Posted on 03 October 2010. Tags: alzheimer's, Aromas, big sur, California, caregiver, caregiving, carmel, carmel highlands, carmel valley, Dementia, elder, elder care, gilroy, hollister, Hospice, king city, live-in, marina, memory walk, monterey, Moss Landing, pacific grove, pebble beach, private duty, prunedale, salinas, sand city, seaside, senior, senior care The upcoming mid-term elections have both Republicans and Democrats targeting an important voter segment: senior citizens. I hope you all go to the polls! The Wall Street Journal ran an article 9/29 talked about the growing battle over a number of issues, including Health Care and Social Security. With inflation at a stand still causing the elderly to get by without cost of living increases necessary to cover rising health care and other day-to-day costs, these are hot issues.
According to the article, Republicans are focused on telling elderly voters that the Democratic health care overhaul will cripple Medicare by cutting $50 bil. from the program, while Democrats are telling older voters that the Republicans wan to gut Social Security, with some calling for a partial phase out of this money into private investment accounts.
This is a terrible idea in my opinion. At my last job I watched a man who was almost 70 and just getting ready to retire sitting at his computer crying as the market crash wiped out much of his 401K plan which he had planned to tap to have a peaceful and happy retirement. This was a few years ago but I just saw him last week–still sitting at his desk and unable to retire.
One problem these lawmakers may not have considered is the growing number of seniors with dementia and Alzheimer’s disease. My company, Family in Home Caregiving of Monterey, services these people with private duty caregivers which drive all over the peninsula to meet whatever needs they have. From Salinas to Gilroy to Monterey, our caregivers sometimes take the place of family, and we form a special bond with them. A frequent problem is getting them to take their medications. Many are forgetful or just don’t care. We don’t delve into their financial situations, however, I have spoken to many other people in the industry and there are a lot of seniors slipping into dementia and Alzheimer’s which unfortunately haven’t prepared for this situation with a living trust or someone who can take over their affairs. What would happen to these people if their social security were invested in the stock market and we had another prolonged economic downturn? It’s unlikely they would be able to make the proper financial decisions in order to protect their assets. My company motto is to allow seniors to remain independent and live in their own homes as long as possible. One sad story I recently witnessed was a caregiver looking for a job because the person she was caring for was being foreclosed on and they had to move in with a relative. I hope politicians don’t enable this to happen by throwing what should be a safe annuity payment, social security, into the volatile stock market. In the 2008 presidential election, voters 65 and older were 16% of the vote. 30% of voter were over 60 in the 2006 mid-term elections–I hope to see more seniors at the polls in these important elections. Posted on 03 October 2010. Tags: alzheimer's, Aromas, big sur, California, caregiver, caregiving, carmel, carmel highlands, carmel valley, Dementia, elder, elder care, gilroy, hollister, Hospice, king city, live-in, marina, memory walk, monterey, Moss Landing, pacific grove, pebble beach, private duty, prunedale, salinas, sand city, seaside, senior, senior care There was a disturbing story in the New York Times today about patients in nursing homes having to go out to pain clinics to get medication because of a policy many live-in facilities have which will not allow them to dispense certain medications without a written or faxed prescription from the Doctor on file.
The Drug Enforcement Administration (DEA) is now scrutinizing this practice, which can result in seniors being in pain for days before the proper paperwork arrives. The practice is an unfortunate consequence of the DEA cracking down on abuse of prescription narcotics, which some people get filled and then sell on the black market. Some unscrupulous Doctors have even been involved in this practice.
The DEA has also examined some nursing homes which allegedly dispensed narcotics without a written order from a Doctor, resulting in the current situation where some of the elderly living in assisted living facilities are left to suffer in pain, particularly on weekends when it’s difficult to get in touch with their primary care physician. Even on a good day Doctors are busy–according to the medical directors association, a doctor at a nursing home typically writes 169 prescriptions per month for a controlled substance. And many assisted living facilities don’t have a Doctor on staff causing further delays.
I’ve written on my blog many times about the unintended negative consequences of the new health care reform laws, which is costing seniors time and money. And many of them simply don’t have an abundance of either. I founded my company, Family inHome Caregiving of Monterey to help seniors from of all walks of life stay in their own homes and remain independent. I have Clients all over the county from Pacific Grove to Castroville and Salinas, and up to Moss Landing and Aromas. They are thankful that there is someone to help.
For many of them, we stop by and make sure they take their meds, get a hot meal, and get out and about and socialize with others which improves their mental faculties. They are the lucky ones who have friends and family looking after them, or have had the foresight to put money away and establish a trust or buy long-term health care insurance so they can be taken care of properly.
Unfortunately, there are millions of others which are shut away in nursing home and have no one looking after their best interests. As the NYT article pointed out, this often results in pain and suffering. It’s bad enough being left on your own with no friends and family, I hope the DEA can resolve this issue quickly.
Posted on 03 October 2010. Tags: alzheimer's, Aromas, big sur, California, caregiver, caregiving, carmel, carmel highlands, carmel valley, Dementia, elder, elder care, gilroy, hollister, Hospice, king city, live-in, marina, memory walk, monterey, Moss Landing, pacific grove, pebble beach, private duty, prunedale, salinas, sand city, seaside, senior, senior care New theories and possible solutions to treating Alzheimer’s Disease and dementia appear in the press on a weekly basis. The latest report in the Monterey Herald this week called attention to a recently published study with a new theory by Alison Goate of Washington University in St. Louis, MO in the PLoS Genetics journal. For a full copy of the study, click on this link.
Much of the research on Alzheimerse revolves around beta-amyloid plaque, although success has been mixed–I wrote in my blog about Eli Lilly’s pulling a promising new drug (Semagacestat) from the market in August after finding that those on the drug fared worse than those given a placebo.
The more recent report focused on protein tangles that clog brain cells. This could determine how quickly a person develops symptoms of Alzheimer’s Disease. This, paired with a second protein called tau, might signal how aggressive the onset of the disease becomes. The research report found that patients with mild Alzheimer’s and high levels of tau harbored a genetic alteration that predicted that they would worsen faster. The race is on now to figure out how to lower tau levels in patients which could be developing Alzheimer’s Disease, because this could slow down its onset. The new study posits that both proteins, tau and amyloid, play a role in how quickly people develop Alzheimer’s. Many harbor the disease for years, even decades, without showing symptoms. The study from Goate showed that there was up to a seven-fold difference in how quickly people deteriorated if they had a gene which caused them to produce abnormal tau. Genetic testing may one day be able to uncover signs that people are going to develop Alzheimer’s and many other terrible diseases. Although the research is promising, unfortunately it’s just the first-step in what is likely to be a long research project to explore this line of thought. Goate told a reporter that tau is just likely to be one of many genetic markers to be discovered that impacts Alzheimer’s Disease. That’s one reason I am a major supporter of the Alzheimer Association’s annual Memory Walk, their largest fundraiser of the year. This great organization is the largest private funding group for Alzheimer’s Research and the Family inHome Caregiving team has raised over $20,000 for this noble cause. To track our progress or find out more about the event (10:00 a.m. at the Custom House in Monterey on Saturday, October 16) click on this link. As always, thanks for your support.
Physical Therapists Offer Home Safety Tips To Avoid Falls
As the nation observed the third annual Falls Prevention Awareness Day on September 23, the American Physical Therapy Association urged older adults to take a moment to complete a room-by-room checklist to identify and repair possible fall hazards in their homes and begin an exercise plan to reduce chances of falling and risk of injury. "It’s critical that seniors remain active in and outside their homes to help reduce their risk of falling," says APTA spokesperson Patrice Winter, PT, MPT.
"However, hazards in the home are one of the leading causes of falls in older adults. Removing throw rugs, rerouting electrical cords, and installing handrails are simple ways in which one can make a home safer. Furthermore, an older adult’s risk of falling can be decreased through an individualized exercise program, designed by a physical therapist, to improve his or her strength, mobility, and balance."
According to the Centers for Disease Control and Prevention, more than one third of adults ages 65 and older fall each year in the United States. Falls are the leading cause of deaths due to injuries and the most common cause of nonfatal injuries and hospital admissions for trauma for the aging population. In addition to addressing home safety and exercise, older adults should ask all health care providers to review their medicines — both prescription and over-the counter — to reduce side effects and interactions. They should also have their eyes checked by an eye doctor at least once a year.
Family inHome Caregiving Blog
by Richard Kuehn on 07/11/14
There is quite a bit of
controversy revolving around a number of new expensive drugs, and whether or
not Medicare and private insurance companies should pay for them. Over the past year, of the 27 drugs which
were approved by the Food & Drug Administration (FDA), 19 were so-called
"specialty drugs" which typically come at a very high price. Novartis,
for instance, introduced the first ever oral medication for those suffering
from multiple sclerosis in 2010 called Gilenya.
Although this was a watershed event at the time, it also set a new high
bar for the price of an MS drug at $4,000 per month. However, one lesson that has been learned is
that when a drug comes on the market it's often very expensive but as more
people start to use it and demand rises, the price drops. Gilenya is now the cheapest drug for MS so
Medicare and private insurance companies must consider this price curve when
looking at whether or not to approve new drugs.
Inevitably, if there is demand, the price will fall dramatically.
by Richard Kuehn on 07/09/14
is a huge
problem in America and those dealing it often initially struggle with how
to manage their blood glucose level while avoiding severe hypoglycemia. A recent study in JAMA Internal Medicine
found that every year about 100,000 people end up in the emergency room because
of hypoglycemia, with a third of them having to be hospitalized. This number is too high! One important thing to remember is that
friends and family can help. Let those
close to you know about your condition because if your blood sugar levels get
too low you may pass out, or close to it, and be unable to care for
yourself. There's also a bracelet that you
can get to let medical staff and others know that you have diabetes. Communication is key to staying healthy and
by Richard Kuehn on 07/08/14
The extremely slow pace of new treatments for
ALS, also known as Lou Gehrig's disease, has caused a local man to start a
non-profit biotech organization called SciOpen Resarch Group to try to spur
more scientists to pay attention to this rare neuro-degenerative disease. It's an inspiring story as the man is in
extremely bad health but calls himself a "biotech guerilla" who
searches databases for new compounds, designs study protocols, while also doing
fundraising. "His intellect and
willingness to contribute to the fight should be an inspiration to all
scientists to find a therapy for ALS and all neurodegenerative diseases,"
Dave Schubert, director of the Salk Institute's Cellular Neurobiology
of the man who was diagnosed with the disease at age 36. He soon found out that there is no cure for
amyotrophic lateral sclerosis, and no known cause. Like many who receive a diagnosis of something
which is degenerative and there is little hope of recovering from, he found
hope in himself to try and seek out new information and in this case took it to
the extreme, to try and change the diagnosis for anyone with ALS.
by Richard Kuehn on 07/07/14
Many towns in Monterey County have a number
of restrictions regarding what you can and can not do on your own
property. Most rules revolve around
water, building more square footage being added (particularly when it can
obstruct views) and cutting down trees. The latter is
causing quite a bit of stress for an elderly PG couple after the city rejected
a bid by 80-year old Gene Olsen to install a wheelchair ramp so that he can get
to his car safely. To do so, they would
have to remove three trees, which is a no-no in Pacific Grove. "It's a bucket of worms," Olsen
told the Carmel Pine Cone, adding that he is considering legal action. "They are creating an extremely
dangerous situation," David Davis, his son-in-law, told the Pine
Cone. It's not just Olsen who could get
injured, but caregivers and home health workers who have to walk across a lawn
which is buckled and bulging due to intrusive roots. Utility lines have also been damaged so the
city may bear some expense as well. The
sad thing is, the Veterans Health Administration came down to install the
wheelchair ramp at no charge but because the land was not compliant with the
Americans with Disabilities Act they packed up the equipment and left.
by Richard Kuehn on 07/06/14
Medical costs have been skyrocketing in this
country and I am glad to see that law enforcement and Medicare have been
vigilant about uncovering major fraud cases.
The cases have ranged from small mom and pops to multi-million dollar criminal
enterprises. The latest, reported
in the Wall Street Journal,,is a clinic in Los Angeles which billed
Medicare more than $2 million for a rarely used cardiac treatment. The clinic collected more money from this
treatment than any other medical facility in the nation. A clinic and an affiliated lab owned by an
internist collected more than $17.5 million from Medicare between 2006 and
2012. The FBI, private insurers and
Medicare have all honed in on this clinic and I am sure there will be more
written on this case and many others like it.
by Richard Kuehn on 06/29/14
There was a disturbing story in The
Wall Street Journal entitled, "Life lessons from dad." It took up the entire review section, and
Dave Shiflett talked about caring for his 91-year old father, who suffered from
dementia. Like most children faced with
this difficult issue, he took the task seriously and it had a long-lasting
impact on how he thought about life.
"Even in the sadness of hopeless decline, my parents—members in
good standing of the Greatest Generation—had a few things to teach their
baby-boomer offspring about toughness, perseverance, quality of life and,
especially love. We were reminded,
vividly, that we are often at our best when life is at its worst,"
Shiflett wrote. Caring for someone with
Alzheimer's disease is an extremely difficult task and I feel for him. Regular readers of my blog know that both my
father and my grandmother had Alzheimer's disease when they passed away. It's a terrible disease for which there is no
cure. I am currently raising money for
the Alzheimer's Association's annual Walk to End Alzheimer's event. If you can afford to help, please click here.
by Richard Kuehn on 06/25/14
Criticism has been lobbed at a number of
physicians after a report from Medicare came out with a report in April detailing
how much the government paid on a doctor-by-doctor basis during 2012. Oncologists were high on the list of the best
paid, although many complained the report was unfair because the numbers that
were released included chemotherapy treatments which were done at little to no
Wall Street Journal, however, came out with a story last week stating that
many cancer doctors were using Procrit, which helps with the side effects of
chemo, despite the fact that it's expensive and has recently been found to
speed tumor growth and hasten death in those with cancer. One large oncology group was singled out by
the Journal for billing Medicare a whopping one-sixth of the total $128 million
the agency paid doctors to administer the drug in 2012. Despite the fact that the FDA has warned
doctors not to use the drug on chemotherapy patients and to warn patients of
the risk of taking the drug, it's being used quite frequently by a handful of
medical clinics. It's likely that the
Wall Street Journal has, once again, done great journalistic reporting and may
have identified a multi-million dollar fraud.
I hope that's not the case.
Doctors are supposed to be one of the top professionals that we trust in
our day to day lives and it's sad when you see them in the headlines accused of
by Richard Kuehn on 06/25/14
Most people don't view IBM as a company
that's on the cutting edge of creating breakthroughs in new medical
recent article in Fast Company magazine, however, pointed out that the
company is trying to reinvent itself with nanotechnology, using hardware in
order to solve a wide range of medical programs. The company is working on creating better
antimicrobial and antifungal agents, new methods of drug delivery and novel
ways of combating diseases ranging from HIV to tuberculosis. IBM has devoted a huge amount of resources
into experimental nanomedicine. This
company has such a massive amount of resources that it's bound to make cutting
edge discoveries in a number of arenas.
After many stumbles, it's great to see IBM reinventing itself in a
sector with such great potential.
by Richard Kuehn on 06/25/14
There haven't been a lot of
advancements in the treatment of diabetes over the last few years, but there
appear to be several workable theories on how the treatment of this widespread
disease will become much easier over the next five years. Two
small studies were released this month at the meeting of the American
Diabetes Association in San Francisco which implied that patients with Type 1
diabetes might be able to control their blood sugar levels using a new insulin
pump system. It's controlled by an algorithm
in a smartphone which determines the timing of injections. Although small, both studies were published
in the widely respected New England Journal of Medicine and were conducted by
Boston University, the Massachusetts General Hospital, and both were funded by the
National Institutes of Health. Although
a commercial roll-out is probably a couple of years away, independent experts
have said that these studies provide a solid proof-of-concept which could speed
up approval by the FDA of such a device.
Type 1 Diabetes is typically diagnosed in childhood and impacts about
1.5 to 2.0 million Americans, which have to deal with the disease their entire
lives. "What we're providing is a
smart pump that overtakes your diabetes management completely," Dr. Edward
Damiano, told the Wall Street Journal.
by Richard Kuehn on 06/24/14
There are amazing advancers in cancer
treatment which are being announced almost on a daily basis. Many experimental drugs are being developed
based on DNA research and so-called personalized medicine. Now, a former Google employee has formed
a start-up called Flatiron Health. It
is making use of a vast amount of information about those without the disease
which isn't currently being exploited.
The company is taking advantage of the time gap between when clinical
trials are conducted and information is reported in medical journals. Many cancer centers are now contributing
information about actual cases with the names taken out of the file, and the
company has built its database into a massive amount of information, with case
studies on 550,000 patients. Google
Ventures has just made its biggest investment ever in a start-up, $130 million
in Flatiron Health, so they obviously have high expectations for this line of
business. I hope this type of anonymous
sharing of information becomes more widespread in the medical community,
particularly regarding patients with rare types of cancer where there isn't
much data out there to show physicians how to treat the disease.