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Wednesday, May 30, 2012

Dementia Patients Prescribed Antipsychotics at Greater Risk for Heart Attack

A cocktail of pills is not
the way to treat dementia!
@Dan Hallman
Elderly dementia patients who are prescribed antipsychotic medications face a greater risk for a heart attack within the first month of treatment.

Seniors aging in place taking antipsychotics to treat aggressive and agitated dementia were compared with dementia patients not taking such medications. The group of seniors taking the medications had a hirer risk for heart attack compared to the group not taking the drugs. The heart attack risk gradually decreased over the next year.

Using these medications to control aggressive dementia patients is generally frowned upon in the industry and The Centers for Medicare and Medicaid Services (CMS) recently announced an initiative to combat their use in nursing homes.

CMS's “National Initiative to Improve Behavioral Health & Reduce the Use of Antipsychotic Medications in Nursing Home Residents” aims to raise awareness of antipsychotic misuse, improve regulatory oversight and train nursing home workers on non-drug treatments for aggressive and agitated dementia behaviors.

What is important for you is to be aware that there are alternative means to treat dementia patients that are far more dignified than putting them into a drug stupor. So be aware and question your care providers.

Friday, May 25, 2012

Weight Loss Surgery Could Be Cure for Diabetes

 

Two studies released in March compare stomach-reducing operations to medicines alone for treating Type 2 diabetes brought on by obesity. 
Weight-loss surgery can reverse and possibly cure diabetes, and doctors say the operation should be offered sooner to more people with the disease.

Both studies found that surgery helped far more patients achieve normal blood-sugar levels than medicines alone did. Some people were able to stop taking insulin as soon as three days after their operations. Other heart risk factors also improved.

More than a third of American adults are obese, and more than 8 percent have diabetes, a major cause of heart disease, strokes and kidney failure. For a century, doctors have been treating diabetes with pills and insulin, and encouraging weight loss and exercise with limited success.

An adult who has a body mass index of 30 or more is considered obese. The government recently lowered the criteria for use of gastric bands from a BMI of 35 down to 30 in diabetics or people with heart disease.

I am not a big fan of surgery. To me once you open up a body cavity things are never the same. But that's me being in healthcare for 25+ years. Certainly these studies are encouraging. And diabetes and obesity are epidemics.

So of course talk with your physician if you are contemplating this surgery as a cure for your diabetes.

Source: AP

Wednesday, May 23, 2012

A Quick Veterans Guide to Avoiding a Rip-Off


The following is a guest blog by Bob Mason.


(The opinions expressed here are those of the author and do not necessarily reflect the positions of the blog owner.)

Scraping up extra money to pay for an assisted living facility is a priority for many. And, of course, assisted living facilities have a great incentive for wanting to help families find extra money. It could be the difference between comfort in an assisted living facility or extreme hardship in some other setting. Unfortunately, in all the anxiousness folks are getting ripped off.

Veterans (and widows of veterans) are being duped into funneling hundreds of thousands of dollars into totally inappropriate (even disastrous) annuities. The come on? “I can qualify Mom for another $1,094 a month in veterans benefits and you’ll be able to afford the assisted living facility.”

Often a seminar is hosted by an assisted living facility and led by a “veterans’ benefits specialist” who is nothing more than annuity salesman (and often from out of town). Occasionally the family of someone recently admitted to a facility will receive a telephone call with the enticement of another $1,094 or more monthly.

A Few Plain Facts About Veterans Benefits

  • Veterans benefits impose NO transfer penalties like Medicaid does.
  • A veteran must not have assets in excess of certain levels.
  • A veteran can actually transfer the excess assets to another person and instantly qualify for benefits.
  • Transferring to another person might not be too smart, though.
    • What if that person dies, divorces, gets sued, goes bankrupt?
    • What if the veteran later needs Medicaid (which DOES impose transfer sanctions)?
    • There are a number of different strategies involving how assets are titled, or perhaps involving the use of a trust, that do NOT involve an inappropriate annuity!


The worst cases involve the veteran (or widow) being counseled to transfer most of his or her money to a child (at this point the veteran is qualified for benefits, but he or she won’t be told that) and THEN having the child purchase the “special” annuity. Buried in the fine print, the annuity will have huge surrender charges for many years.

I have nothing against appropriate use of annuities. I have everything against the use of a totally unnecessary annuity that will tie up a great deal of a veteran’s money (nearly all, in fact) for many years, and pay an annuity sales person tens of thousands of dollars in commissions.

I am also bothered by assisted living facilities that host these seminars and give sales people access to their residents. I hope that the involvement of the assisted living facility is simply misguided, but well-meaning. In any event, there are plenty of knowledgeable sources who would be happy to present at a facility without trying to steer the attendees into an expensive and unnecessary annuity.

AARP has an excellent article on this called Taking Aim At Old Soldiers. I don’t always agree with “Everything AARP,” but I agree with almost everything they have written regarding veterans annuity scams in assisted living facilities. I take some exception to the article’s condemnation of trusts, because the use of a trust might be totally appropriate. Their point about a trust causing potential Medicaid problems is very well taken, however. The important take away is to make sure that anyone recommending and preparing a trust understands the complex trust rules of BOTH the VA and Medicaid.

Again, I have nothing against wise use of annuities. If you are thinking of buying one, buy from someone locally you know and trust. You’ll know where to find them if things go wrong, because if things do go wrong the presenter who sells the annuities as part of the traveling road show will be back in Vegas!

Bob Mason is owner of Mason Law, PC, a law practice devoted exclusively to solving problems for elders, the disabled, and their families throughout North Carolina and to helping lawyers help others anywhere.  Bob, a Board Certified Specialist in Elder Law, is a past Chairman of the Elder Law Section of the North Carolina Bar Association and incoming Chairman of the Elder Law Specialization Committee of the North Carolina Board of Legal Specialization.  Follow Mason Law, PC on Facebook at www.facebook.com/masonlawpc