New Alzheimer's Guidelines Proposed

From the New York Times - New diagnostic guidelines presented at an international Alzheimer’s meeting in Hawaii would mean that new technology like brain scans would be used to detect the disease even before there are evident memory problems or other symptoms. Some experts predict a two-to threefold increase in the number of people with Alzheimer’s disease. Many more people would be told they probably are on their way to getting it.

The current formal criteria for diagnosing Alzheimer’s require steadily progressing dementia and an inability to carry out day-to-day activities, like dressing or bathing — along with a pathologist’s report of plaque and another abnormality, known as tangles, in the brain after death.

But researchers are now convinced that the disease is present a decade or more before dementia.

The new guidelines include criteria for three stages of the disease: preclinical disease, mild cognitive impairment due to Alzheimer’s disease and, lastly, Alzheimer’s dementia.

Under the new guidelines diagnoses will aim to identify the disease as it is developing by using results from brain scans and spinal taps that reveal telltale brain changes. One of the newest, a PET scan, shows plaque in the brain — a unique sign of Alzheimer’s brain pathology.

Of course all this has implications.

• More testing means more medical costs.
• More testing will likely reveal higher incidences of the disease.
• More testing will also lead to false positives as well, scaring those who need not be worried.
• It moves researchers closer to the source of the disease and therefore a path for a cure.
• The new diagnostic criteria will have consequences for lawyers, insurance companies and workers’ compensation programs.

Part of me applauds this but frankly if you tell me I have Alzheimer's or am on the road to getting it at 53 and you have no cure than perhaps ignorance is bliss. Perhaps I don't want to know. But that is a choice I can make by not undergoing the tests being recommended. The other side of me grapples with my whole platform, educated aging choices sooner in life. After all couldn't you plan better for yourself and loved ones knowing what you know? Hard call.

Your thoughts please....

Two New Videos on ICYOU Health

Two of my recent written blogs are now video blogs on icyou health.

Mom Always Liked You Best

NC Boomers - Fat and Flat Broke

Who's Doing the Dreaming in Your Organization?

Who's Doing the Dreaming in Your Organization? Guest blog, MDS Central.

Top 50 Active Adult Communities Named

From Long-Term Living Magazine

This year's list of the most popular active adult and 55+ communities from Topretirements.com shows that the nation's 2nd smallest state, Delaware, ended up with 10% of the developments on the 2010 list.

The top two communities remained unchanged from last year. The most popular 55+ community in the country is Green Valley, a vast retirement community near the Mexican border in Arizona. The Villages, home to 80,000 active retirees near Ocala, Florida, repeated as the #2 active adult community on the list.

The list of Best 50 Active Adult Communities at Topretirements.com for 2010:

1. Green Valley (Green Valley, AZ)

2. The Villages (Ocala, FL)

3. Holly Lake Ranch* (Tyler, TX)

4. The Settlement at Powhatan Creek* (Williamsburg, VA)

5. Hot Springs Village* (Hot Springs, AR)

6. Tellico Village (TN)

7. Laguna Woods Village (Laguna Woods, CA)

8. The Village of San Buenas*, (Costa Rica)

9. Silver Sage Village (Boulder, CO)

10. Hampton Lake* (Bluffton, SC)

11. Enchanted Canyon (Prescott, AZ)

12. Crest Mountain (Asheville, NC)

13. Sun City (Sun City, AZ)

14. The Moorings (Vero Beach, FL)

15. Fairfield Glade (TN)

16. The Residence at South Park (Charlotte, NC)

17. The Orchard Villas (Apex, NC)

18. Century Village (Southern FL)

19. High Country Villas (San Diego, CA)

20. Robson Ranch* (near Dallas, TX)

21. Rarity Bay* (Vonore, TN)

22. The Venetian at Capri Isles (Venice, FL)

23. Biltmore Lake (Asheville, NC)

24. Pelican Sound (Estero, FL)

25. The Villages at Lynx Creek (Prescott, AZ)

26. The Village at Penn State (State College, PA)

27. Lakewood Ranch (Sarasota, FL)

28. Merrill Gardens at Parmer Woods (Austin, TX)

29. Millville by the Sea (Bethany Beach, DE)

30. Ladd Landing (Knoxville, TN)

31. Querencia at Barton Creek (Austin, TX)

32. Sun City of Texas (Georgetown, TX)

33. Pine Lakes (Prescott, AZ)

34. Terra Vista at Citrus Hills* (Hernando, FL)

35. Lofts at Mica Village (Asheville, NC)

36. Bayside* (Selbyville, DE)

37. Talking Rock (Prescott, AZ)

38. Carolina Preserve (Cary, NC)

39. Shenandoah* (Winchester, VA)

40. The Cliffs at Walnut Cove (Asheville, NC)

41. West Bay (Lewes, DE)

42. The Ponds* (Summerville, SC)

43. Sun City Grand (Surprise, AZ)

44. Soleil Laurel Canyon* (Canton, GA)

45. Southern Meadow* (Magnolia, DE)

46. Pleasant Place (Paris, TN)

47. The Half-Way Tree Mobile Home Park (Hendersonville, NC)

48. Four Seasons Charlottesville (Charlottesville, VA)

49. Bay Crossing (Lewes, DE)

50. Venetian Falls (Venice, FL)

Nursing Home Restraint Drop

The number of residents at nursing homes who were kept physically restrained dropped by more than half from 1999 to 2007, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ).

According to the Federal agency, the percentage of nursing home residents who were kept physically restrained declined from 11 percent in 1999 to 5 percent in 2007. Restraints include belts, vest, and wrist ties or bands, or special chairs or bedside rails to keep residents seated or in bed.

Overuse of physical restraints may reflect poor quality of care because residents who are restrained daily can become weak and lose daily functioning abilities. They are also more prone to pressure sores and other problems, such as chronic constipation or incontinence as well as emotional problems.

This AHRQ News and Numbers is based on information in "Long-stay nursing home residents who were physically restrained, United States, 1999 and 2007," Table 11_1_17.1 appendix to the 2009 National Healthcare Disparities Report, which examines the disparities in Americans' access to and quality of health care, with breakdowns by race, ethnicity, income, and education.

For other information, contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.

Overall good news. If you are looking into a facility make sure you ask about their restraint policy.

NC Boomers Fat and Flat Broke

There is an article in the Charlotte Observer today entitled Some N.C. boomers: Fat and flat broke. Worth a read because I am sure that it applies to more than just N.C. boomers.

Some of the highlights:

• Those among the first decade of boomers - now at retirement age or within 10 years of it - may find a combination of unhealthy living and unwise personal finance decisions will leave them in rough shape after age 65.
  
  
• State health statistics show the 55- to 64-year-old Tar Heels exercise less than younger groups. Also they are more likely than any other group to gamble once or more a week.
  
  
• Illegal drug use by people in their 50s has increased by 46 percent over a five-year period, from about one in 20 to about one in 10. Combine that with the prescription medicines they take and the interactions they might cause and you have a toxic stew brewing.
  
  
• More than a third of Tar Heels between 55 and 64 are obese. They're not only fatter than those a decade younger but also heftier than those a decade older. 85 percent of first-wave boomers in the state admit to getting effectively no exercise.
  
  
• About three-quarters of baby boomers say their retirement plans have been negatively affected by the current financial downturn.

Researchers say this all will probably increase the demand for Medicaid and Medicare services as the boomers move into retirement years. And that will affect EVERYONE.

"My sense is that we are in denial about aging," said Joan Pellettier, director of the Triangle J Area Agency on Aging. Experts on aging say the advice on healthy aging is much the same for older people as for anyone else: Eat less, move more. But a particular emphasis on balance and mobility can help ward off the falls and fractures that can be particularly devastating to older adults. Pellettier also urges boomers to start thinking about long-term care insurance, coverage that's been made more accessible through recent state and federal legislation.

OK, if you read my blog regularly than all of this sounds like a broken record. I make three simple points about aging. Prepare now financially, physically and emotionally for aging so that old age does not become one crisis after another.

As F.D.R. said: "Old age is like everything else. To make a success of it, you’ve got to start young."

Are Your Care Providers "in the Moment"?

The following is a guest blog from my colleague Nancy O'Brien. You may first want to view this video that prompted her to speak out.

It is time for leaders to embrace a new form of efficiency – human efficiency – especially in healthcare and it starts with the awareness that the best healing agent we have is within each of us. We need to switch our focus away from DOing more towards BEing more of who we are in each and every interaction and bring our whole selves to the healing experience. When we take time to connect with ourselves and others as the conscious, compassionate human beings - that we all are - we promote healing which improve outcomes, reduce the costs, and creates meaning. I wonder how many organizations are now addicted to LEAN and use it as the prescription to every symptom and disease plaguing their organization. Interesting enough, numerous studies show that the focus on LEAN in healthcare over the past 12 + years, has not alleviated many of the symptoms such as: safety, errors, turnover, burnout, and dissatisfaction, and in many cases things have gotten worse. Isn’t this our wake up call? Or have we, as some suggest, not hit bottom yet? Perhaps it’s time for a 12-step program to break this addiction to LEAN in healthcare and first, acknowledge we have a problem and then second, make a conscious decision to look at not only what we do and how we do but also who we are in the moment so we can all be agents of healing.

Hey I make my living working with the healthcare community and I also see how in an effort to make quality of care better they have in many ways dehumanized that care. After reading ask yourself if the healthcare workers you interact with for your care are truly in the moment with you, genuinely concerned, not just working off a check list, actually listening. There are providers out there that emulate this. If your care provider is not one of them consider your alternatives.

Many ED Visits from Nursing Homes Preventable

From Mcknights - A large percentage of nursing home residents' emergency department (ED) visits are avoidable, according to the Centers for Disease Control and Prevention.

Using data collected for the 2004 National Nursing Home Survey, the CDC found that roughly 8% of nursing home patients—roughly 123,600—had an ED visit in the past 90 days. Among these residents, the CDC estimates that 40%—about 50,300 residents—were potentially preventable. Some of the conditions resulting in an ED visit, such as urinary tract infection, could be more appropriately dealt with in a nursing home, researchers argued.

The number one reason for ED visits by nursing home patients was falls, researchers discovered. Those visits could possibly be prevented through efforts to prevent the falls themselves, according to the report. To download a copy of the report, visit http://www.cdc.gov/nchs/data/databriefs/db33.pdf.

Does the nursing home your loved one resides in or a home you are considering for a loved one have a fall prevention program in place? Make sure to ask.

Protein Found in Jellyfish Improves Cognitive Function

From Mcknights -

A small-scale clinical trial has shown promising results in improving cognitive function among individuals with memory problems through the use of a protein found in jellyfish.

Researchers with Quincy Bioscience have extracted a calcium-binding protein called apoaequorim from the Aequorea victoria jellyfish—also known as the crystal jelly—for use in their memory-enhancement trial. Apoaequorim is considered a promising potential treatment for Alzheimer's disease. The trial comprised 35 adults with an average age of 61 who had “memory concerns.” Over 60 days, the adults who received the jellyfish treatment experienced a 14% improvement in cognitive function over the control group, according to researchers.

Aequorea victoria jellyfish are typically found along the west coast of the Pacific Ocean, and are common in Puget Sound in Washington State. Researchers presented their findings at the annual Alzheimer's Association International Conference on Alzheimer's Disease in Honolulu.

First, jellyfish - who knew?! And I want to be a Alzheimer's researcher and go to Hawaii and present.

Compare the Cost of Care for Long-Term Care Around the Country

Genworth Financial has an interactive map to compare your state or region's median cost of care to other areas in the country. Go here and click a state or region to view and calculate current and projected long term care costs. You actually can view the cost of care for services across the aging continuum - adult day, home care, assisted living, nursing homes. And did you know that 40 percent of people currently receiving long term care services are ages 18 to 64?

My platform has been simple. Start preparing for your older years sooner than later so that you avoid a crisis. Review the costs of long-term care in your area or in the area where a loved one who might need it lives. Then consider a long-term care insurance policy that meets your needs. I am not a spokesperson for the insurance industry but I do know that the public is uneducated in terms of how care is paid for and at the end of the day we as individuals will have to shoulder the burden of the cost of care.

No Strong Scientific Evidence to Support Several Measures for Alzheimer's Prevention

An independent panel of medical experts has determined that there is no strong scientific evidence to support several measures for the prevention of cognitive decline and Alzheimer's disease.

The panel said that there is “currently no evidence of even moderate scientific quality” to support the notion that certain factors such as education, exercise or diet are effective at preventing cognitive decline or Alzheimer's. At best, these preventive measures are loosely associated with positive outcomes, the panel asserted.

"These associations are examples of the classic chicken or the egg quandary," said Dr. Martha L. Daviglus, conference panel chair. "Are people able to stay mentally sharp over time because they are physically active and socially engaged or are they simply more likely to stay physically active and socially engaged because they are mentally sharp? An association only tells us that these things are related, not that one causes the other."

Convenedby the National Institutes of Health, the panel included experts in the fields of preventive medicine, geriatrics and nursing, among others. For more information about the panelists and their findings and conclusions, visit http://consensus.nih.gov/2010/alzmedia.htm.

Mom Always Liked You Best

A surprising look at who actually has the most likelihood of becoming a caregiver to their parents.

Liitle Known Reform Provisions Could Benefit You Sooner

According to Kaiser Health News, there are several lesser-known provisions of health reform that take effect in the following months.

These provisions include eliminating patients' co-payments for certain preventive services such as mammograms, giving the government more power to review health insurers' premium increases and allowing states to expand Medicaid coverage to low-income adults without children.

Insurers won't be able to charge co-payments or deductibles for certain preventive services such as breast cancer screenings every one to two years, cholesterol blood tests and some sexually transmitted disease screenings. Insurers will also have to cover recommended immunizations at no cost to patients. The change takes effect Sept. 23. Check with your health plan.

A new program will help employers handle the cost of health care for retirees age 55 and older who are not eligible for Medicare. The reimbursements will cover 80 percent of medical claims between $15,000 and $90,000 for retirees, their spouses and dependents. Applications are now being accepted to help cover claims dating back to June 1. Check with your employer or former employer.

Insurers must justify premium increases to the federal government and state insurance commissioners. If premium hikes are deemed to be unreasonable – federal regulators have yet to define what "unreasonable" means – states could exclude insurers from offering their coverage on health insurance exchanges beginning in 2014.

In 2014, Medicaid will expand to include everyone who makes less than 133 percent of the poverty line ($14,400 this year for individuals). But in the meantime, under the law, states can expand their Medicaid programs to cover these people, and get federal aid to do so.

Approximately 8.8 million "dual eligibles" -- individuals who qualify for both Medicare and Medicaid, many of whom are poor elderly -- could benefit from a new federal office designed to coordinate their medical care.

Here is the complete article.

Learn to Fall More Safely (Does that make any sense at all?!)

From Mcknights - Researchers say seniors with osteoporosis can use martial arts training to learn to fall more safely.

Testing the force of impact of a variety of different martial arts fall exercises, research subjects performed sideways and forward martial arts falls, which involve turning the fall into a rolling action, from a kneeling position on both a judo mat and a mattress, as well as from a standing position on a mattress. The force of impact on the subject's hip was measured and compared to information on how much force an osteoporosis sufferer can withstand.

While most of the falls exercises would involve too great an impact for seniors with osteoporosis, researchers found ways they could safely perform the exercises. Seniors should wear protective hip padding, perform falls on a thick mattress, and avoid falling forward from a standing position. The report was published in BMC Research Notes.

Well it sort of make sense right, roll with the punches in a way. Learn to fall. But I had to chuckle at the last part. I can imagine calling my 88-year old this morning and say OK I need you to practice your falling routine. Yes that's right. Yes you heard me...hip pads..yes go buy them NOW. OK got them. Ready fall and roll.

Oh brother. In short I think the theory is right but I think we can suggest others ways to practice, perhaps in a controlled environment with an instructor.

NY Nursing Home is One to Emulate

I don't usually plug nursing homes specifically but one caught my eye for a few programs they are doing.

Island Nursing and Rehab Center in Holtsville, NY offers ian nteractive program which aims to link its residents more closely to their families/friends, by means of web-based internet technology. So essentially they are taking things that you and I may use (example - Skype) and using them for a great purpose.

Then I read in Long Term Living Magazine that a group of 33 residents from the center, ages 71 to 98, are the first class of students to participate in and graduate from Suffolk County Community College's Faculty Association Community Outreach Program.

The program, which includes a wide range of adult education lectures, is called "Professors on Wheels," with college professors coming to the nursing home to lecture on a variety of educational topics.

The graduation ceremony was held for residents who attended the complete series of classes over the course of the year. Residents were adorned in caps and gowns, receiving their graduation certificate with family members and fellow residents in attendance.

Educational topics in the series included adult stem cell research, jellyfish and the ecosystem, poetry, fitness, collaborative playwriting, and more.

So really how cool is all this? First the nursing home and its residents are tech savvy. And they are following one of the tenets of my keynote The Meaning of Life, which essentially says that Lifelong Learning is a key to aging with quality.

Check them out.

Fraudulent Health Plans to Watch Out for as Reform Rolls Out

With healthcare reform comes fraud. Two sites to pay attention to so that you can protect yourself.

At the Coalition Against Insurance Fraud, there is a list of things to watch for as fraudulent health plans try to sell you their product. More detail at their site.

· Invasive sales pitches

· Pushy pitchman

· It’s required for health-care reform

· The deal seems too good

· Evasive answers

· Have to join an association or union

· Slick Internet sites

· Slow response

· Suspicious payment delays

· The “federal oversight” con

Following is a list of companies to watch out as posted on the coalition’s site.

· A&B Marketing

· AB National Marketing

· Advanced Marketing Group

· Affinity Group Benefits Association

· Affinity Health Plans

· Alliance Association Health

· Alliance for Affordable Services

· American Consumers Insurance

· American Employers Association

· Americans for Affordable Healthcare

· American Trade Association

· Americans for Affordable Services

· America’s Best Benefits

· Association for Lifestyle Reform

· Association Healthcare

· Association of Franchise and Independent Distributors

· Beema Insurance Company

· Beema Insurance Company of Pakistan

· Beema Insurance Group

· Beema-Pakistan Company Limited

· Benefit Management Administrators

· Claim & Benefit Management

· Consolidated Workers Association

· Consumer Health Benefits Association

· Contractors and Merchants Association

· Depawix Health Resources

· Direct Marketing Services

· Direct Medical

· DNH Consulting Group

· Easy Life Healthcare

· Elite Healthcare

· Family Health Benefits

· Family Healthcare

· Global Healthcare

· Green Cross Managed Health

· HealthAllies

· Healthcare Alliance

· Healthcare Management Advisors

· Healthcare One LLC

· Healthcare Solutions

· Healthshare America

· Health Markets

· Health Services

· Home Health America

· International Association of Benefits

· National Alliance of Associations

· National Alliance of Benefit Services Association

· National Alliance Healthcare

· National Association for the Self-Employed

· National Benefits Consultants LLC

· National Trade Business Alliance of America

· National Trade Business Association

· National Transportation Benefits Alliance Association

· Nationwide Benefits Services Association

· NTBAA

· PBC Direct

· Peck and Peck

· Pinnacle Health Solutions

· Professional Benefit Consultants

· Promotion Healthcare

· Oxonia Insurance Group

· Qualified Administrative Specialists of America

· Prudent Choice

· RBA Administrators

· Real Benefits Association

· Republic Healthcare

· Serve America Assurance

· Signature Health Group/Health Advantage

· Smart Data Solutions

· Spencer & Associates LLC

· United Business Association

· Vantage America Solutions

· W.I.N. Association

NBC Reaches Out to Boomers

You may want to check out NBC's effort to reach the boomer and senior population with useful information.

LifeGoesStrong.com is described as a site for mid-lifers who are living well and still going strong. They are aiming to provide the best information for the 45-65 set with a focus on constant improvement.

Their mission is to provide information and content that supports your journey in life with unique sections in the LifeGoesStrong.com network including

• Health Goes Strong
• Family Goes Strong
• Tech Goes Strong
• Style Goes Strong

Check them out. Here's a sample.

Oh, no! What to do when your kids criticize what you wear, say and do

Senior Summer Safety - How to Cope with the Heat

With the death of a 92-year old woman in Philadelphia this week, it is important to check in on the elderly during these brutal weather conditions on the easy coast.

According to researchers, the elderly should not be left in un-air-conditioned spaces for too long, and should be checked twice daily for signs of heat exhaustion or heat stroke.

Also, avoid hot or heavy meals before going outside. Avoiding alcoholic or sugary beverages, and drinking plenty of water, even if you're not thirsty.

Outdoor activities should be scheduled for early morning or earlier in the evening, and frequent breaks should be taken in shady areas, to allow the body to cool down.

But most of this comes down to common sense and taking the cues that your body is giving you. Stay safe.

Medical Tourism in Long-Term Care

Here is a guest blog I wrote for Advance in Long Term Care Management regarding medical tourism in the nursing home industry.

Live to be 100? It May Be in Your Genes.

Scientists studying the genomes of centenarians in New England say they have identified a set of genetic variants that predicts extreme longevity with 77 percent accuracy. The centenarians had just as many disease-associated variants as shorter-lived mortals, so their special inheritance must be genes that protect against disease, said the authors of the study, a team led by Paola Sebastiani and Thomas T. Perls of Boston University. Their report appears in Thursday’s issue of Science.

This NY Times article can tell you more.

There may be something to this. Take my mother (please)(old joke). Anyway, she smokes like a chimney, has some breathing issues because of it, has had some cardiac issues but at 89 other than breast cancer in her 60s and a fall a couple of years ago, she really does not have major issues. Despite her poor health habits, she keeps chugging along. Interestingly enough I had a full metabolic study a few years back and they found lots of little things floating around my blood stream that probably should be causing me more problems than they are. They concluded that I had an incredible immune system. I attributed it to genetics and immediately thought of my mother.

Being pre-disposed to live longer is somewhat dis-heartening in a way because there are so many of us that fight every day to keep ourselves in shape. When you read a study like this you kind of shrug and wonder what all your hard work is accomplishing. That said don't stop because it certainly is adding years to your life. Genetics may just be choosing how many years that upper limit could be!

Older Folks Watch More TV but Like It Less

From Long-Term Living:

According to the American Journal of Preventive Medicine, a study by researchers at the University of California, San Diego School of Medicine concluded that older people spent a great deal more time watching TV than younger people did, yet they enjoyed the experience less.

The study looked at 3,092 Americans, aged 15 to 98, in survey data collected in 2006. Adults over 65 reported spending three times more of their waking hours watching TV than did younger adults. Older adults did not seem to experience the same "stress buffering" effects that younger adults did from watching TV, and TV use among older adults—unlike time spent on other leisure activities, such as socializing or physical exercise—was related to lower life satisfaction.

Data from other studies indicate that the average American household spends 4.5 hours watching TV per day and, in those over age 65, about 25% percent of their time is spent watching TV.

Recent work suggests that sedentary activity, such as TV watching, is associated with negative changes in many aspects of health including cardiovascular, bone health, and cellular function. Television use in particular has been linked with greater risk for obesity and Type2 diabetes, lower life satisfaction, less frequent engagement in social and physical interaction, and increased risk for dementia.

The researchers concluded that increasing public awareness of alternatives to TV watching and reducing barriers to alternative activities that are more socially and physically engaging could reduce TV use in older people and diminish the potential for associated negative health effects.

OK, I didn't need a study to tell me this. If I call my 88-year-old mom and she is home and she is watching TV, I know this already. She is bored and borderline depressed because she has nothing to do.

An activity director told me once that there were three kinds of people in her assisted living facility. The go goes, slow goes and no goes. Go goes will do anything and are always active. Slow goes need prodding and will participate. And you can guess what the no goes do. I think all people, not just older, fall into one of these categories. Unfortunately some older go goes may not be capable of going because of some ailment. No goes probably choose to stay home and TV watching is a byproduct. For those capable of getting out sometimes there is not a social network to avail themselves of or transport to go somewhere. And for those staying in unfortunately many face lonliness.

This gets back to very basic points I make in my keynote The Meaning of Life. Staying active is the key to an older quality of life. And having friends and a broad social network has been shown to have health benefits. Remember that how you live today will determine how you prosper or not tomorrow. And for those elder shut in at home, we all have a responsibility to look in on them and be involved in their lives.

AAHSA Changing Name to LeadingAge

Read this post in McKnight's about how the American Association of Homes and Services for the Aging (AAHSHA) is proposing a name change to LeadingAge.

— The brand promise is “inspire, serve, advocate.”

— The brand ethos is “transformational stewardship.”

— The new mission is “expanding the world of possibilities for aging.”

I am all for it. AAHSA has shown some pretty aggressive and hip marketing over the last few months for a long term care organization. And what is interesting is that they are now positioning themselves as more than that.

I just wrote a column for my newsletter about healthcare's obligation to educate people about what it means to grow older and to assist them in growing older with a quality of life. LeadingAge (AAHSA until members approve) is positioning itself as a leader in the aging field.

You go Larry Minnix!!