Hospitalized Alzheimer's Patient at Increased Risk for Cogitive Decline, Death

Harvard researchers have found that a hospital stay is related to a faster rate of mental decline and a heightened risk of dying or entering a nursing home for those who already have Alzheimer’s disease.

A study following nearly 800 individuals with mild Alzheimer’s disease found that:

• Those who had been hospitalized during the course of the research were nearly twice as likely to experience increased mental decline or death.
   
• One in 16 passed away.
   
• One is seven had to move to an institutionalized setting.
   
• One in five suffered mental decline within one year of getting out of the hospital. 
   
• If the individual experienced delirium during his hospital stay, it increased the risk for a poor outcome by about 12 percent.

"Delirium prevention may represent an important strategy for reducing adverse outcomes in this population," said Dr. Tamara Fong, an assistant professor of neurology at Harvard Medical School and lead author of the study. 

Delirium can be prevented through:

• Visits by a family member or other familiar person.
   
• Supplying the individual with necessary eyeglasses and hearing aids, as well as encouraging the individual to get out of bed often for walks.
   
• Delirium can also be prevented by keeping older people out of the hospital and treating them in their homes, said Fong.

Lesson - stay out of the hospital.

Learn more about this study.

Courtesy: ALFA

Make Your Home Safer to Prevent Falls (VIDEO)

Make Your Home Safer to Prevent Falls

Would you allow your child to wander outside alone, in the dark, without supervision? The answer to this question is inevitably “no.” However, for some if this question was replaced with “parent” the answer immediately changes to “yes.” But as parents get older, they may need protection too, even from things that seem the norm.

As we age, simple tasks that never seemed challenging or frightening can suddenly become a difficult part of our day. In fact, the chance of a senior citizen becoming physically or cognitively impaired in their live is 2 out of every 3! So it is vital that their homes are safe and free of hazards that are easy to overlook and there are several ways to do so. Some examples are:

·       Telephones should be in each main room, and should be low enough so they can
   be reached from the floor in case of a fall.

·       Keep a working flashlight on the nightstand; check the batteries periodically.

·       Put eye-level decals or reflector tap on glass and screen doors.

·       Remove throw rugs from any high traffic areas.

·       Replace glass shower doors with unbreakable plastic or shower curtains (which
   should be changed every six months.)

·       Fix the height of the bed so it is easier to get out of.

·       Use unbreakable dishes in the kitchen.

There are many other ways similar to the ones above that will help you safe-proof the home. This planning doesn’t need to be as complicated, and in fact, we can take simple, commonsense steps along the way to help ourselves or our loved ones live a more fruitful, independent life during their elderly years. Following these senior safety guidelines will help you keep key areas such as the kitchen, bedroom, bathroom, and outside secure.

Prevention steps may seem simple, but they are often easily overlooked. Unfortunately, at 80 years old, over half of seniors fall annually. Making your or your parent’s home safe shouldn’t be delayed. Review these senior safety steps  with your loved ones to ensure that their own home is safe and everyone can enjoy their peace of mind.

Lonliness Affects Health in Elders (VIDEO)

New Study Shows Severity of Alzheimer's Caregiving on Working Women (VIDEO)

Loneliness Affects Health in Elders

In a study of 1,600 seniors, researchers at the University of California San Francisco (UCSF) found that people who reported being lonely were more likely to suffer a decline in health or die over a six-year period than those who were content with their social lives.

Loneliness didn't necessarily mean being alone - almost two-thirds of seniors who reported feeling lonely were married or living with a partner. Researchers defined loneliness as feeling left out or isolated or lacking companionship.

While not a new issue the UCSF study is among the largest to look at loneliness, as opposed to general depression.

• About 43 percent of the adults reported feeling lonely at least some of the time.
   
• Of those seniors, 23 percent died over the six-year study, compared to 14 percent of the participants who weren't lonely - a 45 percent increase.
• The lonely seniors had a 59 percent greater risk of suffering a decline in function.

Many studies have shown that having a broad social network contributes to a quality of life as you age. What fascinates me is the finding that two-thirds who reported feeling lonely were married or living with a partner. The San Franscisco Chronicle article in the 'read more' below notes that couples may drift apart as they get older. They don't have the same shared interests. They may feel unable to connect with both their children and their grandchildren because of generational or lifestyle differences. And they don't want to bother anyone.

I suggest that we take this study seriously and also own up to our responsibilities as sons and daughters. Especially if you live in the same place, there is no excuse for social isolation of mom and dad. We must create families of inclusion.

And while family is one foundational rock, there are other outlets in our communities that provide opportunities to develop meaningful relationships, whether it be senior centers or adult day care.

There is no reason for a senior to just drift away into loneliness, illness then death.

We need to encourage them too if they are reluctant to reach out for the resources available or find it hard to make friends.

Read more.

New Study Shows Severity of Alzheimer's Caregiving on Working Women

The Working Mother Research Institute surveyed nearly 2,500 women, including more than 1,200 who have cared for a loved one with Alzheimer's, to get a clear picture of how the responsibility of caregiving affects their emotional, financial and work lives, as well as their families.

Women and Alzheimer'sDisease: The Caregiver's Crisis was sponsored by GE and designed with input from the Alzheimer's Association. It explores not only the burden of caring for a loved one with the disease, but also ways that employers, doctors and families can help caregivers lighten their loads ever so slightly.

They also talked to women who are not caregivers, to learn more about how well they understand the disease and to get a sense of their feelings about it.

Among the conclusions:

·    Employers can’t afford to overlook the issue of Alzheimer’s. As society ages and workers retire later, there will be ever more Alzheimer’s caregivers on the job, says Ellen Galinsky, president and co-founder of the Families and Work Institute. “Our data shows 49 percent of workers expect to be caregivers within the next five years,” she says.

·    Doctors need to be more proactive. Despite women’s higher risk for the disease, doctors aren’t regularly discussing Alzheimer’s or aging at checkups. More than three quarters of respondents say their physician hasn’t broached either topic.

·    A substantial number of women are stuck in a caregiving role. Although 30 percent want to provide care themselves, even more—39 percent—appear to be trapped (no other family member can do it, it feels “expected,” or they can’t afford or don’t like the available facility care.)

·    Whether they are tending to someone by choice or by default, caregivers are struggling in every area of life. They are more likely than their predecessors to feel overwhelmed, to feel they don’t have a choice in taking on the role and to be experiencing a financial drain. As well, at a time when extra income is sorely needed, caregiving often places a women’s career on hold—she’s less likely to take a promotion and much more likely to make schedule adjustments (scaled-back hours, a leave of absence) that reduce her chances for immediate advancement.

·    Within the caregiving group, minorities are struggling the most. They spend more on caregiving overall and are twice as likely as white caregivers to spend more than $10,000 per year. They also have fewer hours of help at home, despite being nearly twice as likely to be caring for a patient in the late/severe stage of the disease.

 

·    Caregiver health is a major issue, given that these women often take better care of the loved one with Alzheimer’s than themselves. The Alzheimer’s Association estimates that caregiver health problems cost the U.S. $8.7 billion each year. 

A quick search of this blog will show the enormous amount of space devoted to caregiving issues. This is a societal problem that needs support from everyone, including those not affected by caregiving directly. 

Gastric Bypass Surgery Can Lead to Alcohol Abuse (VIDEO)

Just for Fun - Dissecting a Crash Test Dummy

Presented By: CarInsurance.org

Gastric Bypass Surgery Can Lead to Alcohol Abuse

Patients who had gastric bypass surgery faced double the risk for excessive drinking, according to a study released by in the Journal of the American Medical Association.

Gastric bypass surgery shrinks the stomach's size and attaches it to a lower portion of the intestine. That limits food intake and the body's ability to absorb calories. Researchers believe it also changes how the body digests and metabolizes alcohol.

Researchers asked nearly 2,000 women and men who had various kinds of obesity surgery at 10 centers nationwide about their drinking habits one year before their operations, versus one and two years afterward. Most didn't drink excessively before or after surgery, and increases in drinking didn't occur until two years post-surgery.

Two years after the surgery, almost 11 percent, or 103 of 996 bypass patients, had drinking problems, a 50 percent increase from before surgery.

About 8 percent of U.S. adults abuse alcohol by drinking excessively. The study authors say their results suggest that an additional 2,000 people each year will develop drinking problems because of obesity surgery.

More than 200,000 stomach-reducing surgeries are performed each year.

The benefits of gastric bypass surgery include sometimes reducing diabetes and heart disease risks.

Patients should be screened for alcohol problems before and after surgery and told about the risks, said lead author Wendy King, an assistant professor at the University of Pittsburgh's graduate school of public health.

She noted that obese people are often socially isolated because of their weight, and that drinking often increases when patients have slimmed down and pursue a more active social life.

Avastin Carries Higher Risk for Blindness for Macular Degeneration Treatments (VIDEO)

New Guide Explains Hospitalist Role (VIDEO)

Avastin Carries Higher Risk for Blindness for Macular Degeneration Treatments

Lucentis and Avastin are both used to treat the wet version of age-related macular degeneration. A new study from Queen's University finds that Avastin, traditionally a cancer drug, carries a much higher risk for the development of serious intraocular inflammation, which can lead to blindness.

A review of 1,600 cases of patients who had been given either Lucentis or Avastin found that participants who were given Avastin were 12 times more likely to develop intraocular inflammation.

Researcher Sanjay Sharma, M.D. said: "This is of concern for patients receiving Avastin in the eye," Sharma said. "It is particularly important because many of our seniors need numerous injections — so the risk is cumulative."

Both drugs are injected directly into the user's eye and are made by Genentech. Since both drugs have been found to be equally effective in studies, insurance companies and government health plans prefer the off-label use of Avastin, which costs one-tenth of the price of Lucentis.

Source: McKnight's Long Term Care News

New Guide Explains Hospitalist Role

Next Step in Care, a campaign by the United Hospital Fund has published a useful guide explaining the role of the hospitalist.

In most hospitals, there are now special doctors called “hospitalists.” They manage patient care during the hospitalization. This is a job that used to be done by doctors with offices in the community. Today doctors in the community may not even know that their patients are in the hospital.

It is important for you as a family caregiver to know about hospitalists, and the services they do and do not provide. It is also important for you to know ways to ensure the best care for your family member, both in the hospital and after discharge. 

This guide provides information about hospitalists, along with actions you can take and good questions to ask. But remember that this guide is general – each hospital has its own way of providing patient care. 

Courtesy: Next Step in Care

Low Risk of Shingle Reoccurence in Elderly

Shingles is a skin irritation disease that is caused by the same virus as the chicken pox. It is usually triggered by emotional stress, immune deficiency, cancer, or other illnesses and factors that can be related to aging, according to the Centers for Disease Control and Prevention (CDC).

Because the chicken pox virus never leaves the body, anyone who contracted the disease in childhood is at risk for shingles later in life. New research suggests that elderly adults who have had a single episode of shingles have a relatively low short-term risk for coming down with the painful skin condition again, regardless of vaccination status.

The CDC has recommended that adults aged 60 and over be vaccinated against shingles.

More than 43 million adults are at risk for the disease, and roughly 500,000 seniors contract it every year, according to the CDC. Merck & Co. Inc's vaccine Zostavax has been shown to reduce the occurrence of shingles in seniors by up to 69% in some age groups.

"This study's findings are important because we found that the risk of having a recurrent shingles episode is not as high as previous research indicates," Kaiser Permanente researcher Hung-Fu Tseng, Ph.D., said. “We now have empirical data that show the risk of recurrence is low among an elderly population who did not have compromised immune systems, regardless of their vaccination status."

Led by Tseng, investigators analyzed health records of more than 6,000 people over the age of 60 who had cases of shingles, and then monitored the patients over a two-year follow up period to look at recurrence. At the conclusion of the follow-up period, researchers observed fewer than 30 recurrent cases of shingles, and very little difference in the rate of recurrence among vaccinated and un-vaccinated participants.

Boomers Pessimistic About Their Financial Situation

According to Gallup, older Americans (75+) feel better about their personal financial situation while those aged 18 to 64 feel the least positive. Those aged 75 and older are the most likely to say they feel good about the amount of money they have, are satisfied with their standard of living, have more than enough money to do what they want, and have enough money to buy what they need.

These data, from Gallup Daily tracking interviews conducted Jan. 1-May 2, 2012, reveal that Americans of typical retirement age -- 65 and older -- feel relatively good about how much money they have.

However, the views of those aged 50 to 64, a group nearing retirement, are more in line with -- and often less positive than -- those who are younger rather than those who are older than them. Americans in this age group are the least likely to feel good about the amount of money they have and to be satisfied with their standard of living.

The oldest Americans are the least likely to believe that their financial situation is improving. Older Americans' higher reliance on fixed incomes remains mostly stable over time. Younger Americans, on the other hand, likely believe their incomes will increase in the future.

While 50- to 64-year-olds are much less likely than those who are older to be satisfied with their current standard of living, they are more likely than their elders to say that their standard of living is getting better.

New NIH Senior Website User Friendly

The National Institutes of Health has redesigned and enlarged its wellness-related Web site, NIHSeniorHealth, making it a comprehensive, detailed source of reliable, up-to-date medical information for and about older people. 

The site now covers almost 50 health topics and includes 150 videos and an extensive list of frequently asked questions. On the subject of exercise, for example, two dozen older people describe their own physical regimens. Visitors to the site can also sign up for free email updates containing new topics and videos. 

Courtesy: Met Life Mature Market Foundation

Medical Test You May Not Need (VIDEO)

Medical Tests You May Not Need

Choosing Wisely is part of a multi-year effort of the ABIM Foundation (Advancing Medical Professionalism to Improve Health Care) to help physicians be better stewards of finite health care resources. 

The goal of this campaign is to help physicians, patients and other health care stakeholders think and talk about overuse of health care resources in the United States.

Originally piloted by the National Physicians Alliance through a Putting the Charter into Practice grant, nine medical specialty organizations, along with Consumer Reports, have identified five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. 

The resulting "Five Things Physicians and Patients Should Question" will spark discussion about the need—or lack thereof—for many frequently ordered tests or treatments. It received national New York Times attention earlier this year. Here are tests in question.

EKGs and exercise stress tests
Imaging tests for headaches
Treating sinusitis
Imaging tests for lower-back pain
Bone-density tests
Pap tests
Treating heartburn and GERD 

Read more in this Consumer Reports document.

The Granny Pod - Good Idea of Bad (VIDEO)

Here is a link to the Granny Pod video - http://m.youtube.com/watch?v=v6eWoqSST04

Higher Levels of Purpose Lead to Better Cognitive Function in Alzheimer's Sufferers (VIDEO)

The Granny Pod - Good Idea of Bad

This is reprinted from my Friday about.com blog.

MEDCottage also known as a Granny Pod is a mini mobile home that you park in the backyard, hook it up to your water and electricity, and it becomes a free-standing spare room for mom and dad. While introduced a couple of years ago, it is only this year that a family is actually taking delivery of one in the U.S.

The 12 foot by 24 foot portable, modular “medical home,” can be purchased or leased and are equipped with health monitoring equipment and lifts to assist people who have problems with mobility.

Also included are security cameras that sweep up to 12 inches off the floor (foot sweep) in order to observe falls. A computer or mobile device can monitor the cameras. The cottage also has safety lighting along the floors. 

The AARP calls it an “innovative idea,” but critics describe the portable homes as “storage containers.”

In Virginia, the state government has eased zoning restrictions so no municipality can block them from being installed.

This from their web site. Our signature product, the MEDCottage, supports this idea of family-managed healthcare. The MEDCottage is a mobile, modular medical home designed to be temporarily placed on a caregiver’s property for rehabilitation and extended care. Simply stated, it’s a state-of-the-art hospital room with remote monitoring available so caregivers and family members have peace of mind knowing they are providing the best possible care.

They boldly state that this is an alternative to nursing home care.

The Washington Post asked readers: “Would you purchase a “granny pod” for your aging relatives?” Seventy-six percent responded in the affirmative.

On the site, Care2makeadifference, a dubious writer posed a question to readers about whether they would live in one of these pods. I was survey number 440 and answered with a resounding NO. Interestingly the numbers were split. Thirty-six percent answered ‘no’; 14% were leaning ‘no’; 29% answered ‘ yes’; 21% were leaning ‘yes.’

A lot of the comments that followed tracked for the positive. After all, wouldn’t this be a great getaway for the grand kids too one offered.

I think I rather have a traditional in-law suite attached to the house than a pod on the property. Yet it contains all the innovative things we keep harping about especially in the arena of telehealth. It could never be a nursing home because there is the human element of skilled medical professionals that would be needed.

Perhaps perceptions comes with the dubious nickname of being a “pod.” The term cottage does sound more appealing. And being a marketer I know people will get hung up on this. So call it a pod and people might want to eject themselves from such a place!

So let me hear from you professionals in the industry, caregivers and people who just may be of the age to use these. What do you think?

Higher Levels of Purpose Lead to Better Cognitive Function

The Archives of General Psychology published an article in their May issue entitled “Effect of Purpose in Life on the Relation Between Alzheimer Disease (AD) Pathologic Changes on Cognitive Function in Advanced Age.”

OK. Long title. But the short of it – research study participants who reported higher levels of purpose in life exhibited better cognitive function despite the burden of having Alzheimer’s Disease.

Interesting. I do a keynote I presumptuously call “The Meaning of Life” and I cover eight points about living a quality of life that I have learned from our elders. Particularly elders in nursing homes, which most of society associates with a place to die, exhibit this characteristic. 

PURPOSE.

Researchers essentially wanted to see if purpose in life reduces the harmful effects of pathologic changes in cognition in advanced age.

Two hundred forty-six community-based older persons from the Rush Memory and Aging Project participated. Purpose in life was assessed via structured interview, and cognitive function was evaluated annually and close to death. Post-mortem examinations were also performed on the brain.

Purpose in life reduced the association of tangles with cognition. The tangles and plaques associated with the disease, in other words, did not impact cognition as much as it did for those who did not have purpose.

In fact researchers said that purpose had a protective effect and higher levels of purpose in life reduced the effect of pathologic changes on cognitive decline.

Got purpose?

Vitamin D Deficiency Could Lead to Mobility Limitations

Elderly adults who are deficient in vitamin D are at a higher risk for developing mobility limitations and becoming disabled.

Looking at the link between vitamin D and the onset of mobility and disability, researchers followed 2,100 men and women aged 70 to 79 over six years. Mobility was determined by subjects' ability to walk several blocks, climb stairs and perform other activities of daily living. 

Investigators from Wake Forest Baptist Medical Center observed a 30% increased risk of mobility limitations for older adults with low levels of vitamin D, and almost a twofold higher risk of mobility disability.

"It's difficult to get enough vitamin D through diet alone and older adults, who may not spend much time outdoors, may need to take a vitamin D supplement,” Denise Houston, Ph.D., R.D., said.

The research was published in the Journal of Gerontology: Medical Sciences.

Source: McKnight's LTC