Aspirin May Cut Cancer Deaths, But Caution Urged

Lung, prostate and colon cancers were among those studied
by: Maria Cheng | from: Associated Press Online | December 7, 2010


LONDON, Dec. 7, 2010 (AP Online delivered by Newstex) -- A new report from British scientists suggests that long-term, low-dose aspirin use may modestly reduce the risk of dying of certain cancers, though experts warn the study isn't strong enough to recommend healthy people start taking a pill that can cause bleeding and other problems.

In a new observational analysis published online Tuesday in the medical journal Lancet, Peter Rothwell of the University of Oxford and colleagues looked at eight studies that included more than 25,000 patients and cut the risk of death from certain cancers by 20 percent. Continue reading: http://www.aarp.org/health/conditions-treatments/news-12-2010/aspirin_may_cut_cancer_deaths_but_caution_urged.html?intcmp=dso-hp-ns

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The Miracle of Aging

As children, we couldn't wait to get older. We embraced every second, even rounding up to 7 1/2 years old instead of just 7. As we made our way past the 20s, however, there was a shift—we clung on to the lower numbers, pining away for that last 30 as we headed into our 40s, 50s or 60s. But growing older doesn't have to be a bad thing—and it's up to us to change our perception!

"I want you to begin to believe that 50 and beyond will literally be the most miraculous—and I do mean miracles occurring in your life," Oprah says.

In her book The Age of Miracles: Embracing the New Midlife, author and lecturer Marianne Williamson tells women how to shift the way they think about aging. "It's changing if we allow it to change," Marianne says. Continue reading http://www.oprah.com/spirit/The-Miracle-of-Aging
The Oprah Winfrey Show | March 14, 2008


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A Senior Moment: When do you become 'old' ?

By LESLIE HOWARD
Posted: 10/16/2010 01:17:37 AM PDT

A lively exchange in the "Tell It to the E-R" column caught my attention. An E-R article had referred to a 67-year-old as "elderly," and several Tell It callers took exception.
Quipped one, "I am an active 83-year-old woman and I was amused by your reference to a 68-year-old as an elderly man. Heck, I've got underwear older than that." Another responder complained that the preferred term was "senior," not "elderly." A third announced that "Elderly is (and always will be) someone 20 years older than me."
The federal government may use 65 as the qualifying age for Medicare or Social Security, but in day-to-day life, "senior" does not have a clear-cut definition. An invitation to join AARP, the Association for the Advancement of Retired Persons, shocks many 50-year-olds. Others are pleased to take advantage of senior discounts and specially priced menus for ages 55 and older at restaurants such as Denny's, Jack's and Kalico Kitchen. At 60, some see a movie at the Pageant Theatre for a special price or take classes through Osher Lifelong Learning Institute or Elder College at Chico State University. Continue readinghttp://www.chicoer.com/ci_16355320?source=rss

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Telemedicine for Elderly Depression

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on October 4, 2010

Telemedicine for Elderly DepressionDepression is common among elderly homebound individuals. Unfortunately, treatment for the condition is usually inadequate, if any.

Beyond the decline in mental health, depression can exacerbate medical conditions and may influence mortality.

To address this issue, researchers at Rhode Island Hospital and other organizations have developed a telemedicine-based depression care protocol in home health care. Continue readinghttp://psychcentral.com/news/2010/10/04/telemedicine-for-elderly-depression/19119.html

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Why Older People Are Forgetful

Brain Tissue Changes May Play a Role in Forgetfulness, Researchers Say

By Bill Hendrick
WebMD Health News

Reviewed by Laura J. Martin, MD

Sept. 15, 2010 -- Abnormal brain tissue changes called brain lesions may be more at fault than previously thought in forgetfulness in older people, new research shows.

Scientists at Rush University Medical Center in Chicago say the same brain lesions that are associated with dementia in old age may be responsible for mild memory loss.

The researchers studied 350 Catholic nuns, priests, and brothers who were given memory tests annually for up to 13 years, and after death, had their brains examined for lesions.

The study found that memory decline tended to be gradual before speeding up in the last four or five years of life.

Researchers say they found that strokes as well as protein accumulations called tangles and Lewy bodies seemed to be related to memory loss in older people. Continue readinghttp://www.medicinenet.com/script/main/art.asp?articlekey=119773#


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Helping the Elderly Avoid Falls

Why do we always think it is a medical problem when the elderly fall. This is a great article that gives insight on the health of the elderly when there is a fall. There is a lot of good information we can all use in the article.

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Study on Risk Factors for Indoor and Outdoor Falls May Help Tailor Fall-Prevention Strategies

By Katrina Woznicki
WebMD Health News Reviewed by Laura J. Martin, MD

Sept. 8, 2010 -- The risk factors for indoor and outdoor falls among the elderly differ, and not all falls indicate poor health, a study shows.

Researchers found that risk factors for indoor falls include being a woman and having an inactive lifestyle. Risk factors for outdoor falls include being a man and being more physically active.

The study is published in the Journal of the American Geriatrics Society.

Falls among the elderly are common, with as many as 40% of people age 65 and older falling each year. Falls can lead to serious injuries, such as a fractured hip or concussion. Continue reading http://www.webmd.com/healthy-aging/news/20100908/helping-the-elderly-avoid-falls?ecd=wnl_day_090910

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When Should Family Members Be Concerned About Elderly Drivers

Published September 03, 2010 by:
Dawn Hawkins

As people grow older, things change with their body and their mind. There may come a time that you should be concerned about an elderly person in your family driving. This isn't so with every

senior citizen and so should be taken case by case rather than a mass removal of driving privileges for older Americans. There are some dangers associated with senior citizens driving in many cases though. Deciding whether to take steps to get a senior in your family off the road, you should consider some things very carefully.

When families should be concerned about elderly drivers: Continue readinghttp://www.associatedcontent.com/article/5747488/when_should_family_members_be_concerned.html?cat=12


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Is Your Doctor Ordering Needless Tests?

One new study suggests most doctors practice defensive medicine to protect against lawsuits
by: Tauren Dyson | from: AARP Bulletin | August 24, 2010


A new study looked at just that question and found that most physicians believe their peers do indeed order needless medical tests and procedures.

Why all the tests? Researchers at Mount Sinai Hospital in New York found that 91 percent of 1,231 physicians surveyed said doctors order excessive tests for patients to protect themselves against malpractice suits, says Tara Bishop, M.D., coauthor of the study. The findings of the study were published in the June 28 issueof the Archives of Internal Medicine. And Bishop says they suggest one reason it is so hard to rein in the costs of health care.

“It’s really hard to quantify how much this problem costs the American health care system,” Bishop says. “One of the estimates is that it’s $60 billion a year, some argue that it is actually more than that.”

She noted that the potential threat of a malpractice lawsuit was a constant concern for the doctors she surveyed. According to the study, more than two malpractice claims are paid for every 100 physicians.

The study bolsters earlier research by the American Medical Association that found a sharp increase in the cost of potentially unnecessary cancer testing among Medicare patients between 1999 and 2006.http://www.aarp.org/health/doctors-hospitals/info-08-2010/health_discovery_is_your_doctor_ordering_needless_tests.html

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Losing your vision doesn't mean you have to put away the trowel

By Healthy Aging Admin Published 04/1/2009 Mental Wellness Unrated
Reward Your Senses by Gardening...even if you are visually impaired
Gardening for people who are blind or have low vision can be challenging, but it can also be satisfying. VisionAWARE.org is a free, not-for-profit online resource that can help them keep their gardens growing.
For the millions of Americans who have problems seeing, the idea of planting and tending to a garden may seem unrewarding. But losing your vision doesn't mean you have to put away the trowel. Maureen Duffy, M.S. CVRT and Editorial Director of VisionAWARE.org, explains that "gardens don't only have to be planted for their visual beauty ... they can be just as pleasing to the other senses, especially the sense of smell."

Duffy suggests choosing plants for more than just their appearance. Roses, lilacs, lavender, and gardenias are all excellent options for their aromatic qualities. Plants like mint and geraniums can be selected for their tactual assets.

VisionAWARE.org offers all sorts of gardening tips for people with vision loss including:

-- Planting in raised beds to help create solid boundaries
-- Using tools with brightly colored handles for easy spotting
-- Calling attention to garden stakes by securing old tennis balls to the tops
-- Marking newly planted areas with large print signs, decorative garden art or landscaping rocks

It is the goal of VisionAWARE.org that every web user, regardless of visual, auditory, or other physical impairment, has access to all information on the site. At VisionAWARE, you can learn how to adapt your computer to make it more accessible, including screen magnification, specialized browsers, and screen reading software.


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Antiaging protein also boosts learning and memory

Research in mice suggests additional role for sirtuins By Tina Hesman Saey Web edition : Monday, July 12th, 2010 Text Size
Aging and wisdom are supposed to go together, but it turns out that a molecule that prevents one may actually play a role in the other.

Researchers have discovered a new role for the famous antiaging protein SIRT1. It not only fends off aging, but also aids in learning and memory, a new study published online July 11 in Nature shows.

Sirtuins, a family of proteins that includes SIRT1, help to regulate gene activity and have been implicated in governing metabolism and many of the biological processes that lead to aging. In the new study, Li-Huei Tsai, a neuroscientist and Howard Hughes Medical Institute investigator at MIT, finds that SIRT1 also plays a critical role in protecting learning and memory, at least in mice.

Tsai and her colleagues had an inkling that SIRT1 might play some role in the brain from earlier experiments showing that resveratrol, an activator of sirtuins, could help neurons survive a mouse version of Alzheimer’s disease. Resveratrol also improved the animals’ ability to learn and remember. Since resveratrol can act on all seven of the sirtuins found in mammals and also affects other biological processes (SN Online: 6/28/10), the researchers didn’t know what role, if any, SIRT1 played in the process.

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The Anti-Cancer Diet: Foods to Fight Cancer

Protect yourself from cancer by adding these anti-cancer foods to your diet.
By Eric Metcalf
Medically reviewed by Cynthia Haines, MD

An anti-cancer diet is an important strategy you can use to reduce your risk of cancer. The American Cancer Society recommends, for example, that you eat at least five servings of fruits and vegetables daily and eat the right amount of food to stay at a healthy weight. In addition, researchers are finding that certain foods may be particularly useful in protecting you from cancer. Make room in your diet for the following foods and drinks to fight cancer.

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Active Lifestyles for People With Urinary Incontinence

Urinary incontinence shouldn't keep you from activities you love. Learning bladder control and other techniques for preventing urine leakage can help calm your worries.

By Katherine Lee
Medically reviewed by Lindsey Marcellin, MD, MPH

Living with urinary incontinence, whether caused by an overactive bladder or compromised bladder control, can cause people to shy away from their favorite pastimes out of fear that they’ll have an accident. However, there are ways to handle your fears, lower your risk of involuntary urine leakage, and stay socially active.

Dealing With Emotional Effects of Urinary Incontinence

Urinary incontinence can leave patients feeling a range of emotions, including embarrassment, distress, and helplessness. They may feel isolated and unable to participate in social activities.

One of the most effective ways to deal with emotions related to a condition is to see a doctor for an accurate diagnosis and treatment. However, many people with urinary incontinence ignore warning signs or postpone visiting their doctor. On average, people wait seven years before seeking help.

Continue reading http://www.everydayhealth.com/health-report/urinary-incontinence/active-lifestyles-with-urinary-incontinence.aspx

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Osteoporosis Awareness

Help Slow Bone Loss as You Age

Making a few easy lifestyle changes can help protect against bone loss as you get older. Find out about osteopenia, the first stage of bone loss, and how to keep your bones strong to lower your chances of developing more-serious osteoporosis. Avoiding carbonated drinks and engaging in weight-bearing exercises such as weight training and walking are two simple lifestyle changes that can help prevent osteoporosis. Learn how to slow bone loss. Continue reading at everyday health


Everyday Health



Verlia Caldwell, Pres.

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Stress of Caregiving Hurts Boomers’ Health, Jobs

‘Triple-decker-sandwich generation’ seeing higher rate of depression than earlier generation
By Cindy Chan
Epoch Times Staff


Related articles: World > North America


OTTAWA—Between caring for elderly parents, raising children, and looking after their own busy lives, baby boomers have a higher rate of depression than the previous generation, says an expert.

Dr. Richard Earle, managing director at the Canadian Institute of Stress, describes the world’s boomers as a “triple-decker-sandwich generation,” a term generally referring to those born during the approximately two-decades of strong employment and economic growth in the post-World War II era.

“What we’re noticing at the Canadian Institute of Stress and throughout the research literature is a significant rise in mood disorders, including depression, in that baby boomer age group, which is 46 to 64,” said Dr. Earle.

In Canada, about 10 percent of baby boomers are still raising children while looking after—or just beginning to look after—elderly parents, he said.

“Then it’s not just a sandwich generation—it’s a triple-decker sandwich because they’re looking after husband or wife and job and the rest of it.”

Research shows that as many as 4 in 10 boomers are experiencing an unusually high level of stress, which can lead to depression, Dr. Earle said.

About 32 percent say they’ve had to cancel travel plans, 34 percent have dropped personal hobbies and interests, and well over 70 percent say the balancing act is interfering with their ability to fulfill responsibilities at work.

There are emotional impacts as well—a feeling of not being able to find pleasure from things they used to enjoy, Dr. Earle explained, “and within that, not being able to concentrate, to focus on what they’re doing, making decisions, and certainly sleep disturbance.”

In Canada, boomers are defined as those born between 1947 and 1966. They number more than 8 million and make up about a quarter of the population.

Statistics on American boomers, those born between 1946 and 1964, are almost identical, except that the United States has about 80 million baby boomers and they are reporting slightly higher impact on their jobs than Canadians due to stress from home, Dr. Earle said.

He noted that baby boomer issues and the increase in the rate of depression are much the same worldwide, including in such diverse places as Japan, the Middle East, Argentina, Saudi Arabia, India, Spain, and the United Kingdom.

Everywhere, “the core of the problem is very similar”—juggling the demands of caring for parents and children are causing stress.

In particular, Japan has an extremely low birthrate and a significantly older average age than almost any other country, Dr. Earle said. “You have fewer younger people to take care of more older people.” Japan has also been dealing with the boomer depression issue longer than other countries.

As the first wave of boomers turns 65, their needs have been prompting services and research interest in every area from health and lifestyle to leisure and travel, from art and technology to financial services, and economic planning.

A recent study by the U.S.-based Hartford Financial Services Group, a major provider of employee-assistance programs, found that more than 80 percent of boomers report feeling moderate to high levels of stress from providing care or support to children, spouses, and/or parents.

Moreover, 46.6 percent said they felt worried about how caregiving is impacting their job, with 68 percent saying they missed work or left work early due to caregiving duties in the last six months.

University of Waterloo and Royal Bank of Canada launched a retirement research center last month, noted as the first collaborative approach of its kind between academic researchers and the financial services industry aimed at providing solutions and advice to boomers for retirement planning and living.

At last week’s 2010 Congress of the Humanities and Social Sciences held at Montreal’s Concordia University, University of Montreal professor Jacques Légaré presented a paper showing that aging boomers will have to either pay for their own care or find support from sources outside their immediate family circle.

Professor Légaré said that about 70 percent of elderly care currently comes from spouses or children. However, today’s boomers have fewer children to care for them. In addition, the rise in divorce, common-law unions, and blended families means that many boomers may not have a partner to rely on within a stable relationship as they age.

Meanwhile, average life expectancies are rising, putting further demands on society and boomers to create new support systems for tomorrow’s seniors.

The Canadian Institute of Stress is a charitable organization founded 30 years ago by Hungarian-Canadian Dr. Hans Selye, known as “the father of the stress field,” who published the world’s first scientific paper to identify and define stress in 1936.

The institute tracks trends in research literature and provides education to the public, health care professionals, and workplaces in Canada, and other countries on earlier detection of stress problems and methods for controlling stress.

“There are so many things that catch our attention, quite challenging, disturbing things happening in this world,” said Dr. Earle. “[But] the world will work out well to the extent that we look after ourselves and our families in a more informed way.”

He recommends that baby boomers “get refocused back on one’s own family situation and basically on ourselves—not in a selfish way, but in a self-maintaining way.” Continue reading at

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Caffeine May Slow Alzheimer's Disease and Other Dementias, Restore Cognitive Function, According to New Evidence

ScienceDaily (May 18, 2010) — Although caffeine is the most widely consumed psychoactive drug worldwide, its potential beneficial effect for maintenance of proper brain functioning has only recently begun to be adequately appreciated. Substantial evidence from epidemiological studies and fundamental research in animal models suggests that caffeine may be protective against the cognitive decline seen in dementia and Alzheimer's disease (AD).

of Alzheimer's Disease, "Therapeutic Opportunities for Caffeine in Alzheimer's Disease and Other Neurodegenerative Diseases," sheds new light on this topic and presents key findings.
Guest editors Alexandre de Mendonça, Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Portugal, and Rodrigo A. Cunha, Center for Neuroscience and Cell Biology of Coimbra and Faculty of Medicine, University of Coimbra, Portugal, have assembled a group of international experts to explore the effects of caffeine on the brain. The resulting collection of original studies conveys multiple perspectives on topics ranging from molecular targets of caffeine, neurophysiological modifications and adaptations, to the potential mechanisms underlying the behavioral and neuroprotective actions of caffeine in distinct brain pathologies.

"Epidemiological studies first revealed an inverse association between the chronic consumption of caffeine and the incidence of Parkinson's disease," according to Mendonça and Cunha. "This was paralleled by animal studies of Parkinson's disease showing that caffeine prevented motor deficits as well as neurodegeneration "Later a few epidemiological studies showed that the consumption of moderate amounts of caffeine was inversely associated with the cognitive decline associated with aging as well as the incidence of Alzheimer's disease. Again, this was paralleled by animal studies showing that chronic caffeine administration prevented memory deterioration and neurodegeneration in animal models of aging and of Alzheimer's disease."
Key findings presented in "Therapeutic Opportunities for Caffeine in Alzheimer's Disease and Other Neurodegenerative Diseases":

Multiple beneficial effects of caffeine to normalize brain
"Epidemiological studies first revealed an inverse association between the chronic consumption of caffeine and the incidence of Parkinson's disease," according to Mendonça and Cunha. "This was paralleled by animal studies of Parkinson's disease showing that caffeine prevented motor deficits as well as neurodegeneration "Later a few epidemiological studies showed that the consumption of moderate amounts of caffeine was inversely associated with the cognitive decline associated with aging as well as the incidence of Alzheimer's disease. Again, this was paralleled by animal studies showing that chronic caffeine administration prevented memory deterioration and neurodegeneration in animal models of aging and of Alzheimer's disease."
Key findings presented in "Therapeutic Opportunities for Caffeine in Alzheimer's Disease and Other Neurodegenerative Diseases":

Multiple beneficial effects of caffeine to normalize brain function and prevent its degeneration
Caffeine's neuroprotective profile and its ability to reduce amyloid-beta production
Caffeine as a candidate disease-modifying agent for Alzheimer's disease
Positive impact of caffeine on cognition and memory performance
Identification of adenosine A2A receptors as the main target for neuroprotection afforded by caffeine consumption
Confirmation of data through valuable meta-analyses presented
Epidemiological studies corroborated by meta-analysis suggesting that caffeine may be protective against Parkinson's disease
Several methodological issues must be solved before advancing to decisive clinical trials
Mendonça and Cunha also observe that "the daily follow-up of patients with AD has taught us that improvement of daily living may be a more significant indicator of amelioration than slight improvements in objective measures of memory performance. One of the most prevalent complications of AD is depression of mood, and the recent observations that caffeine might be a mood normalizer are of particular interest."
The supplement was funded by the Associação Industrial e Comercial do Café, while leaving full scientific independence to all contributors. The entire issue has been made available on a no-fee basis at http://iospress.metapress.com/content/t13614762731/.

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Is ageing a disease?

BY KATE KELLAND, HEALTH AND SCIENCE CORRESPONDENT, REUTERS MAY 19, 2010


It's clear that the simple fact of growing older - chronological ageing - is relentless and unstoppable. But experts studying the science of ageing say it's time for a fresh look at the biological process.

LONDON -- Is ageing a disease?

It's clear that the simple fact of growing older - chronological ageing - is relentless and unstoppable. But experts studying the science of ageing say it's time for a fresh look at the biological process - one which recognises it as a condition that can be manipulated, treated and delayed.

Taking this new approach would turn the search for drugs to fight age-related diseases on its head, they say, and could speed the path to market of drugs that treat multiple illnesses like diabetes, heart disease and Alzheimer's at the same time.

"If ageing is seen as a disease, it changes how we respond to it. For example, it becomes the duty of doctors to treat it," say something as general as ageing.

"Because ageing is not viewed as a disease, the whole process of

bringing drugs to market can't be applied to drugs that treat ageing. This creates a disincentive to pharmaceutical companies to develop drugs to treat it," said Gems.

The ability of humans to live longer and longer lives is being demonstrated in abundance across the world.

Average life expectancies extended by as much as 30 years in developed countries during the 20th century and experts expect the same or more to happen again in this century.

A study published last year by Danish researchers estimated that more than half of all babies born in wealthy nations since the year 2000 will live to see their 100th birthdays.

"THERE'S ONE THING WE'RE ALL MISSING"

But with greater age comes a heavier burden of age-related disease.

Cases of dementia and Alzheimer's, incurable brain-wasting conditions, are expected to almost double every 20 years to around 66 million in 2030 and over 115 million in 2050.

Diabetes, heart disease and cancer, and the cost of coping with them in ageing populations, are also set to rise dramatically in coming decades in rich and poor countries alike.

Nir Barzilai of the Albert Einstein College of Medicine at Yeshiva University in New York, says one way of trying to face down this enormous burden of disease is to look at the biggest risk factor common to all of them - ageing.

"There's one thing everybody is missing," he said. "Ageing is common for all of these diseases - and yet we're not investigating the common mechanism for all of them. We are just looking at the specific diseases."

To try to reverse that, Barzilai and many other scientists around the world are studying the genes of the very old and starting to find the genetic mechanisms, or pathways, that help them beat off the dementias, cancers, heart diseases and other age-related illnesses that bring down others who die younger.

By finding the genes thought to help determine longevity, scientists think they may be able to mimic their action to not only extend life span, but, crucially, extend health span.

It is ... looking increasingly likely that pharmacological manipulation of these ... pathways could form the basis of new preventative medicines for diseases ageing, and ageing itself," said Andrew Dillin of the Salk Institute in California and the Howard Hughes Medical Institute.

Gems says institutional and ideological barriers are standing in the way - and a major one is the longstanding traditional view that ageing is not a disease, but a natural, benign process that should not be interfered with.

CHANGING ATTITUDES?

All three experts say, however, that the ground is shifting in their direction.

There is now a "groundswell" of specialists in ageing, says Dillin, who are lobbying the world's biggest drug regulator, the U.S. Food and Drug Administration, to consider redefining ageing as a disease in its own right.

Major scientific research bodies like the U.S. National Institutes of Health and the Medical Research Council in Britain are also under pressure to put more emphasis - and funding - into studying how ageing increases disease risk.

For biogerontologis‰s, as scientists who study the biology of ageing are known, the struggle is to convince people that their goal in unpicking the science behind ageing is no longer life, but healthier life.

"The whole reason that we study the ageing process is not actually to make people live a lot longer, it's to get people to have a more healthy lifespan," said Dillin.

He sees it as a matter of re-educating the public and health authorities to see biological ageing in a new light.

"When we are in the public arena we tell people we're working on the ageing process, the first thing they think is that we want to make a a 100-year-old person live to be 250 - and that's actually the furthest from the truth," he said.

"What I want is for a 60-year-old person who is predisposed to have Alzheimer's to be able to delay that, live to be 80, and get to know their grandchildren."

© Copyright (c) Reuters

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Moms in the middle: 'Sandwich Generation' mothers manage life on overload

BY DEBBIE SWARTZ •DSWARTZ@GANNETT.COM • MAY 8, 2010, 8:35 PM


While they've always been known for making boo-boos better with a kiss, tucking tired children into their beds at night and staying up until the wee hours to bake cupcakes for a party at school, many mothers are finding themselves with another labor of love; caring for their ill or elderly mothers.

For moms like Roxanne St. Ives of Port Crane, taking care of her two children, Thomas, 14, and Penny 12, along with her mother Lucille, is a conscious choice to keep her family together.

"I know she's not being watched by a stranger," St. Ives said. "Plus, she gets to watch the children grow."

Kathee Shaff of Lansing, Joan Mandell of Elmira and dozens of other women across Central New York and the Southern Tier have made similar decisions.

Known as the Sandwich Generation, more and more individuals -- nearly 20 million according to published statistics -- are finding themselves taking care of their children as well as their parents.

The requirements for the job of taking care of ones' children and their ailing mother can be daunting: Superb time management and listening skills, basic first aid training -- and in some cases nursing training -- the ability to feed hungry bellies, administer medication, help with homework, chauffer to appointments, and somehow try find time for their own needs. Continue reading athttp://www.pressconnects.com/article/20100508/NEWS01/5080388/1112/NEWS01/Moms-in-the-middle-Sandwich-Generation-mothers-manage-life-on-overload

Verlia Caldwell, Pres.

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A Graying Population, a Graying Work Force

Mary-Lou O’Neill, 73, has been helping Grace Jackson, 101, for four years. “It’s developed into a friendship,” Ms. Jackson said.

By JOHN LELAND
Published: April 24, 2010

PROVIDENCE, R.I. — One recent morning Antonia Antonaccio, a home care aide, got a call to help an elderly couple whose regular aide could not make it. The regular aide, who is 68 years old, had thrown out her back.
Related

Antonia Antonaccio, 73, provides home care for Carmine Spino, 89, and his wife, Mary, 88.

Ms. Antonaccio said she empathized. Sometimes her legs hurt from going up and down stairs. “But it’s nothing I pay attention to,” she said. “I don’t have the time.”

Ms. Antonaccio is 73.

In an aging population, the elderly are increasingly being taken care of by the elderly. Professional caregivers — almost all of them women — are one of the fastest-growing segments of the American work force, and also one of the grayest.

A recent study by PHI National, a nonprofit organization that advocates on behalf of caregivers, found that in 2008, 28 percent of home care aides were over age 55, compared with 18 percent of women in the overall work force.

The organization projects that from 2008 to 2018, the number of direct care workers, which includes those in nursing homes, will grow to 4.3 million from 3.2 million. The percentage of older caregivers is projected to grow to 30 percent from 22 percent.

The average caregiver in Rhode Island from Home Instead Senior Care, the private agency that employs Ms. Antonaccio, is about 60, said Valerie Topp, chief operating officer for the state franchise. Younger aides often do not work out, Ms. Topp said, adding that clients frequently ask that the agency not send over someone too young.

“The older ones came to us after being family caregivers, so they understood the stresses that families were under,” Ms. Topp said. “They came with respect for age. They didn’t see age as a disability.”

Carmine Spino, 89, and his wife, Mary, 88, who are hoping to live out their lives without moving to a nursing home, are two of Ms. Antonaccio’s clients. She often shares stories about growing up in Italy during World War II; Mr. Spino served in the war — a common ground. They know the same music, share the same cultural reference points.

And as Mrs. Spino, who was always quiet, has become more withdrawn with the onset of dementia, Mr. Spino relies on their caregivers for conversation.

“We talk about our experiences,” he said of Ms. Antonaccio. “I don’t look at her as a stranger.”

Caregivers often nurse their own aches and pains, or manage their medications, as they tend to those of their clients, said Dorie Seavey, director of policy research for PHI National. Clients who have to be lifted may not be suited to some older workers, she said.

Linnette Hutchinson, 71, of Tucson, said she often had the same complaints as her clients. “Your eyes are going, and the aches and pains,” she said. “Your back, your legs, your teeth. The aging process sets in.” Ms. Hutchinson has had spinal surgery but still works four hours a day.

For Mara Torres-Rullan, 74, also of Tucson, the big challenge is pain. She started work as a caregiver in 1987 after a divorce; in recent years she has cut her hours because of arthritis.

“My last lady, I had to put pantyhose on her,” Ms. Torres-Rullan said. “I thought my back was going to break in half.”

She continues to work because she needs the money, but she refuses any clients who want vacuuming done because the work is too painful.

In Plymouth, Mass., Judy Brueggeman, 68, felt increasingly fatigued last year and had a stress test on her heart. “After three to five seconds on the treadmill, the doctor shut it off and told me to lie down and be quiet,” she said. She had triple bypass surgery in September.

But even so, she is now back on the job, putting in 12-hour weeks. “This is perfect for me,” she said. “I love my clients, and I love my work.” In some ways, Ms. Brueggeman said, the work has gotten easier because she is better at it than when she started, in 1991. “I learned a lot from my clients, especially not to talk too much,” she said. “They want to do the talking.”

But the industry does not have career paths for workers as they get older, putting a strain on them to continue with the most physically demanding aspects of the job, Ms. Seavey said. “If you look at older women as an asset, to train younger workers, they can be valuable,” she said. Ms. Antonaccio worked in the jewelry industry for 40 years before retiring, then went to work as a caregiver after her husband’s death, drawn by the flexible hours. She did not need health benefits because she was eligible for Medicare. She did need a sense of purpose.

“At 65, I felt my life was ending,” she said. “I took care of my mother, then my mother-in-law, then my husband, then I went into this. And I don’t have any intention to stop.”

Home Instead pays her roughly half the $19.25 an hour it charges clients in Rhode Island.

Her age, she said, makes her more sympathetic to the needs of her clients.

“They need someone to understand them,” she said. “When I first came, Carmine was in the hospital” — Mr. Spino was having respiratory problems — “and Mary was scared. She didn’t understand what was going on. She woke up and her husband wasn’t there. She wanted to call him every five minutes. I had to say he needs his sleep.”

Grace Jackson, who is 101, said she never wanted a helper at home and resented Mary-Lou O’Neill, 73, when she arrived four years ago at Ms. Jackson’s daughters’ insistence. But as their relationship has grown, “It’s developed into a friendship,” Ms. Jackson said, adding that friends who had younger aides were often offended by their manners or language.

Ms. O’Neill worked as a nurse until she was 66, then found herself restless in retirement. Now, she is one of the large number of Americans in their 70s who are still active and robust, without physical pain or limitations. She works only for Ms. Jackson.

“She’s a role model to me,” Ms. O’Neill said. “When she has physical problems, she doesn’t complain.”

Ms. Jackson said she appreciated having a companion with a wealth of life experiences. Last spring, after hip surgery, she complained in the rehabilitation center that she wanted to die.

“‘O.K.,” Ms. O’Neill told her, “if you want to die, get better and die at home.”

Ms. Jackson got better. From a younger aide, Ms. Jackson said, she would not have accepted such a challenge.

“Not that I don’t get along well with younger people,” she said. “But I’m not always pleased, I don’t like the way they talk. Maybe that’s what keeps you alive — not accepting everything.”

Verlia Caldwell, Pres.

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I Care For You Home Care, L.L.C.
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Cataracts, Presbyopia, and More: Aging and Eyesight

Aging doesn't just affect your joints and skin. Your vision is also at risk. Here's what you need to know about cataracts, presbyopia, glaucoma, and age-related macular degeneration.

By Katherine Lee
Medically reviewed by Lindsey Marcellin, MD, MPH

It’s an inevitable fact of life: Your eyes change as you get older. For one thing, your risk of eye diseases such as macular degeneration increases with age. And, as those in their forties can tell you, reading and seeing things up close becomes a problem because of a condition called presbyopia.


Here’s an overview of how your eyes change with age and what you can do to help your eyes stay healthy.

Aging: How Vision Is Affected

Presbyopia is the most common effect of age on vision. “As we age, the lens of the eye becomes less flexible,” says James Salz, a clinical professor of ophthalmology at the University of Southern California in Los Angeles and a spokesperson for the American Academy of Ophthalmologists. When the eye lens becomes more rigid, people have trouble focusing on close objects.

The following are some other ways in which aging can affect vision:

Lighting. As our eyes age, we need more light to see well, especially when we read or do other close-range tasks.
Glare. Age-related changes to the lens cause light entering the eye to be scattered instead of focused mostly on the retina — the light-sensing layer of cells at the back of the eye — producing glare and adding to vision problems.
Colors. The lenses in your eyes can become discolored — for example, by cataracts — making it more difficult to distinguish colors.
Tear production. The tear glands in the eyes make fewer tears with age, leading to dry, irritated eyes, particularly among postmenopausal women.

Vision Problems in Older Eyes

Age also increases your risk for eye diseases. In people age 40 and over, age-related macular degeneration (AMD), glaucoma, and cataracts are the most common eye problems.

Age-related macular degeneration. Macular degeneration, which affects the part of the retina crucial for sharp and clear vision, is the leading cause of blindness in Caucasian people over age 65.
Glaucoma. Glaucoma is actually a group of eye diseases that affect pressure inside the eye. Increased pressure affects the optic nerve, which carries images to the brain. People over age 60 are at increased risk for glaucoma.
Cataracts. A cataract is a clouding of the eye, commonly caused by aging. In age-related cataracts, the center of the lens gradually becomes hard and cloudy; it eventually becomes difficult for a person to see things at a distance and even to distinguish colors.

Symptoms and Warning Signs

Some age-related eye diseases, such as glaucoma and age-related macular degeneration, may cause few or no symptoms until the disease is at an advanced stage. For this reason, it’s important to see a doctor if you notice any of the following symptoms:

Double vision in one eye, a possible symptom of cataracts
Reduced ability to see at night, a possible symptom of cataracts
Colors appearing faded or tinted with yellow, a possible symptom of cataracts
Sensitivity to light or glare, a possible symptom of cataracts
Distorted vision that makes straight lines look blurred or results in a blind spot appearing in the center of your vision, a possible symptom of macular degeneration
Blurry vision, a symptom of a number of potential eye problems, such as cataracts, glaucoma, macular degeneration, and, in diabetics, a condition known as diabetic retinopathy
Any fluctuations in vision, a possible sign of a systemic disorder such as diabetes or high blood pressure
Appearance of floaters or flashes; occasional floaters are normal, but if you see a noticeable increase in floaters, especially if accompanied by flashes of light, you could be at risk for retinal detachment, which requires immediate treatment to prevent blindness
Eye pain, a possible symptom of glaucoma

Caring for Aging Eyes

Annual eye exams for anyone age 65 and older are essential for preventing and getting early treatment for eye diseases.

Also, the following tips can help you protect aging eyes:

Take supplements with lutein, which can help reduce the risk of chronic eye disorders
Always wear sunglasses outdoors to help prevent cataracts and macular degeneration
Eat a nutritious diet that includes dark, leafy green vegetables and orange foods such as carrots, which contain lutein

While presbyopia and increased risk for macular degeneration and other eye conditions are an inevitable part of aging, you can take steps — no matter what your age — to ensure that your eyes stay healthy.

Last Updated: 01/20/2010
This section created and produced exclusively by the editorial staff of EverydayHealth.com. © 2010 EverydayHealth.com; all rights reserved.

Verlia Caldwell, Pres.

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Sense of Home Important Is in Residential Care for the Elderly

ScienceDaily (Apr. 4, 2010) — Many elderly people in residential care feel insecure during relocation or renovation work -- but there are ways of handling the situation. Those who manage to create a sense of home where they live are in a better position to cope with the stresses that go with change, reveals a thesis from the Sahlgrenska Academy.

Going into residential care means that elderly people have to adapt to an environment that differs in many ways to what they are used to.
"A sense of belonging where you live is important for your sense of self and identity, which, in turn, strengthens a person's ability to deal with the changes that impaired function and institutionalisation can bring," says Hanna Falk, nurse and doctoral student at the Institute of Health and Care Sciences.
The thesis also examines how the elderly define the concept of "a sense of home," and found that it covers far more than just a pleasant physical environment.

"There are other factors that come into play, for example that the elderly furnish their rooms exactly as they did when they lived at home, or that they make new friends who contribute to a greater sense of home," says Falk, stating that actual attachment to the institution is vital if it is to be viewed as home.
She also found that renovations designed to help create a more home-like and supportive environment in residential care have little impact on how the elderly perceive the atmosphere. Furthermore, relocation and renovations -- and the problems that they bring -- can negatively affect the quality of life and wellbeing of the elderly.

"The vulnerability of the elderly in connection with changes to their environment must be given greater consideration in the context of extensive renovations than is currently the case in the care of the elderly," says Falk. "There's still plenty of work to be done, for example the development of action plans to handle relocations and renovations so that the elderly and the staff are in the best possible position to cope with the situation."

Verlia Caldwell, Pres.

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Men and Women Respond Differently to Stress

ScienceDaily (Mar. 23, 2010) — Age and gender play a major role in how people respond to stress, according to a new study on 20-to-64-year-olds. Published in the journal Psychophysiology, the investigation was led by scientists from the Université de Montréal and the Montreal Heart Institute in collaboration with colleagues from the Université du Québec à Montréal and McGill University.

"Our findings suggest that women who are more defensive are at increased cardiovascular risk, whereas low defensiveness appears to damage the health of older men," says Bianca D'Antono, a professor at the Université de Montréal Department of Psychiatry and a Montreal Heart Institute researcher.
Defensiveness is a trait characterized by avoidance, denial or repression of information perceived as threatening. In women, a strong defensive reaction to judgment from others or a threat to self-esteem will result in high blood pressure and heart rate. Contrarily, older men with low defensive reactions have a higher cardiovascular rates.

The study was conducted on 81 healthy working men and 118 women. According to Dr. Jean-Claude Tardif a Université de Montréal professor and Montreal Heart Institute researcher, the physiological response to stress in women and older men is linked to this desire of maintaining self-esteem and securing social bonds.

"The sense of belonging is a basic human need," says D'Antono. "Our findings suggest that socialization is innate and that belonging to a group contributed to the survival of our ancestors. Today, it is possible that most people view social exclusion as a threat to their existence. A strong defensive reaction is useful to maintain one's self-esteem faced with this potential threat."

As part of the experiment, participants completed four tasks of varying stress levels. The first task involved reading a neutral text on Antarctica's geography before a person of the same sex. The second and third tasks involved role-playing in which participants followed a script where they were sometimes agreeable and sometimes aggressive. The final task involved a non-scripted debate on abortion.

Heart rate and blood pressure were measured during each of these tasks as was the level of cortisol in saliva. Results showed that women and older men had elevated cardiovascular, autonomic and endocrine responses to stress -- all potentially damaging to their health. The research team cautions, however, that more studies are needed to evaluate the long-term effects of defensiveness and its association to stress response patterns in disease development.
This study was supported by the Canadian Institutes of Health Research and the Fonds de la recherche en santé du Québec.
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Story Source:
Adapted from materials provided by University of Montreal.

Verlia Caldwell, Pres.

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Cat Care: Pets for Senior Citizens by the American Animal Hospital Association

You've probably noticed that when you pet a soft, warm cat or play fetch with a dog whose tail won't stop wagging, you relax and your heart feels a little warmer.

Scientists have noticed the same thing, and they've started to explore the complex way animals affect human emotions and physiology. The resulting studies have shown that owning and handling animals significantly benefits health, and not just for the young. In fact, pets may help elderly owners live longer, healthier, and more enjoyable lives.

A study published in the Journal of the American Geriatrics Society in May of 1999 demonstrated that independently living seniors that have pets tend to have better physical health and mental wellbeing than those that don't. They're more active, cope better with stress, and have better overall health. A 1997 study showed that elderly pet owners had significantly lower blood pressure overall than their contemporaries without pets. In fact, an experimental residential home for the elderly called the Eden Alternative, which is filled with over 100 birds, dogs, and cats and has an outside environment with rabbits and chickens, has experienced a 15 percent lower mortality rate than traditional nursing homes over the past five years.

How do they do it?
There are a number of explanations for exactly how pets accomplish all these health benefits. First of all, pets need walking, feeding, grooming, fresh water, and fresh kitty litter, and they encourage lots of playing and petting. All of these activities require some action from owners. Even if it's just getting up to let a dog out a few times a day or brushing a cat, any activity can benefit the cardiovascular system and help keep joints limber and flexible. Consistently performing this kind of minor exercise can keep pet owners able to carry out the normal activities of daily living. Pets may also aid seniors simply by providing some physical contact. Studies have shown that when people pet animals, their blood pressure, heart rate, and temperature decrease.

Many benefits of pet ownership are less tangible, though. Pets are an excellent source of companionship, for example. They can act as a support system for older people who don't have any family or close friends nearby to act as a support system. The JAGS study showed that people with pets were better able to remain emotionally stable during crises than those without. Pets can also work as a buffer against social isolation. Often the elderly have trouble leaving home, so they don't have a chance to see many people. Pets give them a chance to interact. This can help combat depression, one of the most common medical problems facing seniors today. The responsibility of caring for an animal may also give the elderly a sense of purpose, a reason to get up in the morning. Pets also help seniors stick to regular routines of getting up in the morning, buying groceries, and going outside, which help motivate them to eat and sleep regularly and well.

Pets in residence
Many nursing homes have taken this information to heart. For years, organizations like Pets on Wheels and Therapy Dogs International have been bringing thoroughly vaccinated, groomed, and behavior-tested animals into hospitals, hospices, and assisted living homes to give seniors a chance to pet and play with them. The residents get to have some therapeutic physical contact and a fun activity to break up their day. More recently, some resident homes have even begun letting animals live in the home full time. The Stanton Health Center in Stanton, Nebraska, a residential nursing home, has had dogs for its Alzheimer wing and now has an aviary and cats that live in the center's common area.

"The animals help patients keep their mind off their problems," says Jean S. Uehl, the center's director of nurses. "The love the patients get from the animals is unconditional." One particular stroke patient was withdrawn and rarely smiled, until she began to play with the resident cat. The patient and the cat became closely bonded to each other, and when the cat had kittens, "they became like the patient's babies," according to Uehl. The kittens played and slept on a tray on the resident's wheelchair and slept in a chair near her bed whenever they could. The kittens brought the resident out of her shell and she began to talk and smile. "The kittens in particular get all the residents' attention," says Uehl. "Everyone always wants to know where they're at and what they're doing." When there are kittens in the building, a number of residents stay busy all day, following them, playing with them, and keeping an eye on them.

Finding that furry friend
If there are older people in your life that you think might benefit from having a pet at home, be sure to talk to them before you pick one out. Make sure that they want the responsibility of a new pet, as well as the noise and the messes that may come along with it. Talk to them about whether they feel capable of feeding, watering, grooming, exercising, and cleaning up after an animal. If they decide they're willing to accept that responsibility, take your elderly friend or family member out with you to the humane society or the breeder to pick out a new furry friend. They may fall in love with a dog or cat that might never have caught your eye.

Finally, before you encourage an older person to adopt a pet, consider whether you could take care of the animal if its owner is no longer able. Often, if seniors reach the point where they have to leave their homes and move into assisted-living facilities, they also have to give up their pets. The number of nursing homes and other types of housing for the elderly that will accept animals is growing, but the vast majority still don't allow pets. Seniors can plan ahead and find a pet-friendly nursing facility, just in case they need to use it someday. They may also want to consider planning for their pet in their estate.

Pets and the elderly have a lot to give to each other. Research and experience has shown that animals and older people can share their time and affection, and ultimately, full and happy lives. Though pets can't replace human relationships for seniors, they can certainly augment them, and they can fill an older person's life with years of constant, unconditional love.

Verlia Caldwell, Pres.

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Long Distance Caring

by Emily Carton

It is not uncommon for families to be separated by great distances. But what happens when one or both parents reach a stage in their lives where they appear to be frail and vulnerable? What can you do to keep from living with an enormous amount of guilt and worry or feeling that to help means sacrificing your own life?

This article will offer a few suggestions as starting points for gaining control of the situation.

Begin by having a thorough assessment of your parent's situation. You need to make sure that what you hear long distance from your parent and about your parent matches the reality of the situation. Everyone has different perceptions about how one should live and when one's safety is at risk. A dirty or cluttered house may not mean a parent can no longer live by himself, only that he needs help in caring for his home. It may mean he is willing to live with lower standards in order to remain at home. If you are uncertain about the situation and potential risks, consider an assessment by an outside professional who can offer a more objective evaluation.

A careful evaluation means taking a close look at the physical, emotional, and social well being of the older person to determine what her needs are. For example: Is your parent able to prepare her own meals? Does she still have friends and a social life? Are her medical needs being met? Is she managing her own medication. How safe is her living situation? Is she still able to manage finances? What is her state of health? What long term plans need to be made?
Once you understand the issues, a care plan can be put in place. Are there people or agencies available to him that can provide him with home delivered meals? Are there senior centers where he can go? Does he have an informal network of people, who can look in on him or telephone him? Does he have funds to pay for services he might need? Is there a friend or a professional who could be an emergency contact? Is relocating to a different environment the best option for him?

Clearly, there may be a great deal of emotional turmoil, guilt, and concern in regards to an aging parent. It is important to remember that if your parent is still able to articulate what she wants, and a physician determines she still has the capacity to make her own decisions, then it is her decision as to where and how she lives. Just as a parent needs to let go of adult children to live their own lives, a child needs to give his parent space as well. Unless your parent wishes to move or receive more assistance, she has every right to refuse, even if family and friends think she is making a mistake. All you can do is insure that she is making an informed decision and share your concern with her.

If you feel that your parent is not capable of making an informed decision, then contact his physician for an assessment of his cognitive abilities. This poses different questions about safety and the ability to care for oneself. Yet, even in cases of dementia, there still might be resources available to help keep your parent at home. To do this, engage a geriatric social worker to assist you in making up a care plan and obtaining the necessary resources. If this is not possible due to a parent's extreme incapacity or limited resources, a social worker can also help you to either relocate him to a safer environment or assist in relocation to a facility closer to you.

Without fully assessing your parent's situation no one can offer specific options. Find a professional who can fully evaluate the situation and provide a series of options for your parent. Prior to your next visit to your parent, you may wish to locate a physician if your parent does not already have an ongoing relationship with one. You can also contact a social service agency or a private care manager to meet with you and your parent. If there are legal matters you may need an attorney. By trying to locate services prior to your next visit, you will save yourself days of searching and waiting for appointments.

There are no simple answers or solutions. Each person's situation is different. Each child has a different relationship with her parent, and this may also determine the level of your involvement. You need to think about your parent's needs and your own needs as well. You cannot force services upon a parent who is capable of making decisions and willing to live with some level of risk in order to remain at home. However, if your parent is no longer capable, then you need to act. Even if you notice only a small decline, it is not too early to know what resources are available and who might be able to help. You don't need to do it all yourself. Elicit the help of family members and friends, and, if appropriate, find a professional who knows the resources and can help you through the maze of decision making. You do not have to face this alone.

Verlia Caldwell, Pres.

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Elderly patients who survive ICU stay have high rate of death in following years

March 2, 2010

An analysis of Medicare data indicates that elderly patients who are hospitalized in an intensive care unit (ICU) and survive to be discharged from the hospital have a high rate of death in the following three years, and that, in particular, patients who receive mechanical ventilation have a substantially increased rate of death compared with both hospital and general population controls in the first several months after hospital discharge, according to a study in the March 3 issue of JAMA.

Although there has been a decrease over time in the risk of in-hospital death for patients who receive intensive care in the United States, little is known about subsequent outcomes for those discharged alive. "Patients older than 65 years now make up more than half of all ICU admissions," the authors write. "Information is needed to understand the patterns of mortality, morbidity, and health care resource use in the months and years that follow critical illness to allow for better targeting of follow-up care."

Hannah Wunsch, M.D., M.Sc., of Columbia University Medical Center and NewYork-Presbyterian Hospital/Columbia, New York, and colleagues examined the 3-year outcomes and health care resource use of ICU survivors, and identified subgroups of patients and periods in which patients are at highest risk of death, using a 5 percent sample of Medicare beneficiaries older than 65 years. A random half of all patients were selected who received intensive care and survived to hospital discharge in 2003 with 3-year follow-up through 2006. From the other half of the sample, 2 matched control groups were generated: hospitalized patients who survived to discharge (hospital controls) and the general population (general controls), individually matched on age, sex, race, and whether they had surgery (for hospital controls).
In the data analyzed for the study, 35,308 ICU patients survived to hospital discharge. The ICU survivors had a higher 3-year mortality (39.5 percent) than hospital controls (34.5 percent) and general controls (14.9 percent). The ICU survivors who did not receive mechanical ventilation had minimal increased risk compared with hospital controls (3-year mortality, 38.3 percent vs. 34.6 percent).
"However, mortality for those who received mechanical ventilation was substantially higher than for the corresponding hospital controls (3-year mortality: 57.6 percent vs. 32.8 percent, respectively). This difference was primarily due to mortality during the first 2 quarters following hospital discharge (6-month mortality: 30.1 percent for ICU survivors vs. 9.6 percent for hospital controls)," the authors write.
Discharge to a skilled care facility for ICU survivors (33.0 percent) and hospital controls (26.4 percent) also was associated with high 6-month mortality (24.1 percent for ICU survivors and hospital controls discharged to a skilled care facility vs. 7.5 percent for ICU survivors and hospital controls discharged home).
"The magnitude of the postdischarge use of skilled care facilities for both ICU survivors and hospital controls and the high long-term mortality for all of these patients call into question whether discharge to skilled care facilities is merely a marker for higher severity of illness with appropriate delivery of care. These patients could have been discharged prematurely from acute care hospitals, and needed a higher level of care than they received. It also is possible that these patients could have had better outcomes if discharged home, but were not able to be sent there due to lack of sufficient support from family or friends to act as caregivers. These findings highlight the need for a much more detailed understanding of the long-term care needs of these patients," the authors conclude.
More information: JAMA. 2010;303[9]:849-856.
Provided by JAMA and Archives Journals (news : web)

Verlia Caldwell, Pres.

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Vision problems linked to higher dementia risk

By Amy Norton

NEW YORK (Reuters Health) - Elderly adults with poor vision, particularly untreated vision problems, may have a higher risk of developing dementia than those with better vision, a new study suggests.

Researchers found that among 625 older Americans with initially normal cognition, those who said they had poor vision even with corrective lenses were more likely to develop dementia over the next 8.5 years.

During the study period, 168 participants developed Alzheimer's disease or other forms of dementia. Of those men and women, less than 10 percent had rated their vision as "excellent" at the start of the study. That compared with almost 31 percent of participants who maintained normal brain function over the study period.

On the other hand, about one-quarter of the study participants who went on to develop dementia had rated their vision as "fair" or "poor" at the outset, versus 11 percent of those whose memory and thinking remained intact.

When the researchers looked at the effects of treatment, they found that the highest odds of dementia were among people with poor vision left untreated. The risk was lower when they received some form of eye care.

The findings, published in the American Journal of Epidemiology, do not prove that vision problems contribute to dementia -- or that eye care can help slow cognitive decline.

But they do suggest that could be the case, according to lead researcher Dr. Mary A.M. Rogers, a research assistant professor of internal medicine at the University of Michigan in Ann Arbor.

It has long been known that there is an association between dementia and vision disorders, Rogers noted in an interview with Reuters Health. But in practice those problems are often detected and treated after a dementia diagnosis.

The current findings, Rogers said, show that vision problems may precede a dementia diagnosis by years.

It's not clear why eye disorders and poor vision would contribute to dementia. One possibility, Rogers explained, is the fact that limited vision could keep older adults from being active -- whether it's getting out and walking, reading, doing crosswords or socializing. All of those things, she noted, have been linked to a decreased risk of dementia in older adults.

The findings are based on 625 older U.S. adults who were part of a larger health study begun in 1992.

Overall, Rogers' team found, study participants who reported "very good" or "excellent" vision were 63 percent less likely to develop dementia over the next 8.5 years than those with poor vision.

The researchers then looked at the combined effects of vision problems with or without treatment on the risk of Alzheimer's disease specifically. Compared with people who had good vision and at least one visit to an ophthalmologist during the study period, those with poor vision and no visits were more than nine times as likely to be diagnosed with Alzheimer's.

By comparison, among study participants who had poor vision and at least one ophthalmologist visit, the risk of Alzheimer's was not significantly increased.

Similarly, men and women with poor vision who had received no eye procedures, such as cataract removal, had a five-fold increase in the risk of Alzheimer's. That risk was elevated by 2.5 times among people with poor vision who had received such procedures.

According to Rogers, the findings imply that older adults with vision problems should seek treatment -- if for no other reason than to improve their sight.

"If you have poor vision, don't sit on it. Go and see your doctor," she said. It's best, Rogers added, to see an ophthalmologist, a medical doctor who can diagnose the range of problems common in elderly adults, such as cataract, glaucoma, macular degeneration and diabetes-related retinopathy.

More studies are needed to replicate the current findings and determine whether vision problems are an actual risk factor for dementia, according to Rogers. With the number of people with Alzheimer's disease increasing, she said, it is becoming even more important to "take a look at the things we can do to either delay or prevent dementia."

SOURCE: American Journal of Epidemiology, online February 11, 2010.

Verlia Caldwell, Pres.

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Love Is (Not) All You Need

by Mary A. Fischer, March & April 2010

To provide for loved ones who need long-term care, too many older Americans are resorting to extreme measures. It doesn't have to be this way

In 2004 Roberta H. and her husband, Alex, both 64, were living a contented life in a small town in western Massachusetts. Married for 39 years, with two grown sons, they had saved for years and were looking forward to traveling in a year or two, once they retired from their respective jobs—Alex was a college English professor, and Roberta was director of communications for a consortium of local colleges.

Then disaster struck. Alex was diagnosed with early-stage dementia and took early retirement from his job. Determined to care for her husband at home, Roberta paid a variety of people—at a cost of about $1,000 a month—to take him for walks, drive him to the YMCA, and prepare his lunch. She filled in the gaps by telephoning him several times a day.

As his dementia worsened, though, Alex needed full-time care, so Roberta found an adult-daycare center that could take care of him while she worked. For 18 months Roberta dropped off Alex in the mornings and picked him up after work, a routine that worked well until he had a medical emergency—painful urine retention—that landed him in the hospital. Medicare paid for Alex's stay, but after three days the hospital released him, even though he could barely walk. "It was such a stressful time," says Roberta, "and I had no time to figure out where Alex should go to get the therapy he needed."

"I felt terribly guilty about getting a divorce, but I felt I had no choice."

A flurry of phone calls later, she found a skilled nursing home that didn't have a waiting list, but there was a catch: Medicare would cover a total of only 100 days of skilled care and rehab. After the coverage ended, Roberta began drawing on the couple's savings, paying the nursing home $7,500 a month, plus miscellaneous expenses. Eight months and $75,000 later, the stock market crashed and cut the value of the couple's savings in half.

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"I was so scared," Roberta recalls. "Not only was my husband disappearing, but our savings were, too. All I could think was, if something happened to me, there'd be nothing left and I'd be out on the street." At the urging of a financial counselor, she made an appointment with a respected elder-law attorney in the area. When he laid out her options, only one—divorce—allowed her to get care for her husband and hang on to their remaining savings. By divorcing Alex, the love of her life, he would become indigent, thus becoming eligible for Medicaid.

"I felt terribly depressed and guilty," says Roberta, "but I felt I had no choice." She received the final divorce papers on August 15, 2008, the day before the couple's 44th wedding anniversary.

Verlia Caldwell, Pres.

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Offering Care for the Caregiver

By PAULINE W. CHEN, M.D.
Published: January 21, 2010

The man was nearing 90, losing his sight and showing signs of early dementia. After examining his abdomen, I fumbled trying to help him get his shirt and pants back on. After an awkward few seconds, the patient’s middle-aged son sprang forward from his seat near the door and began working through the buttons, zipper and belt with a practiced deftness.

“Daddy,” he murmured softly as his fingers nimbly pushed each pearly button through its hole, “you can usually do this yourself, can’t you?” He continued cajoling his father, as he cinched the old man’s belt and patted the haphazard pleating that appeared around his waistline. “You can even feed yourself if I help get your food on the spoon, can’t you?”

My patient nodded absentmindedly, smiling at the fluorescent lights on the ceiling and tapping his fingers against his drooping mouth.

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I felt as if I had just witnessed a scene that played itself over and over again every morning.

Later outside the exam room, the son pulled me aside. I noticed the dark circles around his eyes. “You’re tired, aren’t you?” I asked him.

The man’s dark eyes began to fill with tears. I immediately, reflexively almost, started apologizing for not being able to do more for his father. But he stopped me.

“No, no,” he said, wiping the tears away with the back of his hand. “It’s not that. It’s not that at all.” He paused and looked toward his father, still lying on the table in the room and smiling at the lights. “It’s just that no doctor has ever asked me if I was tired.”

In truth, I probably would have never done so either except that a few years ago, I too had spent time caring for a frail loved one.

For all our assertions about the importance of caring in what we do, doctors as a profession have been slow to recognize family members and loved ones who care for patients at home. These “family caregivers” do work that is complex, physically challenging and critical to a patient’s overall well-being, like dressing wounds, dispensing medication, and feeding, bathing and dressing those who can no longer do so themselves.

Many of these caregiving tasks were once the purview of doctors and nurses, a central component of the “caring professions.” But over the past century, as these duties increasingly fell to individuals with little or no training, doctors and even some nurses began to confer less importance, and status, to the work of caregiving.

It comes as no surprise, then, that physicians now rarely, if ever, learn about what a family caregiver or health care aide must do unless they are faced with caring for their own loved ones. We doctors don’t know or aren’t always fully aware of what it takes to care for a patient after we leave the room.

In other words, for the 37 million people attending to the health care needs of a relative, partner, friend or neighbor, our best care goes only so far.

“If you look at the amount of time devoted to actual caregiving, the physician contributes a very modest amount,” said Dr. Arthur Kleinman, a professor of medical anthropology and psychiatry at Harvard Medical School and now a family caregiver himself.

“We’ve had outstanding diagnoses and very careful attention to defining the problem,” Dr. Kleinman said, referring to his own experience. “But once the problem is defined and the limited pharmacological interventions prescribed, there has been neither interest nor knowledge about the rest of the aftercare, even in the most simple parts like finding a home health aide or getting a needs assessment by a social worker.”

But our profession’s indifference may hopefully soon be a thing of the past.

This month, the American College of Physicians, the country’s leading professional organization of internal medicine physicians, issued its first position paper on working with caregivers. Endorsed by almost a dozen other professional medical organizations, the paper, published in The Journal of General Internal Medicine, highlights the challenges that can arise from the complex interaction among patient, doctor and caregiver and offers guidelines for providing the best care.

Using a framework of broad principles, like the need to respect and maintain a primary focus on the patient’s rights, dignity and values, the paper explores specific issues that are likely to arise in a given patient-doctor-caregiver relationship. How, for example, should physicians approach long-distance family caregivers? What should they consider when working with the caregiver of a terminal patient? How can they best support the caregiver who is convinced that he or she can never do “enough”?

“Normally everyone is always focused on the patient, patient autonomy and the patient’s wishes in terms of the ethical standpoint,” said Dr. Virginia L. Hood, chairwoman of the Ethics, Professionalism and Human Rights Committee of the American College of Physicians and one of the paper’s authors. “But family caregivers are an important part of the health care team, too. We need to value these caregivers better, think about their needs and consider how they are central to the patient’s care, not just someone who happens to be pushing the wheelchair.”

Of particular importance is understanding how the work of caregiving can also give rise to a new set of medical issues: those of the caregiver.

Caregiving duties place tremendous stresses on an individual, and not all of those stressors are simply physical and emotional. “Some of these 37-going-on-40 million family caregivers have had to give up their own jobs in order to care for the patients,” Dr. Hood said. “That means they aren’t going to be able to put aside money for their retirement. Who is going to take care of them and their medical problems in the future?”

Caring for more people can be difficult for physicians who are already stretched and not reimbursed for additional time spent with patients. “This tension regarding time and reimbursement has to be resolved,” Dr. Hood said. But, she added, “if the physician needs to spend more time with patients and their caregivers in order to make things better for the patients, then it has to be done; it’s all about the patient.”

And perhaps, it is also about how we define care, whether that care is provided by family members and loved ones, or by doctors and other clinicians.

“There is a moral task of caregiving, and that involves just being there, being with that person and being committed,” said Dr. Kleinman, of Harvard Medical School. “When there is nothing that can be done, we have to be able to say, ’Look, I’m with you in this experience. Right through to the end of it.’ ”

Join the discussion on the Well blog.

Psychology and Aging

People 65 years of age and older are the fastest growing segment of the U.S. population. An increasing number of older adults are immigrants or members of ethnic or racial minority groups. More than 5 million older adults were below the poverty level or classified as “near poor” in 2001.
Most older adults enjoy good mental health. However, it is anticipated that the number of older adults with mental and behavioral health prob- lems will almost quadruple, from 4 million in 1970 to 15 million in 2030. Mental health disorders, including anxiety and depression, adversely affect physical health and ability to function, especially in older adults. Some late-life problems that can result in depression and anxiety include coping with physical health problems, caring for a spouse with dementia or a physical disability, grieving the death of loved ones, and managing conflict with family members.
Psychology and Aging
Addressing Mental Health Needs of Older Adults...Continue to read http://www.apa.org/pi/aging/resources/guides/aging.pdf

Verlia Caldwell, Pres.

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How to Train the Aging Brain

By BARBARA STRAUCH
Published: December 29, 2009

I LOVE reading history, and the shelves in my living room are lined with fat, fact-filled books. There’s “The Hemingses of Monticello,” about the family of Thomas Jefferson’s slave mistress; there’s “House of Cards,” about the fall of Bear Stearns; there’s “Titan,” about John D. Rockefeller Sr.

The problem is, as much as I’ve enjoyed these books, I don’t really remember reading any of them. Certainly I know the main points. But didn’t I, after underlining all those interesting parts, retain anything else? It’s maddening and, sorry to say, not all that unusual for a brain at middle age: I don’t just forget whole books, but movies I just saw, breakfasts I just ate, and the names, oh, the names are awful. Who are you?

Brains in middle age, which, with increased life spans, now stretches from the 40s to late 60s, also get more easily distracted. Start boiling water for pasta, go answer the doorbell and — whoosh — all thoughts of boiling water disappear. Indeed, aging brains, even in the middle years, fall into what’s called the default mode, during which the mind wanders off and begin daydreaming.

Given all this, the question arises, can an old brain learn, and then remember what it learns? Put another way, is this a brain that should be in school?

As it happens, yes. While it’s tempting to focus on the flaws in older brains, that inducement overlooks how capable they’ve become. Over the past several years, scientists have looked deeper into how brains age and confirmed that they continue to develop through and beyond middle age.

Many longheld views, including the one that 40 percent of brain cells are lost, have been overturned. What is stuffed into your head may not have vanished but has simply been squirreled away in the folds of your neurons.

One explanation for how this occurs comes from Deborah M. Burke, a professor of psychology at Pomona College in California. Dr. Burke has done research on “tots,” those tip-of-the-tongue times when you know something but can’t quite call it to mind. Dr. Burke’s research shows that such incidents increase in part because neural connections, which receive, process and transmit information, can weaken with disuse or age.

But she also finds that if you are primed with sounds that are close to those you’re trying to remember — say someone talks about cherry pits as you try to recall Brad Pitt’s name — suddenly the lost name will pop into mind. The similarity in sounds can jump-start a limp brain connection. (It also sometimes works to silently run through the alphabet until landing on the first letter of the wayward word.)

This association often happens automatically, and goes unnoticed. Not long ago I started reading “The Prize,” a history of the oil business. When I got to the part about Rockefeller’s early days as an oil refinery owner, I realized, hey, I already know this from having read “Titan.” The material was still in my head; it just needed a little prodding to emerge.

Recently, researchers have found even more positive news. The brain, as it traverses middle age, gets better at recognizing the central idea, the big picture. If kept in good shape, the brain can continue to build pathways that help its owner recognize patterns and, as a consequence, see significance and even solutions much faster than a young person can.

The trick is finding ways to keep brain connections in good condition and to grow more of them.

“The brain is plastic and continues to change, not in getting bigger but allowing for greater complexity and deeper understanding,” says Kathleen Taylor, a professor at St. Mary’s College of California, who has studied ways to teach adults effectively. “As adults we may not always learn quite as fast, but we are set up for this next developmental step.”

Educators say that, for adults, one way to nudge neurons in the right direction is to challenge the very assumptions they have worked so hard to accumulate while young. With a brain already full of well-connected pathways, adult learners should “jiggle their synapses a bit” by confronting thoughts that are contrary to their own, says Dr. Taylor, who is 66.

Teaching new facts should not be the focus of adult education, she says. Instead, continued brain development and a richer form of learning may require that you “bump up against people and ideas” that are different. In a history class, that might mean reading multiple viewpoints, and then prying open brain networks by reflecting on how what was learned has changed your view of the world.

“There’s a place for information,” Dr. Taylor says. “We need to know stuff. But we need to move beyond that and challenge our perception of the world. If you always hang around with those you agree with and read things that agree with what you already know, you’re not going to wrestle with your established brain connections.”

Such stretching is exactly what scientists say best keeps a brain in tune: get out of the comfort zone to push and nourish your brain. Do anything from learning a foreign language to taking a different route to work.

“As adults we have these well-trodden paths in our synapses,” Dr. Taylor says. “We have to crack the cognitive egg and scramble it up. And if you learn something this way, when you think of it again you’ll have an overlay of complexity you didn’t have before — and help your brain keep developing as well.”

Jack Mezirow, a professor emeritus at Columbia Teachers College, has proposed that adults learn best if presented with what he calls a “disorienting dilemma,” or something that “helps you critically reflect on the assumptions you’ve acquired.”

Dr. Mezirow developed this concept 30 years ago after he studied women who had gone back to school. The women took this bold step only after having many conversations that helped them “challenge their own ingrained perceptions of that time when women could not do what men could do.”

Such new discovery, Dr. Mezirow says, is the “essential thing in adult learning.”

“As adults we have all those brain pathways built up, and we need to look at our insights critically,” he says. “This is the best way for adults to learn. And if we do it, we can remain sharp.”

And so I wonder, was my cognitive egg scrambled by reading that book on Thomas Jefferson? Did I, by exploring the flaws in a man I admire, create a suitably disorienting dilemma? Have I, as a result, shaken up and fed a brain cell or two?

And perhaps it doesn’t matter that I can’t, at times, recall the given name of the slave with whom Jefferson had all those children. After all, I can Google a simple name.

Sally.

Barbara Strauch is The Times’s health editor; her book “The Secret Life of the Grown-Up Brain” will be published in April.

Verlia Caldwell, Pres.

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Older workers get help in a tough job market

Baylie Evans

Dec. 27, 2009 (McClatchy-Tribune Regional News delivered by Newstex) -- CHEYENNE -- Searching for a job is hard for anyone, particularly in an economy like this one. But for senior workers, it can be even harder.

Many are entering the workforce for the first time because they find a need for additional income. Others are re-entering after retirement.

One of the biggest obstacles that older workers face when entering the workforce is a lack of computer knowledge, said Amy Reyes, the employment and training coordinator for the local Experience Works program.

Experience Works is a national, non-profit organization aimed at helping workers aged 55 and older find, keep and train for work.

The local Experience Works program recently received additional federal grant money from the American Recovery and Reinvestment Act to help teach computer skills to older workers.

"You can't even apply anywhere nowadays without having some knowledge of computers," she said.

So Experience Works helps train workers in computer skills while giving them work to do and a salary. And they have room for more in the program.

Nationwide, unemployment numbers for people 55 and older have gone up 54 percent since November of 2008, according to a news release from the national Experience Works program.

And nationally, "the number of older workers who are seeking assistance from Experience Works has increased an average of 33 percent over last year," said Cheryl Kulm, Wyoming state director for Experience Works in the release.

The local office is seeing increased traffic as well. That office used to get about one or two phone calls a day from people interested in the program, Reyes said. Now, it's up to four or five calls a day.

And even the demographics are changing locally. Where the office used to serve mostly people older than 60, now most are 55-58.

Despite their possible lack of training, older workers are a valuable and overlooked group of workers, Reyes said

For Mary Abraham, the program helped her get back on her feet after her husband passed away last May. She lost all of his income when he died and had to return to work.

She had been retired for more than two years when she decided to go back to work. And she had held just one job for many years before that.

She hadn't interviewed for a job in about 15 years, she said, and things had changed.

"They just kind of looked at my gray hair and said 'We don't want you,'" she said.

The problem wasn't that she had never worked before or didn't have office experience.

"It never dawned on me that I wouldn't get a job," she said.

She has been in the Experience Works program for about five months now. And after a year, the expectation is that she will have reliable, fulltime employment.

For questions about the program or to get involved, call the local office at 634-7417.

Verlia Caldwell, Pres.

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I Care For You Home Care, L.L.C.
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