Eldercare, Aging and Long Term Care

World’s oldest marathon runner finishes his last race at age 101 - The Globe and Mail

Fauja Singh finished the Hong Kong marathon’s 10-kilometre (6.25-mile) race in a time of 1 hour, 32 minutes and 28 seconds.

via www.theglobeandmail.com

In Korea, Changes in Society and Family Dynamics Drive Rise in Elderly Suicides - NYTimes.com

“How can you do this to me?” read the suicide note that the police said they had found in a purse next to her body. “A law should serve the people, but it didn’t protect me.”

The woman’s death is part of one of South Korea’s grimmest statistics: the number of people 65 and older committing suicide, which has nearly quadrupled in recent years, making the country’s rate of such deaths among the highest in the developed world. The epidemic is the counterpoint to the nation’s runaway economic success, which has worn away at the Confucian social contract that formed the bedrock of Korean culture for centuries.

That contract was built on the premise that parents would do almost anything to care for their children — in recent times, depleting their life savings to pay for a good education — and then would end their lives in their children’s care. No Social Security system was needed. Nursing homes were rare.

But as South Korea’s hard-charging younger generations joined an exodus from farms to cities in recent decades, or simply found themselves working harder in the hypercompetitive environment that helped drive the nation’s economic miracle, their parents were often left behind. Many elderly people now live out their final years poor, in rural areas with the melancholy feel of ghost towns.

via www.nytimes.com

CMA || Judge Approves Settlement in Jimmo v. Sebelius After Court Hearing

1.       What Does the Jimmo Settlement Agreement Mean?

A. The Jimmo agreement settles once and for all that Medicare coverage is available for skilled services to maintian an individual’s condition

Under the maintenance coverage standard articulated in the Jimmo Settlement, the determining issue regarding Medicare coverage is whether the skilled services of a health care professional are needed, not whether the Medicare beneficiary will "improve." Pursuant to Jimmo, medically necessary nursing and therapy services, provided by or under the supervision of skilled personnel, are coverable by Medicare if the services are needed to maintain the individual’s  conditon, or prevent or slow their decline.

via www.medicareadvocacy.org

Therapy Plateau No Longer Ends Coverage - NYTimes.com

The lawsuit was filed by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of four Medicare patients and five national organizations, including the National Multiple Sclerosis Society, Parkinson’s Action Network and the Alzheimer’s Association. A tentative settlement had been reached in October and on Jan. 24 a federal judge in Vermont approved the deal.

For seniors getting skilled services at home under a doctor’s order, the settlement means Medicare’s home health coverage has no time limit, Margaret Murphy told lawyers attending the annual meeting of the National Academy of Elder Law Attorneys in Washington, D. C., shortly after the then-tentative settlement was announced.

The coverage “can go on for years and years, if your doctor orders it,” said Ms. Murphy, the center’s associate director, who added that patients must be homebound (though not bedbound) and need intermittent care — every couple of days or weeks – that can only be provided by a physical therapist, nurse or other trained health care professional. When physical therapy is provided as part of Medicare’s home health benefit, the therapy dollar limits may not apply.

The settlement ensures that nursing home residents will also get coverage for skilled care regardless of improvement, but does not change the duration, which is still limited to up to 100 days per “benefit period.” That begins when a patient is admitted as an inpatient to a hospital or a nursing home for skilled care and ends after 60 days without skilled care. The agreement preserves the requirement that they must also have spent at least three days as inpatients in a hospital.

via newoldage.blogs.nytimes.com

Brain Aging Linked to Sleep-Related Memory Decline - NYTimes.com

The report, posted online on Sunday by the journal Nature Neuroscience, suggests that structural brain changes occurring naturally over time interfere with sleep quality, which in turn blunts the ability to store memories for the long term.

Previous research had found that the prefrontal cortex, the brain region behind the forehead, tends to lose volume with age, and that part of this region helps sustain quality sleep, which is critical to consolidating new memories. But the new experiment, led by researchers at the University of California, Berkeley, is the first to directly link structural changes with sleep-related memory problems.

The findings suggest that one way to slow memory decline in aging adults is to improve sleep, specifically the so-called slow-wave phase, which constitutes about a quarter of a normal night’s slumber.

via www.nytimes.com

Our Failed Approach to Schizophrenia - NYTimes.com

“Psychosis” — a loss of touch with reality — is an umbrella term, not unlike “fever.” As with fevers, there are many causes, from drugs and alcohol to head injuries and dementias. The most common source of severe psychosis in young adults is schizophrenia, a badly named disorder that, in the original Greek, means “split mind.” In fact, schizophrenia has nothing to do with multiple personality, a disorder that is usually caused by major repeated traumas in childhood. Schizophrenia is a physiological disorder caused by changes in the prefrontal cortex, an area of the brain that is essential for language, abstract thinking and appropriate social behavior. This highly evolved brain area is weakened by stress, as often occurs in adolescence.

via www.nytimes.com

Exercise May Help Preserve Memory and Thinking Skills - NYTimes.com

Remaining physically active as you age, a new study shows, may help protect parts of your brain from shrinking, a process that has been linked to declines in thinking and memory skills. Physical exercise not only protected against such age-related brain changes, but also had more of an effect than mentally and socially stimulating activities.

In the new report, published in the journal Neurology, a team at the University of Edinburgh followed more than 600 people, starting at age 70. The subjects provided details on their daily physical, mental and social activities.

Three years later, using imaging scans, the scientists found that the subjects who engaged in the most physical exercise, including walking several times a week, had less shrinkage and damage in the brain’s white matter, which is considered the “wiring” of the brain’s communication system. The relationship remained even after the researchers controlled for things like age, health status, social class and I.Q.

via well.blogs.nytimes.com

Can You Do Too Much to Prevent a Stroke? - NYTimes.com

Currently, some experts say, far too many people who are free of symptoms that might herald a stroke are undergoing surgery to ream out carotid arteries that feed the brain, or are having stents inserted in these arteries, than is justified by available evidence.

Critics say these invasive procedures on asymptomatic patients are unnecessary and create a risk of serious complications like heart attack or, ironically, stroke itself, even death, and drive up health care costs by billions of dollars a year.

Based on the latest research, they maintain, most patients without symptoms like a mild stroke or transient ischemic attack do as well — or nearly as well — with intensive medical therapy to control blood pressure, cholesterol and diabetes.

via well.blogs.nytimes.com

Algerian Chaabi Musicians Reunite in the Band El Gusto - NYTimes.com

The musicians lost contact. The Algerian version of the popular Arabic-language music known as chaabi was forgotten.

Now, 50 years later, they are together again. On the evening of Sept. 30, 20 of them bewitched an audience of 900 in the outdoor courtyard of the Museum of the Art and History of Judaism in the heart of the Marais neighborhood here.

via www.nytimes.com

The Effect of Anesthesia and Surgery on Alzheimer's - What is Alzheimer's Disease? - Alzheimer's

Following surgery, loss of cognitive abilities and problems with thinking, memory, attention, problem solving and language are regularly reported in older people. This ‘post operative cognitive decline’ syndrome was experienced by the father of OurAlzheimer’s sharepost blogger Carol Bradley Bursack. She has written a lot about the adverse effect surgery had on her father and the problems his dementia had on him and her family. The question is what caused his decline? Was it the anesthetic drugs or the surgery that caused his (and others) dementia? Certainly Carol, like many other caregivers, time the onset of Alzheimer’s disease to the time of his surgery.

 

Researchers led by Roderic Eckenhoff, MD from the Perelman School of Medicine at the University of Pennsylvania, used mice with human Alzheimer disease genes and subjected them to either anesthesia alone, or anesthesia and abdominal surgery. They found a number of interesting things:

• That the mice who had undergone surgery showed a lasting increase in Alzheimer’s pathology primarily through brain inflammation.
• That mice not altered genetically showed no changes as the result of the surgery or anesthesia.
• There was a clear and persistent decrease in learning and memory caused by surgery as compared with anesthesia in the transgenic mice.
• That significant cognitive impairment persisted for at least 14 weeks after surgery compared to controls receiving anesthesia alone.

via www.healthcentral.com