Eldercare, Aging and Long Term Care

Care management reduces depression and suicidal thoughts in older primary care patients.

Depression in older adults too often goes unrecognized and untreated, resulting in untold misery, worsening of medical illness, and early death. A new study has identified one important remedy: Adding a trained depression care manager to primary care practices can increase the number of patients receiving treatment, lead to a higher remission rate of depression, and reduce suicidal thoughts.

Alzheimer's - Communication Techniques in Late Stage Alzheimer's.

In the late stage of Alzheimer's people find it increasingly difficult to communicate their needs and their distress in a verbal way. Caregivers have to find new ways, and at a more basic level, to find activities that relax the person, decrease their anxiety and maintain their wellbeing. There is evidence that even people with very advanced dementia can benefit through exploring mediums of interaction other than verbal communication. If verbal communication is extremely limited you can still get a level of connection with a loved one. Communication, using the five senses of touch, sight, hearing, smelling, and taste is the key. Two researchers, Arnold and Amy Mindell, have developed an approach for communicating with people in a coma. One of the things they did was to rhythmically match the patients' breathing, touch and voice. This has been applied to people with dementia such as Alzheimer's, by Tom Richards and Stan Tomandl, two practitioners who trained with the Mindells. They have written a book called, ‘An Alzheimer's Surprise Party' about their communications with Tomandl's father who had Alzheimer's disease. They found he was able to respond to communications by hand squeezing, eye contact, by joining in singing and through expressive gestures.

Again, a bit off topic but of some topical interest nonetheless:

Chatham House - Publications - Reports and Papers - View Paper.

Working from the province by province breakdowns of the 2009 and 2005 results, released by the Iranian Ministry of Interior, and from the 2006 census as published by the official Statistical Centre of Iran, this paper offers some observations about the official data and the debates surrounding the 2009 Iranian Presidential Election.

Drug Makers Agree to Offer Medicare Discounts - NYTimes.com.

Drug makers have offered to spend $80 billion over 10 years to help older Americans afford medicines and to lower the cost of a proposed overhaul of the health care system, officials said Saturday. In a statement, President Obama said an agreement reached between drug makers and Senator Max Baucus, a Montana Democrat who is the chairman of the Finance Committee, narrowed the “doughnut hole” in the Medicare prescription-drug program that raises costs for many seniors.

Blogger's Note: While not on topic this is an important caution for internet users about personal privacy.

Shortcuts - Typing In an E-Mail Address, and Giving Up Your Friends’ Too - NYTimes.com.

I THOUGHT it was a little strange when I received separate e-mail messages from two people I knew only slightly asking me to click and see their photos on a social networking site called Tagged. I ignored them at first, but then thought maybe I should check it out. After all, I should keep up on what’s hot in the social networking world, right? This could be the new Twitter. That’s when I started doing everything wrong. I obligingly typed in my e-mail address and a password to see those photos. Well, the photos didn’t exist, but I had unwittingly given the site “permission” to go through my entire e-mail contact list and send a message to everyone, inviting them to see my “photos.” I found this out only when I started receiving e-mail back from people agreeing to be my friend. I quickly realized what had happened and shot off an apologetic message explaining why I inadvertently spammed them.

Alcohol a Common Factor in Suicides - NYTimes.com.

“Alcohol is a component of suicidal behavior,” said Dr. Alex Crosby, author of the report published on Thursday in the C.D.C.’s Morbidity and Mortality Weekly Report. “It leads to disinhibition, and it can enhance feelings of hopelessness and depression. Alcohol impairs judgment and can lead to much more impulsive behavior." “Any suicide prevention efforts must take that into account and address alcohol and substance abuse as well,” he added.

Brain imaging technique could help identify those who will develop Alzheimer's - McKnight's Long Term Care News.

Researchers have discovered a way to predict whether someone with cognitive decline will develop Alzheimer's disease: They measure the size of certain areas of that person's brain, according to a new report. An automated process called Volumetric MRI measures the brain's memory centers, the report from the University of California, San Diego, found. Those brain areas, which include the hippocampus, amygdala and temporal horn, are then compared to their "expected size." According to researchers, patients with mild cognitive impairment that experience atrophy in those areas of the brain are much more likely to progress to Alzheimer's disease. Mild cognitive impairment (MCI) is considered a transitional stage between the forgetfulness associated with normal aging and Alzheimer's disease. The fully automated process provides an objective observation of three areas of the brain. This is more effective than traditional, subjective physician interpretation of regular MRIs, which tend to focus solely on the hippocampus. The technique can be readily used in clinics, according to the report, which appears in the June issue of the journal Alzheimer's Disease and Associated Disorders,.

Newswise Medical News | Appetite-Stimulating Hormone is First Potential Medical Treatment for Frailty in Older Women.

Older women suffering from clinical frailty stand to benefit from the first potential medical treatment for the condition, according to a study presented today by Penn Medicine researchers at ENDO, The Endocrine Society’s 91st Annual Meeting. Ghrelin, a hormone that stimulates appetite, was administered to older women diagnosed with frailty, a common geriatric syndrome characterized by unintentional weight loss, weakness, exhaustion and low levels of anabolic hormones which increases risk of falls, hospitalizations, disability, and death. Those who received ghrelin infusions consumed 51 percent more calories than the placebo group, with an increase in carbohydrate and protein intake, not fat. Their growth hormone levels were also higher throughout the ghrelin infusion. “As Americans are increasingly living into their 80s and 90s, we need to identify ways to prevent or treat common geriatric conditions, such as unexplained weight loss and frailty, which have serious health consequences,” said senior author Anne Cappola, MD, ScM, Assistant Professor of Medicine in Endocrinology, Diabetes, and Metabolism at the University of Pennsylvania School of Medicine. “We’re gaining a better understanding of the hormonal changes that occur as we get older and, with treatments like ghrelin, we

Is More Care Better Care? - Economix Blog - NYTimes.com.

For the last three decades, John Wennberg and his Dartmouth colleagues have documented regional variation in Medicare spending and a puzzling lack of association between spending and better health outcomes. Regions that spend more on medical care don’t necessarily have sicker people, and they don’t get better results. It isn’t clear what benefit they are receiving for all the money they’re spending.

Dusk-to-Dawn Therapy for Dementia’s Restless Minds - NYTimes.com.

While there are countless day care programs for the nation’s estimated 5.3 million Alzheimer’s patients, some experts believe that ElderServe at Night, which began a decade ago, is the only one of its kind in the country. Participants are fetched from their homes by vans and spend 7 p.m. to 7 a.m. painting, potting plants, dancing and talking — or, for those immobilized by their disease, relaxing amid music, massage and twinkling lights. The patients rest as they need, for a few minutes or a few hours, and return home the next morning fed, showered and, usually, tuckered out.