behavioral treatments. - Cognitive behavioral therapy seeks to help people recognize, avoid, and cope with situations in which they are most likely to abuse substances. Cognitive behavioral therapy seeks to help people recognize, avoid, and cope with situations in which they are most likely to abuse substances. - Motivational incentives offer rewards or privileges for attending counseling sessions, taking treatment medications, and not abusing substances. Motivational incentives offer rewards or privileges for attending counseling sessions, taking treatment medications, and not abusing substances. -  Motivational interviewing is typically conducted by a treatment counselor and occurs when a person first enters a drug treatment program. It aims to get people to recognize the need for treatment and to take an active role in their recovery.  Motivational interviewing is typically conducted by a treatment counselor and occurs when a person first enters a drug treatment program. It aims to get people to recognize the need for treatment and to take an active role in their recovery. - Group therapy, preferably with ones own age group, helps people face their substance abuse and the harm it causes. It teaches skills for dealing with personal problems without abusing medications or drugs. Group therapy, preferably with ones own age group, helps people face their substance abuse and the harm it causes. It teaches skills for dealing with personal problems without abusing medications or drugs. </s>


Input: What are the treatments for Prescription and Illicit Drug Abuse ?

Output: Recovering from addiction is hard. Even with treatment, many people return to substance abuse, sometimes months or years after having stopped drug use. This is commonly referred to as relapse. As with most chronic diseases, relapse in addiction is not unusual, and signals a need to restart, adjust, or modify the treatment. </s>


Input: What is (are) COPD ?

Output: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The "airways" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upside-down tree. At the end of each branch are many small, balloon-like air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because - The airways and air sacs lose their elasticity like an old rubber band.  - The walls between many of the air sacs are destroyed.  - The walls of the airways become thick and inflamed or swollen.  - Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else. </s>


Input: What causes COPD ?

Output: Smoking Most cases of COPD develop over time, from breathing in fumes and other things that irritate the lungs. Some of the things that put you at risk for COPD include smoking, environmental exposure, and genetic factors. Cigarette smoking is the most common cause of COPD in the United States (either current or former smokers). Pipe, cigar, and other types of tobacco smoking can also cause COPD, especially if the smoke is inhaled. Environmental Exposure COPD can also occur in people who have had long-term exposure to things that can irritate your lungs, like chemical fumes, or dust from the environment or workplace. Heavy or long-term exposure to secondhand smoke or other air pollutants may also contribute to COPD even if you have never smoked or had long-term exposure to harmful pollutants. Secondhand smoke is smoke in the air from other people smoking. Genetic Factors In a small number of people, COPD is caused by a genetic condition known as alpha-1 antitrypsin, or AAT, deficiency. People who have this condition have low levels of alpha-1 antitrypsin (AAT)a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you're exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly. While very few people know if they have AAT deficiency, it is estimated that about 1 in every 1,600 people to about 1 in every 5,000 people have it. People with AAT deficiency can get COPD even if they have never smoked or had long-term exposure to harmful pollutants. Asthma Although uncommon, some people who have asthma can develop COPD. Asthma is a chronic (long-term) lung disease that inflames and narrows the airways. Treatment usually can reverse the inflammation and narrowing. However, if not, COPD can develop. </s>


Input: How to prevent COPD ?

Output: If you have COPD, you can take these steps to prevent complications and control the disabling effects of the disease. - Quit smoking.   - Avoid exposure to pollutants and lung irritants.  - Take precautions against the flu.  - Talk to your doctor about the flu and pneumonia vaccines.  - See your doctor on a regular basis.   - Follow your treatments for COPD exactly as your doctor prescribes. Quit smoking. Avoid exposure to pollutants and lung irritants. Take precautions against the flu. Talk to your doctor about the flu and pneumonia vaccines. See your doctor on a regular basis. Follow your treatments for COPD exactly as your doctor prescribes. Quit Smoking If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. Quitting can help prevent complications and slow the progress of the disease. It is also important to stay away from people who smoke and places where you know there will be smokers. To help you quit, there are many online resources and several new aids available from your doctor or health care provider. The National Cancer Institute (NCI) has information on smoking cessation. Visit SmokeFree.gov , or check out NCI's  Clear Horizons,  a quit smoking guide for people 50+. You can also visit The American Lung Association, or call 1-800-QUIT NOW (1-800-784-8669). Avoid Exposure to Pollutants and Lung Irritants Try to stay away from other things that could irritate your lungs, like dust and strong fumes. Stay indoors when the outside air quality is poor. You should also stay away from places where there might be cigarette smoke. Take Precautions Against the Flu The flu (influenza) can cause serious problems for people who have COPD. Do your best to avoid crowds during flu season. In addition to avoiding people with the flu, remembering to wash and sanitize your hands can be one of the best ways to guard against getting sick. Talk to Your Doctor About the Flu (influenza) and Pneumonia Vaccines Talk with your doctor about getting a yearly flu shot and whether and when you should get the pneumonia vaccine. Flu shots can reduce your risk of getting the flu, and the pneumonia vaccine lowers your risk for pneumococcal pneumonia (NU-mo-KOK-al nu-MO-ne-ah) and its complications. Both of these illnesses are major health risks for people who have COPD. See Your Doctor Regularly See your doctor or health care provider regularly even if you are feeling fine. Make a list of your breathing symptoms and think about any activities that you can no longer do because of shortness of breath. Be sure to bring a list of all the medicines you are taking to each office visit. Follow Your Treatments Follow your treatments for COPD exactly as your doctor prescribes. They can help you breathe easier, stay more active, and avoid or manage severe symptoms. </s>


Input: What are the symptoms of COPD ?

Output: Common Symptoms The most common symptoms of COPD are -  a cough that does not go away   - coughing up lots of sputum (mucus).  a cough that does not go away coughing up lots of sputum (mucus). These symptoms often start years before the flow of air in and out of the lungs is reduced. Not everyone who has a cough and sputum goes on to develop COPD. Other common symptoms of COPD include -  shortness of breath while doing activities you used to be able to do  -  wheezing (a whistling sound when you breathe)  - tightness in the chest.  shortness of breath while doing activities you used to be able to do wheezing (a whistling sound when you breathe) tightness in the chest. Getting a Diagnosis Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results. If your doctor thinks you may have COPD, he or she will examine you, listen to your lungs, and ask you questions about your medical history, and what lung irritants you may have been around for long periods of time. The Spirometry Test To confirm a diagnosis of COPD, your doctor will use a breathing test called spirometry. The test is easy and painless and shows how much air you can breathe out and measures how fast you can breathe it out. In a spirometry test, you breathe hard into a large hose connected to a machine called a spirometer. When you breathe out, the spirometer measures how much air your lungs can hold and how fast you can blow air out of your lungs. Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals. The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms. Determining COPD Severity Based on this test, your doctor can determine if you have COPD and how severe it is. There are four levels of severity for COPD: - people at risk for COPD  - people with mild COPD  - people with moderate COPD  - people with severe COPD. people at risk for COPD people with mild COPD people with moderate COPD people with severe COPD. People at risk for developing COPD have a normal breathing test and mild symptoms such as chronic cough and sputum (mucus) production. People with mild COPD have mild breathing limitation. Symptoms may include a chronic cough and sputum (mucus) production. At this stage, you may not be aware that airflow in your lungs is reduced. People with moderate COPD have a breathing test that shows worsening airflow blockages. Symptoms may be worse than with mild COPD and you may experience shortness of breath while working hard, walking fast, or doing brisk activity. At this stage, you would seek medical attention. People with severe COPD have a breathing test that shows severe limitation of the airflow. People with severe COPD will be short of breath after just a little activity. In very severe COPD, complications like respiratory failure or signs of heart failure may develop. At this stage, quality of life is impaired and worsening symptoms may be life-threatening. Other Tests Other tests are used to rule out other causes of the symptoms. - Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. -  A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms.  A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. - An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. </s>


Input: What is (are) COPD ?

Output: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it harder to breathe. With COPD, airways become blocked, making it harder to get air in and out. </s>


Input: What causes COPD ?

Output: COPD is a disease that slowly worsens over time, especially if you continue to smoke. If you have COPD, you are more likely to have lung infections, which can be fatal. If the lungs are severely damaged, the heart may be affected. A person with COPD dies when the lungs and heart are unable to function and get oxygen to the body's organs and tissues, or when a complication, such as a severe infection, occurs. Treatment for COPD may help prevent complications, prolong life, and improve a person's quality of life. </s>


Input: What causes COPD ?

Output: Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or have been smokers in the past. Breathing in other fumes and dusts over long periods of time can also lead to COPD. Pipe, cigar, and other types of tobacco smoking can cause COPD, especially if the smoke is inhaled. Exposure to secondhand smoke can play a role in causing COPD. Most people with COPD are at least 40 years old or around middle age when symptoms start. </s>


Input: What are the symptoms of COPD ?

Output: The most common symptoms of COPD are a cough that does not go away and coughing up a lot of sputum (mucus). These symptoms may occur years before lung damage has reduced the flow of air in and out of the lungs. Other symptoms of COPD include shortness of breath, especially with exercise; wheezing (a whistling sound when you breathe); and tightness in the chest. </s>


Input: How to diagnose COPD ?

Output: To confirm a COPD diagnosis, a doctor will use a breathing test called spirometry. The test is easy and painless. It shows how well the lungs are working. The spirometer measures how much air the lungs can hold and how fast air is blown out of the lungs. Other tests, such as bronchodilator reversibility testing, a chest X-ray, and arterial blood gas test, may be ordered. </s>


Input: What are the treatments for COPD ?

Output: Treatment for COPD can be different for each person and is based on whether symptoms are mild, moderate or severe. Treatments include medication, pulmonary or lung rehabilitation, oxygen treatment, and surgery. There are also treatments to manage complications or a sudden onset of symptoms. </s>


Input: How to diagnose COPD ?

Output: If you have not been exercising regularly, you should get the advice of your doctor before starting. The symptoms of COPD are different for each person. People with mild COPD may not have much difficulty walking or exercising. As the symptoms of COPD get worse over time, a person may have more difficulty with walking and exercising. You should talk to your doctor about exercising and whether you would benefit from a pulmonary or lung rehabilitation program. </s>


Input: How to prevent COPD ?

Output: If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. It is also important to stay away from people who smoke and places where you know there will be smokers. Avoid exposure to pollutants like dust, fumes, and poor air quality, and take precautions to prevent flu and pneumonia. Following your doctor's instructions with medications and rehabilitative treatment can help alleviate COPD symptoms and control the disabling effects of the disease. </s>


Input: What are the treatments for COPD ?

Output: Bronchodilators and inhaled steroids are two medications used to treat COPD. Bronchodilators work by relaxing the muscles around the airways, opening them and making it easier to breathe. People with mild COPD take bronchodilators using an inhaler only when needed. Those with moderate or severe COPD may need more regular treatment. Inhaled steroids also are used for people with moderate or severe COPD in order to reduce swelling in the airways. </s>


Input: What are the symptoms of COPD ?

Output: Call your doctor right away if your symptoms worsen suddenly. People with COPD may have symptoms that suddenly get worse. When this happens, you have a much harder time catching your breath. Symptoms that worsen suddenly can include sudden chest tightness, more coughing, a change in your sputum (mucus), or fever. Your doctor will look at things that may be causing these sudden symptoms. Sometimes the symptoms are caused by a lung infection. </s>


Input: What is (are) COPD ?

Output: More information on COPD is available at:  What is COPD? and at the  Learn More, Breathe Better Campaign  For information on quitting smoking, visit http://www.surgeongeneral.gov/tobacco/ or  Smokefree.gov. For information on the H1N1 flu and COPD, go to  The Centers for Disease Control and Prevention. </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Medicare is a federal health insurance program for people - age 65 and older - under age 65 with certain disabilities who have been receiving Social Security disability benefits for a certain amount of time (24 months in most cases) - of any age who have End-Stage Renal Disease (ESRD), which is permanent kidney failure requiring dialysis or a transplant. age 65 and older under age 65 with certain disabilities who have been receiving Social Security disability benefits for a certain amount of time (24 months in most cases) of any age who have End-Stage Renal Disease (ESRD), which is permanent kidney failure requiring dialysis or a transplant. Medicare helps with the cost of health care, but it does not cover all medical expenses. </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Medicare Part A is hospital insurance that helps cover inpatient care in hospitals. Part A also helps cover skilled nursing facility care for a limited period of time, hospice care, and home health care, if you meet certain conditions. Most people don't have to pay a monthly premium for Medicare Part A when they turn age 65 because they or a spouse paid Medicare taxes while they were working. If a person is hospitalized, Medicare helps pay for the following services. - Care - general nursing - Room - semiprivate room  - Hospital services - meals, most services and supplies Care - general nursing Room - semiprivate room Hospital services - meals, most services and supplies If a person is hospitalized, Medicare does NOT pay for the following services. - Care - private-duty nursing  - Room - private room (unless medically necessary) - Hospital services - television and telephone Care - private-duty nursing Room - private room (unless medically necessary) Hospital services - television and telephone For important information about Medicare Part A, visit http://www.medicare.gov to view or print copies of "Your Medicare Benefits" or "Medicare & You." (Under "Search Tools," select "Find a Medicare Publication.") </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Medicare Part B is medical insurance. It helps cover medical services such as doctor's services, outpatient care and other medical services that Part A doesn't cover. Part B also covers some preventive services, such as flu shots and diabetes screening, to help you maintain your health and to keep certain illnesses from getting worse. Enrollment in Part B is optional, and most people who choose it must pay a monthly fee, or premium. There may be a late enrollment penalty for Part B if the person doesn't join when he or she is first eligible. For important information about Part B, visit http://www.medicare.gov to view or print copies of "Your Medicare Benefits" or "Medicare & You." (Under "Search Tools," select "Find a Medicare Publication.") You can also contact your State Health Insurance Assistance Program (SHIP) which gives free health insurance counseling and guidance to people with Medicare -- or to family and friends who have authorization to help someone with Medicare questions. To get the most up-to-date telephone numbers, call 1-800-Medicare (1-800-633-4227) or visit http://www.medicare.gov. (TTY users should call 1-877-486-2048.) Under "Search Tools," select "Find Helpful Phone Numbers and Websites." To sign up for Medicare Part B, call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. If you are getting benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772. </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Medicare Advantage Plans, sometimes known as Medicare Part C, are plans people can join to get their Medicare benefits. Medicare Advantage Plans are available in many areas of the country, and a person who joins one of these plans will get all Medicare-covered benefits. These plans cover hospital costs (Part A), medical costs (Part B), and sometimes prescription drug costs (Part D). Medicare Advantage Plans may also offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Medicare Advantage Plans are managed by private insurance companies approved by Medicare. To join a Medicare Advantage Plan, a person must have Medicare Part A and Part B and must pay the monthly Medicare Part B premium to Medicare. In addition, it might be necessary to pay a monthly premium to the Medicare Advantage Plan for the extra benefits that they offer. In most of these plans, there are generally extra benefits and lower co-payments than in Original Medicare. (See Question #6 for information about Original Medicare.) However, a person may have to see doctors that belong to the plan or go to certain hospitals to get services. A person can switch plans each year in the fall if desired. To find out what Medicare Advantage Plans are available in your area, visit http://www.medicare.gov and choose the link Compare Health Plans and Medigap Policies in Your Area to use the Medicare Options Compare tool, or call 1-800-MEDICARE (1-800-633-4227). </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Medicare Part D helps pay for medications that a doctor may prescribe. This coverage may help lower prescription drug costs. Medicare drug plans are run by insurance companies and other private companies approved by Medicare. A person who joins Original Medicare and who wants prescription drug coverage will need to choose and sign up for a Medicare Prescription Drug plan (PDP). A person who joins one of the Medicare Advantage Plans will automatically receive prescription drug coverage through that plan if it's offered, usually for an extra cost. For more information about Medicare Part D, visit http://www.medicare.gov to get free copies of "Your Guide to Medicare Prescription Drug Coverage" and "Compare Medicare Prescription Drug Plans." (Under "Search Tools," select "Find a Medicare Publication.") You may also call 1-800-Medicare (1-800-633-4227). TTY users should call 1-877-486-2048. </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Original Medicare is managed by the Federal government and lets people with Medicare go to any doctor, hospital or other health care provider who accepts Medicare. It is a fee-for-service plan, meaning that the person with Medicare usually pays a fee for each service. Medicare pays its share of an approved amount up to certain limits, and the person with Medicare pays the rest. People in Original Medicare must choose and join a Medicare Prescription Drug Plan if they want to get Medicare prescription drug coverage. For more information about Original Medicare, visit http://www.medicare.gov for a free copy of "Your Medicare Benefits." (Under "Search Tools," select "Find a Medicare Publication.") </s>


Input: What is (are) Medicare and Continuing Care ?

Output: People who choose Original Medicare may wish to consider Medigap, a type of Medicare supplement insurance. Medigap policies are sold by private insurance companies to fill gaps in Original Medicare Plan coverage, such as out-of-pocket costs for Medicare co-insurance and deductibles, or for services not covered by Medicare. A Medigap policy only works with Original Medicare. A person who joins a Medicare Advantage Plan generally doesn't need (and can't use) a Medigap policy. For more information about Medigap policies, visit  http://www.medicare.gov to view a copy of "Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare." (Under "Search Tools," select "Find a Medicare Publication.") You can also call 1-800-Medicare (1-800-633-4227). TTY users should call 1-877-486-2048. </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Some people think that Medicare and Medicaid are the same. Actually, they are two different programs. Medicaid is a state-run program that provides hospital and medical coverage for people with low income and little or no resources. Each state has its own rules about who is eligible and what is covered under Medicaid. Some people qualify for both Medicare and Medicaid. If you have questions about Medicaid, you can call your State Medical Assistance (Medicaid) office for more information. Visit  http://www.medicare.gov on the web. (Under "Search Tools," select "Find Helpful Phone Numbers and Websites.") Or, call 1-800-Medicare (1-800-633-4227) to get the telephone number. TTY users should call 1-877-486-2048. </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Home health care is short-term skilled care at home after hospitalization or for the treatment of an illness or injury. Home health agencies provide home care services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, medical social work, and care by home health aides. Home health services may also include durable medical equipment, such as wheelchairs, hospital beds, oxygen, and walkers, and medical supplies for use at home. </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Here are questions to ask when considering a home health agency. - Is the agency Medicare-approved?   - How long has the agency served the community?   - Does this agency provide the services my relative or friend needs?   - How are emergencies handled?   - Is the staff on duty around the clock?   - How much do services and supplies cost?   - Will agency staff be in regular contact with the doctor? Is the agency Medicare-approved? How long has the agency served the community? Does this agency provide the services my relative or friend needs? How are emergencies handled? Is the staff on duty around the clock? How much do services and supplies cost? Will agency staff be in regular contact with the doctor? You can use Medicare's "Home Health Compare" tool to compare home health agencies in your area. Visit http://www.medicare.gov. Under "Search Tools," select "Compare Home Health Agencies in Your Area." </s>


Input: What is (are) Medicare and Continuing Care ?

Output: Here are some questions to ask when considering choosing a nursing home. You may want to make surprise visits at different times of the day to verify conditions. - Is the nursing home Medicare- or Medicaid-certified?  - Does the nursing home have the level of care needed (such as skilled or custodial care) and is a bed available?  - Does the nursing home have special services if needed in a separate unit (such as a ventilator or rehabilitation) and is a bed available?   - Are residents clean, well groomed, and appropriately dressed for the season or time of day?  - Is the nursing home free from strong, unpleasant odors?  - Does the nursing home appear to be clean and well kept?  - Does the nursing home conduct staff background checks?  - Does the nursing home staff interact warmly and respectfully with home residents?  - Does the nursing home meet cultural, religious, and language needs?  - Are the nursing home and the current administrator licensed?  Is the nursing home Medicare- or Medicaid-certified? Does the nursing home have the level of care needed (such as skilled or custodial care) and is a bed available? Does the nursing home have special services if needed in a separate unit (such as a ventilator or rehabilitation) and is a bed available? Are residents clean, well groomed, and appropriately dressed for the season or time of day? Is the nursing home free from strong, unpleasant odors? Does the nursing home appear to be clean and well kept? Does the nursing home conduct staff background checks? Does the nursing home staff interact warmly and respectfully with home residents? Does the nursing home meet cultural, religious, and language needs? Are the nursing home and the current administrator licensed? </s>


Input: What to do for Medicare and Continuing Care ?

Output: Nursing home care can be very expensive. Medicare generally doesn't cover nursing home care. There are many ways people can pay for nursing home care. For example, they can use their own money, they may be able to get help from their state, or they may use long-term care insurance. Nursing home care isn't covered by many types of health insurance. Most people who enter nursing homes begin by paying for their care out of their own pocket. As they use up their resources over a period of time, they may eventually become eligible for Medicaid. Medicaid is a state and Federal program that will pay most nursing home costs for people with limited income and resources. Eligibility varies by state. Medicaid pays for care for about 7 out of every 10 nursing home residents. Medicaid will pay for nursing home care only when provided in a Medicaid-certified facility. For information about Medicaid eligibility, call your state Medical Assistance (Medicaid) Office. If you have questions about Medicaid, you can call your State Medical Assistance (Medicaid) office for more information. Visit http://www.medicare.gov on the web. (Under "Search Tools," select "Find Helpful Phone Numbers and Websites.") Or, call 1-800-Medicare (1-800-633-4227) to get the telephone number. TTY users should call 1-877-486-2048. </s>