Who determines when the elderly stop driving...families or doctors?

Families may have to watch for dings in the car and plead with an older driver to give up the keys — but there’s new evidence that doctors could have more of an influence on one of the most wrenching decisions facing a rapidly aging population.

A recent study in the New England Journal of Medicine found that when doctors warn patients, and tell driving authorities, that the older folks may be medically unfit to be on the road, there’s a drop in serious crash injuries among those drivers.

The study, could not tell if the improvement was because those patients drove less, or drove more carefully once the doctors pointed out the risk.

But as the number of older drivers surges, it raises the question of how families and doctors could be working together to determine if and when age-related health problems — from arthritis to frailty to Alzheimer’s disease — are bad enough to impair driving.

Often, families are making that tough choice between safety and independence on their own.

By one U.S. estimate, about 600,000 older drivers a year quit because of health conditions. The problem: There are no clear-cut guidelines to tell who really needs to — and given the lack of transportation options in much of the country, quitting too soon can be detrimental for someone who might have functioned well for several more years.

Doctors aren’t trained to evaluate driving ability, and the study couldn’t tell if some drivers were targeted needlessly, noted Dr. Matthew Rizzo of the University of Iowa. Yet he called the research valuable.

“The message from this paper is that doctors have some wisdom in knowing when to restrict drivers,” said Rizzo. His own research shows some cognitive tests might help them better identify who’s at risk, such as by measuring “useful field of view,” essentially how much your brain gleans at a glance — important for safety in intersections.

Today, the American Medical Association recommends that doctors administer a few simple tests in advising older drivers. Among them:

—Walk 10 feet down the hallway, turn around and come back. Taking longer than 9 seconds is linked to driving problems.

—On a page with the letters A to L and the numbers 1 to 13 randomly arranged, see how quickly and accurately you draw a line from 1 to A, then to 2, then to B and so on. This so-called trail-making test measures memory, spatial processing and other brain skills, and doing poorly has been linked to at-fault crashes.

—Check if people can turn their necks far enough to change lanes, and have the strength to slam on brakes.

Dr. Gary Kennedy, geriatric psychiatry chief at New York’s Montefiore Medical Center, often adds another question: Are his patients allowed to drive their grandchildren?

“If the answer to that is no, that’s telling me the people who know the patient best have made a decision that they’re not safe,” said Kennedy, who offers “to be the bad cop” for families or primary care physicians having trouble delivering the news.

There are no statistics on how often doctors do these kinds of assessment.

“It’s this touchy subject that nobody wants to talk about,” said Dr. Marian Betz of the University of Colorado, whose surveys show most senior drivers don’t think their doctors know whether they drive. She is testing if an advance directive would help get older adults talking with their doctors about how to keep watch on their driving fitness before trouble arises.

More objective measures are needed — and to help find them, hundreds of older drivers are letting scientists install video cameras, GPS systems and other gadgets in their cars as part of massive studies of everyday driving behavior.

Identifying who needs to quit should be a last resort, said Jon Antin of the Virginia Tech Transportation Institute. He helps oversee data collection for a study that’s enrolling 3,000 participants, including hundreds of seniors, in Florida, Indiana, New York, North Carolina, Pennsylvania and Washington. The drivers undergo a battery of medical checks before their driving patterns are recorded for 12 to 24 months.

For now, advocacy groups like the Alzheimer’s Association and KeepingUs Safe offer programs to help family’s spot signs of driving problems and determine how to talk about it. 

Founded in 2008, Keeping Us Safe is an organization that serves older drivers and their families across both the United States and Canada. "Beyond Driving with Dignity is a workbook to help your family make driving-related decisions that are in the best interest of the older driver", says founder & President Matt Gurwell.

Alzheimer's disease promotes isolation

Patients with Alzheimer’s disease, the most common form of dementia, and their caregivers say the illness leaves them feeling isolated and apart from family, friends and life’s typical connections, a report shows.

About a quarter of people with dementia hide or conceal their diagnosis because of the stigma surrounding the disease and 40 percent say they are excluded from everyday life, according to the World Alzheimer Report 2012 released today by London-based Alzheimer’s Disease International.

About 36 million people worldwide are living with dementia and the numbers will more than triple to 115 million by 2050, according to the report. The global cost of the disease is estimated at $604 billion. More education is needed about dementia, especially as seemingly healthy people are diagnosed earlier with the disease, said Beth Kallmyer, vice president of constituent services at the Alzheimer’s Association in Chicago.

Activities for Aging in Place

written by Sarah Jennings, guest blogger

The most difficult part of post-employment life is the loneliness. Even if you don’t live alone, you probably crave the company of more than just one person. Even if you were not particularly buddy-buddy with anyone at your workplace, work offered a variety of people to interact with. Meeting people can be difficult if you don’t have anywhere to start. Luckily, no one at this age has to start with a blank slate. There are a few different places you can draw from to find people to associate with.

Old Friends

Maybe you haven’t talked to the boys from the office, or the girls from your old book club for years, but people you were close to in your younger life are great to catch up with. You can compare lives, brag on grandchildren, and talk about the other people you used to know. This will also give you some perspective about where you are in life and what you want to do while you still can.

Church

The best way to find people to spend time with is to draw on your resources. If you attend church or any other weekly function, reach out and talk to new people. There are probably plenty of people you’ve known for years but never really gotten to know. Invite some of them to lunch or to try a yoga class with you or something.

Finding people isn’t the only difficult part though.  What are things you can actually do with limited funds and possibly mobility? Well, there’s actually a lot.

Community classes

Life is a never-ending parade of lessons. We never stop learning. So look into the offerings of your community to see what learning opportunities there are. The local recreation center probably offers a yoga class or another stretch-based exercise option. This is a great way for you to stay fit, learn something new, and meet people.

A local university or art studio might offer pottery or sculpture as a community class. These can be either low-cost or free depending on your location. Learning a new art style not only broadens your mind, but keeps you sharp. Adding skills to your repertoire as you get older keeps your mind strong and reminds you that you are still fully functional even though some days you may not feel like it.

Senior Centers

Senior Centers in your area probably offer a plethora of activities for both residents and non-residents. Senior centers are all about community so there is probably an easy way for you to get involved. By doing this, you can be a part of game tournaments, physical activities, and events such as shows, dances, and movie showings. These activities will also all be people-centered, so you are sure to make some new acquaintances.

It is important to get out in nature, as tempting as it might be to stay cooped up at home all day. Whether it’s just feeding the birds and reading a book in the park or going for a hike, find ways to get outside and enjoy the world. Have you always had a passion for photography? Utilize it now. Getting outside can be as simple as eating lunch on your porch or as involved as maintaining a garden.

Life after retirement can be full of time, and there are plenty of ways to fill the hours. Whether you are as active as ever or need to slow down a bit, you can find ways to fulfill lifelong dreams and satisfy curiosities. By utilizing your resources and accessing your goals from younger days, you can be sure to have a fulfilling retirement.

Sarah Jennings has been taking care of others her whole life. In 2005, she moved her mother into her family home. She uses her personal experience to share with others about caring for the elderly. She currently writes for Brookedale Senior Living.

Trouble on the horizon for LTC...

Low interest rates and policyholders' unwillingness to drop coverage are two of the key reasons the long-term care insurance market is in trouble, an expert recently asserted. Long-term care insurance carriers used to operate under the assumption that a reliable number of policyholders would drop their coverage before they reaped their claim, Howard Gleckman, a journalist and Urban Institute fellow, writes in Forbes magazine. But as interest rates plunged in the economic downturn, more policyholders have not cashed in. Additionally, not enough consumers are buying the policies, he says.

In this environment, LTC insurance carriers have had to either exit the market or increase premiums substantially. Genworth increased premiums this year and decreased product offerings, while Prudential has decided to offer only group long-term care policies.

“Overall, though, the decline of the private LTC market is a huge problem, especially since it is coming just as Washington is seeking ways to reduce Medicaid, the most important payer of long-term care costs,” Gleckman wrote.

More evidence that poor dental hygiene leads to dementia

Researchers who followed close to 5,500 elderly people over an 18-year period, found those who reported brushing their teeth less than once a day were up to 65 percent more likely to develop dementia than those who brushed daily.

"Not only does the state of your mind predict what kind of oral health habits you practice, it may be that your oral health habits influence whether or not you get dementia," said Annlia Paganini-Hill, who led the study at the University of California.

Inflammation stoked by gum disease-related bacteria is implicated in a host of conditions including heart disease, stroke and diabetes.

And some studies have found that people with Alzheimer's disease, the most common form of dementia, have more gum disease-related bacteria in their brains than a person without Alzheimer's, said Paganini-Hill.

It's thought that gum disease bacteria might get into the brain causing inflammation and brain damage, she told Reuters Health.

So she and her team wanted to look at whether good dental health practices over the long term would predict better cognitive function in later life.

The researchers followed 5,468 residents of a Californian retirement community from 1992 to 2010. Most people in the study were white, well-educated, and relatively affluent. When the study began, participants ranged in age from 52 to 105, with an average age of 81.

All were free of dementia at the outset, when they answered questions about their dental health habits, the condition of their teeth and whether they wore dentures.

When the researchers followed-up 18 years later, they used interviews, medical records and in some cases death certificates to determine that 1,145 of the original group had been diagnosed with dementia.

Of 78 women who said they brushed their teeth less than once a day in 1992, 21 had dementia by 2010, or about one case per 3.7 women. In comparison, among those who brushed their teeth at least once a day, closer to one in every 4.5 women developed dementia. That translates to a 65-percent greater likelihood of dementia among those who brushed less than daily.

Among the men, the effect was less pronounced, with about one in six irregular brushers developing the disease - making them 22 percent more likely to have dementia than those who did brush daily. Statistically, however, the effect was so small it could have been due to chance, the researchers said.

There was a significant difference seen between men who had all, or at least most, of their teeth, or who wore dentures, and those who didn't - the latter group were almost twice as likely to develop dementia.

That effect was not seen in women, though.

Paginini-Hill could only speculate on the reasons for the different outcomes among men and women. Perhaps women wear their dentures more often than men, and they visit the dentist more frequently, she suggested.

The new findings, published in the Journal of the American Geriatrics Society, cannot prove that poor dental health can cause dementia.

Neglecting one's teeth might be an early sign of vulnerability to dementia, for instance, or some other factor could be influencing both conditions.

Still, this report "is really the first to look at the effect of actions like brushing and flossing your teeth," said Dr. Amber Watts, who studies the causes of dementia at the University of Kansas and was not involved in the research.

The new study does have some limitations. Paganini-Hill and her team looked at behavior and tooth count as a kind of proxy for oral health and gum disease. They didn't carry out any dental exams so they couldn't determine if people had gum disease or not.

And tooth loss isn't always related to gum disease, Watts noted. Head injury and malnutrition are also important causes of tooth loss in adults, and any of those might increase risk for dementia, she said.

"I would be reluctant to draw the conclusion that brushing your teeth would definitely prevent you from getting Alzheimer's disease," Watts said.

Yet despite the limitations, Watts said the study is an important step toward understanding how behavior might be linked to dementia.

"It's nice if this relationship holds true as there's something people can do (to reduce their chances of developing dementia)," said Paganini-Hill. "First, practice good oral health habits to prevent tooth loss and oral diseases. And second, if you do lose your teeth, wear dentures."

Caregivers responsible for the bulk of elder abuse

A new study confirms that financial elder abuse has reached the point of epidemic,with 65% of more than 750 interviews with experts who work with older Americans revealing victims of investment fraud or financial exploitation.

Of those who commit elder financial fraud, family members and caregivers are among the most common offenders, followed by strangers.

“Our new survey shows that financial swindles targeting older Americans are a bigger problem today than ever before and that seniors need more help.” said Don Blandin, president and CEO, Investor Protection Trust. “…Of course, there is no ‘silver bullet’ that will end the financial abuse of America’s seniors. Putting a major dent in the problem will require new and innovative collaborative efforts by many different experts and organizations, both public and private.”

Education is seen as the No. 1 way to combat the problem, through counseling or personal finance management programs tailored to the needs of older Americans. These programs are most effectively delivered through local professionals, protective service workers, law enforcement agencies and health care professionals, as well as senior centers, the study finds.

The magnitude of the problem and lack of effective ways to identify elder financial abuse has led it to become a health issue in addition to a national concern, says Dr. Mark Lachs, Director of Geriatrics, New York-Presbyterian Healthcare System.

“Elder financial abuse is not only about financial exploitation: It is a major public health problem. When older Americans are financially exploited and there are no resources left for their care, these individuals effectively become wards of the state. In these cases, all Americans end up paying.

Read full study...

Top Ten Things a Caregiver Needs from a Health Care Provider

Excellent insight from our friend Gary Barg of Today's Caregiver.

1. Attention: The caregiver's loved one may be the 27th similar case you've seen today; but to the caregiver, this is Mom or Dad, Sister or Lover.

2. Compassion: Be diligent in its application.

3. Time: A few moments of your undivided time is some of the strongest medicine you'll ever administer—and it costs so very little.

4. Respect: The person pushing the wheelchair is also part-time bookkeeper, psychologist, dietitian, insurance and incontinence expert, and a full-time general in the war they are waging with this illness. They not only need your respect, they DESERVE it.

5. Dedication: Be relentless in your devotion to your craft. The caregiver has entrusted you with their most valuable asset—their loved one. You earn that trust with your skill, knowledge base and ability. 

6. Honesty: The caregiver is your partner in this endeavor; they deserve (and can handle) the truth.

7. Prudence: The graceful administration of the truth is a true test of a caring professional.

8. Advocacy: Never accept less than the best your system has to offer their
loved one.

9. Understanding: The caregiver plays a pivotal role in the well-being of your patient; understanding the needs, wishes and fears of the caregiver improves your patient's care.

10. Your well-being: Know your emotional limit and learn when to ask for help. Your loved ones as well as the caregiver's loved one need you to remain well.

Gary Barg
Editor-in-Chief
Today's Caregiver

Symptoms of Alzheimer's disease

No one experiences Alzheimer's disease in exactly the same way. As memory loss occurs, it affects cognition, coordination, personality, and standard of living very differently from person to person. However, researchers have identified some patterns in the way the disease progresses, allowing doctors to group Alzheimer's symptoms into three specific stages. This classification can help people to better understand how symptoms might unfold after an Alzheimer's diagnosis and can assist families in making plans for the future.

It's important to keep in mind, though, that while Alzheimer's symptoms have been clustered into stages, there's no way to tell how long any one stage or symptom will last or how quickly others will progress. People with Alzheimer’s die on average about four to six years after their diagnosis, but the disease can also take its relentless toll for as long as 20 years before death occurs.

Alzheimer's Symptoms:

You've forgotten where you've placed your keys. Or you can't remember the name of an actress in a particular movie. Or maybe you are relying more and more on notes to remind yourself you need to do important tasks. Are you suffering from Alzheimer's?

In most cases, the answer is probably not. Most of us experience some “normal” loss of memory, those annoying “senior moments,” as we age. Experts say that misplacing your keys isn’t the issue; forgetting what the keys are used for, however, can be. With this in mind, if you or a loved one is having memory problems that seem to be getting worse more rapidly or happening much more frequently than before, it might be time to pay your doctor a visit.

The following are some early warning signs of Alzheimer's, along with caveats you should keep in mind:

Forgetfulness -  People with early Alzheimer's often find themselves regularly forgetting important information they've just recently learned. On the other hand, there’s probably no need to worry about occasional lapses, such as misplacing your wallet or forgetting names — these types of memory lapses are normal and happen to most people as they get older.

Difficulty completing tasks - People with early Alzheimer's might not be able to remember the steps needed to cook a meal, balance a checkbook, or use a computer program. However, forgetting what you were just going to say or why you went into a particular room isn't unusual when it happens every now and then.

Disorientation - If you've found yourself getting lost in your neighborhood, or ever feel as if you suddenly don't know how to get home because you've forgotten where you are and how you got there, these are signs that could indicate the presence of Alzheimer's. But remember, both of these issues are much different than simply forgetting where you were headed, which can happen to anyone from time to time.

Misplacing objects - Putting objects in strange places — like your car keys in the microwave, or your hair dryer in the washing machine — can be a sign of early Alzheimer's disease. Don't worry if you or your loved one temporarily misplaces keys or a purse, though.

Lapses in judgment - If you notice that you or your loved one has started exhibiting some strange behaviors — like putting on several heavy layers of clothing on a warm day, wearing the same clothes day after day, or giving lots of money away to telemarketers or scam artists, there's reason to suspect Alzheimer's might be present.

After the heart attack...

If your parent has recently been hospitalized for a heart attack, the future may seem very uncertain. Now is the time to organize medical care and figure outhow to make the transition from hospital tohome as smooth as possible.

Ask your parent's physician (s) the following:
How serious was the heart attack?
Some heart attacks are worse than others. Knowing how badly your parent's heart was damaged will give you a clearer sense of his prognosis and timeline for recovery. The extent of damage will also determine any complications your parent might have.
What complications should we watch for?
If your parent suffered a very mild heart attack, you might not need to worry about complications at all. But if the attack was more severe, your parent could develop complications, such as an arrhythmia, congestive heart failure, or stroke. Ask the doctor about your parent's risk for these complications and how to recognize them if they develop.
How much care will my parent need -- and for how long?
If your parent will need more care than you can provide, now is the time to make plans. The doctors and nurses should be able to give you an idea of how badly and how long your parent will be disabled.
When can my parent resume normal activities?
How much and what type of activities your parent can do will depend on the condition of his heart. In most cases, heart attack survivors can get back to normal activities within a few months; others may need to take it easy for a longer period of time. Depending on his state's laws, your parent may be able to start driving within a couple of weeks. The doctor can help you and your parent set a realistic timetable for recovery.

What exercises should my parent do?
Physical activity strengthens the heart muscle and is important for overall health. Exercise can help your parent reduce his cholesterol level, lose weight, and lower his blood pressure. But it's important not to overdo it, especially soon after a heart attack. Ask the doctor if your parent could benefit from a cardiac rehabilitation program, in which an exercise specialist will help him develop a program he can continue on his own.

What kinds of dietary restrictions are necessary?
You probably already realize that your parent will need to make changes to his diet, but the thought of implementing those changes may daunt you. The doctors and nurses can help you figure out the best diet for your parent. Ask what foods are good for heart health, what foods he should limit, and how to control portion size. If you need more help, ask for a referral to a nutritionist who specializes in cardiac patients.

What medications will my parent need to take -- and what are the likely side effects?
The doctor has probably prescribed a bewildering array of different medications for your parent. Make sure you understand each medication and its potential side effects.

 For each medication, ask:

• What does it do?
• How often should my parent take it?
• Should my parent take this medication with food?
• Is there anything my parent should not eat or drink with this medication?
• What side effects might we expect?
• What doctors should my parent see?

If your parent's heart attack was fairly mild, he may be able to continue to see only his primary care physician. But if his heart was badly damaged, he'll probably need to see a cardiologist as well. Ask what doctors he'll need to visit and whether your insurance will cover those appointments.

 

What's my parent 's risk for another heart attack, and what signs should we watch for?
Most heart attack survivors are at a higher risk for a second attack. Ask the doctor how you can tell the difference between angina and a heart attack. Be aware that the second heart attack may not exhibit the same symptoms as the first. With that in mind, ask the doctor for a list of signs to watch for and what to do if you see them, including where you should seek emergency care.

Obamacare offers choice...support kids or aging parents

What will we do?

While most Americans wait to find out how Obamacare will affect their own health care situation, Martha R Gore, Watch Dog Politics Examiner, Examiner.com, speculates that those who are most likely to bear the brunt of the legislation are the demographic who care for aging parents as well as adult children. 

Medicare cuts could pose a conflict for those “middleagers,” writes Gore as they choose between health care costs for themselves and their parents while weighing the option of a multigenerational household to help keep costs down. 

The follow is a sample of cuts to Medicare:

• Home health care
• Diagnostic imaging like MRIs, CT scans
• Ambulances
• Diagnostics labs
• Durable medical equipment
• Power wheelchairs unless rented for previously rented for 13 months
• Long term hospitals, nursing homes and inpatient rehab facilities
• Dialysis treatment
• Inpatient psychiatric hospitals
• Hospice
• Hospitals that treat low income seniors

According to an article in NPR the number of elderly Americans needing expensive care is going to surge as more Baby Boomers retire and begin to depend upon Medicare to meet their health needs. This is the age group born between 1946 and 1964 and many of them are expected to live to live 85 years or older. Today there are 6 million Americans in that age group.

As more cuts to Medicare are made it may mean many Americans that are still supporting children may be expected to shoulder more of the cost of taking care of the health and medical needs of elderly parents.

In some cases, this may require that the aging parent move into the family dwelling in order to cope with the financial challenges. The Pew Research Center reports that this is already happening with about 20% of older people living with another generation. However doubling up to split living costs may fall short of what is needed to care for an aging parent. Three generations in one household may become the rule rather than the exception.

Mom, what's wrong with Nana?

Alzheimer's can be baffling to anyone, but for young children and even teens it can be especially hard to grasp all that's happening to someone who has played a central role in their lives. But because Alzheimer's can have a profound impact on family life, it’s important to talk with your children about the disease as soon as possible and help them to understand how this disease will probably have to change the relationship they’ve previously shared with that loved one.
You should expect that your children will have a strong reaction to the news of their loved one's Alzheimer's diagnosis. "Both the five-year-old and the fifteen-year-old are going to be alarmed and stressed, and as grandpa or grandma drifts away they're going to face feelings of bereavement," says Richard Powers, MD, associate professor of neurology and pathology at the University of Alabama at Birmingham School of Medicine and spokesman for the Alzheimer's Foundation of America. "It's important to explain that while grandpa may not remember your name, he still loves you as much as the first day he laid eyes on you, and you need to reach out to the part of the person that's still intact."

To choose the right words to explain a loved one’s Alzheimer diagnosis to a child, first consider their age and modify the conversation to make it age-appropriate. The following tips can help you to do just that:

• Younger children - when talking to a younger child about a loved one's diagnosis, you won't necessarily want to use the term Alzheimer's disease. "I recommend parents say something like, 'Grandpa is having problems with his memory or he is unable to think as well as he used to think, so sometimes we'll have to help him with his thinking or his remembering,'" says Barry J. Jacobs, PsyD, a psychologist, faculty member of the Crozer-Keystone Family Medicine Residency Program in Springfield, Pa., and author of The Emotional Survival Guide for Caregivers. You should mention that the person with Alzheimer’s will get sicker over time. Then, if your child seems to have a good grasp of what's already been explained, you could prepare him for some of the changes he will see in the person with Alzheimer's by going over symptoms and how to handle them appropriately.
• Teenagers - will be capable of understanding more than young children, so you should share details of both the progression of Alzheimer's disease and the treatment options available. "For teenagers, we developed a more sophisticated program that actually gets into the brain pathology," says Dr. Powers. "Often, teenagers will end up playing a role in caring for grandpa or grandma, so it is important for them to know as much as possible up front."

Reassure children that Alzheimer's disease is not infectious as you answer their questions and acknowledge their feelings. Make sure they understand that the dementia patient still loves them and wants to see them, but don't force them to visit if they are very resistant or uncomfortable with the situation.

There are a number of emotions children and teens might experience after hearing of their loved one's Alzheimer's diagnosis, including:

• Sadness and a sense of loss
• Confusion or fear about behavioral changes
• Worry that Alzheimer's is contagious, or that their parents might develop the disease
• Anger or frustration because they have to repeat questions when interacting with the dementia patient or help with caregiving tasks
• Remorse over their anger or frustration
• Embarrassment and not wanting to have friends over if the Alzheimer’s patient lives at home with them

These emotions can also be expressed in ways that are less obvious. The child or teenager might act out by:

• Complaining of vague physical discomfort, like a stomachache
• Performing poorly at school
• Spending more time away from home
• Refusing to invite friends over

Parents should respond with unconditional love and support, allowing their children to work through their feelings and answering all of their questions as honestly as possible. Family-related activities like sorting through old photographs or making a family tree also might help by reinforcing the child's connection to their loved one.

Above all, don't force kids to do things they are not comfortable doing. This could include being present for medical exams, participating in daily care (like toileting), or making visits to a nursing home rather than visiting the person with Alzheimer's at a more neutral or familiar location.
Hearing of a loved one's Alzheimer's diagnosis is tough. Explaining it to kids can be challenging for you as well. But following these tips, and customizing them to your specific situation, can be a great step in the right direction. Opening the lines of communication will ease the transition for everyone, no matter

Support groups provide a non-threatening environment to ask questions.

Even though millions of people have diabetes, when you’re the one receiving the diagnosis you can feel very alone. Joining a diabetes support group, either in person or online, can help you see the many resources available to you, and that you’re far from alone in your battle to control diabetes.


When you meet other people who have diabetes and share your common experiences in a diabetes support group, it can be comforting as well as educational, says Ruth S. Pupo, RD, a diabetes educator at the East Los Angeles Center for Diabetes at White Memorial Medical Center.


The Benefits of Group Support


Participating in a diabetes support group can provide social support as well as ideas and strategies for better diabetes management and more effective diabetes care. By joining a diabetes support group, you can:


Get solutions to common diabetes care problems. People in support groups often have good suggestions for diabetes care issues, like counting carbohydrates and eating without raising blood sugar levels. Someone in your group might know of a great place to buy fresher foods or great gyms for exercise. People with the same health issues as you can often be invaluable resources.


Find out about the latest in diabetes management and treatment. Diabetes research is ongoing, and at a diabetes support group meeting you will often hear about the latest developments. Pupo says professionals as well as people with diabetes and their family members attend her support group meetings, and the professionals can help sort out the rumors that may start when a member hears of a new treatment or drug.


Ask questions you may hesitate to ask your healthcare provider. “I can’t stress enough that it’s a nonthreatening environment,” Pupo says. The people there feel comfortable asking questions they may be afraid to ask their doctor or diabetes educator for fear of looking stupid. 


Explore topics or issues you might not have thought of. People in your support group may bring up an issue or problem they're dealing with — something you realize you hadn’t thought about but probably should, Pupo says. It could be anything from managing your co-workers’ attitudes toward your condition to how to handle holiday meals.

The downside of aging in place...loneliness.

A new study makes a case for seniors to consider moving into congregate senior housing.

Many seniors prefer to age in place and remain in their own homes, but the benefits they might gain by saving money or maintaining a familiar setting can be lost through loneliness, which speeds up the aging process, according to a recent Cornell study published in Psychology and Aging.

The social pain of loneliness produces changes in the body that mimic the aging process and increase the risk of heart disease, according to the study, and while heart functions change as a normal aspect of aging, loneliness accelerates the process. 

Researchers measured cardiovascular reactivity and recovery in 91 young adults (aged 18 to 30) and 91 older adults (aged 65 to 80) who gave a speech and did mental arithmetic in a lab setting. They assessed each person’s level of loneliness before the tasks, and took systolic and diastolic blood pressure measurements before, during, and after the tasks.

“The most striking thing we found was that the cardiovascular response of the lonely young adults to the social stressor task looked more like that of the nonlonely older adults,” said lead author Anthony Ong, associate professor of human development in Cornell’s College of Human Ecology in a statement.

Older adults had a higher resting blood pressure and a greater cardiovascular stress reactivity, along with a longer recovery time, compared to younger adults. The study found that loneliness increased each of these measures, with an even more negative impact in older adults. In fact, the recovery time after the tasks was, on average, “so delayed [that] they did not return to baseline levels during the two-hour-long follow-up period.” 

“I think it’s helpful to distinguish the emotional pangs that are associated with acute loneliness from the more chronic feelings of distress that accompany perceived deficits in the quality of our social relationships,” Ong said. ”Viewed from this perspective, acute loneliness may be seen as adaptive, signaling us to repair social connections. However, it is the persistence of loneliness over time that may set the stage for health problems in later life…one of the most important and life-affirming messages of this research is the reminder that we all desire and need meaningful social connections.”

Older employees working longer to pay for eldercare

Older adults are increasingly providing care for elderly parents or others, according to a May fact sheet from the Boston College Center on Aging and Work. Over the past 20 years, there has been a gradual, moderate increase in the number of those providing elder care, with one in seven older workers having responsibility for a child and an adult, the report states. 

Between 1989 and 1999 the percentage of older adults providing this care rose from 36% to 44% and the number continued to rise over the past 10 years as well, including financial assistance provided to children and grandchildren. 

Because of this financial responsibility, the Boston College research states, many older adults want to remain in the workforce longer so that they can continue to provide this support. It has some bearing on their work schedules as well as their vacation time. Many postpone retirement, but many others stop work earlier or cut back on hours in order to fulfill caregiving responsibilities. 

“Increasing numbers of older adults are involved in caregiving and financial support of their parents, spouses, adult children and grandchildren,” the report states. “Many older adults today find that they need to continue to work in order to help family members financially, while others need flexibility in their work schedules to meet caregiving demands.”

Read full report...

The growing issue of cheating...

Shameless! Cheating Is Now Mainstream in America

We expect people to cheat on their taxes, to cheat on freeway speed limits, to barge into line without challenge. We no longer feel surprised when people cheat in business, sports, in their personal life, and in politics.

Our elders wax poetic about the erosion of values in our nation compared to their youth. However, many older Americans don't think twice about impoverishing themselves to qualify for government funded programs. Is that cheating? I'll let you decide.

The following is an excerpt from an excellent article that appears in The Fiscal Times about this growing moral issue.

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Now I've read everything...

For some older adults, the online video game World of Warcraft appears to offer more than escapist adventure. North Carolina State University researchers have found that playing WoW actually boosted cognitive functioning for older adults — particularly those adults who had scored poorly on cognitive ability tests before playing the game.“We chose World of Warcraft because it has attributes we felt may produce benefits — it is a cognitively challenging game in a socially interactive environment that presents users with novel situations,” says Anne McLaughlin, Ph.D., an assistant professor of psychology at the university.

Even a little physical activity helps...

A new study provides more evidence that physically active seniors may have a better overall health outlook.

Out of 893 people around 80 years old, researchers found that the most active seniors had a lower risk of dying over the four-year study compared to those who moved the least.

"It's another strong piece of evidence that all seniors should be participating in physical activities," said Dr. Catherine Sarkisian, director of the Los Angeles Community Academic Partnership for Research in Aging.

Sarkisian, who was not involved in the new study, told Reuters Health this does not prove exercise makes people live longer. It could be that people who were healthy enough to exercise are the ones who would have lived longer anyway.

However, she said there is enough evidence to suggest that people who are more physically active are less likely to lose their memory or have to go to a nursing home, for example.

To see whether activity levels make a difference in lifespan, researchers led by Dr. Aron Buchman, a professor at Rush University Medical Center in Chicago, measured the daily activity level of local seniors, most in their late 70s and 80s, over 10 days.

The participants wore a small device on their wrists to record how much they were moving throughout the day.

The researchers then followed the group for about four years, during which a quarter of the seniors -- 212 -- died.

The seniors who were most active had about a 25 percent lower chance of dying compared to those who were least active over the four years, according to results published in the Archives of Internal Medicine.

Buchman and his colleagues wrote that the link between physical activity and a lower risk of death remained even after taking into account traits that may have affected both seniors' exercise routine and chance of dying, including mental ability, chronic health conditions and symptoms of depression.

"This suggests if you're increasing your activity -- even in your home -- it has some advantages," said Buchman.

Sarkisian thinks there is a stereotype that seniors are too old to learn new habits, but she said past studies have shown the opposite.

"Physical activity is one of the most important things that seniors can do to improve their health for the rest of their lives," she added.

People are motivated to exercise for different reasons, said Sarkisian. Some may want to exercise after seeing a friend die, become ill or fall. Others may want to exercise because of the immediate physical benefits, such as improved mood.

Older adults can check their local senior centers for exercise programs or talk to their doctors or a physical therapist for ideas, Sarkisian said. There are also programs tailored for people with physical limitations, such as those who are wheelchair bound or at an increased risk for falling.

Buchman,said it can also be as simple as an older person increasing their activities around the house. "If you can do light activity, do light activities."

Elderly patient hospitalizations decrease under the watchful eye of a primary care physician

As the primary-care workforce continues to be strained, new research shows that areas with higher levels of primary care have fewer patient deaths and preventable hospitalizations, according to a study in The Journal of the American Medical Association.

Researchers evaluated seniors with Medicare benefits who live in areas with higher levels of adult primary care physicians and physicians providing primary care. They found that elder patients were less likely to die or land in the hospital.

"A higher level of primary-care physician workforce, particularly with an FTE measure that may more accurately reflect ambulatory primary care, was generally associated with favorable patient outcomes," said the study authors.

Experts agree that graduating medical students electing other specialties other than primary care results in a primary care vacuum that must be filled.

If the United States could fulfill the primary-care need, it would result in 50,000 fewer deaths and 436,000 fewer hospitalizations in a year, notes Reuters.

March is National Colorectal Cancer Awareness Month

Thanks to improvements in prevention, early detection and treatment, more than a million people in the U.S. count themselves as survivors of colorectal cancer.

Most people with early colon or rectal cancer have no symptoms of the disease. Symptoms usually appear only with more advanced disease. From the time the first abnormal cells start to grow into polyps, it usually takes 10 to 15 years for the polyps to develop into colorectal cancer. This is why getting the recommended screening tests before any symptoms develop is so important.

According to the American Cancer Society (ACS), fewer African Americans are dying from colorectal cancer than in previous years. However, African Americans still have the highest death rate of any other racial or ethnic group for most cancers, including colorectal cancer. An estimated 7,020 deaths from colorectal cancer are expected to occur among African Americans in 2012. Colorectal cancer is the third leading cause of cancer death in both African American men and women.

The causes are complex and are thought to reflect social and economic disparities more than biological differences associated with race. These include inequities in work, wealth, income, education, housing and overall standard of living, as well as barriers to high-quality cancer prevention, early detection and treatment services.

Chances of colon cancer increase with age. Diabetes, obesity, smoking and heavy use of alcohol also increase the risk. Screenings should start at age 50 and continue every 10 years after that, as long as results are normal. You should start earlier at the age of 40 if you have a family history.

You can make a difference!

In the latest effort to enlist seniors in the fight against Medicare fraud, federal officials have overhauled Medicare billing statements to make it easier to find bogus charges without a magnifying glass.

The new, more consumer-friendly format, which goes online Saturday on Medicare’s secure Web site, www.mymedicare.gov, includes larger type and explanations of medical services in plain English. The revised paper version, which is mailed to seniors every three months, will be phased in early next year.

“You can make a difference!” the revamped statement says. “Last year Medicare saved taxpayers $4 billion – the largest sum ever reported in a single year thanks to people who reported suspicious activity to Medicare.”

And for those who might need an incentive to scour their bills, the new statements promise a reward of up to $1,000 for a tip that leads to uncovering fraud. Although the bonus isn’t new, there’s no mention of it on current forms, which are sent to about 36 million beneficiaries in traditional Medicare.

“We approached this redesign from the standpoint of making it a more consumer-friendly document for beneficiaries and also a better fraud-fighting tool,” said Erin Pressley, director of creative services for the Centers for Medicare and Medicaid Services. “If they are paying attention to these documents, they are going to be the best defense we have.”
“It shouldn’t be a scavenger hunt,” she added.