Family inHome Caregiving Blog

Big brother seems to be constantly looking over our shoulder and as medical records go electronic, many are concerned about what employers, insurance companies, hackers and others will be able to glean off of leaked records.  This is an important issue because decisions about giving people jobs, covering them for insurance, even housing can be based on a person's health.  A new snooper has been thrown into the mix.  The New York Times recently reported that huge databases of patient and physician information is being used by large pharmaceutical companies to market drugs.  These databases allow drug makers to analyze which doctors are prescribing how much of a certain drug compared to their colleagues, while allowing them to access lab tests and personal information like your age, income and ethnic background.  This sounds like a terrible idea to me, but it doesn't seem as if there is a way to opt out.  This seems amazing given the government scrutiny which has been placed on Bing, Google, Yahoo! and other Internet advertising companies about disclosing what information is given to whom and giving the consumer the ability to opt out.  Physicians can opt out of the tracking system, taking their patients with them, but most do not.  A survey found that out of 767K practicing physicians, only 4% have opted out and many don't even know the tracking is happening.  There should be more public awareness about this issue.  Although Federal law requires that personally identifiable information be removed, we all know that cross checking various databases can narrow this down, particularly when small geographic areas are studied.  "I think the doctors tend not to be aware of the depths to which they are being analyzed and studied by people trying to sell them drugs and other by medical products," Dr. Jerry Avorn, a professor of medicine at Harvard Medical School, told the New York Times.  Pharmaceutical companies have turned to this new tactic because they are increasingly getting the door slammed in their face at doctor's office and they need more powerful selling tools.  As cost cutting by insurance companies and Medicare has forced doctors to see more and more patients, they just don't have the time to sit down and speak with pharmaceutical sales reps about different drugs.  This is an unfortunate unintended consequence of government and private insurance company efforts to cut down on medical bills. 

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Much of the health advice which has been passed down from generation to generation from family members, physicians and just general news articles continues to be challenged.  Part of this is due to advances in technology which allows more sophisticated research projects to go on, while another part is the pressure from government and private insurance companies to focus on solving the health problems which will give them the most bang for their buck.  The most recent thing to be challenged is trying to cut most salt out of your diet in order to improve your health.  Although it's true that overuse of salt can cause health problems, a new expert committee commissioned by the Institute of Medicine by the Centers for Disease Control and Prevention (CDC) recently came out and said there was no rationale for aiming to get sodium levels under 2,300 a day.  That's more than 50% higher than the 1,500 milligrams of sodium on the low end recommended by the American Heart Association (AMA), which contested the CDC-commissioned report.  They are sticking with their recommendation, which was issued in 2005, that sodium levels be kept in the 1,500-2,300/day range, and 1,500 or below if you are in a high-risk group .  The new report looked at data since 2005 and found, "As you go below the 2,300 mark, there is an absence of data in terms of benefit and there begin to be suggestions in subgroup populations about potential harms," according to Dr. Brian L. Strom, chairman of the committee and a professor of public health at the University of Pennsylvania.  Salt reduction, which is supposed to prevent heart attacks and strokes for people at high risk (in particular, those over 50, African Americans and anyone who has chronic kidney disease, diabetes or high blood pressure) can actually do the reverse.  The study found reducing salt intake too much could increase heart attacks and increase the risk of death.  There is evidence that extremely low levels of salt and extremely high levels of salt can have dire consequences, this is not under question.  The ambiguity comes in the middle.  How much is too much and how much is too little?  For most people, common sense should prevail but if you are in a high risk group you should definitely discuss this important issue with your physician who will likely have access to a lot more studies than the general public, particularly if you are seeing a specialist.    

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I've written a number of times on my blog about the huge impact analyzing genes is going to have on our health in the future, and in finding cures for a number of deadly diseases.  This became front page news not just in business and medical journals, but entertainment publications as well following the news that Angelina Jolie had decided to have a double mastectomy to reduce her risk of getting breast cancer from about 95% to roughly 5%.  This caused a flurry of women to call their physician to find out how to see if they have the BRCA1 gene, which puts women at extremely high risk of getting ovarian cancer and invasive breast cancer.  Many, however, got sticker shock when they found out that only one company has the rights to the gene test (Myriad Genetics) and the price can be up to $4,000.  Is it worth it?  Well, thankfully most will find it's a covered test, but not everyone.  Only about 1 in 400 women have BRCA1 or BRCA2, and only about 5%-10% of breast cancer cases are gene related.  But if you are in that minority, you would certainly want to know.  There was a story in the New York Times by a molecular scientist who said he could do DNA sequencing on 20,000 genes for about $1,000 or 5 cents per gene, and another company 23andMe charges $99 to test for gene variants that put you at high risk for 120 diseases.  Thankfully, most insurance companies and Medicare and Medi-Cal pays for the Myriad Genetics test, but this price-tag highlights the fact that those without insurance continue to be in a pickle when it comes to health issues.  There is a case before the U.S. Supreme Court which hasn't been decided yet which focuses on whether it's fair for companies like Myriad to control gene tests and make huge profits.  Clearly, monopolies aren't good for the general public.  I remember when the cable companies were monopolies and provided absolutely terrible service at a high-price until companies like DIRECTV and DISH Network entered the market and customers got more bang for the buck because of competition.  This may require some type of government intervention to make sure everyone has access to medical including testing for genes which can cause fatal diseases.

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It's hard to believe, but after all of the misery that this state has suffered through with the recent budget crisis, the state's independent budget analyst on Friday announced that we are projected to take in $3.2 billion more in revenue for the remainder of this year and through the 2013-2014 budget than the figures Governor Brown relied upon.  Part of the reason for the revised forecast is the fact that the stock market has been booming, so residents are going to have to pay more in capital gains taxes this year than what was originally projected.  I hope some of it goes back to seniors programs which have been cut, although the budget office is saying most of the money will have to go back to the schools.  Although that's a worthwhile cause, the money should be spread around amongst the numerous programs which have been cut, including many senior subsidies. Some Democrats in the state senate are pushing Governor Brown to restore adult dental care for the poor and mental health care, and I hope they are successful.  The Medi-Cal reimbursement rate cut of 10% should also be reversed, in my opinion.  There are so few doctors which currently take Medi-Cal and this flurry of cuts we have seen only drives more doctors to refuse to take the insurance.  With the Affordable Care Act (health care reform) putting many more people on Medi-Cal, it will be critical to find physicians who take the insurance.

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Employees of the city of Pacific Grove got good news last week when a Monterey Superior Court judge ruled a 2010 vote to put a 10% cap on contributions towards employees pensions is unconstitutional.  The rule was enacted by the City Council but challenged by the Pacific Grove Police Officers Association and Police Management Association.  The judge also invalidated a voter-approved measure which would have put the pension cap in synch with the city charter.  Although it's good news for employees headed for retirement, it's definitely bad news for the city which will have to struggle with the additional burden this will put on their budget.  It's also likely to make for prickly negotiations between the city and the police officers union, whose contract is currently up for renegotiation.

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Aromas, CA Private Duty Companion Aide Or Caregiver Jobs Available (Also Big Sur, Carmel, Carmel Valley, Castroville, Corral de Tierra, Del Rey Oaks, Gilroy, Gonzales, Greenfield, Hollister, King City, Marina, Monterey,  Morgan Hill, Moss Landing, Paicines, Pacific Grove, Pebble Beach, Prunedale, San Juan Bautista, Salinas, Sand City, Seaside, Soledad And Tres Pinos)

I am happy to say that business is booming at Family inHome Caregiving!  We have had a greater than anticipated influx of new Clients over the past two weeks, many of which have been referrals from past and current Clients.  Our reputation for having the best caregivers in Monterey County is growing.  Family inHome Caregiving of Monterey is seeking compassionate, mature and dependable caregivers (Companion Aides) who want to improve the lives of our elderly Clients by providing in-home, non-medical care, particularly those seeking live-in positions or those who can work 24-hour shifts.  Our services include: ·        Caring companionship

·        Meal preparation;

·        Incidental transportation;

·        Running errands;

·        Light housekeeping;

·        Medication reminders; 

·        Monitoring of safety while bathing; 

·        Information and referral services; and 

·        Other services that improve the safety, security and quality of life of the seniors we serve. 

If you believe you would make an exceptional Companion Aide, we would love to hear from you!  We prefer those with experience helping the elderly, disabled and others with mobility problems.  Having cared for those with dementia and/or Alzheimer's is a plus.  To work for us, you must have excellent references, a clear criminal record, a good driving record, and an insured reliable vehicle.  To apply, please visit our web site www.fhcofm.com, click on careers where you can fill out an application online.  We have immediate openings all over Monterey County.  Service areas include:  

Aromas, Big Sur, Carmel, Carmel-by-the-sea, Carmel Highlands, Carmel Valley, Castroville, Corral de Tierra, Del Rey Oaks, Gilroy, Gonzales, Greenfield, Hollister, King City, Marina, Monterey,  Morgan Hill, Moss Landing, Paicines, Pacific Grove, Pebble Beach, Prunedale, Salinas,  San Juan Bautista, Sand City, Seaside, Soledad And Tres Pinos.

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I've written many times on my blog about the fact that many people are taking nutritional supplements which may actually have little to no value.  Some can even be dangerous.  My own physician warned me against taking any of them, saying that many are using ingredients from overseas which aren't properly supervised.  There just aren't the same regulations we have in the U.S. for manufacturing plants.  The latest supplement to come under fire is fish oil pills.  Although fish oil in actual fish is known to help reduce cholesterol, taking it in a processed pill form isn't proven to do the same thing.  Still, many people take them, hoping to remain off of statins.  A recent study out of Italy, which was published in the New England Journal of Medicine, found that people at a high risk of heart disease which are already on drugs like statins to prevent this from happening don't benefit from taking fish oil supplements.  Manufacturers of the fish oil supplements probably aren't too happy—they paid for the study.  Omega-3 pills have been found to help people lower heart risks if they have already had heart failure or suffered a serious heart attack.  But the benefit for the general population is still questionable.  A 2010 study found that they fail to prevent flare-ups of atrial fibrillation and there have been other studies which have found little benefit.  The bottom line is, if you are serious about preventing heart disease you should eat more fish high in Omega-3 like salmon.  And not the kind with a heavy butter or cream sauce on it! Another mitigating factor in these studies is that people who eat a lot of fish generally eat a healthier diet than red meat eaters, and they are likely to exercise more which is obviously good for the heart.  So it's still not clear how much of the benefit is coming from the fish and how much is coming from a better diet and a healthy lifestyle with plenty of exercise.

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The Sunset Center in Carmel may be getting a complete makeover in its operations.  Sunset Cultural Center Inc., the current operator, has its contract up for renewal effective June 30 but the city has issued a request for qualifications for the lease and operation.  This signals that any newcomers may apply.  The move could be just a negotiating tactic to try and get better terms out of Sunset Cultural Center Inc., but it's quite possible that a new operator may be chosen.  With funds extremely tight for local government, the city is under pressure to pull in as much revenue as possible.  Mayor Jason Burnett told the Monterey Herald that the city has identified areas where the operation could be strengthened.  He said the city has issued performance measures and wants more accountability, which translates into the move being all about money.  According to the city's request for bids, the new operator would have to have the best possible management services and maximize the facility's event booking audiences and revenue potential, including ensuring the facility is a versatile, year-round venue.  Currently, the city spends about 10% of its budget or $1.3 million per year to operate the 718 seat location.  According to the latest non-profit form 990 with the I.R.S., the Sunset Cultural Center raised $1.1 million in 2011 via donations and grants ($750K from the government, presumably the city of Carmel), and pulled in $1.3 mil. in revenue from the venue.  I hope that the result of all of this is that more attractive performances will be shown at the center.  However, the city has to realize that the business is very seasonal and it may not be reasonable to expect the Sunset Center to be putting on shows every week year-round.

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I am always on the lookout for good news on the Alzheimer's research front.  Unfortunately, there hasn't been much of it recently, although there are a lot of exciting potential projects going on.  It was interesting to read the latest research project which found that drinking two or three glasses of champagne per week could fight off the memory loss which comes with dementia and Alzheimer's disease.  The scientists believe that phenolic acid which is found in Pinot noir and Pinot meunier grapes boosts spatial memory.  I grow Pinot noir and who doesn't like champagne, so I thought this was great news.  The experiment which was conducted on rats, had them run through a maze searching for food.  Five minutes later, the exercise was repeated to see if the rats remembered where they had gone.  Those which had been eating champagne laced food had a 70% success rate, while those who didn't had only a 50% success rate.  Those are pretty good odds!  Regular readers of my blog know that both my grandmother and my father had this terrible disease when they passed away, and I have been working diligently with the Monterey Chapter of the Alzheimer's Association to raise money to find a cure.  In addition to being the largest private funder of Alzheimer's research in the United States, they have support groups and a 24-hour hotline (800-272-3900) where a dedicated staff can help you if you are struggling with caring for a loved one with the disease.  Family inHome Caregiving will be sponsoring the Monterey Memory Walk on October 12.  For the past two years, we have been the number one fundraising team in Monterey and we hope we will be again this year.  We have just started our fundraising team.  If you would like to walk with us, to join our team or to donate, please click here.

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There have been a number of exciting developments on the cancer research front recently.  The latest comes from two early stage studies from drug companies which found that our own immune systems can be powerful tools to fight cancer.  Bristol-Myers recently used a two drug combination therapy which was used to target the immune system to combat skin cancer.  They found that in nearly one-third of the patients treated there was a rapid and deep retreat in the cancer tumors.  The drugs were Yervoy, which is currently on the market, paired with the experimental drug Nivolumab.  Roche Holding also did an experiment using a drug known only as MPDL3280A which was used on patients with advanced lung, kidney and skin cancer.  The research project found that 21% of patients responded to the drug while nearly 20% had no increase in the size of the tumors.  The interesting thing about these studies were that they basically stimulated the patient's own immune system in order to recognize the cancer and fight it off.  This, paired with the recent development in studying genes which I have written about recently, are important developments which could have implications fighting many different types of cancer.

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