Addressing the global epidemic of dementia and improving end-of-life planning and care in the United States are the subjects of two new reports released today by Alzheimer’s Disease International and the Institute of Medicine. Both reports offer insights into the realities of dealing with an aging population and a lack of appropriate services and supports to meet present and future needs.
According to ADI, substantial evidence exists that risk for dementia can be reduced by using the same approaches as those which promote cardiovascular health — eliminating tobacco use, early detection and treatment of hypertension and diabetes. They call for a worldwide campaign to integrate brain health messages into existing public health efforts. Additionally, the report calls for the World Health Organization to include dementia risk in future noncommunicable disease efforts. Continue reading
Postmenopausal women who eat foods higher in potassium are less likely to have strokes and die than women who eat less potassium-rich foods according to new research in Stroke, the journal of the American Heart Association.
Stroke is the fourth leading cause of mortality in the United States, and as this infographic shows, women account for 60 percent of all stroke cases in the U.S. Women also have higher lifetime risk of stroke than men.
In this observational study, researchers tracked 90,137 postmenopausal women, ages 50 to 79, for an average 11 years. They looked at potassium consumption, incidence and type of stroke and mortality during that period. The average dietary potassium intake from food —not supplements — was 2,611 mg/day. All participants were free of stroke history at baseline. Continue reading
I knew next to nothing about the fast-growing assisted-living industry when I started reporting in early 2013 on problem homes in San Diego.
For example, I did not know that many seniors in today’s assisted-living homes are so frail and medically needy that they would have been in nursing homes 20 or 30 years ago. Many live in facilities with no medically trained staff.
Most astonishing to me was the lack of public access to state regulatory reports revealing the quality of care in homes, not only in California but nationally. We’re so accustomed to NursingHomeCompare and HospitalCompare – whatever their flaws – that the hoops families and journalists must leap through to judge an assisted-living home’s quality seem downright primitive. Continue reading
The care needs of 3 million older adults in the U.S. that require help with three or more activities of daily living are not being met and may lead to adverse consequences, according to a new report in the Millbank Quarterly. A detailed analysis finds that a disproportionate share of older people who require substantial assistance are poor, minorities or widowed. Additionally, nearly half of older adults, or about 18 million people, need help with or had trouble carrying out at least one ADL in the month prior to analysis.
Researchers examined a representative sample from the 2011 National Health and Aging Trends Study (NHATS). Of those requiring assistance in non-nursing home settings, one in five — about 6.6 million seniors — received help with the most basic self-care or mobility activities. This includes a wide range of assistance from family or paid caregivers such as bathing, dressing, eating, getting rides to medical appointments, or help with walking.
A new study out of the United Kingdom reinforces the influence that culture and societal attitudes can have on the health status of older adults. Psychologists from the University of Kent used data from the European Social Survey to ask respondents, all age 70 or older, to self-rate their health.
In countries where old age is thought of as signifying low status, participants who identified themselves as ‘old’ felt worse about their own health. The opposite was true in places where older people have a perception of higher social status. The researchers concluded that elevating perceived social status of older people would reduce negative connotations associated with old age and the negative impact on how healthy people felt.
The value different societies place on the elderly has a lot to with how they are cared for later in life, evolutionary biologist Jared Diamond explained in a recent TED talk. These effects in turn, influence public policy for global long-term services and supports. The International Federation of Social Workers recently noted, “Although older adults serve as essential resources to their communities, they face a great risk of marginalization.” Continue reading
The recent suicide of actor/comedian Robin Williams has put a spotlight on suicide and depression. However, older adults who suffer from sleep problems are at even greater risk of suicide, according to a recent study published in JAMA Psychiatry.
Researchers investigated the relative independent risk for suicide associated with poor subjective sleep quality in a population-based study of 14,456 community-dwelling older adults (age 65+) during a 10-year observation period. They compared the sleep quality of 20 suicide victims with the sleep quality of 400 similar individuals during that time. Participants with dysfunctional sleeping patterns had a 1.4 times greater chance of death by suicide than well-rested people.
Even after adjusting for depressive symptoms, they concluded that poor subjective sleep quality appears to present “considerable risk” for severe suicidal behaviors 10 years later. Risk increases among patients with multiple illnesses. Continue reading
Photo by John via Flickr.
Georgia has a new task force targeting Alzheimer’s disease and related dementias. The recently published Georgia Alzheimer’s Disease and Related Dementias State Plan lays out a strategy for addressing the needs of patients in terms of care and prevention, the impact on caregivers, and the costs associated with the disease.
The task force is led by James Bulot, Ph.D., director of Georgia’s Division of Aging Services. According to Bulot, 40 states have dementia plans at various stages. The Georgia plan assesses the risk for citizens in the state and takes inventory of services available to Georgians. It also outlines the importance of finding gaps in resources available on a state level.
Bulot believes the Georgia plan will be different because he’ll hold the task force accountable for progress. Unlike other plans which may be updated every five or 10 years, the Georgia plan will be continually modified to reflect changing scientific knowledge and statistics. Continue reading
AHCJ’s latest update to nursing home inspection data gives members three years of the most severe deficiencies found during inspections and the current star ratings assigned by the U.S. Centers for Medicare and Medicaid Services.
The data could be a good starting point for reporters who want to pursue authoritative stories about their local nursing homes.
The data now contains 16,806 such deficiencies as recorded by CMS. Deficiencies are characterized by their severity, “A” being the least severe and “L” being the most severe. AHCJ pruned down the data to include just the most severe of the deficiencies, letters “G” through “L.” These range from an “isolated incident of actual harm” to “widespread immediate jeopardy to resident health or safety.”
Under its star rating system, CMS gives nursing homes between one and five stars. According to the CMS ratings web site “nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.” Each nursing home is given an overall rating, as well as three specific ratings: health inspections, staffing and quality measures.
The AHCJ version of nursing home data is derived from a large file that is split up for easier use by members.
Dual eligibles are low-income elderly or disabled people enrolled in both Medicare and Medicaid. The distinctions are sometimes bewildering. It’s easy to confuse which program pays for what, what each agency considers “appropriate” care, what factors go into measuring outcomes and how the separate structures of Medicare and Medicaid affect costs and quality.
According to the Congressional Budget Office, in 2009, the federal and state governments spent more than $250 billion, combined, on health care benefits for the 9 million dual eligibles. There is growing concern about the high costs of dual eligibles and the type of care they receive. They may be treated by a variety of health care providers who are not coordinating their care, potentially increasing costs and worsening outcomes.
Many states are already struggling to meet current Medicaid demand, and as boomers age, more stress will be placed on an already fragile system. Learn more about dual eligibles and what issues to look for in your state with this tip sheet.
A Huffington Post exposé in June, “Hospice, Inc.,” rekindled some thoughts I’ve long had about the split personality of the journalism on complex topics like aging.
One week, readers see richly reported news features, usually by health care or feature reporters, about the struggle of elders and their families caught in this country’s messy long-term care system. The next, readers get stories by political, economics reporters on bipartisan budget debates (how much to cut this year) or exposés that aim for accountability, but don’t help most families.
The Huffington Post project got me thinking – what’s the responsibility of an investigative team posting an approximately 7,000-word, six-month investigation? How can they get beyond house-of-horrors revelations? Continue reading