Friday, August 11, 2017

An Elevator Emergency System and the Death of an Elderly Man

Here is another tragic news story for a man, age 82, "who had begun showing signs of dementia and would become 'disoriented at times.'"  

On Aug. 2, nearly a month after he went missing, maintenance workers reported to fire authorities a discovery: a decomposed body in an elevator car in the parking garage. The body was soon identified as Komisarchik’s. . . .  

 

At some point on or before July 6, Komisarchik stepped inside the parking garage elevator. For reasons that remain unclear, he struggled to get out.

 

So in an attempt to seek help, Komisarchik pushed the elevator’s emergency button — twice over the course of eight minutes, a Denver Fire Department spokesman told the Denver Post. But no one responded.

 

Electronic records show that the elevator’s emergency alarm was pressed at 9:09 p.m. and 9:17 p.m. on July 6, the day after Komisarchik was last spotted, according to KUSA. Pushing this emergency button should trigger an alert to an elevator monitoring group or the fire department. But during the time Komisarchik was in the elevator, the fire department received no emergency calls from that car, the Denver Post reported.

 

“Something is not right,” Capt. Greg Pixley, a Denver Fire Department spokesman, told the Denver Post.

For more details, read "He pushed an elevator's alarm button but no one came. . . ." from the Washington Post

August 11, 2017 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Ethical Issues | Permalink | Comments (0)

Wednesday, August 9, 2017

Tragic Deaths of Long-Married Couple Underscore Family Dilemmas

The Washington Post carried a recent story by Samantha Schmidt on the tragedy that befell the Tarnowski family in Minnesota when Mary, age 78, and Ron, age 81, somehow wound up stranded with their car on a remote rural trail.  Sadly, they both perished, with heat and dehydration likely factors in their deaths.  

One element of the story has attracted a lot of reader attention -- the report that Ron Tarnowski, who had been his wife's primary caregiver for more than 35 years, was "showing signs of early-stage dementia" in recent years.   Implications from this label raise questions for many. 

From the article, a facebook page, and the obituary, it is apparent that the couple's two sons were very caring and attentive.  One son had built them a home "adjacent to his own so he could keep an eye on them."  That son's wife had given his mother a bath and cooked breakfast for the couple earlier on the day they went missing, and the fact that they were missing was reported the very same day.  Despite the sons' attentiveness, and the all-out efforts of authorities and volunteers to locate the missing couple, the search lasted eight days.

I read with interest the comments to the story posted on-line at the Washington Post website. I expected there would be "flamers" and shaming, so typical of many on-line comment websites. But for the most part, the readers showed kindness and empathy, especially as they told their own stories of struggles to balance protection with respect, attempting to preserve autonomy of beloved family members who are aging.  

Significantly, many readers addressed the potential for modern technology in the form of automated trackers on cars and cell phones to help avoid, if not completely prevent such a tragedy. 

August 9, 2017 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Ethical Issues, Health Care/Long Term Care, Housing | Permalink | Comments (0)

Friday, August 4, 2017

The New Uniform Guardianship Act

The Uniform Law Commissioners recently approved the new guardianship act. The prior act, the Uniform Guardianship & Protective Proceedings Act was approved in 1997. The new act, the Uniform Guardian, Conservatorship & Other Protective Arrangements Act was approved in mid-July at the ULC's 126th annual meeting.  Terminology has changed with this new act, with the use of incapacitated person falling by the wayside. Instead, the act refers to "adult subject to guardianship" or adult subject to conservatorship" both of which are defined in Section 102. Less restrictive alternative now includes supported decision-making, along with other alternatives such as a health care or financial power of attorney or representative payee.  More emphasis is put on protective arrangements (Article 5 of the Act) as an alternative to guardianship. Another version of the new act with a prefatory note and commentary will be available on the ULC website soon.

August 4, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, August 2, 2017

Las Vegas Guardian Sentenced Following Conviction for Theft and Exploitation

Clark County, Nevada has been at the center of serious allegations of abuse by court-appointed guardians, including "public" guardians, as we have reported here in the past. Most recently, the county was the site of a conviction and sentencing of a woman who was charged with theft from her "long-time companion," the incapacitated person she was appointed to protect.

Helen Natko was found guilty by a Las Vegas jury in April of theft and exploitation of a vulnerable person:

Natko raised suspicions when she transferred nearly $200,000 out of a joint account. Natko returned the money but that's when Del's daughter, Terri Black, tried to protect her father leading to a guardianship case. 

 

"That began our 4 year odyssey of pain and sorrow that continues to this day for my family," says Terri. She says the most painful part was not having quality time with her father in his final days.  

Although the prosecutor (and the protected person's family members) sought "prison time" following the conviction, ultimately the state court judge sentenced Natko to 5 years probation, a $10,000 fine and a bar on "gambling."  Further,  according to Las Vegas Contact 13 KTNV news reports, "she's disqualified to be a guardian under new laws passed" since the channel's investigation and news series exposed problems in the county's guardianship system.  

For more see Contact 13: Guardian Sentenced to Probation.  My thanks for the update from Rick  Black, the son-in-law of the victim in this case.   It's been a long haul for the family.  Mr. Black commented, "We are satisfied with the [July 31, 2017] sentence. Although we wanted prison time, it wasn't in the statutes.  Thanks to the many victim family members and advocates who came to support Terri [Rick's wife]." 

Mr. Black is a volunteer with Americans Against Abusive Probate Guardianship (AAAPG), which was founded in Florida in 2013 by Sam J Sugar, M.D., in response to his own experiences in the Miami-Dade probate court.   

My thanks to those who wrote to correct my earlier mistake in describing the history of AAAPG. 

 

August 2, 2017 in Cognitive Impairment, Crimes, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink | Comments (1)

Friday, July 28, 2017

Ted Talk: Can Alzheimer's Disease be Prevented?

Neuroscientist Lisa Genova PhD, author of the novel Still Alice (that, in turn, became the movie with Julianne Moore in the leading role), has an encouraging new piece on Ted Talk on what all of us can and should do now to reduce the risk of Alzheimer's or even slow the disease after diagnosis. As she says, "DNA alone does not determine whether you will be symptomatic for Alzheimer's."  It is one of a multi-part feature on Ted Talk addressing various "Prevention" topics.  Here's and NPR link to the 14 minute podcast for Lisa's piece,  "What You Can Do to Prevent Alzheimer's?"

Correction:  My thanks to the readers who caught my typo -- it's "Still Alice," not Still Alive, for the title to the book and movie I've linked here!

 

July 28, 2017 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Science | Permalink | Comments (1)

Wednesday, July 26, 2017

Dementia Prospects Down?

Good news for all of us!  The July 2017 issue of Today's Research on Aging from the Population Reference Bureau reports a proportional decline in dementia. Dementia Trends: Implications for an Aging America explains that

While the absolute number of older Americans with dementia is increasing, the proportion of the population with dementia may have fallen over the past 25 years, according to a recent U.S. study (Langa et al. 2017). Researchers say this downward trend may be the result of better brain health—possibly related to higher levels of education and more aggressive treatment of cardiovascular risk factors such as high blood pressure and diabetes.

After discussing the research, the research report also notes this

The decline in dementia prevalence coupled with longer life expectancy may be contributing to another change: A growing share of older Americans are spending less of their lifetimes with cognitive impairments, another recent study based on HRS data and vital statistics shows (Crimmins, Saito, and Kim 2016). The gains in life expectancy between 2000 and 2010 represent more time older Americans spend cognitively intact, the researchers report. The share of Americans 65 and older without cognitive problems increased by 4.5 percentage points for men and 3.4 percentage points for women during the decade. At the same time, the average time older people spent with dementia or cognitive impairment shortened slightly.

The report discusses the various theories and work done to help  with "brain training", the correlations (if any) between certain diseases and dementia, and policy and budgetary implications. The report concludes:

Improvements in understanding, diagnosing, preventing, and treating Alzheimer’s disease and other dementias are top NIA priorities. The 2011 National Alzheimer’s Project Act and related legislation lay the foundation and provide new funding for “an aggressive and coordinated national plan to accelerate research.” This initiative includes research designed to better answer the following questions:

•What roles do education and intellectual stimulation play in delaying or preventing dementia?

•What are the connections among dementia, cardiovascular disease, obesity, and diabetes?

•What are the best ways to reduce the dementia risks that minority group members face?

Refining our understanding of the answers to these questions can enable policymakers and

planners to design and test prevention strategies that can contribute to continued future decline

in dementia prevalence.

 

July 26, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Science, Statistics | Permalink | Comments (0)

Wednesday, May 24, 2017

LA Times Series on the Brain and Alzheimer's

Kaiser Health News ran a story about a series from the LA Times on Alzheimer's. The LA Times did a 3-part series on the brain and Alzheimer's.  The first story focused on when the brain begins to be affected, the second about the benefits of exercise and the third about 8 items to do now to protect against dementia later.  Some examples of those 8 items: exercise, eat right, don't smoke, get enough sleep, don't be isolated, be happy, and use your brain.

May 24, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s | Permalink | Comments (0)

Monday, May 15, 2017

Elder Financial Abuse Video from Pennsylvania Departments of Banking and Aging

Here's a seven-minute video on elder financial abuse, focusing mostly on "scam artists," from the Pennsylvania Departments of Aging and Banking & Securities.  You might find this useful for classes.

I found the discussion of "mild cognitive impairment" interesting, especially as it allows a conversation about planning without the dreaded words, dementia or Alzheimer's Disease.

May 15, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Film | Permalink | Comments (0)

Tuesday, May 9, 2017

Alzheimer's Caregiver Boot Camp

Kaiser Health News ran a story about a boot camp for caregivers who care for those with dementia or Alzheimer's.  Boot Camp’ Helps Alzheimer’s, Dementia Caregivers Take Care Of Themselves, Too explains the importance of caregivers learning to take care of themselves while caring for others.  The boot camp featured in the story hosted "25 people who went to a Los Angeles-area adult day care center on a recent Saturday for a daylong “caregiver boot camp.” In the free session, funded in part by the Archstone Foundation, people caring for patients with Alzheimer’s or another form of dementia learned how to manage stress, make their homes safe and handle difficult patient behaviors. They also learned how to keep their loved ones engaged, with card games, crossword puzzles or music."  The article mentions the direct correlation between the caregiver's health and the care the provide to others.

UCLA's boot camp was started 2 years ago; the catalyst in part was the frequency of hospitalizations for those whose caregivers weren't ready for the job. UCLA currently offers 4 boot camps a year, but plans are underway to increase the number. California is not the only location for boot camps. Boot camps have taken place in Florida, New Jersey and Virginia.

May 9, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Monday, April 24, 2017

Living Life to the Fullest With Alzheimer's?

Last week Kaiser Health News (one of my favorite go-to sites) ran this story, How To Help Alzheimer’s Patients Enjoy Life, Not Just ‘Fade Away’. The article opens explaining that Alzheimer's is #1 on the list of diseases folks in the U.S. most fear.  The loss of self is a big part of that fear. However, "a sizable body of research suggests this Alzheimer’s narrative is mistaken. It finds that people with Alzheimer’s and other types of dementia retain a sense of self and have a positive quality of life, overall, until the illness’s final stages... They appreciate relationships. They’re energized by meaningful activities and value opportunities to express themselves. And they enjoy feeling at home in their surroundings."

Just how many folks with Alzheimer's have a good quality of life? According to Dr. Peter Rabins,      "[o]verall, about one-quarter of people with dementia report a negative quality of life, although that number is higher in people with severe disease.”  What are the implications of this? To make sure that folks with Alzheimer's have a quality of life, "[promote] well-being [which] is both possible and desirable in people with dementia, even as people struggle with memory loss, slower cognitive processing, distractibility and other symptoms."

Folks with severe or end-stage Alzheimer's present a different challenge. For others, the article suggests the following: emphasis social connections, maximize physical health, improve communications, respond to unmet needs, and give deference to individuality and autonomy.

"None of this is easy. But strategies for understanding what people with dementia experience and addressing their needs can be taught. This should become a priority, Rabins said, adding that 'improved quality of life should be a primary outcome of all dementia treatments.'"

April 24, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Monday, April 10, 2017

What's Next in the Fight Against Alzheimer's?

Alzheimer's & Dementia, the journal for the Alzheimer's Ass'n newest issue published a new report, Alzheimer's disease: The next frontier—Special Report 2017, A subscription is required but here is the abstract:

In the history of medicine, one means to progress is when we make the decision that our assumptions and definitions of disease are no longer consistent with the scientific evidence, and no longer serve our health care needs. The arc of scientific progress is now requiring a change in how we diagnose Alzheimer's disease. Both the National Institute on Aging—Alzheimer's Association (NIA-AA) 2011 workgroup and the International Work Group (IWG) have proposed guidelines that use detectable measures of biological changes in the brain, commonly known as biological markers, or biomarkers, as part of the diagnosis. This Special Report examines how the development and validation of Alzheimer's disease biomarkers—including those detectable in the blood or cerebral spinal fluid, or through neuroimaging—is a top research priority. This has the potential to markedly change how we diagnose Alzheimer's disease and, as a result, how we count the number of people with this disease. As research advances a biomarker-based method for diagnosis and treatment at the earliest stages of Alzheimer's disease, we envision a future in which Alzheimer's disease is placed in the same category as other chronic diseases, such as cardiovascular disease or diabetes, which can be readily identified with biomarkers and treated before irrevocable disability occurs.

 

April 10, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s | Permalink | Comments (0)

Monday, March 27, 2017

Planning for End of Life: the 4 Ws and the Conversation Project

Amos Goodall sent me a link to an article he recently wrote, How to plan for end-of-life wishes.  Referencing the Conversation Project,  Amos writes about how important it is for a client to let others know what the client wants.

These questions boil down to the four Ws:

▪ Who should speak for you when you can’t?

▪ What should they be saying?

▪ When do you want these issues raised? 

▪ Where do you want to spend your final time — at home or in a hospital?

Essentially, you need to let folks know how you want to live your life at its end.

After discussing the law, Amos turns back to the Conversation Project and references the toolkit that is available and notes that his firm has adapted some resources for their clients which anyone can access via his firm's website.

According to the project's website, the purpose of the Conversation Project is "to helping people talk about their wishes for end-of-life care." The project offers a 12 page starter kit (available in 8 languages) as well as a 16 page toolkit on choosing and being a health care proxy. There's a 20 page starter kit for those who have a family member or significant other with dementia, including Alzheimer's disease and an 11 page kit for talking to the patient's doctor. There's also one when the patient is your child.

 

 

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Read more here: http://www.centredaily.com/living/article139165628.html#storylink=cpy

 

March 27, 2017 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Friday, March 17, 2017

Alzheimer's and Marijuana-The Federal Block

I've blogged a couple of times recently about the fight against Alzheimer's disease.  Here's a recent story about research efforts stymied by federal law.  Big Alzheimer's research roadblock: Federal government was published by CNBC on March 9, 2017.   "Promising new research conducted last year at the Salk Institute for Biological Studies has shown that marijuana extracts may hold a key to treating Alzheimer's disease. The next step: To conduct tests on mice and, if the results are promising, move on to human trials. But Salk Institute researchers have run into a major hurdle, and not a scientific one: the federal government. The Salk Institute is based in La Jolla, California — a state that legalized marijuana last November — but it is a federally funded research institute."

The story reminds us that although marijuana use may be legal in several states, it's still not ok at the federal level-it's still a controlled substance. And when a research institute like Salk gets federal dollars for research, there's a problem.

So does this mean a dead end for marijuana/Alzheimer's research? Not necessarily. There is a path, but it won't be a quick or guaranteed one. "In order to acquire marijuana for further studies, the lab must first apply to the Drug Enforcement Agency, which carries out the application process jointly with the U.S. Department of Health and Human Services. The Salk researchers sent in their application in December...."  It takes several months for such a request to be approved.  The article discusses the costs of Alzheimer's disease  (which we have written about in prior posts)

The cost to the economy of caring for Alzheimer's and dementia patients was estimated to be about $236 billion in 2016. In 2015 a study funded by the National Institutes of Health estimated that the costs associated with late-stage dementia are greater than for any other disease.

During the last five years of a person with dementia's life, total health-care spending was more than a quarter of a million dollars per person ($287,038), about 57 percent greater than costs associated with death from other diseases, including cancer ($173,383) and heart disease ($175,136).

We all know how important it is to find an effective treatment (or even cure?) for Alzheimer's.  For now, the folks at Salk have to wait to hear if they can move forward.

BTW, those astute readers will notice the url for the story includes the phrase "major buzz kill." To  follow up, I'll close now with some my own pithy phrase,  "dude, serious bummer".  You insert your own pithy phrase here.....

March 17, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Science | Permalink | Comments (0)

Wednesday, March 15, 2017

Alzheimer's Disease and Medicare

Yesterday I blogged about the 2017 Alzheimer's Disease Facts & Figures. An article in Huffington Post focused on the impact on Medicare as the Boomers move into that age group where Alzheimer's risk increases. Rising Numbers Of Alzheimer’s Patients Could Bankrupt Medicare offers that

This year, for the first time, total costs related to caring for patients with Alzheimer’s will surpass a quarter of a trillion dollars, according to the Alzheimer’s Association annual report, released Wednesday. 

With roughly 75 million boomers only beginning to reach the age of greatest risk for the disease, the U.S. may be disturbingly close to the tipping point for runaway Alzheimer’s-related health care costs. The 88-page report lays out some sobering statistics, including the possible bankruptcy of Medicare.

The article covers dual eligible, the need for funding and research, and some of the proposals from Congress. "Simply put, Alzheimer’s is a public health crisis. Yet due to the social stigma surrounding dementia, its full dimensions are still cloaked in shadow. Combating the disease is going to require that politicians and members of the public speak out and demand real solutions."

 

March 15, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Tuesday, March 14, 2017

2017 Facts & Figures from the Alzheimer's Association

The Alzheimer's Association has released the 2017 Alzheimer's Disease Facts & Figures report. The report offers an updated terminology

That is, the term “Alzheimer’s disease” is now used only in those instances that refer to the underlying disease and/or the entire continuum of the disease. The term “Alzheimer’s dementia” is used to describe those in the dementia stage of the continuum. Thus, in most instances where past editions of the report used “Alzheimer’s disease,” the current edition now  uses “Alzheimer’s dementia.” The data examined are the same and are comparable across years — only the way of describing the affected population has changed. For example, 2016 Alzheimer’s Disease Facts and Figures reported that 5.4 million individuals in the United States had “Alzheimer’s disease.” The 2017 edition reports that 5.5 million individuals have “Alzheimer’s dementia.” These prevalence estimates are comparable: they both identify the number of individuals who are in the dementia stage of Alzheimer’s disease. The only thing that has changed is the term used to describe their condition.

The report contains a lot of good information that would help our students understand dementia and Alzheimer's.  The section on prevalence is sobering. For example, "[a]n estimated 5.5 million Americans of all ages are living with Alzheimer’s dementia in 2017. This number includes an estimated 5.3 million people age 65 and older, and approximately 200,000 individuals under age 65 who have younger-onset Alzheimer’s, though there is greater uncertainty about the younger-onset estimate." (citations omitted). The report also explores the gender, ethnic and racial factors regarding prevalence of Alzheimer's.  The report gives a breakdown by state. There is an amazing amount of critical information in this report.  The report also includes a special report, Alzheimer's Disease: The Next Frontier.

I'm going to make it assigned reading to my students. Be sure to read this. It's important.

March 14, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Monday, March 13, 2017

Planning Ahead for the What-Ifs In Your Last Years of LIfe

We don't know what the future holds for us, especially in our final years, but we can bet that we may be faced with some health care issues. Wouldn't it be great to have a guidebook for the final years? Well now you can.  According to an article in Kaiser Health News, A Playbook For Managing Problems In The Last Chapter Of Your Life, there is "a unique website, www.planyourlifespan.org, which helps older adults plan for predictable problems during what Lindquist calls the “last quarter of life” — roughly, from age 75 on...“Many people plan for retirement,” the energetic physician explained in her office close to Lake Michigan. “They complete a will, assign powers of attorney, pick out a funeral home, and they think they’re done.”...What doesn’t get addressed is how older adults will continue living at home if health-related concerns compromise their independence." The focus isn't on end of life planning, according to the article, it's the time before. "Investigators wanted to know which events might make it difficult for people to remain at home. Seniors named five: being hospitalized, falling, developing dementia, having a spouse fall ill or die, and not being able to keep up their homes."

The result of the work is an interactive website that deals with issues such as falls, hospitalization, dementia, finances and conversations. The website offers that "Plan Your Lifespan will help you learn valuable information and provide you with an easy-to-use tool that you can fill in with your plans, make updates as needed, and easily share it with family and friends."  Try it!

March 13, 2017 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Housing, Web/Tech | Permalink | Comments (0)

Friday, March 10, 2017

Preventing Alzheimer's?

We all want a cure for Alzheimer's no question.  If not a cure, then a way to prevent it. I blogged twice this week about Alzheimer's so I wanted to add one more story. Newsweek 's cover story for February 24, 2017 focused on prevention of Alzheimer's: The New Offensive on Alzheimer’s Disease: Stop it Before it Starts. The story opens with the news last year that an experimental drug failed to make much of an impact on those in the early stages of the disease. The story focuses on prevention:

This aggressive attempt to prevent Alzheimer’s rather than treating it is the most exciting new development in decades, as well as a radical departure for researchers and the pharmaceutical industry. Traditionally, drug companies have tested their therapies on patients who already have memory loss, trouble thinking and other signs of dementia. It’s been a losing tactic: More than 99 percent of all Alzheimer’s drugs have failed tests in the clinic, and the few that have made it to the market only ameliorate some symptoms. Not a single medicine has been shown to slow the relentless progression of the disease.

But with this new approach, even partial success—an appreciable slowing of brain degeneration—could have a big impact, says Dr. Reisa Sperling, a neurologist who directs the Center for Alzheimer’s Research and Treatment at Boston’s Brigham and Women’s Hospital. If a drug therapy can push back the onslaught of dementia by five or 10 years, she says, “many more people would die of ballroom dancing instead of in nursing homes.”

There are several ongoing clinical trials focusing on prevention, according to the article. There are also new tools to diagnosis Alzheimer's (where in the past, a brain autopsy was needed),   We need to hope for a success, because otherwise, as the article points out, the numbers are very very bad:

The consequences of failure could be dire. Approximately 5.4 million Americans suffer from Alzheimer’s, and if no disease-delaying therapies are found soon, that number is expected to nearly triple by 2050, at which point the cost of treating and caring for all those people could top $2 trillion per year, after adjusting for inflation. That’s up from $236 billion today. O ne in every five Medicare dollars is now spent on people with Alzheimer's and other dementias. In 2050, it will be one in every three dollars. And those figures don’t even include the hundreds of billions more in lost wages for family members who take time away from their jobs to care for loved ones. It’s not a question of a day off now and again. People with Alzheimer’s require around-the-clock care—and more than one-third of all dementia caregivers develop clinical depression.

The article also discusses the costs and coverage of any medication that proves successful in preventing Alzheimer's. Stay tuned.

March 10, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Tuesday, March 7, 2017

In Case You Missed It: Sister Shares Moving Account of Early Onset Dementia

From the Washington Post, an especially moving account written by former White House Communications Director Jennifer Palmieri about her sister, who died at age 58 following some ten years with "early onset" Alzheimer's:

Every day, more Americans receive the devastating news that someone in their family has this affliction. For now, there is not a lot of hope for recovery. It can make you envious of cancer patients; their families get to have hope. Having come through this experience with my sister, I am afraid that I can’t offer these new Alzheimer’s families hope for a recovery. But I do hope that by relaying the story of my sister’s journey, I can offer them some peace.

 

My sister Dana was brilliant, beautiful, full of positive energy, a force of nature. She was not an easy person. She was driven and successful, and, as the disease progressed unbeknown to all of us, it became harder to connect with her. Ironically, that began to change once she got the diagnosis.

 

When she called each of us with the news, she already had it all figured out. We were all to understand that, really, she saw the diagnosis as a blessing. It was going to allow her to retire early. It would motivate our family to spend time together we would not have otherwise done. It would shorten her life, but she would make sure the days she had left were of the highest quality.

The thoughtful piece can help all of us as we and our family members tackle challenges.  For more, read The Blessings Inside my Sister's Alzheimer's Disease.

March 7, 2017 in Advance Directives/End-of-Life, Cognitive Impairment, Dementia/Alzheimer’s, Ethical Issues, Retirement, Science | Permalink | Comments (0)

Tuesday, February 28, 2017

More on Supreme Court Nominee Neil Gorsuch on End-of-Life Issues

Paula Span, the thoughtful columnist on aging issues from the New York Times, offers "Gorsuch Staunchly Opposes "Aid-in-Dying." Does It Matter?"   The article suggests that the "real" battle over aid-in-dying will be in state courts, not the Supreme Court.

I'm in the middle of reading Judge Gorsuch's 2006 book, The Future of Assisted Suicide and Euthanasia. There are many things to say about this book, not the least of which is the impressive display of the Judge's careful sorting of facts, legal history and legal theory to analyze the various advocacy approaches to end-of-life decisions, with or without the assistance of third-parties.  

With respect to what might reach the Supreme Court Court, he writes (at page 220 of the paperback edition): 

The [Supreme Court's] preference for state legislative experimentation in Gonzales [v. Oregon] seems, at the end of the day, to leave the state of the assisted suicide debate more or less where the Court found it, with the states free to resolve the question for themselves.  Even so, it raises interesting questions for at least two future sorts of cases one might expect to emerge in the not-too-distant future.  The first sort of cases are "as applied" challenges asserting a constitutional right to assist suicide or euthanasia limited to some particular group, such as the terminally ill or perhaps those suffering grave physical (or maybe even psychological) pain....

 

The second sort of cases involve those like Lee v. Oregon..., asserting that laws allowing assisted suicide violate the equal protection guarantee...."

While most of the book is a meticulous analysis of law and policy, in the end he also seems to signal a personal concern, writing "Is it possible that the Journal of Clinical Oncology study is right and the impulse for assistance in suicide, like the impulse for old-fashioned suicide, might more often than not be the result of an often readily treatable condition?" 

My thanks to New York attorney, now Florida resident, Karen Miller for pointing us to the NYT article.

February 28, 2017 in Advance Directives/End-of-Life, Consumer Information, Crimes, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Cases, Health Care/Long Term Care, Religion, Science, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Sunday, February 19, 2017

Increase in Alzheimer's within Latino Population?

Kaiser Health News ran a story recently about the increase in Alzheimer's cases amongst Latinos. 'Tsunami’ Of Alzheimer’s Cases Among Latinos Raises Concerns Over Costs, Caregiving citing to a recent report explains

Across the United States, stories [of people with Alzheimer's] are becoming more common, particularly among Latinos — the fastest growing minority in the country.

With no cure in sight, the number of U.S. Latinos with Alzheimer’s is expected rise by more than eight times by 2060, to 3.5 million, according to a report by the USC Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network.

Advanced age is the leading risk factor for Alzheimer’s disease and the likelihood of developing Alzheimer’s doubles about every five years after age 65. As a group, Latinos are at least 50 percent more likely than whites to have Alzheimer’s, in part because they tend to live longer, the report notes.

Caregiving (which we have blogged about on several occasions) is of course an important issue for all of us, but in particular, this story explains, "[a]bout 1.8 million Latino families nationwide care for someone with Alzheimer’s and other types of dementia. And while the Roybal report shows that Latino families are less likely than whites to use formal care services, such as nursing home care, institutionalized care is becoming more common among these families."  Although there are some in nursing homes, limited resources factor in to the family's ability to turn to outside help for the elder with Alzheimer's.

The story covers the economics of care, available community programs, the importance of public education, and resources for the family.

When seeking support, the best place to start is at a local community group or center — a church, a nonprofit, a United Way office, or the local Alzheimer’s Association chapter, for example, Mizis said. These groups will most likely refer caregivers to a county’s Agency on Aging or a state’s Department of Aging.

February 19, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)