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 10/17/14
Although diabetes is a huge problem in this
researchers say the rates of diabetes growth (it's doubled over the past
two decades) may be leveling off.
Currently, 9.3% of the population (about 29.1 million people) have
diabetes, according to the Centers for Disease Control and Prevention. This generated $245 billion in medical costs
in 2012. A key driver of the slowing
growth rate is a plateauing of obesity rates.
About 95% of diabetes are Type 2, and many in this group are obese. Although the number of diabetes cases are
still rising, if people can be educated that eating right and getting enough
exercise can significantly reduce their risk of getting diabetes, we may be
able to turn this trend around.
by Richard Kuehn on 10/17/14
More and more people are getting direct results
of medical tests due to a Federal rule which went into effect in
April. These were once guarded by
doctors and other medical professionals but the new Federal rules override a
number of state laws which prevented consumers from getting direct access to
this data, although there is currently a 30-day delay to give physicians time
to review them before patients can. Many
doctors, however, will give you a copy immediately if you ask. As a result, some laboratories and medical facilities
are trying to get more consumer friendly.
For example, Quest Diagnostics launched a secure patient website called
MyQuest by Care360 where patients can go to review their tests within 48-72
hours or get them on a cell-phone app.
This is great progress because many of us get anxious after getting
tests done so it's nice to be able to get access to the results quickly.
by Richard Kuehn on 10/16/14
Most people believe that asthma is caused by
a reaction to pollen, food and other allergens.
Researchers are focusing on another type which is a bit more mysterious
asthma (when the body acts in the same way with constricted airways,
wheezing and coughing, but it's not due to an allergen). With a typical asthma outbreak, your immune
system becomes overactive because of pollen or some other factor. With nonalergenic asthma, however, the body's
immune system isn't involved. The latest
study from the Columbia University Medical Center found that one factor may be
related to chemicals which are included in plastic products. Another study from Weill Cornell Medical
College found that when a normal type of fat in the lungs isn't present (which
oddly enough occurs often in obese people), the risk of asthma goes up
significantly. The number of people
diagnosed with asthma jumped from 5.5% of the population in 1996 to 8.4% in
2010, according to the Centers for Disease Control and prevention. I'm glad more issue is being paid to this
by Richard Kuehn on 10/15/14
Many people aren't even aware of what palliative
care, often referred to as hospice care, is. A recent report by the Institute of Medicine,
the research branch of the National Academy of Sciences, found that end-of-life
care needs a revamp in order to save costs and improve patient care. "What we call for is that there be an
opportunity for discussions with clinicians throughout the life cycle and not
just one time," Phillip Pizzo, co-chair of the panel and former dean of
the Stanford University Medical School, told The Wall Street Journal. "It's part of the process of
living," he said. The committee
believes that one change that should be made is that you currently can't have
access to Hospice via Medicare until a doctor says that you have less than six
months to live. This rule should be
changed if people can benefit from the extra care earlier, the committee
said. It pointed out that many people
are in and out of the hospital repeatedly which costs more than if they were on
hospice care. Make sure than you have an
up-to-date POLST (Physician's Order for Life Sustaining
Treatment) and let your doctors and your family know what your wishes are for
end of life care.
by Richard Kuehn on 10/15/14
There's likely to be protracted litigation
over the decision by Actavis PLC to stop selling a popular Alzheimer's
drug called Namenda (a twice daily drug) and replace it with the same drug
in a once-per-day dose called Namenda XR.
The move is to thwart competition when competitors are able to make a
generic version of the drug next year.
The patent for Namenda expires next year. However, the patent for Namenda XR won't
expire until 2029. Although it's not
unusual for a drug company to try to reformulate a drug as its patent nears
expiration, Actavis' move is very unusual because it plans to halt sales of the
original drug this fall, prior to competitors entering the market with a
generic. The company says it is doing so
after positive feedback from doctors and caregivers, but the decision is likely
more to do with money. There is no
question the strategy is a success. About
40% of Namenda users have already been switched over to Namenda XR and nursing
homes have complained about a shortage of the drug. The New York Attorney General is asking for a
temporary restraining order as its lawsuit goes through the system.
by Richard Kuehn on 10/15/14
studies on artificial sweeteners have had surprising results; they may
actual raise your blood sugar level instead of reducing it, increasing the risk
of diabetes. Zero-calorie sweeteners
have been found to alter the population of bacteria in the gut and trigger
higher blood glucose levels. The
researchers have also studied whether the use of no-calorie sweeteners cause
you to lose weight. The study, which was
published in the journal Nature, finds the opposite of jointly published
guidelines in 2012 by the American Heart Association and the American
Diabetes. They said that when artificial
sweeteners are used judiciously they could facilitate reductions in added
sugar. Although the jury is still out on
this issue, it may be prudent to switch from diet soda to unsweetened iced tea.
by Richard Kuehn on 10/14/14
There have been a number of breakthroughs in
genetic testing which now allow people to see if they are at high risk of
getting numerous diseases. However, the
fact of the matter is that many
people don't want to know. For
instance, many diseases like Alzheimer's have no cure, so people may not want
to know if they are at risk of getting it because it can cause anxiety. However, there are real positives to
knowing. For instance, one woman who
recently saw her mother die from Alzheimer's disease was considering having a
baby. If she had just one copy of the mutation,
she would develop an early-onset of Alzheimer's disease that ran in her
mother's family. The doctor tested the
patients eggs and found two embryos that didn't contain the Alzheimer's
mutation and these were used for in-vitro fertilization. Researchers presented the case at the
American Neurological Association conference as the first instance of pre-implantation
genetic diagnosis, or PGD, for Alzheimer's disease. The patient told the doctor that she didn't
want to know if she had the gene and did not want to be told about the results
of the testing on the embryos. Still,
she was able to plan to have a healthy baby and peace of mind.
by Richard Kuehn on 10/14/14
Sclerosis is a terrible neurological disease which causes problems with
movement, balance, coordination and thinking.
However, there are things which can be done to make the symptoms ease
up. Excessive salt consumption and
smoking, for instance can both worsen MS symptoms. Even being in extreme heat or cold weather
can be difficult. Researchers believe
that exercise, getting enough sleep and maintaining a low-sodium diet can
mitigate many of the more difficult symptoms of the disease. The disease impacts about 500,000 people in
the U.S. and while it strikes people while they are relatively young, many
people live with it for decades. About
85% of those impacted are dubbed "relapsing-remitting" which
translates to attacks happening with very acute symptoms only to be followed by
a long period of time with few to no symptoms.
Researchers are now looking at ways to prolong those periods, and I hope
they are successful.
by Richard Kuehn on 10/14/14
For the first time in history, researchers
have created what they are calling Alzheimer's in a dish, a petri dish with
human brain cells which develop into the same structure as Alzheimer's
disease. The hope is that these
cells can be treated with various types of drugs, and a cure may quickly be
found. Researchers at Massachusetts
General Hospital got the idea to grow human brain cells in a gel and then give
them genes for Alzheimer's disease.
Quickly, the cells began growing plaques and tangles, signs of Alzheimer's
disease. Published in the journal
Nature, the study could be the first step in identifying a process whereby new
drugs can be quickly tested in petri dishes and then go on to human trials if
they are successful. "It is a giant
step forward for the field. It could drastically
accelerate testing of new drug candidates," Dr. P. Murali Doraiswamy, an
Alzheimer's researcher at Duke University, told the New York Times.
by Richard Kuehn on 10/12/14
Medicare premiums will remain flat in 2015 for most seniors. Those with high incomes will get a rate hike
but the base level will remain flat at $104.90 per month. Unfortunately, the deductible for hospital
visits is going up from $1,216 this year to $1,250 in 2015 and the cost of
being in a skilled nursing facility is going up to $157.50 per day after the 20th
day, up from $152 a day now. The
Department of Health and Human Services said Medicare costs are trending lower
than expected. However, they believe
this is due to a weak economy which has caused many seniors to forgo medical
care because of the high out of pocket costs.