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Posts Tagged ‘senior care’
September 19, 2011
Seniors Are Saying No to High Tech
The digital revolution may be changing the way we live and work. But large numbers of older Americans are not going online, using smartphones, or even participating in the benefits of electronic healthcare tools specifically designed to help them.
The costs of not participating in electronic communications are growing. Government and the private sector are shifting to online tools as their dominant form of public communication. It saves time and money, and provides more responsive public services. But surveys of Internet and technology use show that many, if not most, older consumers are bypassed with online communication.
Earlier this year, for example, the U.S. Social Security Administration said it would stop sending paper statements to Americans explaining their Social Security benefits. Instead, such statements would be available online. As part of a broader government policy, Social Security will also be ending paper-based benefit checks by May 2013.
The Social Security Administration says growing use of the Internet will allow it to save money on paper-based statements and still meet public needs. However, while the agency has stopped mailing out its annual statement of benefits, it has yet to begin offering this information online. And an agency spokesman says privacy rules prevent the agency from even measuring how many people visit its website. The agency knows that total page views on the site are rising, the spokesman said, but it is not allowed to collect specifics on how many beneficiaries are actually using the site.
The most probable answer, however, is “not many.” According to the Pew Research Center’s Internet & American Life Project, only 42 percent of Americans age 65 and older go online at all. Of these, even smaller percentages use the Internet to research information on specific topics. These numbers are rising, but still are roughly half the level of younger Americans. The Social Security Administration does say it plans to provide paper-based statements to older people, but has not yet spelled out the timing of this effort.
Laurie Orlov is a former Forrester Research analyst who started her own company, Aging in Place Technology Watch, to research and provide consulting advice about seniors and technology. While there have been some gains in technology use by older consumers, price and complexity are barriers to larger gains, as is seniors’ comfort with familiar ways of doing things.
“People are pretty inflexible” about technology use, she says, “so there’s a chance those numbers won’t improve much.” Is it fair to describe seniors as the lost generation in terms of technology? “I think they are,” she says.
Orlov can rattle off an impressive list of the costs to seniors of not being online, from paying extra for airline tickets by using a reservations agent, to missing out on online coupons and other digital bargains, to becoming isolated from grandchildren and other family members who increasingly rely on digital devices to communicate.
Baby boomers, by contrast, are using new technology at rates nearly equal to younger consumers. They are likely to continue such habits as they join the ranks of senior citizens, and it will be this trend that will firmly establish electronic communication and commerce as a senior activity.
For now, Orlov says, she’s extremely optimistic that computers and hand-held tablets and other devices will become easier to use and more friendly to inexperienced and older consumers alike.
Ingenious “apps” and uses for smartphones and other mobile communications devices are driving broad gains in consumer adoption. Orlov thinks the improvements in user interfaces and ease-of-use gains in these mass markets will help all consumers, including seniors. “I think technology is becoming multi-age friendly,” she says.
“We’re at the beginning of a remarkable time,” she says. “It’s going to get better because it can. That’s the nature of technology.”
By Phil Moeller
September 13, 2011
Dieting Beats Exercise for Diabetes Prevention in Older Women, Combo Is Best Strengthening exercise appears to have greater benefits for insulin resistance than aerobic exercise
Lifestyle changes that include dieting to lose weight and exercise can help prevent type 2 diabetes, but researchers were uncertain which element contributes more. A new study suggests that, in postmenopausal women at least, dietary weight loss alone is effective while exercise alone is not effective, and both together are best of all.
“The effects seems to be additive,” said Caitlin Mason, Ph.D., lead study author.
“The women who did both diet and exercise together had the greatest weight loss and greatest improvement in insulin and blood sugar control.”
In light of the additional benefits of exercise, such as preserving muscle mass during weight loss, “a combined program is the way to go,” said Mason, a postdoctoral fellow in public health sciences at the Fred Hutchinson Cancer Research Center.
For the study, which appears online and in the October issue of the American Journal of Preventive Medicine, 439 inactive, overweight postmenopausal women were randomly assigned to participate in a dietary weight loss program, an aerobic exercise program, or a program that included diet and exercise, or were told not to change their eating or exercise patterns.
Participants received diet and exercise counseling in groups of eight to 15 women, rather than individually.
The researchers estimated the women’s insulin resistance – which reflects how well or poorly the body metabolizes sugar – and their fasting blood sugar, when the study began and after 12 months. Increased insulin resistance and elevated blood sugar are signs that the risk of diabetes is high.
Insulin resistance improved significantly with diet and a bit more in the diet-plus-exercise group, but not with exercise alone, compared to women who made no changes. Exercise alone did improve fasting glucose, but only when it was elevated to begin with.
Women in the diet group lost an average of 8.5 percent of their initial body weight, while those who had diet plus exercise lost more than 10 percent. Improvement in insulin resistance was proportional to the amount of weight lost.
Jill Crandall, M.D., director of the Diabetes Clinical Trials Unit at the Albert Einstein College of Medicine, said she was “most impressed” by the magnitude of weight loss achieved in the study, “but the effect this will have on glucose metabolism or diabetes risk in the long run is a little hard to say from this paper.”
One of the most useful things the study did was to show that “a group-based program could be very effective for weight loss,” added Crandall, who has no affiliation with the study. From a public health perspective, she said, “anything done in the group setting is more feasible.”
She noted that strengthening exercise appears to have greater benefits for insulin resistance than aerobic exercise, and suggested that its inclusion in future studies might be “a desirable feature.”
By Carl Sherman, Health Behavior News Service
September 6, 2011
When Lapses Are Not Just Signs of Aging
By JANE E. BRODY
Who hasn’t struggled occasionally to come up with a desired word or the name of someone near and dear? I was still in my 40s when one day the first name of my stepmother of 30-odd years suddenly escaped me. I had to introduce her to a friend as “Mrs. Brody.”
But for millions of Americans with a neurological condition called mild cognitive impairment, lapses in word-finding and name recall are often common, along with other challenges like remembering appointments, difficulty paying bills or losing one’s train of thought in the middle of a conversation.
Though not as severe as full-blown Alzheimer’s disease or other forms of dementia, mild cognitive impairment is often a portent of these mind-robbing disorders. Dr. Barry Reisberg, professor of psychiatry at New York University School of Medicine, who in 1982 described the seven stages of Alzheimer’s disease, calls the milder disorder Stage 3, a condition of subtle deficits in cognitive function that nonetheless allow most people to live independently and participate in normal activities.
One of Dr. Reisberg’s patients is a typical example. In the two and a half years since her diagnosis of mild cognitive impairment at age 78, the woman learned to use the subway, piloted an airplane for the first time (with an instructor) and continued to enjoy vacations and family visits. But she also paid some of the same bills twice and spends hours shuffling papers.
Dr. Ronald C. Petersen, a neurologist at the Mayo Clinic College of Medicine in Rochester, Minn., described mild cognitive impairment as “an intermediate state of cognitive function,” somewhere between the changes seen normally as people age and the severe deficits associated with dementia.
While most people experience a gradual cognitive decline as they get older (only about one in 100 lives long without cognitive loss), others experience more extreme changes in cognitive function, the neurologist wrote in The New England Journal of Medicine in June. In population-based studies, mild cognitive impairment has been found in 10 percent to 20 percent of people older than 65, he noted.
Dr. Petersen described two “subtypes” of the condition, amnestic and nonamnestic, that have different trajectories. The more common amnestic type is associated with significant memory problems, and within 5 to 10 years usually — but not always — progresses to full-blown Alzheimer’s disease, he said in an interview.
“Subtle forgetfulness, such as misplacing objects and having difficulty recalling words, can plague persons as they age and probably represents normal aging,” he wrote. “The memory loss that occurs in persons with amnestic mild cognitive impairment is more prominent. Typically, they start to forget important information that they previously would have remembered easily, such as appointments, telephone conversations or recent events that would normally interest them,” like the outcome of a ballgame would a sports fan.
The forgetfulness is often obvious to those who are affected and to people close to them, but not to casual observers.
The less common nonamnestic type, which is associated with difficulty making decisions, finding the right words, multitasking, visual-spatial tasks and navigating, can be a forerunner of other kinds of dementia, Dr. Petersen said.
In general, Dr. Reisberg said, “mild cognitive impairment lasts about seven years before it begins to interfere with the activities of daily life.”
The Correct Diagnosis
Distinguishing mild cognitive impairment from the effects of normal aging can be challenging. Typically, new patients take a short test of mental status, provide a thorough medical history and are checked for conditions that may be reversible causes of impaired cognition. Problems like depression, medication side effects, vitamin B12 deficiency or an underactive thyroid can mimic the symptoms of mild cognitive impairment.
Other tests, like an M.R.I. or CT scan of the brain, can look for evidence of a stroke, brain tumor or leaky blood vessel that may be impairing brain function.
It is natural, Dr. Petersen said, for patients and their families to want to know whether and how quickly the disorder might progress. While patients decline by about 10 percent each year, on average, certain factors are associated with more rapid progression. Among these are the presence of a gene called APOE e4, more common among patients with Alzheimer’s disease; a reduced hippocampus, a region of the brain important to memory; and a low metabolic rate in the temporal and parietal regions of the brain.
Amyloid plaques in the brain, while a hallmark of Alzheimer’s disease and a predictor of progression, have also been found at autopsy in people with perfectly normal cognitive function.
Preserving Cognitive Function
Despite a number of clinical trials that tested various medications, no drug to treat mild cognitive impairment has been approved by the Food and Drug Administration. But experts like Dr. Reisberg and Dr. Petersen suggest several approaches that may slow the decline in cognitive function.
Although studies did not show that medications like donepezil (brand name Aricept) and memantine (Namenda), both used to treat Alzheimer’s disease, change the ultimate course of mild cognitive impairment, Dr. Reisberg said they can be useful temporary treatments that may stabilize patients for a few years.
Although the drugs are not approved for this condition, licensed physicians can prescribe approved medications “off label.” “Clinicians have to work with what we have,” Dr. Reisberg said.
There are people who think they are having memory problems, but tests do not show anything definitive. Some may be in Stage 1 of Alzheimer’s disease, Dr. Reisberg said, and perhaps could benefit from early treatment with the drugs.
It is also important to reduce cardiovascular risk factors like smoking, elevated cholesterol and high blood pressure; keep blood sugar at normal levels; minimize stress (which in animal studies can cause the hippocampus to shrink); and avoid anticholinergic drugs that can interfere with brain chemicals important to memory. These include Demerol to treat pain, Detrol to treat a leaky bladder, tricyclic antidepressants, Valium, and over-the-counter medications with Benadryl (diphenhydramine), like Tylenol PM, Dr. Petersen said.
Some cognitive rehabilitation exercises, like computer games that enhance focus, may be helpful, Dr. Petersen said, but there have been few good studies to demonstrate a benefit. Compensatory techniques, like taking notes, creating mnemonics and making structured schedules, can be useful aids, he added.
But most promising is regular physical exercise, which in animal studies was found to reduce the accumulation of amyloid in the brain. An Australian study in patients with memory problems showed that brisk walking for 150 minutes a week improved cognitive function.
August 2, 2011
How Exercise Can Keep the Brain Fit
For those of us hoping to keep our brains fit and healthy well into middle age and beyond, the latest science offers some reassurance. Activity appears to be critical, though scientists have yet to prove that exercise can ward off serious problems like Alzheimer’s disease. But what about the more mundane, creeping memory loss that begins about the time our 30s recede, when car keys and people’s names evaporate? It’s not Alzheimer’s, but it’s worrying. Can activity ameliorate its slow advance — and maintain vocabulary retrieval skills, so that the word “ameliorate” leaps to mind when needed?
Obligingly, a number of important new studies have just been published that address those very questions. In perhaps the most encouraging of these, Canadian researchers measured the energy expenditure and cognitive functioning of a large group of elderly adults over the course of two to five years. Most of the volunteers did not exercise, per se, and almost none worked out vigorously. Their activities generally consisted of “walking around the block, cooking, gardening, cleaning and that sort of thing,” said Laura Middleton, an associate professor at the University of Waterloo in Ontario and lead author of the study, which was published last week in Archives of Internal Medicine.
But even so, the effects of this modest activity on the brain were remarkable, Dr. Middleton said. While the wholly sedentary volunteers, and there were many of these, scored significantly worse over the years on tests of cognitive function, the most active group showed little decline. About 90 percent of those with the greatest daily energy expenditure could think and remember just about as well, year after year.
“Our results indicate that vigorous exercise isn’t necessary” to protect your mind, Dr. Middleton said. “I think that’s exciting. It might inspire people who would be intimidated about the idea of quote-unquote exercising to just get up and move.”
The same message emerged from another study published last week in the same journal. In it, women, most in their 70s, with vascular disease or multiple risk factors for developing that condition completed cognitive tests and surveys of their activities over a period of five years. Again, they were not spry. There were no marathon runners among them. The most active walked. But there was “a decreasing rate of cognitive decline” among the active group, the authors wrote. Their ability to remember and think did still diminish, but not as rapidly as among the sedentary.
“If an inactive 70-year-old is heading toward dementia at 50 miles per hour, by the time she’s 75 or 76, she’s speeding there at 75 miles per hour,” said Jae H. Kang, an assistant professor of medicine at Brigham and Women’s Hospital at Harvard Medical School and senior author of the study. “But the active 76-year-olds in our study moved toward dementia at more like 50 miles per hour.” Walking and other light activity had bought them, essentially, five years of better brainpower.
“If we can push out the onset of dementia by 5, 10 or more years, that changes the dynamics of aging,” said Dr. Eric Larson, the vice president of research at Group Health Research Institute in Seattle and author of an editorial accompanying the two studies.
“None of us wants to lose our minds,” he said. So the growing body of science linking activity and improved mental functioning “is a wake-up call. We have to find ways to get everybody moving.”
Which makes one additional new study about exercise and the brain, published this month in Neurobiology of Aging, particularly appealing. For those among us, and they are many, who can’t get excited about going for walks or brisk gardening, scientists from the Aging, Mobility and Cognitive Neuroscience Laboratory at the University of British Columbia and other institutions have shown, for the first time, that light-duty weight training changes how well older women think and how blood flows within their brains. After 12 months of lifting weights twice a week, the women performed significantly better on tests of mental processing ability than a control group of women who completed a balance and toning program, while functional M.R.I. scans showed that portions of the brain that control such thinking were considerably more active in the weight trainers.
“We’re not trying to show that lifting weights is better than aerobic-style activity” for staving off cognitive decline, said Teresa Liu-Ambrose, an assistant professor at the university and study leader. “But it does appear to be a viable option, and if people enjoy it, as our participants did, and stick with it,” then more of us might be able, potentially, to ameliorate mental decline well into late life.
By GRETCHEN REYNOLDS
July 18, 2011
South Carolina:Missing Persons and Alzherimer’s
Did you know that there are 2300 people reported missing every day?
Every evening, as I scan the list of missing persons, I am amazed to see how many are senior citizens.
According to TruTV, “Among missing adults, about one-sixth have psychiatric problems. Young men, people with drug or alcohol addictions and elderly citizens suffering from dementia make up other significant subgroups of missing adults.”
Many don’t realize that senior citizens that suffer from dementia will go for a simple walk and become lost. When they leave, they are feeling fine and know where they are going, but during their walk they will begin to forget what their mission was, they become confused and disoriented. They loose track of time, and a hour turns into a day.
Some are found, but sadly, many are not found, until it is too late. Sometimes, It is not until they become lost before anyone realizes that the senior is suffering from Alzheimer’s.
According to the Alzheimer’s Association report, “Generation Alzheimer’s,” it is expected that 10 million baby boomers will either die with or from Alzheimer’s, the only cause of death among the top 10 in America without a way to prevent, cure or even slow its progression.
With more than 10,000 baby boomers a day turning 65, baby boomers will spend their retirement years either with Alzheimer’s or caring for someone with Alzheimer’s.
If you suspect either you or your parent has Alzheimer’s, you might want to try contacting the Alzheimer’s Association as they are the world’s leading voluntary health organization in Alzheimer’s care, support and research, for help.
Written By Jerrie Dean, with the Examiner
July 12, 2011
New Jersey Senior Health: When ‘Take as Directed’ Poses a Challenge
If the label on one bottle of prescription drugs says, “Take one tablet twice daily,” and the label on another says, “Take one tablet every 12 hours,” would you realize that you could take both medications at the same time?
What if one bottle says, “Take with food and water,” but the second doesn’t?
Given that the average adult over age 55 juggles six to eight medications daily, the ability to consolidate pill-popping is no minor matter. “I’m more likely to be able to sustain a medication regimen if I only have to take it three or four times a day,” said Michael Wolf, an associate professor of medicine at Northwestern University who studies drug safety. “Seven or eight times a day is complicated to fit into your daily schedule.”
His sister, who has lupus, sometimes takes up to 16 different drugs, he noted. “Why can’t we standardize prescriptions?’
Why indeed? The idea has been kicked around for years. Nearly three years ago, the Institute of Medicine proposed that pharmaceutical manufacturers adopt a universal dosing schedule that would make it possible for people to take medications at just four times of day: morning, noon, evening and bedtime.
Virtually all drugs could be formulated to fit into this framework, Dr. Wolf said: “It’s ridiculously simple, an incredibly basic idea.”
As it stands now, however, patients must fight their way through a thicket of often conflicting instructions when taking more than one drug. Many studies suggest that most of them don’t do it very well, even when relatively few medications are involved.
Recently Dr. Wolf and his team interviewed 464 adults ages 55 to 74 who were patients at several Chicago medical practices and clinics. The researchers presented each patient with seven typical amber pill bottles with dosing instructions on the labels and a slotted tray marked with times of day. “Show us how you’d take these medications over 24 hours,” the interviewers instructed the patients.
“There was no reason to take these medications more than four times a day,” Dr. Wolf said. In fact, he pointed out, 90 percent of all prescription medications can be taken no more than four times a day.
Yet the patients struggled to consolidate their doses in the experimental tray. About a third didn’t think to take two of the drugs together, even though the instructions on their labels were identical. When one drug was supposed to be taken with food and water and another carried no such instructions, half the study participants didn’t plan to take them at the same time, though they could have.
Two-thirds of the subjects wouldn’t take pills together if one label specified “twice daily” and the other said “every 12 hours,” though those phrases mean the same thing.
“Less than 15 percent succeeded in dosing in the most efficient way,” Dr. Wolf said. Instead, the participants indicated they’d take pills an average of six times a day, with some setting up as many as 14 doses a day.
The more cumbersome and harder to remember a medication schedule becomes, the greater the likelihood that people will misunderstand instructions, skip doses or abandon their drug regimen altogether. “This could be a major risk factor for adherence,” Dr. Wolf said.
The need for more simplified dosing instructions has been demonstrated in several such studies, but change has been slow to come, partly because pharmacists in each state are regulated by a different board of pharmacy. But a bill requiring a universal medication schedule has been introduced in New York State, and a similar measure has already become law in California.
For now, Dr. Wolf advises patients to regularly review the medications they take with a physician and to ask for help in simplifying the dosing. His suggested script: “Help me reduce the number of times I have to take these medications, so that over months and years, it doesn’t become a drag.”
By Paula Span, New York Times
October 16, 2010
Portable Dialysis Gives Grandma At-Home Care in Baltimore, MD
A new lease on life
By Christine McConville / The Pulse
Aurelie Blanchard feels like a teenager, at 70.
After years of dragging herself to a dialysis center twice a week to keep her failing kidneys functioning, this Methuen grandmother of 10 now gets to stay healthy – while staying home.
Thanks to “Clyde,” a portable dialysis machine made by NxStage Medical in Lawrence, Blanchard has reduced her health-care costs, improved her health and boosted her morale.
“I have my social life back,” she said last week.
Blanchard, who suffers from a rare autoimmune disease, is among the 500,000 Americans with kidney failure. To stay alive, she must remove waste products and water from her blood, via a complicated and costly medical procedure known as hemodialysis.
It’s a twice-a-week procedure that some Americans with kidney failure already rely on.
The number is expected to double in coming years as the nation faces the long-term complications of diabetes, obesity and hypertension.
That means our national health-care costs will soar, because Medicaid covers the enormous costs of hemodialysis.
Continue reading…
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providing better, affordable care. CMK Home Care is a home care agency providing Senior Home Care in Baltimore.
October 8, 2010
In Elderly, Celiac Disease is on the Rise in Baltimore, MD
If you or an elderly loved one is suffering from symptoms such as abdominal cramping, anemia, or unexplained weight loss, please read this article from HealthDay News.
Celiac Disease Seems to Be on the Rise, Mainly in Elderly: Study
(HealthDay News) — The autoimmune disorder known as celiac disease appears to be on the rise, particularly among elderly Americans, new research suggests.
Researchers from the United States and Italy uncovered evidence that overall incidence rates of the disease — marked by an intolerance to the protein gluten that is found in wheat, barley and rye — have been doubling every 15 years since 1974.
The findings are reported in the Sept. 27 online edition of Annals of Medicine by lead author Dr. Carlo Catassi, of the Universita Politecnica delle Marche in Ancona, Italy, who also serves as co-director of the University of Maryland School of Medicine Center for Celiac Research.
The study authors said it’s not clear what causes a person to develop the disease. Genetics seem to play a role, and some people are born with it. But, genetic predisposition doesn’t always translate into actual illness, because others without a predisposition can develop gluten intolerance.
Environmental factors are also believed to figure into the equation, although it’s not known why, Catassi and his colleagues said.
To get a better handle on the condition, the researchers took blood samples from more than 3,500 adults. The investigators found that the ratio of people who had blood markers for the disease rose continuously from one in every 501 individuals in 1974 to one in 219 by 1989.
The researchers also pointed to a 2003 study that placed the incidence rate at approximately one in every 133 Americans.
The researchers also found that as their study participants grew older, the rate of disease went up. This mirrored an earlier Finnish study that suggested that celiac disease appears to be two-and-a-half times more common among the elderly than the general population. This contradicts a previously held notion that gluten intolerance usually takes place during childhood, the researchers said.
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October 1, 2010
Baltimore, MD: Dementia If You Do, Dementia If You Don’t
Here is an article from Sharon’s Senior Living Blog/About.com that addresses the conflicting research on dementia prevention.
By: Sharon O’Brien
On the subject of seniors staving off dementia by staying mentally active, there is good news and bad news, according to new research published this month by Rush University Medical Center in Chicago.
Exercising your mind with activities such as reading a newspaper, going to a museum, solving crossword puzzles or playing chess does help slow or prevent the development of dementia, just as we’ve been told for the past several years. But new evidence shows that once dementia begins, that same mentally stimulating lifestyle that helped keep dementia at bay can cause the disease to progress much more quickly.
For the study, researchers recruited 1,157 people who were 65 and older–all free of dementia–from the same Chicago neighborhood, asked them how often they participated in mentally stimulating activities, and gave each person a score on a cognitive activity scale. The more frequently people exercised their minds with stimulating activities, the higher their score.
More than a decade later, researchers found that for seniors who didn’t have dementia the rate of cognitive decline was reduced by 52 percent for each point on the cognitive activity scale. For those who had developed Alzheimer’s disease during the previous decade, however, the average rate of cognitive decline per year increased 42 percent for every point on the cognitive activity scale.
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