Eldercare, Aging and Long Term Care

Housing Crisis Snares Elderly Who Can’t Sell - NYTimes.com.

The housing crisis has kept thousands of older Americans who need support and care from moving into retirement communities or assisted-living centers, effectively stranding them in their own homes.

Adult Children, Aging Parents and the Law - The New Old Age Blog - NYTimes.com.

Iin 30 states, (PDF of 30-state list) adult children are legally responsible, at least on paper, to pay for necessities like food, clothing, shelter and medical attention for indigent parents. These statutes, known as filial responsibility laws, are modeled on the Elizabethan Poor Laws of 1601, which made blood relatives the primary source of support for family members, the elderly included. Public assistance was available only as a last resort.

Medical News: Forget Ginkgo Supplements for Dementia Prevention 

For older adults, ginkgo did not reduce the odds of developing dementia overall (hazard ratio 1.12, P=0.21) or Alzheimer's disease specifically (HR 1.16, P=0.11), reported Steven T. DeKosky, M.D., of the University of Virginia, and colleagues in the Nov. 19 issue of the Journal of the American Medical Association.

Editorial - The Wrong Place to Be Chronically Ill - NYTimes.com.

More than half of the American patients went without care because of high out-of-pocket costs. They did not visit a doctor when sick, skipped a recommended test or treatment or failed to fill a prescription. The uninsured suffered most, but even 43 percent of those who had insurance all year skipped care because of costs.

Analysis Finds Marked Increase in Chronic Kidney Disease - NYTimes.com.

An analysis of federal health data published last November in The Journal of the American Medical Association found that 13 percent of American adults — about 26 million people — have chronic kidney disease, up from 10 percent, or about 20 million people, a decade earlier.

Brains of High-Functioning Elderly Have More Plaques, Fewer Tangles 

The brains of people whose cognition remained super-sharp in their 80s and beyond showed distinct features compared with those with age-normal functioning, a researcher said here. On autopsy their brains showed little or no evidence of neurofibrillary tau-protein tangles, reported Changiz Geula, Ph.D., of Northwestern University in Chicago, at the Society for Neuroscience meeting here.

Older Heart Failure Patients Opt for Longer Survival Over Quality of Life 

Three out of every four heart failure patients ages 60 to 97 said they would not trade "even one single day" for improved quality of life, Hans Peter Brunner-La Rocca, M.D., of University Hospital Basel, reported at the American Heart Association meeting.

In Chronic Condition: Experiences Of Patients With Complex Health Care Needs, In Eight Countries, 2008 -- Schoen et al., 10.1377/hlthaff.28.1.w1 -- Health Affairs.

ABSTRACT: This 2008 survey of chronically ill adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States finds major differences among countries in access, safety, and care efficiency. U.S. patients were at particularly high risk of forgoing care because of costs and of experiencing inefficient, poorly organized care, or errors. The Dutch, who have a strong primary care infrastructure, report notably positive access and coordination experiences. Still, deficits in care management during hospital discharge or when seeing multiple doctors occurred in all countries. Findings highlight the need for system innovations to improve outcomes for patients with complex chronic conditions.

Use of advance directives increases among nursing home residents - McKnight's Long Term Care News.

Advance directive documentation is sharply on the rise in the nation's nursing homes, according to a recent report from the Institute for the Future of Aging Services, a research arm of the American Association of Homes and Services for the Aging. 

Nearly 70% of all nursing home residents over the age of 65 have at least one advance directive document in their records. That is up from 53% in 1996, according to the report. The documents were more common for married, white and female residents. Residents at nonprofit homes were 60% more likely to have advance directives, according to the report. The IFAS report is an analysis of data from the 2004 National Nursing Home Survey, which includes data representing America's 1.3 million nursing home residents over the age of 65. 

Advance directives provide written documentation of a patient or resident's end-of-life choices. "Both residents and families must continue to engage in the discussions needed to accurately document end-of-life choices," said Helaine Resnick, Ph.D., director of research at IFAS, adding that providers, as well, must continue to stress the importance of advance directives.

Spotlight on Alzheimer's Disease - U.S. News & World Report (usnews.com).

Alzheimer's disease is a progressive disease that damages nerve cells (neurons) in parts of the brain involved in memory, learning, language, and reasoning. As the disease progresses, communication among the neurons breaks down. In early stages, short-term memory begins to fail. Over time, functions such as long-term memory, language, and judgment decline. Alzheimer's disease is the most common cause of dementia in older adults. Dementia is a loss of mental functions-such as thinking, memory, and reasoning-that is severe enough to interfere with a person's daily functioning.