Mealtime with an Alzheimer's patient can be stressful and challenging, to make sure the patient gets sufficient nutrition. To help mealtime go more smoothly consider the following:
Serve meals in a quiet environment with no distractions.
Clear the table of everything but basic utensils and dishes; keep dishes plain rather than with bright colors or patterns.
Make sure the food isn't too hot.
Serve only one or two foods at a time, and make an effort to honor the patient's food preferences.
Have meals together, and don't rush the meal.
Be understanding if the patient can't remember already having eaten.
Above all else, try and be patient
Welcome ...
All too many times overwhelmed caregivers are physically and emotionally depleted and need to take time to rest and care for themselves. Believing in a holistic approach to caregiver stress and a strong commitment to helping our members find the right solutions, we created this blog to help you connect with others who, like you, may be facing the same eldercare issues and challenges. Feel free to comment, ask questions, and submit articles. Please forward the blog link to your family and friends. They'll be glad you did.
Warm regards,
Patricia Grace
founder & CEO
Aging with Grace
All too many times overwhelmed caregivers are physically and emotionally depleted and need to take time to rest and care for themselves. Believing in a holistic approach to caregiver stress and a strong commitment to helping our members find the right solutions, we created this blog to help you connect with others who, like you, may be facing the same eldercare issues and challenges. Feel free to comment, ask questions, and submit articles. Please forward the blog link to your family and friends. They'll be glad you did.
Warm regards,
Patricia Grace
founder & CEO
Aging with Grace
Saturday, July 30, 2011
Tuesday, July 26, 2011
Regular dental check-up's...important at any age
Very few U.S. retirees have dental insurance today. Without coverage from traditional Medicare, and with private dental insurance typically costing too much to be feasible, most seniors are stuck paying full out-of-pocket prices every time they visit a dentist. While there's no one simple solution to affordable dental care there are a variety of options that can help cut your costs.
Dental Discounts - one way you may be able to trim your dental care cost is by simply asking your dentist for a senior discount, especially if you're paying up front. Out-of-pocket payers save the dentist office the cost and hassle of filing an insurance claim, so asking for a small 10 to 20 percent discount is not unreasonable.
Another cost-effective way to reduce your dental expenses is to join a dental discount network. How this works is you pay an annual membership fee – roughly $80 to $200 a year – in exchange for 15 to 50 percent discounts on service and treatments from participating dentists. To find a network, go to dentalplans.com (or call 888-632-5353) where you can search for plans and participating dentists by zip code, as well as get a breakdown of the discounts offered.
Brighter (866-893-1694), which launched in May in all states except Florida, Montana and Vermont, is another discounted dental service to check out. It gives subscribers access to a network of 25,000 dentists offering 20 to 60 percent discounts on cleanings, crowns, implants, root canals and other procedures. You can sign up for a free one-month plan or opt for the premium plan, which costs $79 per year for individuals and families.
Low-Cost Care - Another way to get dental care at a lower price is at a dental school clinic. Almost every dental school in the U.S. offers affordable care provided by dental students who are overseen by experienced, qualified teachers. You can expect to pay as little as a third of what a traditional dentist would charge and still receive excellent, well-supervised care.
And for low-cost teeth cleanings, check with local colleges that offer dental hygiene programs. For training purposes, many programs provide teeth cleanings by their students for a fraction of what you'd pay at a dentists office. To locate dental schools or dental hygiene programs in your area visit www.ada.org/267.aspx.
Low Income Care - If you're strapped for cash there are other resources that provide dental care to seniors at a reduced rate or for free. Here's where to look:
Health centers: Federally-funded by the Health Resources and Services Administration (HRSA), there are thousands of health centers around the U.S., many of which provide discounted or free dental care to people based on financial need. To find a center near you visit findahealthcenter.hrsa.gov or call 877-464-4772.
Local services - There are a few states, as well as some local programs or clinics that offer discounted dental care to those with limited means. To find out what may be available in your area, check with your state dental director (see astdd.org for contact information), or your state or local dental society (see ada.org/statelocalorg.aspx).
Dental Life Network: Offers several programs that provide free dental care for elderly and disabled people who can't afford to pay.
To learn more or to apply for care in your state, visit nfdh.org or call 888-471-6334.
Monday, July 25, 2011
Family caregiving growing in leaps and bounds...
Family caregiving is becoming a more and more common phenomena with the rise in numbers of American seniors, and a 2011 AARP study says the value of unpaid family caregiving reached $450 billion in 2009.
Recent data shows one in eight Americans are 65 or older, with the number of seniors doubling between 2000 and 2030; the number of senior household is expected to increase 35% by 2020 from 2010 figures. Many older Americans embrace their independence and prefer receiving care at home and aging in place rather than going to a nursing facility, says AARP; this has contributed to the rise in caregiving in general, as well as family caregiving and the costs associated with it.
To put the costs of caregiving in context, the AARP paper, Valuing the Invaluable: 2011 Update – The Growing Contributions and Costs of Family Caregiving, says that in 2009, approximately one in four adults gave care valued at an estimated $450 billion—more than Wal-mart’s total 2009 sales.
This figure represents a 21% increase from what was found in a 2007 study, and reflects the estimated 61.6 million Americans who provided care in 2009.
“We know most people want to remain in their own homes and communities as they get older. Family caregiving is key to making that possible,” says Susan Reinhard, Senior Vice President for Public Policy at AARP.
The AARP report comes after a 2010 MetLife study found that caregiving represents a $3 trillion drain on adult children’s wallets when factoring in lost wages due to missing work, and how that affects retirement and Social Security contributions.
AARP also mentions the levels and kinds of care offered by caregivers, which has grown more complex over the years, and the toll this care can take on the health and well-being of caregivers.
“Family caregivers are an essential part of the workforce to maintain the health care and long-term services and supports systems for the growing number of people with complex chronic care needs,” says the report. “Family caregiving has been shown to help delay or prevent the use of nursing home care.”
Friday, July 22, 2011
Overwhelming majority of older American choose long term care at home
A recent Sun Life Financial survey found that a growing number of Americans aged 50 and older are concerned about future long term care, Sun Life Financial Inc. recently revealed. This prompted the corporation to introduce Sun Care Whole Life (WL), which it describes as a single premium whole life insurance policy with a linked benefit that owners can apply to long-term care costs, including for in-home care, assisted living, and nursing home facilities.
The policy, which is currently available in 39 states, may provide a long-term care benefit equivalent to as much as three to seven times the value of the policy owner’s single premium, depending on factors such as the riders selected, age, gender, and smoking status, says Sun Life Financial.
“According to the US Department of Health and Human Services, an estimated 70% of people over 65 will eventually need long-term care, often for daily activities, such as eating, bathing, or getting dressed,” Janet Whitehouse, Senior Vice President and General Manager of Sun Life’s Individual Life Insurance Division, said in a statement. “We want to help people prepare, so if they ever need long-term care—they have more freedom to pick the level of care that suits their needs, and the costs don’t have to erode their retirement savings or estate assets.”
The policy will also provide an income tax-free death benefit for beneficiaries of policy holders who pass away without using their long-term care benefits. And, if the policy holder so chooses, Sun Care WL also offers an optional return-of-premium feature, for an additional fee, which would allow the insured to recoup the value of their original premium.
“Once the policy owner pays the single premium, the policy is guaranteed to provide a benefit, either to the individual or the beneficiaries,” said Bob Klein, Vice President of Strategic Planning for the Sun Life’s Individual Life Insurance Division. “This offers several possible advantages over traditional long-term care insurance, which only provides a benefit if the client makes a long-term care claim, requires ongoing premiums to fund the policy, and provides no death benefit if a policy owner never needs long-term care.”
Some of Sun Life Financial’s key findings in the survey include nearly 60% of those polled being worried about long-term care costs and whether or not they’ll be able to afford them; an unclear idea of how much long-term care actually will cost; an 87% preference by older Americans of receiving long-term care at home as long as it doesn’t place too great a burden upon loved ones; and willingness to live a shorter life if it means receiving long-term care at home rather than an extended lifetime in a long-term care facility.
Overall, says Klein, it’s important to plan for, instead of panic about, long-term care.
Wednesday, July 20, 2011
Senior Helpers = Heat Helpers
As the nation wilts during an especially brutal summer, warnings have gone out to the elderly to try to stay cool. The problem is, many seniors hear the message but don’t think it applies to them — because they don’t see themselves as old. Deciding who counts as elderly is a tricky business. The United States Older Americans Act, for instance, targets people aged 60 and older, but it's a rare 60-year-old who considers himself or herself elderly.
Younger adults, too, call 60 the start of old age, but baby boomers are pushing that number back, according to the Associated Press-LifeGoesStrong.com poll. The median age they cite is 70. And a quarter of boomers insist you're not old until you're 80.
But no matter how you define elderly, or how healthy a senior is, high temperatures can be deadly, experts say. That’s because our bodies lose the ability to deal with heat as we age.
From the time we’re born until age 25 to 30, all our organ systems are growing and developing, explains, Dr. Neil Resnick, a professor and chief of geriatric medicine at the University of Pittsburgh Medical Center. Then at age 30 every body part starts to decline at a rate of about 1 percent per year.
“The good news is that when we’re developing we end up with four to six times more capacity in every organ than we need,” Resnick says. “So if we lose half of that capacity, we’ve still got two to three times more than we need.” Unless it’s really hot.
In extreme heat, blood is redirected to the skin to help cool us down. To make up for that, the body needs to make more blood so that the heart, brain and other organs will get enough. But that takes a lot of water, which may be in short supply when a person has been sweating a lot.
Older people may not even realize that they need more water because the sense of thirst diminishes with age so people don’t always know they're dehydrating. Making matters worse, older kidneys aren’t as good at keeping fluids in the system.
Add to that the host of medications taken by seniors — some of which can impair sweating and the heart’s ability to pump harder in response to these heat-related demands — and it's a recipe for disaster on days when the mercury skyrockets.
“The bottom line,” Resnick says, “ is that older people have less of a physical reserve to count on when they’re challenged by high temperatures."
Older folks who think they’re as tough as they were in younger days should think again.
If you’re exercising hard on a hot day, you might dehydrate so much that you end up with too little blood flow to essential organs — like the brain and heart. Worst case scenario, Resnick says, is “you could go into a coma if your brain isn’t getting enough blood supply or you could have a heart attack or kidney failure if those organs don’t get enough blood.”
The consequences can be dire even if you’re not working out hard, says Peter Ross, chief executive and co-founder of Senior Helpers, a company that provides in-home care for seniors.
That's the group that called new attention to a 2006 Kent State University study of more than 900 people aged 65 and older in six Northern American cities: Dayton, Ohio; Phoenix, Ariz.; Philadelphia, Penn., and Toronto, Canada.
Seniors who dehydrate enough to get dizzy run the risk of falling and breaking bones, Ross explains.
Ross'company has designed a program, called Heat Helpers, to educate the elderly. Seniors are advised to limit strenuous activities on hot days to stay cool and to pay extra attention to getting enough to drink.
“You have to understand that as you age, your body is changing,” Ross says. “And you have to listen to your body.”
Tuesday, July 19, 2011
The rising cost of elder caregiving
When Maria and Bernie Staab laid out their retirement road map a while back, travel was priority No. 1: specifically, extended trips from their Baltimore-area home to visit their grandkids in San Diego and take them to the beach and on other adventures. The odysseys were supposed to kick in next spring, but now something else is at the top of their agenda: Bernie's mother's Alzheimer's disease. The couple says her condition has worsened, and they're now scrambling to finance the $3,800 monthly bill for her care. Not only has Maria questioned her plan to retire from her job as a human resources manager, but Bernie even came out of retirement to work part-time for a while. After all, it was that or blow through their nest egg.
The Staabs aren't the only ones being forced to choose between paying for their own golden years and paying for their parents'. Most people are well aware of the problem: As boomers reach retirement age, a growing cadre of Americans are finding themselves caring for aging relatives with increasing medical needs and dwindling financial resources. Indeed, more than 49 million Americans, or about 20 percent of the population, care for someone over the age of 50 who is ill or aging -- a number that has steadily increased over the past decade, according to the National Alliance for Caregiving. Caregivers take time off from work for doctors' appointments and to look for home health care. They also dip into their own savings to pay for expenses -- even more so now that state and local caregiving programs are facing budget cuts. For many, the question isn't whether they'll face higher costs, but how they'll manage them.
Such costs can be daunting, especially with many adult children still clawing their way back from the financial crisis. On top of out-of-pocket expenses, MetLife Mature Market Institute estimates that a person over the age of 50 will lose an average of $304,000 in total wages, benefits and accumulated wealth by caring for a parent. Of course, that stat is worth taking with a grain of salt: MetLife had until recently sold long-term-care insurance designed to address this financial bogeyman. But financial advisers agree that most caregivers will get stuck with some hefty expenses. Now they're scrambling to offer ideas -- from concrete steps for a portfolio to rather squishy advice about chats with aging parents. "You shouldn't sacrifice your future completely to support your parents, so it's a balance," says Steven Raymond, an adviser at Davis, Calif.-based Navion Financial Advisers, who has been dealing with the issue personally for a decade.
To try to cover extra costs, some caregivers have started investing more aggressively, but planners say that's a move where the risks outweigh the rewards. Instead, Diane Pearson, of Legend Financial in Pittsburgh, suggests caregivers set aside a chunk of their savings for these expenses -- and do so outside their 401(k)s or IRAs. Some advisers suggest concentrating caregiver funds in dividend-paying stocks and bonds, using the income for expenses rather than reinvesting it. And family members can stretch money by paying attention to taxes: Caregivers, for example, can pay medical expenses directly to a hospital rather than writing a parent a check, or they can lessen the burden of capital-gains taxes by giving an aging parent a gift of stock.
For those who have the luxury of time to plan, getting parents to sign up for long-term-care insurance early on can curb one of the biggest costs: assisted-living and nursing-home fees, which can easily top $50,000 a year. While relatives may be tempted to dodge those costs by leaving their jobs to help out, many planners discourage that. "In the long run, it can be less expensive to continue to work and hire someone" to care for family members, says Sandra Timmermann, director of the Mature Market Institute. After all, advisers say the biggest risk is ending up in the same shoes as your parents -- and passing a financial burden on to your kids.
The above article appeared in SmartMoney, 7/14/2010.
Wednesday, July 13, 2011
Cognitive decline can have hazardous affects on boomer wealth
As Baby Boomers age, policy makers and economists may be served by looking at the condition of not just their nest eggs, but the health of their brains.
The late Brooke Astor is an example of the dangers of declining cognitive function.
So says economist David Laibson, of Harvard University in a speech called “The Age of Reason.” Prof. Laibson spoke at Morningstar’s annual conference in Chicago before hundreds of financial advisers and asset managers — industries grappling with the inevitable shift of assets from workers accumulating money to those trying to live on it as they grow older.
Prof. Laibson opened with an image of the famously wealthy Brooke Astor. “One of our most remarkable individuals ended up in this terrible state” because of a lack of cognitive abilities, he said.
About 35% of wealth is controlled by those 65 or older, Prof. Laibson said, and that number will grow as boomers age. The total balance sheet of U.S. households is $53 trillion, he says. As about $18 trillion hang in the balance among seniors, the question is, what will be done to help aging people from becoming another Brooke Astor?
Fluid intelligence — that is intelligence displayed in things like memory tests — decreases dramatically with age. In fact, “it’s all downhill from age 20” Prof. Laibson said. “What about the 80-year-olds? It’s the 80-years-olds who have the million dollar IRAs. Not the 20-year-olds.”
But clearly, there’s a lot more to life than fluid intelligence. Crystallized intelligence — memory, wisdom and so on — does increase over time, but less so, on average, in senior years.
All told, the point at which we make the best financial choices is 53 years old, according to his data. “Of course there are exceptions,” Prof. Laibson said. “I would take Warren Buffett at 81 over most 50-year-olds.” (But he also acknowledges he would take a fiftysomething Buffett over one in his 80s.)
Many seniors end up in a state called cognitive impairment without dementia that isn’t quite dementia, but still (as the name implies) a deterioration of memory. In spite of this, people still may make financial decisions on their own. Prof. Labison estimated that 16% of those 71-79 years old, 29.2% of 80-89 year olds, some 38.8% of those over 90 years old are in such a state.
Those people are at great risk for financial abuse. Some 17% of professional care staff report committing psychological abuse and 10% physical abuse, Prof. Laibson said.
Those over the age of 50 end up paying higher interest rates, even though on average they had better FICO scores and lower default rates, Prof. Laibson said. “Middle aged people get better deals,” he said. In terms of risk-adjusted returns on investments, the young do relatively well, but the “old are doing absolutely abysmal,” paying more in fees and suffering from poor asset allocation, he said.
Prof. Laibson called for keeping things simple for clients, while still giving them a sense of control. He called on policy makers to expand a fiduciary duty for financial advisers and expand regulations requiring power of attorney for the elderly.
That overoptimism about mental muscle keeps people from asking for help. “We procrastinate. We don’t like complexity… We have bad memory and we don’t know the extent of our bad memory,” he said.
Re-print from the WSJ June 10, 2011. Written by Mary Pilon
Monday, July 11, 2011
More minorities living in nursing homes
Minorities have entered nursing facilities in record numbers during the past decade, while wealthier white residents have been leaving skilled nursing care, new research shows. Interesting point that this research does not reference is that most states fund long term nursing home care through Medicaid which is available to low income elderly. Assisted living and in home care are predominately private pay services.
Between 1999 and 2008, the number of whites in nursing homes dropped by 10.2%. The number of blacks in nursing homes increased by 10.8%, the number of Hispanics jumped 54.9% and the number of Asians grew by 54.1%, according to research published in the July issue of Health Affairs.
In a competitive landscape, some nursing homes have marketed minorities more aggressively. But study author Zhanlian Feng, Ph.D., cautions that nursing homes are still seen as a “last resort” for many elderly individuals. The difference is that whites may be more able to afford services like home care, Feng says.
However, Feng told McKnight's that the surprising increase of minorities in nursing homes, particularly among Hispanic and Asian residents, could reflect a cultural shift among immigrant families. Feng says that in many residents' native countries, sending an aging parent or relative to a nursing home carries a huge stigma. That stigma goes away when immigrants move to the United States.
“As time goes by, these cultural ties are becoming loosened,” he says. “In Hispanic countries, due to economic factors, extended families often live together. … I believe there are real things happening that are undermining the family care system in minority families,” Feng told McKnight's.
Feng stressed the need for more empirical evidence. He noted that nursing homes in China are emerging and expanding rapidly, so the trend may not be limited to the United States.
Between 1999 and 2008, the number of whites in nursing homes dropped by 10.2%. The number of blacks in nursing homes increased by 10.8%, the number of Hispanics jumped 54.9% and the number of Asians grew by 54.1%, according to research published in the July issue of Health Affairs.
In a competitive landscape, some nursing homes have marketed minorities more aggressively. But study author Zhanlian Feng, Ph.D., cautions that nursing homes are still seen as a “last resort” for many elderly individuals. The difference is that whites may be more able to afford services like home care, Feng says.
However, Feng told McKnight's that the surprising increase of minorities in nursing homes, particularly among Hispanic and Asian residents, could reflect a cultural shift among immigrant families. Feng says that in many residents' native countries, sending an aging parent or relative to a nursing home carries a huge stigma. That stigma goes away when immigrants move to the United States.
“As time goes by, these cultural ties are becoming loosened,” he says. “In Hispanic countries, due to economic factors, extended families often live together. … I believe there are real things happening that are undermining the family care system in minority families,” Feng told McKnight's.
Feng stressed the need for more empirical evidence. He noted that nursing homes in China are emerging and expanding rapidly, so the trend may not be limited to the United States.
Friday, July 08, 2011
Midlife weight gain linked to dementia
Being overweight during middle age may increase your risk of developing dementia later on, a new Swedish study suggests.
Several studies have already linked obesity in middle age to dementia in later life, but it was unclear whether merely carrying some extra pounds in midlife was a risk factor. The new research suggests that even being overweight -- defined as having a body mass index (BMI) of 25 to 30 -- is linked with a higher risk of dementia.
"Being overweight at midlife increased the risk of dementia in late life by more than 70 percent," said lead study author Dr. Weili Xu, a postdoctoral researcher at Karolinska Institute in Stockholm.
Being obese raised the risk even more, to nearly fourfold.
"Although the effect of midlife overweight on dementia is not as substantial as that of obesity, its impact on public health is significant," Xu said, noting that 1.6 billion adults worldwide are obese or overweight, including 50 percent of adults in the United States and Europe.
The study is published in the May 3 issue of Neurology.
In her study, Xu analyzed information from the Swedish Twin Registry. It included data on 8,534 twins aged 65 and older. Of those, 350 were diagnosed with dementia and 114 with possible dementia.
Thirty years earlier, the participants had provided what then must have seemed like mundane data: their height and weight.
That data would prove invaluable as Xu grouped them according to their BMIs, from underweight to obese (having a BMI higher than 30). Nearly 30 percent, she found, were either overweight or obese during midlife.
Further analysis showed that being overweight or obese in midlife independently increased the risk of later dementia, including Alzheimer's and vascular dementia.
About 26 percent of participants without dementia had been overweight at midlife, compared to 36 percent of those with possible dementia and 39 percent with diagnosed dementia.
And although 2.7 percent of seniors without dementia had been obese at midlife, 6.9 percent of those with dementia had been obese, as well as 5.3 percent of those with possible dementia.
When Xu analyzed twin pairs in which one had dementia in later life and one did not, she found the link to weight no longer significant, suggesting early environment and genetics also play roles in dementia.
Why the weight-dementia link? Several mechanisms could explain it, Xu said. A higher BMI is linked with diabetes and vascular disease, which is in turn related to the risk of dementia. Higher weight at midlife may reflect a long period of exposure to higher inflammation throughout the body, which has been linked with lower cognitive function.
Xu and her colleagues noted several study limitations, including the notion that BMI may not be the perfect measure of body fat composition.
They also noted that in terms of lowering dementia risk, it's never too late to start reducing body fat.
The study has a number of strengths, including the large number of people studied, according to Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center and professor of psychiatry and behavioral science at Albert Einstein College of Medicine in the Bronx.
Although the study finds a link between being overweight in midlife and dementia risk, it does not prove cause-and-effect, he said. Still, there is evidence that fatty tissue secretes inflammatory cytokines and other chemicals. These may have a direct effect on the brain, he said, inflicting damage to the neurons.
Dr. Gisele Wolf-Klein, director of geriatric education at the North Shore-Long Island Jewish Health System in Hyde Park, N.Y., said the study "is of great relevance in view of the growing epidemic of obesity in both the United States and Europe."
SOURCES: Weili Xu, M.D., Ph.D., postdoctoral researcher, Karolinska Institute, Stockholm, Sweden and associate professor, Tianjin Medical University, Tianjin, China; Gary Kennedy, M.D., director of geriatric psychiatry, Montefiore Medical Center and professor of psychiatry and behavioral sciences, Albert Einstein College of Medicine, Bronx, N.Y.; Gisele Wolf-Klein, M.D., director of geriatric education, North Shore-LIJ Health System, New Hyde Park, N.Y.; May 3, 2011, Neurology
Several studies have already linked obesity in middle age to dementia in later life, but it was unclear whether merely carrying some extra pounds in midlife was a risk factor. The new research suggests that even being overweight -- defined as having a body mass index (BMI) of 25 to 30 -- is linked with a higher risk of dementia.
"Being overweight at midlife increased the risk of dementia in late life by more than 70 percent," said lead study author Dr. Weili Xu, a postdoctoral researcher at Karolinska Institute in Stockholm.
Being obese raised the risk even more, to nearly fourfold.
"Although the effect of midlife overweight on dementia is not as substantial as that of obesity, its impact on public health is significant," Xu said, noting that 1.6 billion adults worldwide are obese or overweight, including 50 percent of adults in the United States and Europe.
The study is published in the May 3 issue of Neurology.
In her study, Xu analyzed information from the Swedish Twin Registry. It included data on 8,534 twins aged 65 and older. Of those, 350 were diagnosed with dementia and 114 with possible dementia.
Thirty years earlier, the participants had provided what then must have seemed like mundane data: their height and weight.
That data would prove invaluable as Xu grouped them according to their BMIs, from underweight to obese (having a BMI higher than 30). Nearly 30 percent, she found, were either overweight or obese during midlife.
Further analysis showed that being overweight or obese in midlife independently increased the risk of later dementia, including Alzheimer's and vascular dementia.
About 26 percent of participants without dementia had been overweight at midlife, compared to 36 percent of those with possible dementia and 39 percent with diagnosed dementia.
And although 2.7 percent of seniors without dementia had been obese at midlife, 6.9 percent of those with dementia had been obese, as well as 5.3 percent of those with possible dementia.
When Xu analyzed twin pairs in which one had dementia in later life and one did not, she found the link to weight no longer significant, suggesting early environment and genetics also play roles in dementia.
Why the weight-dementia link? Several mechanisms could explain it, Xu said. A higher BMI is linked with diabetes and vascular disease, which is in turn related to the risk of dementia. Higher weight at midlife may reflect a long period of exposure to higher inflammation throughout the body, which has been linked with lower cognitive function.
Xu and her colleagues noted several study limitations, including the notion that BMI may not be the perfect measure of body fat composition.
They also noted that in terms of lowering dementia risk, it's never too late to start reducing body fat.
The study has a number of strengths, including the large number of people studied, according to Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center and professor of psychiatry and behavioral science at Albert Einstein College of Medicine in the Bronx.
Although the study finds a link between being overweight in midlife and dementia risk, it does not prove cause-and-effect, he said. Still, there is evidence that fatty tissue secretes inflammatory cytokines and other chemicals. These may have a direct effect on the brain, he said, inflicting damage to the neurons.
Dr. Gisele Wolf-Klein, director of geriatric education at the North Shore-Long Island Jewish Health System in Hyde Park, N.Y., said the study "is of great relevance in view of the growing epidemic of obesity in both the United States and Europe."
SOURCES: Weili Xu, M.D., Ph.D., postdoctoral researcher, Karolinska Institute, Stockholm, Sweden and associate professor, Tianjin Medical University, Tianjin, China; Gary Kennedy, M.D., director of geriatric psychiatry, Montefiore Medical Center and professor of psychiatry and behavioral sciences, Albert Einstein College of Medicine, Bronx, N.Y.; Gisele Wolf-Klein, M.D., director of geriatric education, North Shore-LIJ Health System, New Hyde Park, N.Y.; May 3, 2011, Neurology
Thursday, July 07, 2011
For many, emotional well being deepens with age.
Think you are happy now? According to the Gallup-Healthways well-being index, best emotional times come later in life. I would certainly agree with this finding.
The oldest group outscored the other three age groups in emotions, which was one of six categories measured in a massive study on well-being. Out of a possible score of 100, the 65-and-older age group scored 83. Those 45-64 had the lowest score, 76.
Credit experience, says Kay McCurdy, 72, of Springfield, Va. “You shift your idea of what a good life is into what you can have as a good life,” says McCurdy. “You get realistic. "
Elisabeth Burnett, 73, a neighbor of McCurdy’s at the Greenspring retirement home in the Washington, D.C. metro area, says that having a strong emotional life takes a hefty dose of true grit. Burnett has a daughter going through a divorce and has had to bury another grown child, yet she says she looks ahead with hope and joy.
“Today is the gift,” says Burnett. “I think that’s a kind of wisdom that comes with age that I may have had as a young person but I didn’t exercise as much as I do now.” Randy Weadon, 84, says honesty and discipline turned his sad life around. After going into diabetic shock one night and nearly dying, he started walking, lost 50 pounds and eventually got off insulin. He walks 7 miles a day to keep his weight down.
“I’m happier,” says Weadon, also a Greenspring resident. “I have a better opinion of myself, and just all in all I’m a new person.”
Tuesday, July 05, 2011
Angela...more than a pretty name
The following is a recent article that appeared in Healthcare IT News.
Seniors struggling to deal with healthcare concerns while living independently will soon have a new friend to call upon – Angela.
“Angela” is an interactive telecare platform launched by Independa, a San Diego-based provider of telehealth solutions for home care-based settings and caregivers. Described as “the next Wii or iPad for the golden generation,” it’s designed to not only provide entertainment and a communications platform for seniors living independently, but also to maintain a vital link to caregivers.
“Our vision as a company is to replace ‘I’ve fallen and I can’t get up’ with a social interaction solution,” said Independa’s CEO, Kian Saneii. “The number one issue for the elderly is social isolation. … This offers a version of supported independence.”
Running on an off-the-shelf touch-screen tablet, Angela offers secure, one-touch access to a variety of interactive content, including the Internet, Facebook, games and puzzles, video chat and e-mail. It follows the company’s January launch of Smart Reminders, which allows caregivers to set up automatic reminders for care receivers to take medications, keep medical and social appointments and record “Life Stories.” Later this year, the platform will include sensor-based connectivity.
Angela is specifically designed for older adults, with larger screen fonts, higher contrast and brighter colors.
While the social benefits of Angela are apparent, the clinical effects are there as well. The nation pays approximately $3,000 per episode of care for the elderly, Saneii said. In addition, he said, approximately half of all prescriptions written for seniors are not filled, and one-third of those that are filled are never taken, many because they’re forgotten.
“We’re opening up the world to a lot of individuals who want to live alone but need help doing so,” he said.
“Traditional telehealth boxes and computers are last-decade clumsy approaches to helping older adults, providers and caregivers,” said Laurie Orlov, founder of the market research firm Aging in Place Technology Watch. “Twenty-first century solutions will look more like the integrated engagement and wellness platforms of new firms like Independa and its ‘Angela.’”
“User-friendly technology solutions that encourage social engagement are essential in preserving independence for older adults,” added Richard Della Penna, Independa’s chief medical officer. “While often overlooked, isolation is the number one issue for the elderly, as it commonly triggers depression and physical illnesses, which can hasten the move to less-independent living and shorten life.”
Saneii is quick to point out that Angela is a social engagement platform and not a telemedicine solution. Its purpose is to collect information and improve communications, but “not to diagnose.” “The healthcare system doesn’t need us to become part of the system,” he said.
What it does need, he said, is a platform that allows seniors – as well as others living in some sort of supported independence – to communicate with friends, relatives and caregivers easily and effectively, even if they don’t know how to log on to a computer.
Among the early adopters of Independa’s technology is LivHOME, a Los Angeles-based provider of in-home senior care services.
“We believe that technology is going to play a key role in providing consistent high-level senior in-home care at an affordable price,” said Mike Nicholson, the company’s chief executive officer. “We feel that Independa has the best-in-class solution to date. Over the two years we have followed their development of care monitoring, medication reminders and other technology solutions, LivHOME has been excited about the prospect of offering the Independa solution to our established national locations and our growing franchise markets. With the launch of Angela, we are proud to be able to offer it as a component of the LivHOME solution to our thousands of clients across the country.”
According to Saneii, Angela will be deployed for beta testing in July and should be ready for commercial use by September, at which time Independa will begin beta testing its sensor connectivity solution. Plans call for an option of 10-inch or 22-inch tablets, with the software available for a monthly subscription; tablet pricing will be determined later.
“Angela is the latest building block in the integrated suite of solutions Independa is rolling out to help family members and home-care professionals stay in touch with and watch over care recipients when they can’t be with them,” he said. “Elderly care recipients can use simple, fun tools, and those looking after them need practical solutions that are easy to use and don’t require their own care. Angela meets all those needs, and adds essential social elements.”
Seniors struggling to deal with healthcare concerns while living independently will soon have a new friend to call upon – Angela.
“Angela” is an interactive telecare platform launched by Independa, a San Diego-based provider of telehealth solutions for home care-based settings and caregivers. Described as “the next Wii or iPad for the golden generation,” it’s designed to not only provide entertainment and a communications platform for seniors living independently, but also to maintain a vital link to caregivers.
“Our vision as a company is to replace ‘I’ve fallen and I can’t get up’ with a social interaction solution,” said Independa’s CEO, Kian Saneii. “The number one issue for the elderly is social isolation. … This offers a version of supported independence.”
Running on an off-the-shelf touch-screen tablet, Angela offers secure, one-touch access to a variety of interactive content, including the Internet, Facebook, games and puzzles, video chat and e-mail. It follows the company’s January launch of Smart Reminders, which allows caregivers to set up automatic reminders for care receivers to take medications, keep medical and social appointments and record “Life Stories.” Later this year, the platform will include sensor-based connectivity.
Angela is specifically designed for older adults, with larger screen fonts, higher contrast and brighter colors.
While the social benefits of Angela are apparent, the clinical effects are there as well. The nation pays approximately $3,000 per episode of care for the elderly, Saneii said. In addition, he said, approximately half of all prescriptions written for seniors are not filled, and one-third of those that are filled are never taken, many because they’re forgotten.
“We’re opening up the world to a lot of individuals who want to live alone but need help doing so,” he said.
“Traditional telehealth boxes and computers are last-decade clumsy approaches to helping older adults, providers and caregivers,” said Laurie Orlov, founder of the market research firm Aging in Place Technology Watch. “Twenty-first century solutions will look more like the integrated engagement and wellness platforms of new firms like Independa and its ‘Angela.’”
“User-friendly technology solutions that encourage social engagement are essential in preserving independence for older adults,” added Richard Della Penna, Independa’s chief medical officer. “While often overlooked, isolation is the number one issue for the elderly, as it commonly triggers depression and physical illnesses, which can hasten the move to less-independent living and shorten life.”
Saneii is quick to point out that Angela is a social engagement platform and not a telemedicine solution. Its purpose is to collect information and improve communications, but “not to diagnose.” “The healthcare system doesn’t need us to become part of the system,” he said.
What it does need, he said, is a platform that allows seniors – as well as others living in some sort of supported independence – to communicate with friends, relatives and caregivers easily and effectively, even if they don’t know how to log on to a computer.
Among the early adopters of Independa’s technology is LivHOME, a Los Angeles-based provider of in-home senior care services.
“We believe that technology is going to play a key role in providing consistent high-level senior in-home care at an affordable price,” said Mike Nicholson, the company’s chief executive officer. “We feel that Independa has the best-in-class solution to date. Over the two years we have followed their development of care monitoring, medication reminders and other technology solutions, LivHOME has been excited about the prospect of offering the Independa solution to our established national locations and our growing franchise markets. With the launch of Angela, we are proud to be able to offer it as a component of the LivHOME solution to our thousands of clients across the country.”
According to Saneii, Angela will be deployed for beta testing in July and should be ready for commercial use by September, at which time Independa will begin beta testing its sensor connectivity solution. Plans call for an option of 10-inch or 22-inch tablets, with the software available for a monthly subscription; tablet pricing will be determined later.
“Angela is the latest building block in the integrated suite of solutions Independa is rolling out to help family members and home-care professionals stay in touch with and watch over care recipients when they can’t be with them,” he said. “Elderly care recipients can use simple, fun tools, and those looking after them need practical solutions that are easy to use and don’t require their own care. Angela meets all those needs, and adds essential social elements.”
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