Monday, February 15, 2016

Time Magazine's 4th Cover Issue on "Hope" for Alzheimer's Disease Solutions

Time Magazine's February 29 issue has a provocative image and title, showing a silhouette of a young woman about to ingest a spotlighted, shining capsule.  The issue, titled "The  Alzheimer Pill: A Radical New Drug," focuses on a pill called LM 11 A-31.

By my count, this is at least the fourth cover by Time focused on the latest hopes for a solution to this disease. Prior issues include:

  • October 25, 2010: Alzheimer's: At Last Some Progress Against the Most Stubborn Disease
  • May 14, 2001: Believe it or Not, this 91 Year-Old Nun Could Help Your Beat Alzheimer's, promoting a "landmark study of the disease." 
  • July 17, 2000: The New Science of Alzheimer's Disease

 

February 15, 2016 in Cognitive Impairment, Dementia/Alzheimer’s, Science | Permalink | Comments (0)

Friday, February 12, 2016

Family Dynamics and Caregiving: A Bumpy Road or Smooth Sailing?

Every family has its own unique dynamics with siblings having specific relationships with siblings and with parents.  When a parent needs caregiving, those dynamics can play a role, according to an article posted on the AARP website on January 27, 2016.  The article, When a Troubled Past Affects Present Caregiving, quotes a family therapist who explains:

According to family therapy pioneer Ivan Boszormenyi-Nagy, we subconsciously keep tallies in our relationships — who has done what for whom over time. As a result, our past interactions with family members powerfully shape our responses to calls for care... [a] history of feeling neglected generally creates resentful caregivers.

The article offers several suggestions for helping focus past relationships into positive caregiving decisions including not being trapped by the past, remembering the good, and focusing on values rather than revenge when decision-making. "Living that value through caregiving doesn't completely erase the pain of a flawed past relationship. But it affirms that you are not so hamstrung by old hurts that you can't rise above them and be the kind of person you wish your parent, sibling or whomever you're caring for had been."

 

February 12, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care | Permalink | Comments (0)

Thursday, February 4, 2016

New Brochure-Caregiver Advocates

The National Center on Elder Abuse (NCEA) sent an email to the elderabuse listserv on February 4, 2016 that announced the release of a new brochure for family caregivers on how to advocate for those in their care with dementia.  The email announcement explained that the

material was created by the USC Department of Family Medicine, with funds provided by the Archstone Foundation, and was developed using input from actual family caregivers of people with dementia through informant interviews and focus groups. The brochure provides information about elder abuse, tips for caregivers on how to protect and advocate for their loved ones, real life scenarios, and resources. The goal of this brochure is to help family caregivers of people with dementia to learn how to take care of themselves in order to prevent mistreatment....

The brochure explains elder mistreatment, offers tips on advocating for and protecting relatives with dementia and provides helpful contacts along with examples. The web version is available here and the print version, here.

 

February 4, 2016 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship | Permalink | Comments (0)

Thursday, January 28, 2016

If The Issue Is Accountability, Which Is Better? Power of Attorney or Guardianship?

Here are two recent appellate cases that offer views on issues of "accountability" by surrogate-decision makers.  

In the case of In re Guardianship of Mueller (Nebraska Court of Appeals, December 8, 2015), an issue was whether the 94-year-old matriarch of the family, who "suffered from moderate to severe Alzheimer's disease and dementia and resided in a skilled nursing facility," needed a "guardian."  On the one hand, her widowed daughter-in-law held "powers of attorney" for both health care and asset management, and, as a "minority shareholder" and resident at Mue-Cow Farms, she argued she was capable of making all necessary decisions for her mother-in-law.  She took the position that appointment of another family member as a guardian was unnecessary and further, that allowing that person to sell Mue-Cow Farms would fail to preserve her mother-in-law's estate plan in which she had expressly devised the farm property, after her death, to the daughter-in-law.  

The court, however, credited the testimony of a guardian-ad-litem (GAL), who expressed concern over the history of finances during the time that the daughter-in-law and the mother-in-law lived together on the farm, and further, expressing concerns over the daughter-in-law's plans to return her mother-in-law to the farm, even after a fall that had caused a broken hip and inability to climb stairs.  Ultimately, the Court of Appeals affirmed the lower court's appointment of the biological daughter as the guardian and conservator, with full powers, as better able to serve the best interest of their elder.  

Despite rejection of the POA as evidence of the mother's preference for a guardian,  the court concluded that it was "error for the county court to authorize [the daughter/guardian] to sell the Mue-Cow property.... There was ample property in [the mother's] estate that could have been sold to adequately fund [her] care for a number of years without invading specifically devised property." 

In an Indiana Court of Appeals case decided January 12, 2016, the issue was whether one son had standing to request and receive an accounting by his brother, who, as agent under a POA, was handling his mother's finances under a Power of Attorney.  In 2012, Indiana had broadened the statutory authority for those who could request such an accounting, but the lower court had denied application of that accounting to POAs created prior to the effective date of the statute.  The appellate court reversed:

The 2012 amendment did confer a substantive right to the children of a principal, the right to request and receive an accounting from the attorney in fact. Such right does apply prospectively in that the child of a principal only has the statutory right to request an accounting on or after July 1, 2012, but not prior to that date. The effective date of the powers of attorney are not relevant to who may make a request and receive an accounting, as only the class of persons who may request and receive an accounting, and therefore have a right to an accounting, has changed as a result of the statutory amendments to Indiana Code section 30-5-6-4. Therefore, that is the right that is subject to prospective application, not the date the powers of attorney were created

These cases demonstrate that courts have key roles in mandating accountability for surrogate decision-makers, whether under guardianships or powers of attorney.

January 28, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Property Management, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, January 27, 2016

Learning for Learning's Sake?

Isn't that a great thought. Students learning for thee sake of learning!  The New York Times ran at article on January 1, 2016 on that exact topic. Older Students Learn for the Sake of Learning explains those "the 150,000 men and women nationally who participate each year at more than 119 Osher Lifelong Learning Institutes. The institutes, affiliated mostly with colleges and universities, are among the best-known advanced adult educational programs in the country. Along with an array of other such programs fitting under the “lifelong learning” umbrella, they tend to attract educated, passionate people who are seeking intellectual and social stimulation among peers who often become new friends."

The article distinguishes this type of learning from the more traditional adult ed classes, since "lifelong learning programs position themselves as communities where the participants not only take on challenging subjects but also seek to engage more deeply with their fellow students."  The article runs through the research on the advantages to ongoing education to a sharp brain.

Keep on learning everyone!

January 27, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Retirement | Permalink | Comments (0)

Monday, January 25, 2016

Stopping Alzheimer's?

Earlier this month I read an article about the role of brain inflammation in Alzheimer's.  Scientists May Have Just Discovered the Key to Halting Alzheimer's  was published on January 11, 2016 in Huffington Post Science.  "Researchers at the University of Southampton in England conducted a series of experiments showing a chemical that reduces neuroinflammation may have the potential to protect against the memory and behavioral changes associated with the disease that affects roughly 5.3 million Americans."  The article explains the research and notes that "[a]n overactive immune system can result in chronic inflammation, which previous research has linked to Alzheimer's. These new findings makes it increasingly apparent that inflammation is not a result of Alzheimer's as much as a key driver of the disease." Further research will be taking place.  Exciting!

January 25, 2016 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Science | Permalink | Comments (0)

Science, Elder Law and Genetic Counseling...

I think I might like winter better, if it always happened "conveniently" and with plenty of notice, as did Saturday's snow in Pennsylvania.  For once, I was prepared to be at home, with a stack of good reading materials for catching up when the joys of house-cleaning and snow shoveling faded. 

I am intrigued by the Fall 2015 issue of the NAELA Journal that focuses on how advances in genetic testing and medicine may be reflected in the roles of lawyers who specialize in elder and special needs counseling.  A leading article in the issue introduces the three primary uses of modern genetic testing -- for diagnosis of disease, for determination of carrier status, and for predictive testing -- while reminding us there are limits to each function.  In looking at age-related issues, the authors note:

 

Genetic testing is beginning to reveal information regarding susceptibilities to the dis­eases associated with old age: Alzheimer’s disease, Parkinson’s disease, diabetes, and cancer. Genetic test results showing a higher risk of such diseases can result in a cascade of conse­quences. Francis Collins, mentioned at the beginning of this article, responded to his test results thoughtfully by making lifestyle changes to reduce the probability that the increased genetic risk would be expressed in actual disease. It is important to note that, for some con­ditions, lifestyle factors’ influence on disease risk is understood; however, for many of the conditions that affect seniors, this influence is not yet known.

 

Other reactions to a high-risk test result may be more aggressive than diet and exer­cise changes. A well-publicized example is Angelina Jolie’s bilateral mastectomy. She was cancer-free but learned that she carries a BRCA1 mutation, which increases her lifetime risk for breast and ovarian cancer. She chose to undergo prophylactic mastectomy to reduce her breast cancer risk, whereas other women choose to increase breast cancer surveillance, such as undergoing more mammograms and breast MRIs. Both options are available to women who carry a BRCA1/2 mutation.

 

Will those found to be at elevated risk for more complex conditions such as Alzheimer’s disease or Parkinson’s disease make premature life choices, such as early retirement or mar­riage, based on perceived risk? Earlier in this article it is explained that an individual’s geno­type rarely determines his or her medical destiny. For example, many people with a higher genetic risk for Alzheimer’s disease will not actually develop it, while many with no apparent higher genetic risk will. Is the risk that members of the general public will misunderstand and overreact to the results of a genetic test sufficient reason to prevent them from obtaining the information gleaned from such a test? Should we be ensuring that those undergoing genetic testing are aware of its benefits and limitations through individualized genetic counseling? This, of course, presents its own challenges of access and availability.

In reading this, it seems likely that lawyers may encounter complicated issues of confidentiality, especially when counseling "partnered" clients, while also increasing the significance of long-range financial planning and assets management.  

For more, read Genetic Testing and Counseling Primer for Elder Law and Special Needs Planning Attorneys, by CELA Gregory Wilcox  and Rachel Koff, Licensed Certified Genetic Counselor. 

January 25, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Estates and Trusts, Ethical Issues, Retirement, Science | Permalink | Comments (0)

Wednesday, January 20, 2016

JAMA Current Issue Death, Dying and End of Life

The January 19, 2016 issue of the Journal of the American Medical Association (JAMA) is a theme issue on Death, Dying and End of Life.  There are 15 articles and opinion pieces on a range of topics, including several on physician-aided dying, as well as an audio of the editors' summary.  Check it out!

January 20, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Tuesday, January 19, 2016

University of California-San Diego Rebuilds its Alzheimer's Research Program

Last summer, I blogged on news about the University of Southern California's controversial challenge to University of California-San Diego's position in Alzheimer's research, including USC's successful lure of top researchers (and their money).  Lawsuits were unsuccessful in blocking the move, an attempt to avoid the loss of key research dollars.  

However, the latest news is that UC-San Diego has "recruited a prominent Canadian neurologist to rebuild and lead" its Alzheimer's disease research program.  From the news coverage:

Dr. Howard Feldman comes to La Jolla from the University of British Columbia in Vancouver, where he achieved international acclaim for his examination of dementia and for carrying out large-scale drug trials. A science journal nicknamed him the “master of dementia.” He’s also known as a rainmaker for his ability to raise money for research.

 

Feldman, 61, is receiving a recruitment package that includes $10 million to set up his laboratory and support his research program. His annual salary is $390,000.

Let's hope this means that there are now two stronger sites for research into diagnosis, treatment and cure for this dreaded disease.  

January 19, 2016 in Cognitive Impairment, Dementia/Alzheimer’s, Science | Permalink | Comments (0)

Friday, January 15, 2016

Ageism in Social Media?

I recently ran into an article published in December of 2015 that I thought was interesting.  Fighting Ageism in the Twitter Era (Getting Old Isn't All That Bad) was published in the Arizona Republic/New America Media.  The December article followed up a late November opinion piece titled, Valdez: Getting old isn't all that bad by Linda Valdez that opened with this:

The baby boomers, AKA the nation’s silver tsunami, had better pay as much attention to changing attitudes about aging as they did to shaking up all those previous social norms.

In our culture, old things get replaced with something nice and new. Like the latest smart phone.

Apply the concept to people, and it’s called ageism.

It’s as current as Twitter.

A team of researchers at Oregon State University took a look at tweets about people with Alzheimer’s disease and found ridicule, stigma and stereotypes.

In the December article, the author, reporting on the Gerontological Society of America's annual scientific meeting in November, was in attendance as a Journalist in Aging Fellowship.  After generally reviewing topics covered in the conference, the author notes that the Boomers wish to age in place, yet many may not be physically able to do so and blame themselves for their own inability to do so.  Enter negative thoughts about aging:

Meanwhile, society does its best to accent the negative.

Asked to characterize the aging, some people recorded during on-the-street interviews dredged up cliches about spry retirees on vacation, but most talked about decline, disease, dependency.

“Society isn’t betting on them,” said one man.

These interviews were done as a result of a project with 8 of the national aging organizations, who were looking for metaphors for aging because how we look at something is crucial to how we apply information about it.  The article concludes

[T]he way information is framed has an impact on how people use the information, which should come as no surprise to those who reframed cultural norms about race, gender, sex, the environment and entertainment.

The baby boomers have a lot at stake, and that includes [the author] me. I’m no fan of euphemisms, but I’m all for promoting a fine-wine view of life. It should get better with age. We should feel better about aging.

If some creative wordsmithing and mass marketing helps our society recognize that aging doesn’t diminish value or humanity, it would be a real contribution to our collective understanding of who we boomers are.

Turning to the researchers at Oregon State U who did the analysis of tweets, their article, Portrayal of Alzheimer's Disease on Twitter is available in volume 55 of the Gerontologist, the publication of the Gerontological Society of America.

January 15, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Statistics | Permalink | Comments (0)

Wednesday, January 13, 2016

Revisiting the Saga of Dr. Gerald Klooster

My Blogging colleague Becky Morgan suggested that our faculty readers share hot topics or videos they are using in Elder Law courses.  Along that line, I'm using an excerpt from a Dateline NBC program (archived in part by NBC, although special arrangements appear to be required for copies) from several years ago, that provides a dramatic introduction to a number of age-related legal issues. 

The program tells the story of Dr. Gerald Klooster and his family.  In 1995, friends of the family became concerned when they learned that Dr. Klooster, once a practicing obstetrician in California who was forced to retire early from his practice as the result of a diagnosis of Alzheimer's, had an appointment with his wife to meet with Dr. Kevorkian, of "assisted suicide" fame.  One son, also a physician, became so concerned that he made the decision to whisk away his father to the son's own state of Michigan, for safeguarding.  That triggered a two-state custody battle, initially resulting in inconsistent court rulings.  Eventually, however, Dr. Klooster was returned to California where he resumed living with his wife, Ruth, and regularly saw his other children and grandchildren.  The NBC program shows Gerald swimming and interacting with his family members.

One night, however, emergency personnel were summoned to the Klooster home, when it was learned that Gerald had ingested as many as 60 sleeping pills and alcohol in the middle of the night. Ruth is the one who called the emergency personnel, but then also reportedly directed them not to provide certain life-saving treatments.  She was relying on her husband's pre-dementia living will.

Gerald Klooster did survive, and the NBC program provides fascinating interviews with family members, and shows the couple sitting hand-in-hand.  Did he knowingly attempt to take his own life? Did he do so because he was a physician and, as his wife put it, "didn't want to live the disease through?"  Or did Alzheimer's prevent him from having the capacity to make any such decision?  The saga was also detailed in a New York Times article, linked here.

Lots of food for discussion with this story.  It introduces the limitations of advance directives or living wills; it encourages discussion about Alzheimer's as a "real" phenomenon; it provides a stage for discussing powers of attorney, guardianships and family caregiver roles, just to name a few topics still "hot" today.  Plus, it offers historical perspective on recent changes in laws, including uniform laws on jurisdiction for protective proceedings for adults, and assisted-suicide laws, including the California law that became effective on January 1 of this year.

The Klooster Saga lasts several years beyond the NBC Dateline story itself, as Dr. Klooster did live with his wife in California for additional  years, before spending his last 18 months in a nursing center. According to this San Francisco news report, he passed away at the age of 72 of natural causes, but, sadly, the break in the relationship between his physician-son and the rest of the family had not healed. 

January 13, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Crimes, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, State Cases | Permalink | Comments (0)

Tuesday, January 12, 2016

Get Your ZZZZs

We all know how important it is to get the appropriate amount of sleep. But it may be more important than we realize.  According to an NPR story on January 4, 2016, Lack Of Deep Sleep May Set The Stage For Alzheimer's, we need that deep sleep to help us fend off Alzheimer's.  The story focuses on the work of the Oregon Health & Science University scientists. One of the scientists explains why this deep sleep is so important to us: "[t]he brain appears to clear out toxins linked to Alzheimer's during sleep, [the scientist] explains. And, at least among research animals that don't get enough solid shut-eye, those toxins can build up and damage the brain."  The story notes that there is definitely a link between sleep and Alzheimer's since many of those with Alzheimer's have some kind of sleep disorder. The OHSU scientists are about to start a study of "that should clarify the link between sleep problems and Alzheimer's disease in humans."  The study described is fascinating (let's just say it involves sleeping in an MRI) and will be so important.  Read more about the study here.  Now, take a nap!

January 12, 2016 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, Science | Permalink | Comments (0)

Friday, January 8, 2016

"Fighting Alzheimer's" As An Election Campaign Platform

I've been intrigued by Hillary Clinton's December 2015 campaign announcement of a plan to focus on prevention, treatment and a cure for Alzheimer's disease if elected President.  Certainly there is plenty of data to document the need for such a plan.  Her announcement seems to be attracting attention -- support? -- as demonstrated in this piece from Lois Bowers, Senior Editor at McKnight's Senior Living, an industry-focused publication. 

January 8, 2016 in Cognitive Impairment, Dementia/Alzheimer’s, Ethical Issues, Health Care/Long Term Care | Permalink | Comments (0)

Thursday, January 7, 2016

Our Aging Internal Clocks--Slowing Down?

NPR ran an interesting story on December 22, 2015 on how our internal clocks may begin to lose time, but we have backup clocks ready to start ticking!  As Aging Brain's Internal Clock Fades, A New Timekeeper May Kick In notes that

We all have a set of so-called clock genes that keep us on a 24-hour cycle. In the morning they wind us up, and at night they help us wind down. A study out Monday in Proceedings of the National Academy of Sciences found that those genes might beat to a different rhythm in older folks.

One of the authors of the study refers to the genes as the conductors of a person's orchestra and somehow for elders, "[t]heir orchestras seem to go off the beat, but it isn't known why." Before worrying about being "out of tune", take heart that the study found that elders have a back-up clock that starts keeping time when the main internal clock begins to get out of tune.  The researchers are particularly interested in how this affects individuals who sundown because of dementia.  The NPR story includes an audio version of the story in addition to the print version.

The abstract of the study is available here.  The full article requires a subscription. Click here for more information.

January 7, 2016 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Other | Permalink | Comments (0)

Wednesday, January 6, 2016

SSA releases ABLE POMS

SI 01130.740 Achieving a Better Life Experience (ABLE) Accounts was released December 18, 2015. The POMS has six sections, including an explanation of ABLE accounts, definitions, what is excluded, what is countable, and verification/documentation of the account balances and of the distributions. Check it out! Oh and by the way, it's a good time to explain the POMS to your students. Check out SSA's explanation of the POMS on the POMS home page here.

January 6, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Other, Social Security | Permalink | Comments (0)

Racing Alzheimer's

Runner's World magazine ran the story,  Outrunning the Demons on December 15, 2015.  We all know about sundowning. But have you ever heard it described so eloquently:

I could hear their screeching howls through the canopy of oak and red maple trees that enshroud Lower Road in Brewster, Massachusetts, on the Lower Cape. They were gaining, ready to pounce—I had to sprint to avoid capture at sundown. I felt them closing in as the spring afternoon gave way to dusk and a spectral fog crept over me, first in misty sprays that tingled, then in thick blankets that rose slowly from the base of my neck to my forehead, penetrating my mind and disorienting my senses. Alone, I was soon enveloped in fear and paranoia.

The demons kept advancing as the blazing red sun sank into Cape Cod Bay, doused like a candle. Faster and faster they chased, and faster and faster I ran. I was 61 that day, two years into my diagnosis, and with every ounce of my will, I made it home. But I knew the demons would be back—with a vengeance. My life, once a distance run, has become a race for survival. That’s the way it is with early onset Alzheimer’s. It’s like a death in slow motion, like having a sliver of your brain shaved every day. Alzheimer’s stole my maternal grandfather, my mother, and my paternal uncle. Now, at age 65, it’s coming for me.

This personalized account of one man's fight to hold on in face of a relentless disease is a compelling read.  Photos of the author accompany the story. The author, Greg O'Brien, wrote On Pluto: Inside the Mind of Alzheimer'sRead the  article. It's worth it.

January 6, 2016 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s | Permalink | Comments (0)

Thursday, December 31, 2015

Living Wills: Do they have utility in end of life decision-making?

An article in the most recent issue of the ABA Commission on Law & AgingBIFOCAL focuses on instructional directives.  In light of CMS reimbursing doctors for end of life discussions with patients,  author Susan P. Shapiro, in The Living Will as Improvisation, suggests  "it is appropriate to reflect on the legacy of advance directives and ask how physicians might best serve their patients as they anticipate life’s end."

The author notes that

Although the value of proxy directives, which designate a medical decision maker in the event that a person loses capacity in the future, has been repeatedly demonstrated, that of instructional directives or so-called living wills, which state treatment preferences, has not. A new report by the Institute of Medicine concludes that legal approaches embodied in living wills have “been disappointingly ineffective in improving the care people nearing the end of life receive and in ensuring that this care accords with their informed preferences .... (citations omitted).

However, the author discusses the lack of hard data makes it difficult to determine whether living wills have little usefulness these days. The author turns to her own research, explaining that for 3 years she and hospital social worker

observed medical decision making on behalf of patients without decision-making capacity, day after day, from admission to discharge. Daily observations over the course of each patient’s ICU stay tracked when anyone asked about or referred to an advance directive, how the directive was used, and the correspondence between the patient’s treatment preferences articulated in the directive and the host of decisions made on their behalf....

The article discusses her findings regarding the role of advance directives in these cases .  It's quite illuminating, especially the discussion about the correlation (or lack thereof) between the directive's existence and how decisions are made.  The author suggests there are significant differences between making the directive when all is well and using the directive when all is not.    The author concludes the article with  this thought: "[a] truly directive living will is not a script, but rather an evolving, ongoing dialogue throughout the life course with those who may someday be called to improvise on our behalf. Let’s hope that Medicare dollars are used to help enrich the conversation."

December 31, 2015 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Tuesday, December 22, 2015

Telephone-Based Hearing Test -- a Low-Cost Screening Tool for Everyone

I was listening to NPR's Morning Edition recently while working on this Blog and that's how I learned about  a great resource, a telephone-based screening test for hearing problems, that individuals can take at home.  Offered by The National Hearing Test, the cost is $5 (free for AARP members) and the process was developed with the help of an NIH grant.  What impressed me is it tests for the ability to hear words (numbers) against background noise, a very realistic screen for many people's concerns.  After taking the test, you are offered guidance and resources for follow-up. The NPR story made the point that unlike vision problems, which are hard to blame on others, it is all too easy for those with hearing problems to assume the problem "is" background noise or a failure of younger people to "speak up."  Further, evaluation of hearing can be an important marker for other health issues, including problems with cognition.

For most reliable results, the website encourages you to use a traditional wired-phone connection, not a cell phone.

According to operation's website (linked above):

The National Hearing Test is provided on a nonprofit basis. It has no financial connections with any hearing products or services. (Free tests are typically offered by organizations selling hearing aids or providing services for a fee.) The $5.00 fee helps defray the costs of making it widely available to the public and processing test data; any remaining money goes to support further research on hearing loss.

Perhaps "taking" the screening test is a holiday present we can give our families

December 22, 2015 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Science | Permalink

Thursday, December 17, 2015

Is a Court-Appointed Guardianship, Using Paid, Private Guardian, "Worse Than Prison"? Latest from Nevada

As we've reported several times over the course of the last year, concerns about cost, misuse of authority, and lack of appropriate oversight of court-appointed guardians for adults in Clark County (Las Vegas), Nevada, have lead to a state-wide inquiry into how better to protect the civil rights of alleged incapacitated persons.  According to news reports recent proceedings before the Nevada Supreme Court Guardianship Commission, one judge described past neglect of the alleged incapacitated individual's rights as being "worse than being sent to prison."

A frequent concern raised by family members has been the cost of court-appointed guardians, particularly for individuals or family members who disagree with either the need for a guardianship or the scope of the guardian's powers over the individual or the individual's assets.  During the most recent proceedings addressing potential solutions, judges and others argued that a solution to some of the abuses was court-appointment of a lawyer at the outset of any guardianship proceeding to represent the interests of the individual.  Thus, there is some irony, that an additional layer of potential costs -- the cost of the appointed counsel -- would be argued as part of the solution.  On the other hand, limiting the amount of money such an attorney can charge (whether paid from the individual's estate or from public funds), can have the practical effect of what might be described as "de minimus" representation. 

The Nevada proceedings have attracted considerable attention from media nationally -- and from family advocates challenging court-supervised guardianships in other states and who are sharing information about problems and potential solutions. My thanks to Rick Black for sharing news from Nevada.

December 17, 2015 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Legal Practice/Practice Management, State Statutes/Regulations | Permalink | Comments (4)

Wednesday, December 16, 2015

Caregiver Drones and Other Robot Caregivers?

I'm fascinated by technology and I've read several articles about the use of technology in caregiving for elders.  With the proliferation of drone use by consumers, I was interested in the December 4, 2015 article in the New York Times As Aging Population Grows, So Do Robotic Health Aides. A robotics prof at the University of Illinois has a grant "to explore the idea of designing small autonomous drones to perform simple household chores, like retrieving a bottle of medicine from another room. Dr. Hovakimyan [the professor] acknowledged that the idea might seem off-putting to many, but she believes that drones not only will be safe, but will become an everyday fixture in elder care within a decade or two."  The use of robotic caregivers is viewed as a way to help folks stay at home longer than now. 

Can technology or robots be used to combat isolation and loneliness?  The article turns to "Brookdale Senior Living, one of the nation’s largest providers of assisted living and home care... [which] is using a variety of Internet-connected services to help aging clients stay more closely connected with family and friends."  According to the senior director of dementia care and programs at Brookdale, "there was growing evidence that staying connected, even electronically, offsets the cognitive decline associated with aging." 

The article features several technologies under development, not just the drones which Dr. Hovakimyan refers to as “Bibbidi Bobbidi Bots."  The article notes that Toyota is even getting into the field, noting that adding artificial intelligence to vehicles to make driving safer and to"make it possible for aging people to drive safely longer."

There are concerns about downsides to the use of such technologies, which are discussed in the article. The article turns to other countries leading the way in these advances and concludes with discussing a number of products currently on the market and how those may compare with in-person interactions. 

Interesting times...

 

December 16, 2015 in Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care, Science, Web/Tech | Permalink | Comments (1)