New Test Claims to Detect Early Alzheimer's

Reporting in the June 10 issue of BMJ, researchers have developed a new self-administered cognitive test that is quick to use, examines 10 skills, and reportedly detects 93% of cases of Alzheimer's disease. Lead researcher and neurologist Jeremy Brown, MD, from Cambridge, the United Kingdom says that the test can be administered in a physician's waiting area and says that if there is time during the consultation to observe the patients filling in the test, this can also be a useful aid to diagnosis. His team found that with 10 minutes' training and a scoring sheet, a nurse without experience working in memory clinics was able to evaluate the test as accurately as a specialist. The significance of this test in part is the ability to administer it in the absence of an Alzheimer’s specialist, gerontologist or other similarly trained expert.

Investigators evaluated subjects from three hospitals including a memory clinic. They looked at 540 control participants and 139 patients with dementia or amnesic mild cognitive impairment. Of the 139 patients with dementia or mild cognitive impairment, 108 had Alzheimer's disease and 31 had degenerative dementias.

The test requires participants to write 10 answers on a double-sided card. The requested tasks evaluate a range of areas, including the patient's semantic knowledge, ability to calculate and name objects, and recall. A Web site is being developed for clinicians to download the new test, scoring sheets, and further instructions.

Globally approximately 24 million people have dementia, and it is estimated that the prevalence will double every 20 years. Cognitive tests are useful to diagnose dementia and to evaluate functional ability. Currently available cognitive tests do not satisfy criteria for widespread use by non-specialists.

Changing the Health Care Experience Through Telemonitoring

A big push in healthcare will start to focus on prevention, stabilization of chronic conditions, coordination of care and self responsibility.

In this blog, the author makes a great case for the importance of technology to the patient experience. In this case telemonitoring. To quote:

"Telemonitoring, in and of itself, doesn’t change lives. Telemonitoring is really just a 21^st century biofeedback service. Remote monitoring combined with the “just in time” teaching provided by our telemonitoring nurses give our patients the information they need to decide if they want to change their lives. Increasingly, our patients decide whether their chronic illness controls them or whether they, as much as possible, control it. Telemonitoring doesn’t cure disease, but it gives them another way to understand the information that we, the healthcare clinicians, have been giving them for weeks, months, and sometimes, years. "

So telemonitoring influences behavior far more than verbal and written instructions seem to provide. Sure we know the regimens and instinctively know what we should be doing but when your compliance is demonstrated it puts it in a different perspective.

Lesson for readers, our caregivers and elderly - embrace technology.

CMS Five Star - Friend or Foe?

PentaStar Collaborative published a survey of 356 nursing home administrators on the CMS Five Star Rating System and how they felt it would effect their facilities.

Find the survey here.

Two items stood out for me. When asked what effect their rating would have on the perception of their facility by consumers, 51% felt that consumers would not care. Some answered this way because they felt that they had no competition geographically.

Asked how the rating would effect the facility overall, 50% were neutral; 23% said it would effect positively and 27% said negatively.

In this age of transparency where educated boomers are the caregivers, perhaps facilities need to pay more attention to Nursing Home Compare Five Star however flawed. And as these results become tied to pay for performance there is even more reason to pay attention. Another wild card is that health care in this day and age is not necessarily local any longer. Witness Mexican border state residents choosing Mexican nursing homes because of their low cost and amenities.

Transparency is here to stay.

Guest Blog in Long-Term Living Magazine

Read and view our guest blog in Long-Term Living Magazine.

More About Intergenerational Programming

The New Old Age column in the NYT ran a good article on intergenerational programming where adult day and child day care are combined. It speaks mostly to the benefits to elders. Yet there are great benefits to our youth.

The Harvard School of Public Health-Met Life Foundation Initiative on Retirement and Civil Engagement had this to say about intergenerational programs:

"Community based initiatives that bridge the generations ... build community by integrating the old with the young, transmitting knowledge and experience to future generations and reinforcing the value of people of all ages. Studies have found that young people in such programs show measurable improvements in school attendance, attitudes toward school and the future, and attitudes toward elders. Adult volunteers report substantial benefits to themselves: the satisfaction of sharing their experience, feeling useful. And giving back to the community."

So don't discount the benefit both ways.

We need more programs like this.

Is Home Always the Best Place for our Elders

The NYT's New Old Age column earlier this month contrasted the lives of two people aging in place and wondered whether in at least one case if the person was better served in an assisted living facility. This actually represents an opportunity for ltc providers to educate the public about the advantages of a communal setting whether to provide proper nutrition, socialization and even protection.

And there is a place for ltc providers in the community if they choose to participate. Naturally Occurring Retirement Communities are as the name implies places where seniors have naturally congregated and lived for years. In these community models such as The Village at Brookline in Boston, services come to the seniors.

It is an opportunity for ltc providers to create community and build their word of mouth and brand. It might be a revenue generator but more so it is a way to build relationships so when people need a higher level of care they will think of you.

What does this accomplish?

It promotes independence.
It empowers seniors.
It creates an environment of personal and physical security.
It creates community.
It promotes partnerships.
It broadens your service offerings.
It avoids duplication of services and increases access.
It enhances quality of life.
It encourages volunteerism.

See related article:
http://newoldage.blogs.nytimes.com/2009/06/04/is-home-always-so-sweet/

Elder Abuse Awareness Day June 15

June 15 is World Elder Abuse Awareness Day. The goal of the day is to recognize elder abuse as a public health and human rights issue and to raise awareness to ultimately put an end to the abuse and neglect of older adults. This annual observance of World Elder Abuse Awareness Day is sponsored by the International Network for the Prevention of Elder Abuse (INPEA). Show your support by hosting World Elder Abuse Awareness Day activities such as educational programs, community proclamations and other cultural events. The color for the day is purple and the theme for the day is "My World...Your World...Our World-Free of Elder Abuse."

In this video blog we ask the long term care industry to step up and educate the public about elder abuse and dispel the myth that the majority of abuse takes place in ltc facilities. While doing this you will build your brand and good will.